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BMC Medical Research Methodology
Published in: BMC Medical Research Methodology 1/2010

Open Access 01-12-2010 | Research article

A life-course and time perspective on the construct validity of psychological distress in women and men. Measurement invariance of the K6 across gender

Authors: Aline Drapeau, Dominic Beaulieu-Prévost, Alain Marchand, Richard Boyer, Michel Préville, Sylvia Kairouz

Published in: BMC Medical Research Methodology | Issue 1/2010

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Abstract

Background

Psychological distress is a widespread indicator of mental health and mental illness in research and clinical settings. A recurrent finding from epidemiological studies and population surveys is that women report a higher mean level and a higher prevalence of psychological distress than men. These differences may reflect, to some extent, cultural norms associated with the expression of distress in women and men. Assuming that these norms differ across age groups and that they evolve over time, one would expect gender differences in psychological distress to vary over the life-course and over time. The objective of this study was to investigate the construct validity of a psychological distress scale, the K6, across gender in different age groups and over a twelve-year period.

Methods

This study is based on data from the Canadian National Population Health Survey (C-NPHS). Psychological distress was assessed with the K6, a scale developed by Kessler and his colleagues. Data were examined through multi-group confirmatory factor analyses. Increasing levels of measurement and structural invariance across gender were assessed cross-sectionally with data from cycle 1 (n = 13019) of the C-NPHS and longitudinally with cycles 1 (1994-1995), 4 (2000-2001) and 7 (2006-2007).

Results

Higher levels of measurement and structural invariance across gender were reached only after the constraint of equivalence was relaxed for various parameters of a few items of the K6. Some items had a different pattern of gender non invariance across age groups and over the course of the study. Gender differences in the expression of psychological distress may vary over the lifespan and over a 12-year period without markedly affecting the construct validity of the K6.

Conclusions

This study confirms the cross-gender construct validity of psychological distress as assessed with the K6 despite differences in the expression of some symptoms in women and in men over the life-course and over time. Findings suggest that the higher mean level of psychological distress observed in women reflects a true difference in distress and is unlikely to be gender-biased. Gender differences in psychological distress are an important public health and clinical issue and further researches are needed to decipher the factors underlying these differences.
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Metadata
Title
A life-course and time perspective on the construct validity of psychological distress in women and men. Measurement invariance of the K6 across gender
Authors
Aline Drapeau
Dominic Beaulieu-Prévost
Alain Marchand
Richard Boyer
Michel Préville
Sylvia Kairouz
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Medical Research Methodology / Issue 1/2010
Electronic ISSN: 1471-2288
DOI
https://doi.org/10.1186/1471-2288-10-68

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