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Abstract

This study aimed to investigate the factor structure of the Mental Health Continuum–Short Form (MHC-SF) in the postpartum context using a single-factor model, a correlated three-factor model, and a bifactor model. The reliability and validity of the MHC-SF were also examined. The total sample consisted of 882 postpartum Portuguese women. Confirmatory factor analysis showed that the bifactor model yielded a significantly better fit to the data than the other models. The unidimensionality strength indices (explained common variance = .76, percentage of uncontaminated correlations = .69) and the ω_H values supported the general factor of positive mental health, which accounted for 91.5% of the reliable variance in the total score. Additionally, the MHC-SF showed high reliability (ω = .96), and its total and subscale scores were significantly correlated with other measures related to mental health. The results of this study suggest a strong general factor of positive mental health and support the use of its total score in this context.

Keywords

Mental Health Continuum–Short Form bifactor model confirmatory factor analysis psychometric properties postpartum period

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References

Areias

M. E.

Kumar

Barros

Figueiredo

(1996). Comparative incidence of depression in women and men, during pregnancy and after childbirth: Validation of the Edinburgh Postnatal Depression Scale in Portuguese mothers. British Journal of Psychiatry, 169(1), 30-35. https://doi.org/10.1192/bjp.169.1.30

Augusto

Kumar

Calheiros

J. M.

Matos

Figueiredo

(1996). Post-natal depression in an urban area of Portugal: Comparison of childbearing women and matched controls. Psychological Medicine, 26(1), 135-141. https://doi.org/10.1017/s0033291700033778

Bassi

Delle Fave

Cetin

Melchiorri

Pozzo

Vescovelli

Ruini

(2017). Psychological well-being and depression from pregnancy to postpartum among primiparous and multiparous women. Journal of Reproductive and Infant Psychology, 35(2), 183-195. https://doi.org/10.1080/02646838.2017.1290222

Bauer

Knapp

Parsonage

(2016). Lifetime costs of perinatal anxiety and depression. Journal of Affective Disorders, 192(1), 83-90. https://doi.org/10.1016/j.jad.2015.12.005

Bonifay

Lane

S. P.

Reise

S. P.

(2017). Three concerns with applying a bifactor model as a structure of psychopathology. Clinical Psychological Science, 5(1), 184-186. https://doi.org/10.1177/2167702616657069

Chzhen

Rees

Gromada

(2019). Are the world’s richest countries family friendly? Policy in the OECD and EU, Innocenti Research Report. https://www.unicef-irc.org/publications/pdf/Family-Friendly-Policies-Research_UNICEF_%202019.pdf

Cohen

(1992). A power primer. Psychological Bulletin, 112(1), 155-159. https://doi.org/10.1037/0033-2909.112.1.155

Corno

Etchemendy

Espinoza

Herrero

Molinari

Carrillo

Drossaert

Banos

R. M.

(2018). Effect of a web-based positive psychology intervention on prenatal well-being: A case series study. Women and Birth, 31(1), e1-e8. https://doi.org/10.1016/j.wombi.2017.06.005

Cox

J. L.

Holden

J. M.

Sagovsky

. (1987). Detection of postnatal depression: Development of the 10-item edinburgh postnatal depression scale. British Journal of Psychiatry, 150, 782-786. doi:10.1192/bjp.150.6.782

10.

de Bruin

G. P.

du Plessis

G. A

. (2015). Bifactor analysis of the mental health continuum-short form (MHC-SF). Psychological Reports, 116(2), 438-446. https://doi.org/10.2466/03.02.PR0.116k20w6

11.

Diener

Emmons

R. A.

Larsen

R. J.

Griffin

(1985). The Satisfaction With Life Scale. Journal of Personality Assessment, 49(1), 71-75. https://doi.org/10.1207/s15327752jpa4901_13

12.

Dyrbye

L. N.

Harper

Moutier

Durning

S. J.

Power

D. V.

Massie

F. S.

Eacker

Thomas

Satele

Sloan

Shanafelt

T. D.

(2012). A multi-institutional study exploring the impact of positive mental health on medical students’ professionalism in an era of high burnout. Academic Medicine, 87(8), 1024-1031. https://doi.org/10.1097/ACM.0b013e31825cfa35

13.

Dyrdal

G. M.

Lucas

R. E.

(2013). Reaction and adaptation to the birth of a child: A couple-level analysis. Developmental Psychology, 49(4), 749-761. https://doi.org/10.1037/a0028335

14.

Echeverría

Torres

Pedrals

Padilla

Rigotti

Bitran

(2017). Validation of a Spanish version of the Mental Health Continuum-Short Form Questionnaire. Psicothema, 29(1), 96-102. https://doi.org/10.7334/psicothema2016.3

15.

Emmanuel

St John

(2010). Maternal distress: A concept analysis. Journal of Advanced Nursing, 66(9), 2104-2115. https://doi.org/10.1111/j.1365-2648.2010.05371.x

16.

Franken

Lamers

S. M. A.

Ten Klooster

P. M.

Bohlmeijer

E. T.

Westerhof

G. J.

(2018). Validation of the Mental Health Continuum-Short Form and the dual continua model of well-being and psychopathology in an adult mental health setting. Journal of Clinical Psychology, 74(12), 2187-2202. https://doi.org/10.1002/jclp.22659

17.

Grice

M. M.

Feda

McGovern

Alexander

B. H.

McCaffrey

Ukestad

(2007). Giving birth and returning to work: The impact of work-family conflict on women’s health after childbirth. Annals of Epidemiology, 17(10), 791-798. https://doi.org/10.1016/j.annepidem.2007.05.002

18.

Guo

Tomson

Guo

Keller

Soderqvist

(2015). Psychometric evaluation of the Mental Health Continuum-Short Form (MHC-SF) in Chinese adolescents: A methodological study. Health and Quality of Life Outcomes, 13, 198. https://doi.org/10.1186/s12955-015-0394-2

19.

Bentler

P. M.

(1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6(1), 1-55. https://doi.org/10.1080/10705519909540118

20.

Jovanović

(2015). Structural validity of the Mental Health Continuum-Short Form: The bifactor model of emotional, social and psychological well-being. Personality and Individual Differences, 75, 154-159. https://doi.org/10.1016/j.paid.2014.11.026

21.

Kanotra

D’Angelo

Phares

T. M.

Morrow

Barfield

W. D.

Lansky

(2007). Challenges faced by new mothers in the early postpartum period: An analysis of comment data from the 2000 Pregnancy Risk Assessment Monitoring System (PRAMS) survey. Maternal and Child Health Journal, 11(6), 549-558. https://doi.org/10.1007/s10995-007-0206-3

22.

Karaś

Cieciuch

Keyes

C. L.

(2014). The Polish adaptation of the Mental Health Continuum-Short Form (MHC-SF). Personality and Individual Differences, 69, 104-109. https://doi.org/10.1016/j.paid.2014.05.011

23.

Keyes

C. L.

(1998). Social well-being. Social Psychology Quarterly, 61(2), 121-140. https://doi.org/10.2307/2787065

24.

Keyes

C. L.

(2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43(2), 207-222. https://doi.org/10.2307/3090197

25.

Keyes

C. L.

(2005). Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology, 73(3), 539-548. https://doi.org/10.1037/0022-006X.73.3.539

26.

Keyes

C. L.

(2007). Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health. American Psychologist, 62(2), 95-108. https://doi.org/10.1037/0003-066X.62.2.95

27.

Keyes

C. L.

Wissing

Potgieter

J. P.

Temane

Kruger

van Rooy

(2008). Evaluation of the Mental Health Continuum-Short Form (MHC-SF) in Setswana-speaking South Africans. Clinical Psychology & Psychotherapy, 15(3), 181-192. https://doi.org/10.1002/cpp.572

28.

Kingston

Tough

Whitfield

(2012). Prenatal and postpartum maternal psychological distress and infant development: A systematic review. Child Psychiatry & Human Development, 43(5), 683-714. https://doi.org/10.1007/s10578-012-0291-4

29.

Kline

(2011). Principles and practice of structural equation modeling. Guilford Press.

30.

Ladd

Rodriguez McCullough

Carmaciu

(2017). Perinatal mental illness. InnovAiT, 10(11), 653-658. https://doi.org/10.1002/cpp.57210.1177/1755738017722171

31.

Lamers

S. M.

Westerhof

G. J.

Bohlmeijer

E. T.

ten Klooster

P. M.

Keyes

C. L.

(2011). Evaluating the psychometric properties of the Mental Health Continuum-Short Form (MHC-SF). Journal of Clinical Psychology, 67(1), 99-110. https://doi.org/10.1002/cpp.57210.1002/jclp.20741

32.

Lamers

S. M.

Westerhof

G. J.

Glas

C. A. W.

Bohlmeijer

E. T.

(2015). The bidirectional relation between positive mental health and psychopathology in a longitudinal representative panel study. Journal of Positive Psychology, 10(6), 553-560. https://doi.org/10.1002/cpp.57210.1080/17439760.2015.1015156

33.

Lim

Y.-J.

(2014). Psychometric characteristics of the Korean Mental Health Continuum–Short Form in an adolescent sample. Journal of Psychoeducational Assessment, 32(4), 356-364. https://doi.org/10.1002/cpp.57210.1177/0734282913511431

34.

Lupano Perugini

M. L.

de la Iglesia

Castro Solano

Keyes

C. L

. (2017). The Mental Health Continuum-Short Form (MHC-SF) in the Argentinean context: Confirmatory factor analysis and measurement invariance. Europe’s Journal of Psychology, 13(1), 93-108. https://doi.org/10.1002/cpp.57210.5964/ejop.v13i1.1163

35.

McDonald

(1999). Test theory: A unified approach. Lawrence Erlbaum.

36.

Meades

Ayers

(2011). Anxiety measures validated in perinatal populations: A systematic review. Journal of Affective Disorders, 133(1-2), 1-15. https://doi.org/10.1002/cpp.57210.1016/j.jad.2010.10.009

37.

Murphey

Carter

Price

L. R.

Champion

J. D.

Nichols

(2017). Psychological distress in healthy low-risk first-time mothers during the postpartum period: An exploratory study. Nursing Research and Practice, 2017, Article 8415083. https://doi.org/10.1155/2017/8415083

38.

Murray

A. L.

Johnson

(2013). The limitations of model fit in comparing the bi-factor versus higher-order models of human cognitive ability structure. Intelligence, 41(5), 407-422. https://doi.org/10.1002/cpp.57210.1016/j.intell.2013.06.004

39.

Muthén

(2012). Mplus user’s guide (6th ed.). Muthén & Muthén.

40.

Nazaré

Fonseca

Canavarro

M. C.

(2013). Questionário de Confiança Parental: Análise fatorial confirmatória numa amostra comunitária de casais [Maternal Confidence Questionnaire: Confirmatory factor analysis in a community sample of couples]. Psicologia, Saúde & Doenças, 14(1), 23-37. https://doi.org/10.15309/13psd140102

41.

Nelson

S. K.

Kushlev

English

Dunn

E. W.

Lyubomirsky

(2013). In defense of parenthood: Children are associated with more joy than misery. Psychological Science, 24(1), 3-10. https://doi.org/10.1002/cpp.57210.1177/0956797612447798

42.

Neto

(1993). The Satisfaction with Life Scale: Psychometrics properties in an adolescent sample. Journal of Youth and Adolescence, 22(2), 125-134. https://doi.org/10.1002/cpp.57210.1007/BF01536648

43.

Nowak

M. J.

Naude

Thomas

(2013). Returning to work after maternity leave: Childcare and workplace flexibility. Journal of Industrial Relations, 55(1), 118-135. https://doi.org/10.1002/cpp.57210.1177/0022185612465530

44.

O’Donnell

K. J.

Glover

Barker

E. D.

O’Connor

T. G.

(2014). The persisting effect of maternal mood in pregnancy on childhood psychopathology. Development and Psychopathology, 26(2), 393-403. https://doi.org/10.1002/cpp.57210.1017/S0954579414000029

45.

Oliveira

Matos

A. P.

Pinheiro

M. R.

Oliveira

(2015). Confirmatory factor analysis of the Resilience Scale Short Form in a Portuguese adolescent sample. Procedia-Social and Behavioral Sciences, 165, 260-266. https://doi.org/10.1002/cpp.57210.1016/j.sbspro.2014.12.630

46.

Parker

Zahr

L. K.

(1985). The Maternal Confidence Questionnaire. Boston City Hospital.

47.

Pereira

Canavarro

M. C.

(2015). Reliability and validity of the European Portuguese version of the quality of life index EUROHIS-QOL-8 in HIV-infected patients. Revista Portuguesa de Saúde Pública, 33(2), 183-187. https://doi.org/10.1002/cpp.57210.1016/j.rpsp.2015.04.002

48.

Pereira

Melo

Gameiro

Canavarro

M. C.

(2011). Estudos psicométricos da versão em Português Europeu do índice de qualidade de vida EUROHIS-QOL-8 [Psychometric studies of the European Portuguese version of the EUROHIS-QOL-8 quality of life index]. Laboratório de Psicologia, 9(2), 109-123. https://doi.org/10.1002/cpp.57210.14417/lp.627

49.

Petrillo

Capone

Caso

Keyes

C. L. M.

(2015). The Mental Health Continuum–Short Form (MHC–SF) as a measure of well-being in the Italian context. Social Indicators Research, 121(1), 291-312. https://doi.org/10.1002/cpp.57210.1007/s11205-014-0629-3

50.

Phua

D. Y.

Kee

Koh

D. X. P.

Rifkin-Graboi

Daniels

Chen

Chong

Y. S.

Broekman

B. F. P.

Magiati

Karnani

Pluess

Meaney

M. J.

(2017). Positive maternal mental health during pregnancy associated with specific forms of adaptive development in early childhood: Evidence from a longitudinal study. Development and Psychopathology, 29(5), 1573-1587. https://doi.org/10.1002/cpp.57210.1017/S0954579417001249

51.

Pinheiro

M. R.

Matos

A. P.

(2013). Exploring the construct validity of the two versions of the Resilience Scale in a Portuguese adolescent sample. European Journal of Social & Behavioural Sciences, 2(10), 178-189. https://doi.org/10.1002/cpp.57210.15405/FutureAcademy/ejsbs(2301-2218).2012.2.5

52.

Reise

S. P.

Bonifay

W. E.

Haviland

M. G.

(2013). Scoring and modeling psychological measures in the presence of multidimensionality. Journal of Personality Assessment, 95(2), 129-140. https://doi.org/10.1002/cpp.57210.1080/00223891.2012.725437

53.

Rodriguez

Reise

S. P.

Haviland

M. G.

(2016a). Applying vifactor statistical indices in the evaluation of psychological measures. Journal of Personality Assessment, 98(3), 223-237. https://doi.org/10.1002/cpp.57210.1080/00223891.2015.1089249

54.

Rodriguez

Reise

S. P.

Haviland

M. G.

(2016b). Evaluating bifactor models: Calculating and interpreting statistical indices. Psychological Methods, 21(2), 137-150. https://doi.org/10.1002/cpp.57210.1037/met0000045

55.

Schmidt

Muhlan

Power

(2006). The EUROHIS-QOL 8-item index: Psychometric results of a cross-cultural field study. European Journal of Public Health, 16(4), 420-428. https://doi.org/10.1002/cpp.57210.1093/eurpub/cki155

56.

Schotanus-Dijkstra

Keyes

C. L. M.

de Graaf

Ten Have

(2019). Recovery from mood and anxiety disorders: The influence of positive mental health. Journal of Affective Disorders, 252, 107-113. https://doi.org/10.1002/cpp.57210.1016/j.jad.2019.04.051

57.

Schotanus-Dijkstra

Pieterse

M. E.

Drossaert

C. H. C.

Westerhof

G. J.

de Graaf

ten Have

Walburg

J. A.

Bohlmeijer

E. T.

(2016). What factors are associated with flourishing? Results from a large representative national sample. Journal of Happiness Studies, 17(4), 1351-1370. https://doi.org/10.1002/cpp.57210.1007/s10902-015-9647-3

58.

Sockol

L. E.

(2015). A systematic review of the efficacy of cognitive behavioral therapy for treating and preventing perinatal depression. Journal of Affective Disorders, 177, 7-21. https://doi.org/10.1002/cpp.57210.1016/j.jad.2015.01.052

59.

Sockol

L. E.

Epperson

C. N.

Barber

J. P.

(2013). Preventing postpartum depression: A meta-analytic review. Clinical Psychology Review, 33(8), 1205-1217. https://doi.org/10.1002/cpp.57210.1016/j.cpr.2013.10.004

60.

Stein

Pearson

R. M.

Goodman

S. H.

Rapa

Rahman

McCallum

Howard

L. M.

Pariante

C. M.

(2014). Effects of perinatal mental disorders on the fetus and child. Lancet, 384(9956), 1800-1819. https://doi.org/10.1002/cpp.57210.1016/S0140-6736(14)61277-0

61.

Tabachnick

Fidell

(2007). Using multivariate statistics (5th ed.). Pearson.

62.

Trompetter

H. R.

Lamers

S. M. A.

Westerhof

G. J.

Fledderus

Bohlmeijer

E. T.

(2017). Both positive mental health and psychopathology should be monitored in psychotherapy: Confirmation for the dual-factor model in acceptance and commitment therapy. Behaviour Research and Therapy, 91, 58-63. https://doi.org/10.1002/cpp.57210.1016/j.brat.2017.01.008

63.

Van de Schoot

Lugtig

Hox

(2012). A checklist for testing measurement invariance. European Journal of Developmental Psychology, 9(4), 486-492. https://doi.org/10.1002/cpp.57210.1080/17405629.2012.686740

64.

Wagnild

(2009). A review of the Resilience Scale. Journal of Nursing Measurement, 17(2), 105-113. https://doi.org/10.1002/cpp.57210.1891/1061-3749.17.2.105

65.

Westerhof

G. J.

Keyes

C. L.

(2010). Mental illness and mental health: The two continua model across the lifespan. Journal of Adult Development, 17(2), 110-119. https://doi.org/10.1002/cpp.57210.1007/s10804-009-9082-y

66.

Winson

(2017). Transition to motherhood. In Squire

(Ed.), The social context of birth (3rd. ed., pp. 145-160). Routledge. https://doi.org/10.1201/9781315378077-9

67.

Woolhouse

Gartland

Perlen

Donath

Brown

S. J.

(2014). Physical health after childbirth and maternal depression in the first 12 months post partum: Results of an Australian nulliparous pregnancy cohort study. Midwifery, 30(3), 378-384. https://doi.org/10.1002/cpp.57210.1016/j.midw.2013.03.006

68.

Woolhouse

McDonald

Brown

(2012). Women’s experiences of sex and intimacy after childbirth: Making the adjustment to motherhood. Journal of Psychosomatic Obstetrics & Gynecology, 33(4), 185-190. https://doi.org/10.1002/cpp.57210.3109/0167482X.2012.720314

69.

World Health Organization. (2004). Promoting mental health: Concepts, emerging evidence, practice. https://www.who.int/mental_health/evidence/en/promoting_mhh.pdf

70.

Zwaanswijk

Veen

V. C.

Vedder

(2017). The Youth Psychopathic Traits Inventory: A bifactor model, dimensionality, and measurement invariance. Assessment, 24(7), 932-944. https://doi.org/10.1002/cpp.57210.1177/1073191116632340

Measuring Positive Mental Health in the Postpartum Period: The Bifactor Structure of the Mental Health Continuum–Short Form in Portuguese Women

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