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Construct validity of the psychological general well being index (PGWBI) in a sample of patients undergoing treatment for stress-related exhaustion: a rasch analysis

Åsa Lundgren-Nilsson14*, Ingibjörg H Jonsdottir2, Gunnar Ahlborg2 and Alan Tennant3

Author Affiliations

1 The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden

2 Institute of Stress Medicine (ISM), Gothenburg, Sweden

3 Faculty of Medicine and Health, The University of Leeds, Leeds, United Kingdom

4 Institute of Neuroscience and Physiology, Department of clinical neuroscience and rehabilitation, The Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 14, plan 3, 413 45, Gothenburg, Sweden

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Health and Quality of Life Outcomes 2013, 11:2  doi:10.1186/1477-7525-11-2

Published: 7 January 2013



The Psychological General Well Being Index (PGWBI) is a widely used scale across many conditions. Over time issues have been raised about the dimensional structure of the scale, and it has not yet been subjected to scrutiny by modern Psychometric approaches. The current study thus evaluates the PGWBI with Rasch- and factor analysis.


Consecutive patients recruited to a tertiary stress clinic were administered the PGBWI as part of routine clinical assessment at baseline and three months. Data from the scale was subjected to Factor Analyses and to Rasch analysis. In both cases adjustments for local independence violations were allowed.


179 patients were recruited, with a mean age of 43 years, and of whom 70% were female. An initial Confirmatory Factor Analysis (CFA) with baseline data failed, but the modification indices also indicated considerable levels of local dependency requiring errors to be correlated. An EFA highlighted positive and negative effect domains. Rasch analysis confirmed that fit of data to the model was influenced by local dependency, and that in practice if the items from the six underlying domains were treated as six ‘super’ items, the scale was shown to measure one dominant construct of well being. An interval scale transformation was therefore possible. A significant improvement in well-being was observed over a three month period.


The PGWBI scale has satisfactory internal construct validity when tested with modern psychometric techniques, using data obtained from patients treated for stress-related exhaustion. The instrument has qualities that make it suitable also for monitoring well-being during interventions for stress-related exhaustion/clinical burnout.

Rasch; Well-being; PGWBI; Stress