ADAPTATION AND VALIDATION OF THE GHQ-28 IN ORPHAN ADOLESCENTS IN PAKISTAN

Abstract

This study aimed to translate, culturally adapt, and validate the General Health Questionnaire-28 (GHQ-28) for orphan adolescents in Pakistan, addressing a critical gap in mental health assessment tools for this vulnerable population. A total of 300 orphan adolescents (ages 12–18) from orphanages in Lahore participated in the validation process. The GHQ-28 was translated into Urdu following rigorous multi-step guidelines, including forward and backward translation, expert panel review, cognitive interviews, and cross-language validation. Psychometric evaluation using SPSS 27 and AMOS 24 demonstrated excellent internal consistency (Cronbach’s α = .76) and strong test-retest reliability. Confirmatory factor analysis supported the original four-factor structure—Somatic Symptoms, Anxiety and Insomnia, Social Dysfunction, and Severe Depression—with excellent model fit indices (χ²/df = 1.50, CFI = .919, TLI = .916, RMSEA = .042). Item-total correlations ranged from .56 to .76, indicating robust internal homogeneity. The Urdu GHQ-28 exhibited strong cross-linguistic equivalence with the original English version (r = .81, p < .001), confirming its reliability and validity for assessing psychological distress in orphan adolescents. This validated instrument provides a culturally relevant and psychometrically sound tool for mental health screening and research in marginalized youth populations in Pakistan, facilitating early identification and intervention.