A Rasch Analysis of the 10-item Kessler Psychological Distress Scale (K10) in the Urban-rural fFinge of China

Abstract Background The impact of urbanization on the physical and mental health of the rural-urban population has been ignored. The primary objective of this investigation was to demonstrate the reliability, validity, and responsiveness of the 10-item Kessler Psychological Distress Scale (K10) in the measurement of psychological distress in the rural-urban fringe population. Methods Data were obtained from the mental health section of chronic disease survey in Longzihu District, urban-rural fringe area, of Bengbu City, with 3354 participants. The Mandarin version of K10 was used for face-to-face interviews. The Rasch model was used to analyze the psychometry characteristics and differential item functioning (DIF) of K10.Results Rasch analysis results revealed that the K10 scale showed ordered response categories. The results of principal component analysis (PCA) and information-weighted fit statistic (infit) mean square (MNSQ) indicated that the K10 scale conforms to unidimensionality. The Cronbach's alpha coefficient of K10 was 0.916 (95% confidence interval (CI): 0.907,0.924), which had good reliability, but the Cronbach's alpha coefficient would be increased if the fifth item was removed. The results of the Rasch model showed that all the 10 items in the K10 scale had a good fitting effect (Infit MNSQ value, 0.928-1.072). A non-significant differential item functioning (DIF) was found on K10 of age and gender. Overall, the K10 scale was more difficult, and the psychological distress score of the subjects was generally low.Conclusion Rasch analysis showed that the Mandarin version of K10 was an effective and reliable scale for measuring and screening mental distress of residents in the urban-rural fringe. However, it was still recommended that further research should be conducted to solve inappropriate and difficult items.