Validity of the mental health subscale of the SF-36 in persons with spinal cord injury

C. M. C. van Leeuwen, L. H. V. van der Woude, M. W. M. Post*

*Corresponding author for this work

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Study design: Cross-sectional study 5 years after discharge from inpatient rehabilitation.

Objective: To examine the psychometric properties of the Mental Health subscale (MHI-5) of the 36-Item Short Form Health Survey (SF-36) in persons with spinal cord injury (SCI).

Setting: Eight Dutch rehabilitation centres with specialised SCI units.

Methods: Possible floor and ceiling effects were assessed, and Cronbach's alpha coefficient was calculated to assess internal consistency. Concurrent and divergent validity were assessed using Spearman correlations between the MHI-5 and measures of life satisfaction, neuroticism, vitality, general health, functional independence, participation, lesion characteristics and demographics.

Results: There were no floor or ceiling effects, but the total MHI-5 score was slightly skewed (-1.15). Internal consistency was good (alpha = 0.79). Concurrent validity was shown by significant Spearman correlations between the MHI-5 and life satisfaction (0.53), neuroticism (-0.55), vitality (0.53) and general health (0.37). Divergent validity was shown by weak and, in part, nonsignificant correlations between the MHI-5 and functional independence (0.09), participation (-0.28) and lesion characteristics (range -0.01-0.19).

Conclusion: The MHI-5 showed reliability and validity as a measure of mood in persons with SCI, and is a promising measurement instrument to assess mental health problems in this population. Spinal Cord (2012) 50, 707-710; doi:10.1038/sc.2012.33; published online 10 April 2012

Original languageEnglish
Pages (from-to)707-710
Number of pages4
JournalSpinal Cord
Issue number9
Publication statusPublished - Sep-2012


  • spinal cord injury
  • mental health
  • depressed mood
  • psychometrics
  • validation studies
  • 5-ITEM

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