Psychological General Well-Being Index (PGWBI)

Abstract

The Psychological General Well-Being Index (PGWBI) is a widely utilized self-administered questionnaire designed to assess subjective psychological well-being and distress over the preceding month. Developed by H.J. Dupuy in the 1970s and formalized in 1984, the PGWBI consists of 22 items that measure general feelings of well-being, mood, vitality, and emotional stability. It is frequently employed in clinical trials, epidemiological studies, and health-related Quality of Life (QoL) research to evaluate the mental health component of health outcomes across diverse populations, including those with chronic medical conditions. The instrument provides a robust measure of overall psychological adjustment by combining scores across six core dimensions: Anxiety, Depressed Mood, Positive Well-Being, Self-Control, General Health, and Vitality.

Keywords

Psychological General Well-Being Index, PGWBI, psychological well-being, quality of life, QoL, mental health, distress, mood, vitality, self-report scale.

Authors

H.J. Dupuy, S.M. Hunt, S. McKenna, E. Grossi, P. Mosconi, N. Groth, G. Apolone.

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Purpose

The primary purpose of the PGWBI is to provide a concise and reliable measure of an individual’s subjective experience of psychological well-being and emotional distress. It was initially developed as part of larger health surveys to capture the mental component of overall health status. The scale is particularly valuable in assessing changes in emotional state, mood, and vitality in response to medical interventions or chronic disease management, serving as a critical outcome measure in clinical research.

The index is designed to quantify six specific dimensions of well-being, allowing researchers and clinicians to obtain a nuanced profile of a patient’s mental health status. The total score, ranging from 0 to 110, provides a robust indicator of the respondent’s overall psychological adjustment and general mood during the recall period (the past month).

Construct

The PGWBI measures the multidimensional construct of psychological well-being, focusing primarily on affective and emotional states experienced over the past four weeks. The instrument is fundamentally concerned with subjective feelings of happiness, satisfaction, personal control, and freedom from debilitating psychological symptoms such as generalized anxiety, depression, and persistent tension. The scale operationalizes well-being through six principal sub-dimensions:

• Anxiety: Measures symptoms of nervousness, tension, and worry.
• Depressed Mood: Assesses feelings of sadness, hopelessness, and general low spirits.
• Positive Well-Being: Reflects happiness, satisfaction, and contentment with personal life.
• Self-Control: Measures the perceived ability to manage behavior, thoughts, and emotions.
• General Health: Assesses perceived health status and the presence of somatic symptoms (e.g., aches or pains).
• Vitality: Measures energy levels, pep, and feelings of exhaustion or fatigue.

Validity

Extensive research confirms the validity of the PGWBI across various clinical and non-clinical settings. The scale has demonstrated strong construct validity, showing high correlations with other established measures of mood and psychological distress, such as the General Health Questionnaire (GHQ) and comparable domains within comprehensive Quality of Life instruments. This evidence supports the notion that the PGWBI effectively measures the intended psychological construct.

Criterion validity is supported by the PGWBI’s documented ability to successfully differentiate between healthy populations and those suffering from chronic illnesses or psychiatric disorders. Furthermore, the instrument exhibits robust responsiveness or sensitivity to change, making it a reliable outcome measure in clinical trials assessing the efficacy of pharmacological or psychological interventions targeting mental health improvement.

Reliability

The PGWBI demonstrates high internal consistency and reliability. Studies examining the scale’s psychometrics typically report high Cronbach’s alpha coefficients for the total score, frequently exceeding 0.90, which indicates excellent homogeneity among the 22 items. This strong internal consistency confirms that the items reliably measure the same underlying construct.

Test-retest reliability has also been confirmed across different time intervals and populations, suggesting stability of measurement when the respondent’s psychological status is assumed to be stable. The short version of the instrument, the Psychological General Well-Being Index-Short (PGWBI-S), developed and validated by Grossi et al. (2006), also maintains acceptable levels of reliability while significantly reducing administration time.

Factor Analysis

Initial Factor Analysis conducted on the PGWBI generally supports a multidimensional structure, aligning conceptually with the six subscales (Anxiety, Depressed Mood, Positive Well-Being, Self-Control, General Health, and Vitality). This six-factor model provides detailed diagnostic information regarding specific domains of distress or well-being.

However, due to the high inter-correlations among these six factors, the results also strongly support the extraction of a single, overarching latent factor—the General Well-Being score. This confirms the utility of using both the detailed subscale scores and the comprehensive total score. Research across different cultural adaptations, including the Italian and British versions, has largely replicated this original factor structure, confirming the robustness and cross-cultural applicability of the instrument’s underlying dimensions.

Instrument

Test Type: Self-report questionnaire / Subjective Health Status Measure

Format: 22 items rated on a 6-point Likert scale (ranging from 0 to 5).

Language Available: English, Italian, British Adaptation, and numerous other validated translations.

Population Group: Clinical and non-clinical populations, frequently used in cardiovascular, psychiatric, and chronic disease research.

Age Group: Adults (typically 18 years and older).

Population Details: Suitable for use in general population surveys as well as specific patient groups undergoing treatment or rehabilitation.

Test Methodology: Respondents answer based on their feelings during the past month. Scoring requires the reversal of nine specific items (1, 4, 6, 7, 9, 10, 14, 16, and 21) to ensure that a higher numerical response consistently reflects a higher level of well-being. Total scores range from 0 (worst well-being) to 110 (best well-being).

Keywords

Psychological General Well-Being Index, PGWBI, subjective health, emotional stability, depression, anxiety, vitality, mood assessment, psychometrics.

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Authors

Author ORCID Identifier: N/A (Information not provided in source.)

Affiliation Email addresses: N/A (Information not provided in source.)

Correspondence Address: N/A (Information not provided in source.)

Permissions & Fee and Test Year

The PGWBI was initially developed by H.J. Dupuy and formally published in 1984. The instrument is generally managed by the Mapi Research Trust (now Mapi Research Institute) for distribution and licensing. Researchers seeking to use the scale must typically obtain permission and may be subject to licensing fees, depending on the research context and funding source. The user manual is available online, and the original PDF can be downloaded here: http://178.23.156.107:8085/Instruments_files/USERS/pgwbi.pdf.

Reference’s

1. Dupuy‚ H.J. (1984). The Psychological general Well-Being (PGWB) Index. In: Assessment of Quality of Life in clinical trials of cardiovascular therapies. Edited by Wenger NK‚ Mattson ME‚ Furberg CD‚ Elinson J. Le Jacq Publishing; Chap 9:170-183.
2. Hunt‚ S.M.‚ McKenna‚ S. (1992). A British adaptation of the general Wellbeing Index: a new tool for clinical research. British J Med Economics‚ 2:49-60.
3. Grossi‚ E.‚ Mosconi‚ P.‚ Groth‚ N.‚ Niero‚ M.‚ & Apolone‚ G. (2002). Questionario Psychological Geeral Well-Being Index. Versione Italiana. Milano: Istituto di Ricerche Farmacologiche “Mario Negri”.
4. Grossi‚ Enzo.‚ Groth‚ Nicola.‚ Mosconi‚ Paola.‚ Cerutti‚ Renata.‚ Pace‚ Fabio.‚ Compare‚ Angelo.‚ and Apolone‚ Giovanni. (2006). Development and validation of the short version of the Psychological General Well-Being Index (PGWB-S). Health Qual Life Outcomes‚ 4: 88.
5. Grossi‚ Enzo.‚ Compare‚ Angelo. (2006). Psychological General Well-Being Index (PGWB). Health and Quality of Life Outcomes ‚ 4:88.
6. Chassany‚ Olivier.‚ Dimenäs‚ Elof.‚ Dubois‚ Dominique.‚ Wu‚ Albert.‚ The Psychological General Well-Being Index (PGWBI): User Manual. Mapi Research Institute.
7. Additional online resources: http://www.opapc.com/uploads/documents/PGWBI.pdf, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1647268/, https://www.researchgate.net/publication/289838731, http://www.iqod.org/.

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Items of the Psychological General Well-Being Index (PGWBI)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

1. How have you been feeling in general during the past month?

0) In excellent spirits

1) In very good spirits

2) In good spirits mostly

3) I have been up and down in spirits a lot

4) In low spirits mostly

5) In very low spirits

2. How often were you bothered by any illness‚ bodily disorder‚ aches or pains during the past month?

0) Every day

1) Almost every day

2) About half of the time

3) Now and then‚ but less than half the time

4) Rarely

5) None of the time

3. Did you feel depressed during the past month?

0) Yes – to the point that I felt like taking my life

1) Yes – to the point that I did not care about anything

2) Yes – very depressed almost every day

3) Yes – quite depressed several times

4) Yes – a little depressed now and then

5) No – never felt depressed at all

4. Have you been in firm control of your behaviour‚ thoughts‚ emotions or feelings during the past month?

0) Yes‚ definitely so

1) Yes‚ for the most part

2) Generally so

3) Not too well

4) No‚ and I am somewhat disturbed

5) No‚ and I am very disturbed

5. Have you been bothered by nervousness or your “nerves” during the past month?

0) Extremely so – to the point where I could not work or take care of things

1) Very much so

2) Quite a bit

3) Some – enough to bother me

4) A little

5) Not at all

6. How much energy‚ pep‚ or vitality did you have or feel during the past month?

0) Very full of energy – lots of pep

1) Fairly energetic most of the time

2) My energy level varied quite a bit

3) Generally low in energy or pep

4) Very low in energy or pep most of the time

5) No energy or pep at all – I fell drained‚ sapped

7. I felt downhearted and blue during the past month.

0) None of this time

1) A little of the time

2) Some of the time

3) A good bit of the time

4) Most of the time

5) All of the time

8. Were you generally tense or did you feel any tension during the past month?

0) Yes – extremely tens‚ most or all of the time

1) Yes – very tense most of the time

2) Not generally tense‚ but did feel fairly tense several times

3) I felt a little tense a few times

4) My general tension level was quite low

5) I never felt tense or any tension at all

9. How happy‚ satisfied‚ or pleased have you been with your personal life during the past month?

0) Extremely happy – could not have been more satisfied or pleased

1) Very happy most of the time

2) Generally satisfied‚ pleased

3) Sometimes fairly happy‚ sometimes fairly unhappy

4) Generally dissatisfied or unhappy

5) Very dissatisfied or unhappy most or all the time

10. Did you feel healthy enough to carry out the things you like to do or had to do during the past month?

0) Yes – definitely so

1) For the most part

2) Health problems limited me in some important ways

3) I was only healthy enough to take care of myself

4) I needed some help in taking care of myself

5) I needed someone to help me with most or all of the things I had to do

11. Have you felt so sad‚ discouraged‚ hopeless‚ or had so many problems that you wondered if anything was worthwhile during the past month?

0) Extremely so – to the point that I have just about given up

1) Very much so

2) Quite a bit

3) Some – enough to bother me

4) A little bit

5) Not at all

12. I woke up feeling fresh and rested during the past month.

0) None of the time

1) A little of the time

2) Some of the time

3) A good bit of the time

4) Most of the time

5) All of the time

13. Have you been concerned‚ worried‚ or had any fears about your health during the past month?

0) Extremely so

1) Very much so

2) Quite a bit

3) Some‚ but not a lot

4) Practically never

5) Not at all

14. Have you had any reason to wonder if you were losing your mind‚ or losing control over the way you act‚ talk‚ think‚ feel or of your memory during the past month?

0) Not at all

1) Only a little

2) Some – but not enough to be concerned or worried about

3) Some and I have been a little concerned

4) Some and I am quite concerned

5) Yes‚ very much so and I am very concerned

15. My daily life was full of things that were interesting to me during the past month.

0) None of the time

1) A little of the time

2) Some of the time

3) A good bit of the time

4) Most of the time

5) All of the time

16. Did you feel active‚ vigorous‚ or dull‚ sluggish during the past month?

0) Very active‚ vigorous every day

1) Mostly active‚ vigorous – never really dull‚ sluggish

2) Fairly active‚ vigorous – seldom dull‚ sluggish

3) Fairly dull‚ sluggish – seldom active‚ vigorous

4) Most dull‚ sluggish – never really active‚ vigorous

5) Very dull‚ sluggish every day

17. Have you been anxious‚ worried‚ or upset during the past month?

0) Extremely so – to the point of being sick or almost sick

1) Very much so

2) Quite a bit

3) Some – enough to bother me

4) A little bit

5) Not at all

18. I was emotionally stable and sure of myself during the past month.

0) None of the time

1) A little of the time

2) Some of the time

3) A good bit of the time

4) Most of the time

5) All of the time

19. Did you feel relaxed‚ at ease or high strung‚ tight‚ or keyed-up during the past month?

0) Felt relaxed and at ease the whole month

1) Felt relaxed and at ease most of the time

2) Generally felt relaxed but at times felt fairly high strung

3) Generally felt high strung but at times felt fairly relaxed

4) Felt high strung‚ tight‚ or keyed-up most of the time

5) Felt high strung‚ tight‚ or keyed-up the whole month

20. I felt cheerful‚ lighthearted during the past month.

0) None of the time

1) A little of the time

2) Some of the time

3) A good bit of the time

4) Most of the time

5) All of the time

21. I felt tired‚ worn out‚ used up‚ or exhausted during the past month.

0) None of the time

1) A little of the time

2) Some of the time

3) A good bit of the time

4) Most of the time

5) All of the time

22. Have you been under or felt you were under any strain‚ stress‚ or pressure during the past month?

0) Yes – almost more than I could bear or stand

1) Yes – quite a bit of pressure

2) Yes‚ some – more than usual

3) Yes‚ some – but about usual

4) Yes – a little

5) Not at all

Scoring of the items 1‚ 4‚ 6‚ 7‚ 9‚ 10‚ 14‚ 16‚ and 21must be reversed (0=5‚ 1=4‚ 2=3‚ 3=2‚ 4=1 and 5=0)