General Well-Being Schedule (GWB)

Abstract

The General Well-Being Schedule (GWB), often referred to later as the Psychological General Well-Being (PGWB) Index, is a widely utilized self-report instrument designed to measure subjective feelings of Psychological well-being and distress in the general population. Developed by H. J. Dupuy for the U.S. National Center for Health Statistics (NCHS), the scale was initially created for use in large-scale health surveys to monitor the mental health status of American adults. The GWB comprises 25 items, with the core 18 questions focusing on the respondent’s emotional state over the past month, structured across six distinct subscales: Anxiety, Depression, Positive Well-being, Self-control, Vitality, and General Health. The remaining items assess situational and behavioral indicators of past year psychological problems.

Keywords

General Well-Being Schedule, GWB, Psychological General Well-Being Index, PGWB, Subjective Well-being, Quality of Life, Mental Health, Affect, Distress, Anxiety, Depression.

Authors

H.J. Dupuy, A.F. Fazio

Purpose

The primary purpose of the General Well-Being Schedule (GWB) is to provide a standardized, quantifiable measure of an individual’s self-perceived psychological state. It functions as a screening tool to assess the spectrum of mental health, ranging from severe distress (e.g., symptoms of Depression or Anxiety) to high levels of positive functioning and life satisfaction.

The scale was specifically developed to capture a comprehensive picture of subjective well-being in large epidemiological studies, allowing researchers and public health officials to monitor changes in the mental health status of populations over time. It measures not only the presence of negative symptoms but also the positive aspects of mental health, such as energy levels and general life satisfaction.

Construct

The GWB measures the construct of multi-dimensional Psychological well-being, defined as a subjective assessment of emotional and mental health status. This construct is operationalized through six principal subscales:

• Anxiety: Measures nervousness, worry, upset, strain, stress, or pressure.
• Depression: Measures feelings of sadness, discouragement, hopelessness, feeling “down-hearted and blue,” and general depressed mood.
• Positive Well-being: Measures general good spirits, happiness, satisfaction with life, and feeling pleased with one’s personal life.
• Self-control: Measures the ability to maintain firm control over behavior, thoughts, and emotions, and freedom from fear of losing one’s mind or control.
• Vitality: Measures energy level, pep, waking up fresh and rested, and feeling tired, worn out, or exhausted.
• General Health: Measures concern about health and whether the individual is bothered by illness or bodily disorders.

Validity

The GWB has demonstrated strong concurrent and construct Validity, particularly in its original validation studies conducted by Fazio (1977) for the NCHS. These studies established that the GWB total score correlated significantly with other established measures of psychological distress and mental health service utilization.

The later version, the Psychological General Well-Being (PGWB) Index (Dupuy, 1984), which is derived from the GWB, has been extensively validated globally, showing sensitivity to change in clinical trials, particularly those involving cardiovascular therapies and chronic conditions. Its ability to discriminate between clinically ill and healthy populations further underscores its criterion Validity.

Reliability

The internal consistency of the GWB is considered high. Studies using the 18-item core scale (PGWB Index) generally report Cronbach’s alpha values exceeding 0.90 for the total score, indicating excellent internal Reliability across the subscale domains. The subscales themselves typically show acceptable to good reliability (alphas generally ranging from 0.70 to 0.85).

Test-retest Reliability has also been demonstrated to be stable over short periods, confirming that the scale provides consistent measures of subjective well-being when respondents’ actual mental states are stable.

Factor Analysis

Initial Factor Analysis of the GWB confirmed its multi-dimensional structure, supporting the division of the scale into the six specified subscales. These factors represent distinct, though correlated, aspects of subjective well-being and distress, justifying the use of both a total score and individual subscale scores for detailed assessment.

While the six-factor model is standard for the GWB, research has also supported the use of a single, higher-order factor representing overall psychological well-being, demonstrating the instrument’s utility in providing a single summary score for global mental health assessment.

Instrument

Test Type: Self-report questionnaire, psychological screening tool, and quality of life measure.

Format: 25 items in total. The core GWB Index (18 items) uses a combination of 6-point Likert scale response formats (Items 1-14) and 11-point visual analog/rating scales (Items 15-18). Items 19-25 are situational and behavioral indicators, usually scored dichotomously or categorically.

Language Available: English (Original), widely translated into numerous languages (e.g., French, Spanish, German, Italian, Swedish) for use in international clinical trials (as PGWB).

Population Group: General adults and clinical populations.

Age Group: Typically utilized for adults (18+).

Population Details: Originally developed based on large-scale surveys of American adults conducted by the NCHS.

Test Methodology: Respondents are asked to reflect on their feelings and experiences DURING THE PAST MONTH for the core well-being items (1-18). Items 19-24 ask about experiences over THE PAST YEAR, focusing on help-seeking behavior and clinical episodes.

Keywords

Mental Health Assessment, Quality of Life, Subjective Well-being, NCHS, Psychological Screening, Affective States, Self-Control, Vitality, Health Measurement.

Authors

Author ORCID Identifier: Not publicly available for H.J. Dupuy.

Affiliation Email addresses: Not publicly available.

Correspondence Address: Correspondence is typically directed through the National Center for Health Statistics (NCHS) for the original GWB, or through current publishers/rights holders for the later PGWB Index.

Permissions & Fee and Test Year

The original General Well-Being Schedule (GWB) was developed by H.J. Dupuy in the 1970s as part of the National Center for Health Statistics (NCHS) surveys. The core 18-item index is often referred to as the Psychological General Well-Being (PGWB) Index, formally presented by Dupuy in 1984.

The use of the original GWB within public health research contexts, particularly those involving NCHS data, may be permissible, but researchers intending to use the PGWB Index should seek formal permission from the current copyright holders, typically a commercial publisher, as licensing fees may apply.

Reference’s

• Dupuy‚ H.J. (1978). Self-representations of general psychological well-being of American adults. Los Angeles‚ California: Paper presented at American Public Health Association Meeting.
• Fazio AF. (1977). A concurrent validational study of the NCHS General Well-Being Schedule. Hyattsville‚ MD: U.S. DHEW‚ National Center for Health Statistics.
• Monk‚ M. (1981). Blood pressure awareness and psychological well-being in the Health and Nutrition Examination Survey. Clin Invest Med‚ 4:183–189.
• Dupuy.H.J. (1984). The Psychological general Well-Being (PGWB) Index. In N. Wenger (Eds.)‚ Assessment of quality of life in clinical trials of cardiovascular therapies (pp.170-183). New York: Le Jacq.
• McDowell‚ Ian. (2006). Measuring Health: A Guide to Rating Scales and Questionnaires‚ Third Edition. OXFORD UNIVERSITY PRESS.

The full instrument can be found in academic literature and public health documents. The original PDF documentation can be downloaded here: www.a4ebm.org/sites/default/files/Measuring%20Health.pdf and https://www.cdc.gov/nchs/data/series/sr_02/sr02_073.pdf.

Items of the General Well-Being Schedule (GWB)

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

DURING THE PAST MONTH

1. How have you been feeling in general?

(1)In excellent spirits

(2)In very good spirits

(3)In good spirits mostly

(4)I have been up and down in spirits a lot

(5)In low spirits mostly

(6)In very low spirits

2. Have you been bothered by nervousness or your “nerves”?

(1) Extremely so—to the point where I could not work or take care of things

(2) Very much so

(3) Quite a bit

(4) Some—enough to bother me

(5) A little

(6) Not at all

3. Have you been in firm control of your behavior‚ thoughts‚ emotions‚ OR feelings?

(1)Yes‚ definitely so

(2)Yes‚ for the most part

(3)Generally so

(4)Not too well

(5)No‚ and I am somewhat disturbed

(6)No‚ and I am very disturbed

4. Have you felt so sad‚ discouraged‚ hopeless‚ or had so many problems that you wondered if anything was worthwhile?

(1)Extremely so—to the point that I have just about given up

(2)Very much so

(3)Quite a bit

(4)Some—enough to bother me

(5)A little bit

(6)Not at all

5. Have you been under or felt you were under any strain‚ stress‚ or pressure?

(1)Yes—almost more than I could bear or stand

(2)Yes—quite a bit of pressure

(3)Yes—some‚ more than usual

(4)Yes—some‚ but about usual

(5)Yes—a little

(6)Not at all

6. How happy‚ satisfied‚ or pleased have you been with your personal life?

Extremely happy—could not have been more satisfied or pleased

(1)Very happy

(2)Fairly happy

(3)Satisfied—pleased

(4)Somewhat dissatisfied

(5)Very dissatisfied

7. 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?

(1)Not at all

(2)Only a little

(3)Some—but not enough to be concerned or worried about

(4)Some and I have been a little concerned

(5)Some and I am quite concerned

(6)Yes‚ very much so and I am very concerned

8. Have you been anxious‚ worried‚ or upset?

(1)Extremely so—to the point of being sick or almost sick

(2)Very much so

(3)Quite a bit

(4)Some—enough to bother me

(5)A little bit

(6)Not at all

9. Have you been waking up fresh and rested?

(1)Every day

(2)Most every day

(3)Fairly often

(4)Less than half the time

(5)Rarely

(6)None of the time

10. Have you been bothered by any illness‚ bodily disorder‚ pains‚ or fears about your health?

(1)All the time

(2)Most of the time

(3)A good bit of the time

(4)Some of the time

(5)A little of the time

(6)None of the time

11. Has your daily life been full of things that were interesting to you?

(1)All the time

(2)Most of the time

(3)A good bit of the time

(4)Some of the time

(5)A little of the time

(6)None of the time

12. Have you felt down-hearted and blue?

(1)All the time

(2)Most of the time

(3)A good bit of the time

(4)Some of the time

(5)A little of the time

(6)None of the time

13. Have you been feeling emotionally stable and sure of yourself?

(1)All the time

(2)Most of the time

(3)A good bit of the time

(4)Some of the time

(5)A little of the time

(6)None of the time

14. Have you felt tired‚ worn out‚ used-up‚ or exhausted?

(1)All the time

(2)Most of the time

(3)A good bit of the time

(4)Some of the time

(5)A little of the time

(6)None of the time

For each of the four scales below‚ note that the words at each end of the 0 to 10 scale describe opposite feelings. Circle any number along the bar which seems closest to how you have generally felt DURING THE PAST MONTH

15. How concerned or worried about your HEALTH have you been?

Not concerned at all 0 1 2 3 4 5 6 7 8 9 10 Very concerned

16. How RELAXED or TENSE have you been?

Very relaxed 0 1 2 3 4 5 6 7 8 9 10 Very tense

17. How much ENERGY‚ PEP‚ VITALITY have you felt?

No energy AT ALL‚ listless 0 1 2 3 4 5 6 7 8 9 10 Very ENERGETIC‚ dynamic

18. How DEPRESSED or CHEERFUL have you been?

Very depressed 0 1 2 3 4 5 6 7 8 9 10 Very cheerful

*******

19. Have you had severe enough personal‚ emotional‚ behavior‚ or mental problems that you felt you needed help? THE PAST YEAR?

(1)Yes‚ and I did seek professional help

(2)Yes‚ but I did not seek professional help

(3)I have had (or have now) severe personal problems‚ but have not felt I needed professional help

(4)I have had very few personal problems of any serious concern

(5)I have not been bothered at all by personal problems during the past year

20. Have you ever felt that you were going to have‚ or were close to ha‎ving‚ a nervous breakdowns?

(1)yes -‎- during the past year

(2)Yes -‎- more than a year ago

(3)No

21. Have you ever had a nervous breakdown?

(1)Yes -‎- during the past year

(2)Yes -‎- more than a year ago

(3)No

22. Have you ever been a patient (or outpatient) at a mental hospital‚ a mental health ward of a hospital‚ or o mental health clinic‚ for any personal‚ emotional‚ behavior‚ or mental problem?

(1)Yes -‎- during the past year

(2)Yes-‎- more than a year ago

(3)No

23. Have you ever seen a psychiatrist‚ psychologist or psychoanalyst about any personal‚ emotional‚ behavior‚ or mental problem concerning yourself?

(1)Yes -‎- during the past year

(2)Yes -‎- more than a year ago

(3)No

24. Have you talked with or had any connection with any of the following about some personal‚ emotional‚ behavior‚ mental problem‚ worries‚ or “nerves” CONCERNING YOURSELF DURING THE PAST YEAR?

1. Regular medical doctor (except for definite physical conditions or routine check-ups) (1) Yes‚ (2) No
2. Brain or nerve specialist (1) Yes‚ (2) No
3. Nurse (except for routine medical conditions) (1) Yes‚ (2) No
4. Lawyer (except for routine legal services) (1) Yes‚ (2) No
5. Police (except for simple traffic violations)  (1) Yes‚ (2) No
6. Clergyman‚ minister‚ priest‚ rabbi‚ etc (1) Yes‚ (2) No
7. Marriage Counselor (1) Yes‚ (2) No
8. Social Worker (1) Yes‚ (2) No
9. Other formal assistance (1) Yes– What kind? -‎–‎–‎–‚ (2) No

25. Do you discuss your problems with any members of your family or friends?

(1)Yes – and it helps a lot

(2)Yes – and it helps some.

(3)Yes – but it does not help at all

(4)No – I do not have anyone I can talk with about my problems

(5)No – no one cares to hear about my problems

(6)No – I do not care to talk about my problems with anyone

(7)No – I do not have any problems