This study evaluated the dimensionality, invariance, and reliability of the Depression, Anxiety, and Stress Scale–21 (DASS-21) within and across Brazil, Canada, Hong Kong, Romania, Taiwan, Turkey, United Arab Emirates, and the United States ( N = 2,580) in college student samples. We used confirmatory factor analyses to compare the fit of four different factor structures of the DASS-21: a unidimensional model, a three-correlated-factors model, a higher order model, and a bifactor model. The bifactor model, with three specific factors (depression, anxiety, and stress) and one general factor (general distress), presented the best fit within each country. We also calculated ancillary bifactor indices of model-based dimensionality of the DASS-21 and model-based reliability to further examine the validity of the composite total and subscale scores and the use of unidimensional modeling. Results suggested the DASS-21 can be used as a unidimensional scale. Finally, measurement invariance of the best fitting model was tested across countries indicating configural invariance. The traditional three-correlated-factors model presented scalar invariance across Canada, Hong Kong, Romania, Taiwan, and the United States. Overall, these analyses indicate that the DASS-21 would best be used as a general score of distress rather than three separate factors of depression, anxiety, and stress, in the countries studied.

Stigma is an important barrier to seeking psychological services worldwide. Two types of stigma exist: public stigma and self-stigma. Scholars have argued that public stigma leads to self-stigma, and then self-stigma is the primary

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Researchers have found that the stigma associated with seeking therapy--particularly self-stigma--can inhibit the use of psychological services. Yet, most of the research on self-stigma has been conducted in the United States. This is a considerable limitation, as the role of self-stigma in the help-seeking process may vary across cultural groups. However, to examine cross-cultural variations, researchers must first develop culturally valid scales. Therefore, this study examined scale validity and reliability of the widely used Self-Stigma of Seeking Help scale (SSOSH; Vogel, Wade, & Haake, 2006) across samples from 6 different countries (England, Greece, Israel, Taiwan, Turkey, and the United States). Specifically, we used a confirmatory factor analysis framework to conduct measurement invariance analysis and latent mean comparisons of the SSOSH across the 6 sampled countries. Overall, the results suggested that the SSOSH has a similar univariate structure across countries and is sufficiently invariant across countries to be used to explore cultural differences in the way that self-stigma relates to help-seeking behavior.

This study builds on previous help‐seeking research in the United States by examining the role of counseling stigma in Turkey. Undergraduate students in Turkey (N = 520) completed self‐report measures of attitudes and intentions to seek counseling and 3 forms of help‐seeking stigma. Results indicated that perceptions of public and social network stigma each uniquely contributed to the experience of self‐stigma, which, in turn, influenced attitudes toward seeking counseling and then help‐seeking intentions.

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Although the Social Appearance Anxiety Scale (SAAS) is most often validated with the use of confirmatory factor analysis (CFA) on undergraduate students, exploratory factor analysis and multiple factor retention decision criteria necessitate the analysis of underlying factor structure to prevent over and under factoring as well as to reveal convergence and divergence in different factor analysis methods. This study examines the factor structure of SAAS using exploratory factor analysis (EFA) with multiple factor retention decision criteria, and CFA in a large sample of adolescents in Turkey via secondary data analysis. The number of participants was 2,098 (1,072 female and 1,026 male; M = 12.77 years; SD=1.69) students attending 22 junior high schools. Results suggest that the Social Appearance Anxiety Scale is a valid and reliable measure with a unidimesional structure for Turkish early adolescents.

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