Factor structure and validity of the Depression, Anxiety and Stress Scale‐21 in Swedish translation

Abstract

Introduction There is a constant need for theoretically sound and valid self-report instruments for measuring psychological distress. Previous studies have shown that the Depression, Anxiety and Stress Scale-21 (DASS-21) is theoretically sound, but there have been some inconsistent results regarding its factor structure. Aims The aim of the present study was to investigate and elucidate the factor structure and convergent validity of the DASS-21. Methods A total of 624 participants recruited from student, primary care and psychotherapy populations. The factor structure of the DASS-21 was assessed by confirmatory factor analyses and the convergent validity by investigating its unique correlations with other psychiatric instruments. Results A bifactor structure with depression, anxiety, stress and a general factor provided the best fit indices for the DASS-21. The convergent validity was adequate for the Depression and Anxiety subscales but more ambiguous for the Stress subscale. Discussion The present study overall supports the validity and factor structure of the DASS-21. Implications for practice The DASS-21 can be used to measure symptoms of depression and anxiety as well as overall distress. It can be useful for mental health nurses, and other first-line psychiatric professionals, in need of a short, feasible and valid instrument in everyday care.

Depression, Anxiety and Stress Symptomatology among Swedish University Students Before and During the COVID-19 Pandemic: A Cohort Study.

“…Therefore, there is a possibility that selection bias in uenced our results. However, the baseline pre-pandemic levels of mental health symptoms measured in our cohort were similar to those reported in previous studies of Swedish university students using the same Instrument (DASS-21) [31]. This suggests that our sample is representative of the mental health status of Swedish university students before the pandemic.…”

Psychometric Properties of the Depression, Anxiety, Stress Scales-21 (DASS-21) in a Greek Sample

“…The above research findings show that the DASS-21 is a reliable and valid scale for the measurement of depression, anxiety, and stress in clinical and nonclinical groups across different cultures (Alfonsson et al, 2017;Antony et al, 1998;Bottesi et al, 2015;Clara et al, 2001;Daza et al, 2002;Henry & Crawford, 2005;Norton, 2007;Vasconcelos-Raposo et al, 2013). Furthermore, the DASS-21 is an instrument easy to administer and suitable both for clinical and research purposes.…”

“…Although there are also high correlations between the Depression scale and anxiety measures and between the Anxiety scale and depression measures, these correlations are lower than the correlation between similar constructs (Daza et al, 2002). The Stress scale has been shown to correlate both with similar measures and with anxiety measures revealing a broader symptom pattern and an overlapping of anxiety and stress (Alfonsson, Wallin, & Maathz, 2017;Bottesi et al, 2015).…”

“…Furthermore, the 21-item version has been shown to have a cleaner factor structure and smaller inter-factor correlations than the longer version (Antony et al, 1998), mainly because some items reducing the discriminant validity of the measure have been removed (Henry & Crawford, 2005). Some researchers, however, have found that a quadripartite structure consisting of a common general factor of overall psychological distress plus orthogonal depression, anxiety and stress factors provides better fit indices (Alfonsson et al, 2017;Bottesi et al, 2015;Henry & Crawford, 2005;Osman et al, 2012;Vasconcelos-Raposo et al, 2013). Other studies report revised three-factor structures where one or more items load on other than their designated scale (Wang et al, 2016).…”

The Relationship between Eating Disorder and General Life Stressors among College Students in Jordan

“…The following two scales were used in this study after they were translated into Arabic. The researchers benefited from previous related literature in the field of stressful life issues among college students in order to develop the scale [8,28,34,35].…”