The Depression Anxiety Stress Scale 8-Items Expresses Robust Psychometric Properties as an Ideal Shorter Version of the Depression Anxiety Stress Scale 21 Among Healthy Respondents From Three Continents

Abstract

To examine the cultural limitations and implications in the applicability of the Depression Anxiety Stress Scale 8-items (DASS-8)—a shortened version of the DASS-21 recently introduced in an Arab sample—this study evaluated its psychometric properties, including measurement invariance, among healthy subjects from the United States, Australia, and Ghana. Confirmatory factor analysis revealed good fit of the DASS-8 relative to a 12-item version (DASS-12). Both the DASS-8 and the DASS-12 were invariant at all levels across genders, employment status, and students vs. non-students. The DASS-8/DASS-12 also expressed invariance at the configural and metric levels across all countries, albeit scalar invariance was not maintained due to misspecification of the factor loadings in the Ghanian sample. Mann–Whitney U test revealed significantly lower levels of mental symptomatology on the DASS measures among Ghanian students than in English-speaking respondents (both students and non-students). The DASS-8 expressed excellent internal consistency (coefficient alpha = 0.89), good convergent validity—noted by high values of item-total correlations (r = 0.87 to 0.88), good predictive validity—indicated by significantly strong correlation with the DASS-21 and its subscales (r = 0.95 to 0.80), and adequate discriminant validity—indicated by heterotrait–monotrait ratio of correlations <0.85. The DASS-8 correlated with the Internet Gaming Disorder-9, the Adult attention-deficit/hyperactivity disorder Self-Report Scale, and the Individualism and Collectivism Scale/Culture Orientation Scale at the same level as the DASS-21 and the DASS-12, denoting its adequate criterion validity. The DASS-8 can be used as a brief alternative to the DASS-21 to screen for mental symptomatology in English-speaking and African cultures. However, the same scores on the DASS-8 and the DASS-12 may not always indicate the same level of symptom severity in subjects from different countries. Further inter-cultural evaluations of the DASS-8 are needed.

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“…However, it does not discriminate mental symptoms underlying the tripartite model (depression, anxiety, and stress) [ 31 , 32 , 33 ]. Discriminant validity tests uncovered better discrimination among the subscales of the DASS-8, a shortened version of the DASS-21, than the parent scale [ 28 ]. Therefore, we included the DASS-8 in the present analysis for criterion validity testing.…”

“…The DASS-8 comprises eight items in three subscales: depression (three items, e.g., had nothing to look forward), anxiety (three items, e.g., felt close to panic), and stress (two items, e.g., found it difficult to relax). The minimum score of the DASS-8 and its subscales is 0 while their maximum scores are 24, 9, 9, and 6, respectively [ 28 , 29 ]. The reliability of the DASS-8 and its subscales ranges from excellent to very good in sample 1 (α = 0.94, 0.85, 0.89, 0.84, respectively) and sample 2 (α = 0.91, 0.79, 0.79, 0.80, respectively) [ 29 ].…”

“…We also assessed its measurement invariance across gender, age, and marital status. Criterion validity was examined by assessing the association of the IES-R with the Depression Anxiety Stress Scale-8 (DASS-8) and its subscales as measures of psychological distress, depression, anxiety, and stress [ 28 , 29 ]. We hypothesized that the IES-R will positively correlate with the DASS-8 and its subscales.…”