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

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Abstract

Accessible summary

What is known on the subject?

What does this paper add to existing knowledge?

What are the implications for practice?

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

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