Cited by 708Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and TestingMental Health Research Topics

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Depression Anxiety and Stress Scales (DASS-21): Psychometric analysis across four racial groups

Norton, Peter J.·2007·Anxiety, Stress, & Coping

DOI 10.1080/10615800701309279

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Abstract

Growing cross-cultural awareness has led researchers to examine frequently used research instruments and assessment tools in racially diverse populations. The present study was conducted to assess the psychometric characteristics of the 21-item version of the Depression, Anxiety, and Stress Scales (DASS-21) among different racial groups. The DASS-21 was chosen because it appears to be a reliable and easy to administer measure, ideal for both clinical and research purposes. Results suggest that the internal consistency, and convergent and divergent validity of the DASS-21 are similar across racial groups. Multigroup CFA, however, indicated that item loadings were invariant, while scale covariances were not invariant. This suggests that, although the items may load similarly on the depression, anxiety and stress constructs, these constructs may be differentially inter-related across groups. Implications for application in clinical practice are discussed.

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Glodosky, N. C., & Cuttler, C. (2019) · Addictive Behaviors · doi:10.1016/j.addbeh.2019.106188 · Cited by 92
Relationship of Anxiety and Depression with Respiratory Symptoms: Comparison between Depressed and Non-Depressed Smokers in Singapore
Ho, C. S. H., Tan, E. L. Y., Ho, R., & Chiu, M. Y.-L. (2019) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph16010163 · Cited by 89
“It has been demonstrated to be a good psychometric screening tool with good validity and reliability [14].”
Background
Factor structure of the depression anxiety stress Scale-21 (DASS-21): Unidimensionality of the Arabic version among Egyptian drug users
Ali, A. M., & Green, J. (2019) · Substance Abuse Treatment Prevention and Policy · doi:10.1186/s13011-019-0226-1 · Cited by 89
The Relationship Between Mental Toughness, Job Loss, and Mental Health Issues During the COVID-19 Pandemic
Mojtahedi, D., Dagnall, N., Denovan, A., Clough, P., Hull, S., Canning, D., Lilley, C., & Papageorgiou, K. Α. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.607246 · Cited by 91
From Daily Need Experiences to Autonomy-Supportive and Psychologically Controlling Parenting via Psychological Availability and Stress
van der Kaap‐Deeder, J., Soenens, B., Mabbe, E., Dieleman, L. M., Mouratidis, A. A., Campbell, R., & Vansteenkiste, M. (2019) · Parenting · doi:10.1080/15295192.2019.1615791 · Cited by 93
“The DASS has been widely used across diverse cultures and has high internal consistency (Norton, 2007).”
Method
Do self-report measures of alexithymia measure alexithymia or general psychological distress? A factor analytic examination across five samples
Preece, D. A., Becerra, R., Boyes, M. E., Northcott, C., McGillivray, L., & Hasking, P. A. (2019) · Personality and Individual Differences · doi:10.1016/j.paid.2019.109721 · Cited by 82
Digital technologies for mental health improvements in the COVID-19 pandemic: a scoping review
Li, J. (2023) · BMC Public Health · doi:10.1186/s12889-023-15302-w · Cited by 81
“Mental health outcomes in these studies were measured by validated self-report scales, such as Depression, Anxiety, and Stress Scale [33], Patient Health Questionnaire–9 [34] or UCLA Loneliness Scale [35], which were mainly distributed as an electronic form through the internet.”
Method
The hierarchical model of social interaction anxiety and depression: The critical roles of fears of evaluation
Wang, W., Hsu, W., Chiu, Y.-C., & Liang, C. (2011) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2011.11.004 · Cited by 80
Facebook Addiction Disorder in Germany
Brailovskaia, J., Schillack, H., & Margraf, J. (2018) · Cyberpsychology, Behavior, and Social Networking · doi:10.1089/cyber.2018.0140 · Cited by 77
Integration of the brief behavioral activation treatment for depression (BATD) into a college orientation program: depression and alcohol outcomes
Reynolds, E. K., MacPherson, L., Tull, M. T., Baruch, D. E., & Lejuez, C. W. (2011) · Journal of Counseling Psychology · doi:10.1037/a0024634 · Cited by 77
“…depression score at the first assessment (M ϭ 5.00, SD ϭ 6.14) fell into the normal range and is comparable to other reports using the Depression Anxiety Stress Scales (DASS-21; Lovibond & Lovibond, 1995) in college samples (Mahmoud, Hall, & Staten, 2010; Norton, 2007), with reported means of 7.”
Influential
Measurement invariance of the Depression Anxiety Stress Scales-21 across medical student genders
Jafari, P., Nozari, F., Ahrari, F., & Bagheri, Z. (2017) · International Journal of Medical Education · doi:10.5116/ijme.58ba.7d8b · Cited by 78
Black Girl Blues: The Roles of Racial Socialization, Gendered Racial Socialization, and Racial Identity on Depressive Symptoms among Black Girls
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“The scale has been a reliable measure among a racially diverse sample of Black adolescent boys (α= 0.90; Del Toro et al. 2019) and Black college students (α= 0.84; Norton 2007).”
MethodInfluential
Social media mindsets: a new approach to understanding social media use and psychological well-being
Lee, A. Y., & Hancock, J. T. (2023) · Journal of Computer-Mediated Communication · doi:10.1093/jcmc/zmad048 · Cited by 82
Comparing an Emotion- and a Behavior-Focused Parenting Program as Part of a Multsystemic Intervention for Child Conduct Problems
Duncombe, M. E., Havighurst, S. S., Kehoe, C. E., Holland, K. A., Frankling, E. J., & Stargatt, R. (2014) · Journal of Clinical Child & Adolescent Psychology · doi:10.1080/15374416.2014.963855 · Cited by 83
“The DASS has shown good internal consistency and convergent and divergent validity (Norton, 2007).”
Background
A pilot randomised controlled study of the Mental Health First Aid eLearning course with UK medical students
Davies, E. B., Beever, E., & Glazebrook, C. (2018) · BMC Medical Education · doi:10.1186/s12909-018-1154-x · Cited by 75
Psilocybin microdosing does not affect emotion-related symptoms and processing: A preregistered field and lab-based study
Marschall, J., Fejer, G., Lempe, P., Prochazkova, L., Kuchar, M., Hajkova, K., & van Elk, M. (2022) · Journal of Psychopharmacology · doi:10.1177/02698811211050556 · Cited by 72
“It is considered a reliable and valid measure of each subscale construct, with strong convergent validity with the original DASS, the Hospital Anxiety and Depression Scale and the Beck Depression Inventory-II (Bener et al., 2016; Henry and Crawford, 2005; Norton, 2007; Osman et al., 2012).”
Method
Probing the implicit suicidal mind: Does the Death/Suicide Implicit Association Test reveal a desire to die, or a diminished desire to live?
Harrison, D. P., Stritzke, W. G. K., Fay, N., Ellison, T. M., & Hudaib, A. (2014) · Psychological Assessment · doi:10.1037/pas0000001 · Cited by 72
Age‐related differences in diagnostic categories, psychological states and oral health–related quality of life of adult temporomandibular disorder patients
Yap, A. U., Cao, Y., Zhang, M., Lei, J., & Fu, K. (2020) · Journal of Oral Rehabilitation · doi:10.1111/joor.13121 · Cited by 71
Ideal cardiovascular health in Chinese urban population
Zeng, Q., Dong, S.-Y., Song, Z., Zheng, Y., Wu, H., & Mao, L. (2012) · International Journal of Cardiology · doi:10.1016/j.ijcard.2012.06.022 · Cited by 69
Depression Anxiety Stress Scales-21
Gomez, R., Summers, M. J., Summers, A., Wolf, A., & Summers, J. J. (2014) · Assessment · doi:10.1177/1073191113514106 · Cited by 74
“…a few studies have examined this by analyzing the DASS-21 items obtained from participants’ ratings of the DASS (Clara et al., 2001; Henry & Crawford, 2005; Norton, 2007), while others have examined this from direct ratings of the DASS21 (Daza, Novy, Stanley, & Averill, 2002; Gloster et al., 2008).”
BackgroundResult
Psychometric Evaluation of the Problem Gambling Severity Index-Chinese Version (PGSI-C)
Loo, J. M. Y., Oei, T. P. S., & Raylu, N. (2010) · Journal of Gambling Studies · doi:10.1007/s10899-010-9221-1 · Cited by 68
“The Chinese validated version of the Depression, Anxiety, and Stress Scale (DASS; Norton 2007) will be utilised in this study as these variables have been found to be positively related to PG (Petry 2005a).”
Method
Correlation between emotional intelligence and negative emotions of front‐line nurses during the COVID‐19 epidemic: A cross‐sectional study
Sun, H., Wang, S., Wang, W., Han, G., Liu, Z., Wu, Q., & Pang, X. (2021) · Journal of Clinical Nursing · doi:10.1111/jocn.15548 · Cited by 79
Outcomes of Percutaneous Zygapophysial and Sacroiliac Joint Neurotomy in a Community Setting
Speldewinde, G. C. (2010) · Pain Medicine · doi:10.1111/j.1526-4637.2010.01022.x · Cited by 65
Can the Depression Anxiety Stress Scales Short Be Shorter? Factor Structure and Measurement Invariance of DASS-21 and DASS-9 in a Greek, Non-Clinical Sample
Kyriazos, T. A., Stalikas, A., Prassa, K., & Yotsidi, V. (2018) · Psychology · doi:10.4236/psych.2018.95069 · Cited by 72
Psychological State and Associated Factors During the 2019 Coronavirus Disease (COVID-19) Pandemic Among Filipinos with Rheumatoid Arthritis or Systemic Lupus Erythematosus
Tee, C., Salido, E. O., Reyes, P. W. C., Ho, R., & Tee, M. L. (2020) · Open Access Rheumatology Research and Reviews · doi:10.2147/oarrr.s269889 · Cited by 67
Posttraumatic stress disorder symptom structure in Chinese adolescents exposed to a deadly earthquake.
Wang, L., Long, D., Li, Z., & Armour, C. (2011) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-011-9508-4 · Cited by 65
“Numerous studies have found support for reliability, validity and factor structure of the DASS-21 (e.g., Antony et al. 1998; Gloster et al. 2008; Norton 2007; Szabó 2010; Tully et al. 2009; Willemsen et al. 2011).”
Mindfulness and emotion regulation: promoting well-being during the transition to college
Finkelstein-Fox, L., Park, C. L., & Riley, K. E. (2018) · Anxiety, Stress, & Coping · doi:10.1080/10615806.2018.1518635 · Cited by 65
“Self-reported depression, anxiety, stress, meaning, peace, and faith levels appeared to fall within the range typically seen in non-clinical college student samples (Lovibond & Lovibond, 1995; Norton, 2007; Park, 2017).”
Background
Psychometric Properties of the DASS-21 Among Latina/o College Students by the US-Mexico Border
Camacho, Á., Cordero, E. D., & Perkins, T. (2016) · Journal of Immigrant and Minority Health · doi:10.1007/s10903-016-0415-1 · Cited by 70
Ecological Momentary Assessment of Adolescent Problems, Coping Efficacy, and Mood States Using a Mobile Phone App: An Exploratory Study
Kenny, R., Dooley, B. A., & Fitzgerald, A. (2016) · JMIR Mental Health · doi:10.2196/mental.6361 · Cited by 63
“The DASS-21 has shown convergent validity with other measures of negative affect [35], and it has been found to have a high level of internal reliability as an overall measure of distress (alpha=.”
The psychometric properties of the Depression Anxiety Stress Scale-21 (DASS-21) Bangla version
Ahmed, O., Faisal, R. A., Alim, S. M. A. H. M., Sharker, T., & Hiramoni, F. A. (2022) · Acta Psychologica · doi:10.1016/j.actpsy.2022.103509 · Cited by 68
Psychological status and coping styles of caregivers of individuals with intellectual disability and psychiatric illness
Panicker, A. S., & Ramesh, S. (2018) · Journal of Applied Research in Intellectual Disabilities · doi:10.1111/jar.12496 · Cited by 60
International Handbook of Behavioral Health Assessment
Krägeloh, C. U., Alyami, M. M., & Medvedev, O. N. (2022) · Springer eBooks · doi:10.1007/978-3-030-89738-3 · Cited by 60
Multiple Group Confirmatory Factor Analysis of the DASS-21 Depression and Anxiety Scales: How Do They Perform in a Cancer Sample?
Fox, R. S., Lillis, T. A., Gerhart, J. I., Hoerger, M. P., & Duberstein, P. R. (2017) · Psychological Reports · doi:10.1177/0033294117727747 · Cited by 63
“Similar patterns of responding have been observed in other studies using the DASS-21 in varied populations (Henry & Crawford, 2005; Norton, 2007).”
Result
Therapist-Led, Internet-Delivered Treatment for Early Child Social Anxiety: A Waitlist-Controlled Evaluation of the iCALM Telehealth Program
Comer, J. S., Furr, J. M., del Busto, C., Silva, K., Hong, N., Poznanski, B., Sanchez, A., Cornacchio, D., Herrera, A., Coxe, S., et al. (2021) · Behavior Therapy · doi:10.1016/j.beth.2021.01.004 · Cited by 59
Community pharmacy interventions for health promotion: effects on professional practice and health outcomes
Steed, L., Kassavou, A., Madurasinghe, V., Edwards, E. A., Todd, A., Summerbell, C. D., Nkansah, N., Bero, L. A., Durieux, P., Taylor, S. J., et al. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011207 · Cited by 58
The Deepwater Horizon Oil Spill and the Mississippi Gulf Coast: Mental health in the context of a technological disaster.
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Assessing Disruptions in Meaning: Development of the Global Meaning Violation Scale
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Authors: Norton, P. J.
Affiliations: University of Houston (US)
Corresponding author: Norton, Peter J.
ORCID: Norton, Peter J.
Venue: Anxiety, Stress, & Coping
Publisher: Informa UK Limited
Published: 2007-08-08
Volume: 20
Issue: 3
Pages: 253-265
ISSN: 1061-5806 (ISSN-L)
1477-2205
DOI: 10.1080/10615800701309279
OpenAlex: W2088994872
Cited by: 708
References: 46
Citations by year: 2026: 33 · 2025: 64 · 2024: 76 · 2023: 73 · 2022: 74 · 2021: 78 · 2020: 70 · 2019: 41 · 2018: 39 · 2017: 26 · 2016: 27 · 2015: 16 · 2014: 31 · 2013: 18 · 2012: 18
FWCI: 7.29
Type: journal article
Language: en
Open access: closed
Locations: Anxiety Stress & Coping (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords: DASS-21, DASS, cross-cultural validity, racial groups, measurement invariance, multi-group confirmatory factor analysis, convergent and discriminant validity, internal consistency, depression, anxiety, stress
MeSH terms: Adolescent, Adult, Affect, Anxiety, Cross-Cultural Comparison, Depression, Humans, Middle Aged, Psychometrics, Surveys and Questionnaires, Severity of Illness Index, Racial Groups

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Depression Anxiety and Stress Scales (DASS-21): Psychometric analysis across four racial groups

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