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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“…to clinical (Clara et al., 2001; Ng et al., 2012; Page et al., 2007) or nonclinical samples (Henry & Craw-ford, 2005; Johnson et al., 2016; Norton, 2007; Osman et al., 2012; Yılmaz et al., 2017) as well as to a combination of both groups (Antony et al., 1998; Bottesi et al., 2015;…”
Background
Factor structure of the Depression, Anxiety and Stress Scale among caregivers in Southeastern Europe
Murphy, H., Prandstetter, K., Ward, C. L., Hutchings, J., Kunovski, I., Tăut, D., & Foran, H. M. (2023) · Family Relations · doi:10.1111/fare.12882 · Cited by 15
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Lam, A. H. Y., Ho, L. M. K., Lam, S. K. K., Chan, C. K. Y., Chan, M. M. K., Pun, M. W. M., & Wang, K. M. P. (2023) · Nurse Education Today · doi:10.1016/j.nedt.2023.106039 · Cited by 19
Menstrual Cycle Variations in Wearable-Detected Finger Temperature and Heart Rate, But Not in Sleep Metrics, in Young and Midlife Individuals
Alzueta, E., Gombert, M., Javitz, H. S., Yüksel, D., Perez-Amparan, E., Camacho, L., Kiss, O., de Zambotti, M., Sattari, N. S., Pena, A., et al. (2024) · Journal of Biological Rhythms · doi:10.1177/07487304241265018 · Cited by 15
“The DASS-21 scale is a self-reported questionnaire that has demonstrated good reliability and validity in various populations (Norton, 2007).”
A Cross‐Sectional Network Analysis Study Applied to the Depression Anxiety Stress Scale‐21 (DASS‐21): A New Factor Revealed
Alvarenga, M. A. S., Ali, A. M., Guilhermino, C. S., de Azevedo, T. G., Olímpio, K. F., Kersul, C., da Cunha, G. L., Álvares-Teodoro, J., Ribeiro, P. C. C., Mansur‐Alves, M., et al. (2024) · Mental Illness · doi:10.1155/2024/9534110 · Cited by 16
Screening negative affectivity in young adults: Validation and psychometric evaluation of the French version of the Depression Anxiety Stress Scales.
Ciobanu, T., Brodard, F., Antonietti, J., Genoud, P. A., & Brandner, C. (2018) · Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement · doi:10.1037/cbs0000110 · Cited by 15
“Norton (2007) suggested that although the DASS items may load similarly on the depression, anxiety, and stress constructs, these constructs may be differentially interrelated across different races and that among different peoples with different backgrounds, symptoms, syndromes, and clusters of…”
Background
The Price of Persistence: Investigating the Impact of Pursuing Engineering on Undergraduate Student Mental Health
Coley, B., & Jennings, M. (2019) · IEEE Frontiers in Education Conference (FIE) · doi:10.1109/fie43999.2019.9028426 · Cited by 15
Systematic review of the psychometric properties of the Depression Anxiety and Stress Scale-21 (DASS-21)
Zolotareva, A. A. (2020) · V M BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY · doi:10.31363/2313-7053-2020-2-26-37 · Cited by 15
Spiritual and mental health of teenagers in Hong Kong and in mainland China under the impact of COVID-19
Leung, C. H., & Mu, Y. (2021) · Asian Education and Development Studies · doi:10.1108/aeds-04-2021-0076 · Cited by 15
Unit-weighted scales imply models that should be tested!
Beauducel, A., & Leue, A. (2020) · doi:10.7275/y3cg-xv71 · Cited by 15
Dispositional Mindfulness and Psychotic Symptoms in Schizophrenia Spectrum Disorders: The Mediating Roles of Rumination and Negative Emotion
Lam, A. H. Y., Cheung, Y. T. D., Wong, K. H., Leung, S. F., & Chien, W. T. (2022) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s338133 · Cited by 13
Depression, anxiety, stress, sleep quality, and life satisfaction among undergraduate medical students in the Gaza Strip: a cross-sectional survey
Aldabbour, B., Jaradat, R., Aljbour, O. A., Abdo, M., Aljbour, J., Dayya, A. A., Asad, M. D., & Abuabada, A. (2025) · Middle East Current Psychiatry · doi:10.1186/s43045-025-00507-z · Cited by 20
“Depression, anxiety, and stress were assessed using the Depression Anxiety and Stress Scale 21 (DASS21), which is comprised of 21 items divided over three subscales that measure Depression, Anxiety, and Stress, respectively [22].”
Associations between pressure to breastfeed and depressive, anxiety, obsessive-compulsive, and eating disorder symptoms among postpartum women
Thompson, K. A., White, J. P., & Bardone‐Cone, A. M. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115432 · Cited by 14
The impact of pressured information management on boys' and girls' psychological functioning
Paparo, J., & Bussey, K. (2014) · Journal of Applied Developmental Psychology · doi:10.1016/j.appdev.2014.01.002 · Cited by 14
Brief Report: Preliminary Outcomes of a Peer Counselling Program for Parents of Children with Autism in the South Asian Community
Mills, A. S., Vimalakanthan, K., Sivapalan, S., Shanmugalingam, N., & Weiss, J. A. (2020) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-020-04538-9 · Cited by 16
“The internal consistency, convergent validity, and divergent validity of the DASS scales are similar across cultural groups (Norton 2007).”
Tendencias de la investigación sobre síntomas de trastornos mentales durante la pandemia por COVID-19
Gómez, J. A. M., Suárez, Y. B., Yanez-Peñúñuri, L. Y., & Anacona, C. A. R. (2020) · Medicina UPB · doi:10.18566/medupb.v39n2.a05 · Cited by 13
Evaluation of Stress, Anxiety, Depression, and Sleep Disorders in Medical Students of Hamadan University of Medical Sciences, Iran, during the COVID-19 Pandemic
Miri, Z., Razavi, Z., & Mohammadi, S. F. (2021) · مجله پزشکی بالینی ابن سینا · doi:10.52547/ajcm.27.4.238 · Cited by 14
Prevalence of Anxiety, Depression and Stress in CABG Candidate Patients and Factors affecting it at Farshchian Cardiovascular Hospital in Hamadan
Goli, B., Jaafaripooyan, E., Moradi, A., Safiarian, R., Moradi, M., & Darabı, F. (2021) · ranian Journal of Health Education and Health Promotion · doi:10.52547/ijhehp.9.2.212 · Cited by 14
A large clinical trial to improve well-being during the transition to college using wearables: The lived experiences measured using rings study
Price, M., Hidalgo, J. E., Bird, Y. M., Bloomfield, L. S. P., Buck, C., Cerutti, J., Dodds, P. S., Fudolig, M. I., Gehman, R. M., Hickok, M., et al. (2023) · Contemporary Clinical Trials · doi:10.1016/j.cct.2023.107338 · Cited by 15
Friend or Foe? Memory and Expectancy Biases for Faces in Social Anxiety
Bielak, T., & Moscovitch, D. A. (2012) · Journal of Experimental Psychopathology · doi:10.5127/jep.019711 · Cited by 14
Psychological Distress in Elite Sambo and Recreational Athletes
Tubić, T., Živanović, B., Lakičević, N., Zenić, N., Gilić, B., Rudas, E., Eliseev, S., Trivić, T., Bianco, A., & Drid, P. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.781880 · Cited by 13
“However, gender differences studies that used DASS offer inconsistent results, often indicating no gender differences (e.g., Norton, 2007; Mahmoud et al., 2010; Apóstolo et al., 2012; Bottesi et al., 2015).”
Result
Self-reported symptoms of developmental dyslexia predict impairments in everyday cognition in adults
Protopapa, C., & Smith-Spark, J. H. (2022) · Research in Developmental Disabilities · doi:10.1016/j.ridd.2022.104288 · Cited by 14
Effect of body image perception and skin-lightening practices on mental health of Filipino emerging adults: a mixed-methods approach protocol
Regencia, Z. J. G., Gouin, J., Ladia, M. A. J., Montoya, J. C., & Baja, E. S. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-068561 · Cited by 16
The impact of war on the development and progression of arterial hypertension and cardiovascular disease: protocol of a prospective study among Ukrainian female refugees
Shalimova, A., Stoenoiu, M. S., Cubała, W. J., Burnier, M., Persu, A., & Narkiewicz, K. (2024) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1324367 · Cited by 17
Clinical effectiveness of guided breathing exercises in reducing anxiety, stress, and depression in COVID-19 patients
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“The DASS-21 contains 21 items, with 7 items for each of the three constructs 33 .”
Background
The Mood and Anxiety Symptom Questionnaire across four ethnoracial groups in an undergraduate sample.
Talkovsky, A. M., & Norton, P. J. (2015) · American Journal of Orthopsychiatry · doi:10.1037/ort0000095 · Cited by 13
Self-citation
Parents’ Dispositional Mindfulness, Child Conflict Discussion, and Childhood Internalizing Difficulties: A Preliminary Study
Bird, A. L., Russell, P. S., Pickard, J. A., Donovan, M. O., Madsen, M., & Herbert, J. S. (2021) · Mindfulness · doi:10.1007/s12671-021-01625-5 · Cited by 18
“The DASS-21 demonstrates cross-cultural validity (Norton, 2007) and strong discriminant validity within clinical samples (Antony et al., 1998).”
Background
Psychological responses and associated factors during the initial stage of the coronavirus disease (COVID-19) epidemic among the adult population in Poland - a cross-sectional study
Sozański, B., Ćwirlej-Sozańska, A. B., Wiśniowska-Szurlej, A., Jurek, K., Górniak, P., Górski, K., Englert-Bator, A., & Perenc, L. (2021) · BMC Public Health · doi:10.1186/s12889-021-11962-8 · Cited by 13
Mental Health of Nurses during the Fourth Wave of the COVID-19 Pandemic in Poland
Dziedzic, B., Kobos, E., Sienkiewicz, Z., & Idzik, A. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031785 · Cited by 13
“It can be used as a screening tool and the result is not a clinical diagnosis [22,23].”
Method
Sense of Humor and Its Association with Psychological Disturbances Among Dental Students in India
Madhan, B., Barik, A. K., Patil, R. K., Gayathri, H., & Reddy, M. S. R. (2013) · Journal of Dental Education · doi:10.1002/j.0022-0337.2013.77.10.tb05608.x · Cited by 13
Cross-cultural validation of a French version of the Emotional Processing Scale (EPS-25)
Gay, M., Baker, R. D., Vrignaud, P., Thomas, P., Heinzlef, O., Haag, P., Banovic, I., & Thomas, S. (2019) · European Review of Applied Psychology · doi:10.1016/j.erap.2019.05.002 · Cited by 13
Exploring the promotive pathway between ethnic-racial identity, depression and anxiety symptoms, and substance use among African American emerging adults.
Byer-Tyre, C. A., Clifton, R. L., Faidley, M. T., Schoeps, K., & Zapolski, T. C. B. (2022) · Cultural Diversity & Ethnic Minority Psychology · doi:10.1037/cdp0000558 · Cited by 14
Maladaptive emotion regulation strategies mediate the relationship between biased cognitions and depression
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The Role of Gender and Sexuality in the Experience, Internalization, and Mental Health Correlates of Sexual Victimization Stigma
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“The DASS-21 is a widely used measure in research and clinical areas and demonstrated good reliability and validity across different ethnic groups (Norton, 2007).”
Method
Validity, reliability, and the factorial structure of bangla version depression, anxiety, and stress scale (DASS-21) among Bangladeshi healthcare professionals
Ahmed, S., Kabir, H., Tazmeem, F., Sunna, T. C., Tonmon, T. T., Nasrullah, S. M., Roy, P. C., & Chowdhury, S. R. (2024) · Discover Psychology · doi:10.1007/s44202-024-00185-8 · Cited by 12
“The DASS-21 has shown consistent outcomes and exhibited robust concurrent validity with several scales used to measure mental health symptoms in validation studies conducted across many nations and languages [10, 11, 13].”
International Swiss Primary Hypersomnolence and Narcolepsy Cohort Study ( iSPHYNCS) : the impact of psychiatric comorbidities on daily life in central disorders of hypersomnolence—a vicious circle
Süzgün, M. A., Wenz, E., van der Meer, J., Fregolente, L. G., Warncke, J. D., Miano, S., Acker, J. G., Strub, M., Olliges, E., Khatami, R., et al. (2024) · Journal of Sleep Research · doi:10.1111/jsr.14367 · Cited by 12
“In former studies, scales and questionnaires predominantly related to mood or anxiety disorders were used, as follows: Generalized Anxiety Disorder seven-item (GAD-7) (Spitzer et al., 2006), Minnesota Multiphasic Personality Inventory-second edition (MMPI-2) (Munley, 2002), Patient Health Questionnaire (PHQ) for Depre…”
The Role of Youth Coping Strategies and Caregiver Psychopathology in Predicting Posttraumatic Stress Symptoms in Pediatric Burn Survivors
Enlow, P. T., Kirschman, K. J. B., Mentrikoski, J. M., Szabo, M. M., Butz, C., Aballay, A. M., & Duncan, C. L. (2019) · Journal of Burn Care & Research · doi:10.1093/jbcr/irz067 · Cited by 13
Successful Thermal Neurotomy of the Painful Sacroiliac Ligament/Joint Complex—A Comparison of Two Techniques
Speldewinde, G. C. (2019) · Pain Medicine · doi:10.1093/pm/pnz282 · Cited by 12
Trauma-Focused Tuning in to Kids: Evaluation in a Clinical Service
Havighurst, S. S., Murphy, J., & Kehoe, C. E. (2021) · Children · doi:10.3390/children8111038 · Cited by 13
“The measure has been found to have good reliability and validity [35].”
Background

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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