Factor structure and validity of the Depression, Anxiety and Stress Scale‐21 in Swedish translation
Abstract
WHAT IS KNOWN ON THE SUBJECT?: The Depression, Anxiety and Stress Scale-21 (DASS-21) is a widely used measurement for psychological symptoms and distress. Some previous studies have shown that the DASS-21 can accurately measure symptoms of anxiety, depression and stress, while other studies have indicated that the DASS-21 mainly measures overall distress. The factor structure of the DASS-21 is important and debated since if affects interpretations of findings. WHAT DOES THIS PAPER ADD TO EXISTING KNOWLEDGE?: In this study, the DASS-21 was translated into Swedish and evaluated in three diverse samples. The DASS-21 subscales of Depression and Anxiety correlated significantly with corresponding criteria instruments. The DASS-21 Stress subscale showed more diverse associations with psychological distress. The analyses supported a bifactor model of the DASS-21 with three specific factors of depression, anxiety and stress as well as a general distress factor. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: The results show that the DASS-21 may be used to measure unique symptoms of depression, anxiety and, with some caveat, stress as well as overall psychological distress. This study confirms that the DASS-21 is theoretically sound instrument that is feasible for both research and clinical practice. The DASS-21 can be an accessible tool for screening and evaluation in first-line mental health services. 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.
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The measures were translated and back translated for previous studies, except the Cognitive Fusion Questionnaire (CFQ) which was translated for this study by a group of researchers with long experience in acceptance-, mindfulness-, and value-based interventions.
“The measures have been translated and back translated for previous studies [33, 36–38], except the Cognitive Fusion Questionnaire (CFQ) that was translated for this study by a group of researchers with long experience in acceptance-, mindfulness-, and value-based interventions.”
From Psychological inflexibility explains distress in parents whose children have chronic conditions (2018) · cites this paper as [36]
The factor structure and validity of the DASS-21 have been supported.
“The factor structure and validity of the DASS-21 have been supported [36]”
From Psychological inflexibility explains distress in parents whose children have chronic conditions (2018) · cites this paper as [36]
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910 · see citing works
A Global Measure of Perceived Stress
Cohen, S., Kamarck, T., & Mermelstein, R. (1983) · Journal of Health and Social Behavior · doi:10.2307/2136404 · Cited by 32,807 · see citing works
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765 · see citing works
Evaluating Goodness-of-Fit Indexes for Testing Measurement Invariance
Cheung, G. W., & Rensvold, R. B. (2002) · Structural Equation Modeling: A Multidisciplinary Journal · doi:10.1207/s15328007sem0902_5 · Cited by 16,280 · see citing works
Lovibond, P. F., & Lovibond, S. H. (1995) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)00075-u · Cited by 14,523 · see citing works
Schermelleh-Engel, K., Moosbrugger, H., & Müller, H. (2003) · Department of Psychology - University of Koblenz-Landau · doi:10.23668/psycharchives.12784 · Cited by 8,975 · see citing works
Structural Equation Modelling: Guidelines for Determining Model Fit
Hooper, D., Coughlan, J., & Mullen, M. R. (2008) · Dublin Institute of Technology · doi:10.21427/d7cf7r · Cited by 8,746 · see citing works
Reporting Structural Equation Modeling and Confirmatory Factor Analysis Results: A Review
Schreiber, J. B., Nora, A., Stage, F. K., Barlow, E. A., & King, J. (2006) · The Journal of Educational Research · doi:10.3200/joer.99.6.323-338 · Cited by 6,937 · cited 1× · see citing works
“A nonsignificant Satorra–Bentler v2, a RMSEA < 0.06 and NNFI and CFI > 0.97 were for this study considered indices for good model fit, while an adequate model fit was indicated of a RMSEA between 0.06 and 0.08 and NNFI and CFI > 0.95 (Schermelleh-Engel et al. 2003, Schreiber et al. 2006).”
MethodInfluential(1995) · Cited by 6,909 · see citing works
Henry, J. D., & Crawford, J. R. (2005) · British Journal of Clinical Psychology · doi:10.1348/014466505x29657 · Cited by 5,801 · see citing works
Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998) · Psychological Assessment · doi:10.1037/1040-3590.10.2.176 · Cited by 4,874 · see citing works
Principles and practice in reporting structural equation analyses.
McDonald, R. P., & Ho, M.-H. R. (2002) · Psychological Methods · doi:10.1037/1082-989x.7.1.64 · Cited by 4,734 · see citing works
Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications.
Clark, L., & Watson, D. (1991) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.100.3.316 · Cited by 4,616 · see citing works
Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications
Clark, L. A., & Watson, D. (1991) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.100.3.316 · Cited by 4,601 · see citing works
Kroenke, K., Spitzer, R. L., Williams, J. B. W., & Löwe, B. (2010) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2010.03.006 · Cited by 4,057 · see citing works
How to Use a Monte Carlo Study to Decide on Sample Size and Determine Power
Muthén, L. K., & Muthén, B. O. (2002) · Structural Equation Modeling: A Multidisciplinary Journal · doi:10.1207/s15328007sem0904_8 · Cited by 2,362 · see citing works
Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples
Brown, T. A., Chorpita, B. F., Korotitsch, W., & Barlow, D. H. (1997) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(96)00068-x · Cited by 1,860 · see citing works
Crawford, J. R., & Henry, J. D. (2003) · British Journal of Clinical Psychology · doi:10.1348/014466503321903544 · Cited by 1,756 · see citing works
Osman, A., Wong, J. L., Bagge, C. L., Freedenthal, S. L., Gutierrez, P. M., & Lozano, G. (2012) · Journal of Clinical Psychology · doi:10.1002/jclp.21908 · Cited by 1,097 · see citing works
Depression Anxiety and Stress Scales (DASS-21): Psychometric analysis across four racial groups
Norton, P. J. (2007) · Anxiety, Stress, & Coping · doi:10.1080/10615800701309279 · Cited by 708 · see citing works
Bottesi, G., Ghisi, M., Altoè, G., Conforti, E., Melli, G., & Sica, C. (2015) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2015.04.005 · Cited by 701 · see citing works
Using the Depression Anxiety Stress Scale 21 (DASS‐21) across cultures
Oei, T. P. S., Sawang, S., Goh, Y. W., & Mukhtar, F. (2013) · International Journal of Psychology · doi:10.1080/00207594.2012.755535 · Cited by 566 · see citing works
Leung, D. Y., Lam, T.-H., & Chan, S. S. (2010) · BMC Public Health · doi:10.1186/1471-2458-10-513 · Cited by 562 · see citing works
Sinclair, S. J., Siefert, C. J., Slavin-Mulford, J. M., Stein, M. B., Renna, M., & Blais, M. A. (2012) · Evaluation & the Health Professions · doi:10.1177/0163278711424282 · Cited by 543 · see citing works
The Depression Anxiety Stress Scale-21: Spanish Translation and Validation with a Hispanic Sample
Daza, P., Novy, D. M., Stanley, M. A., & Averill, P. (2002) · Journal of Psychopathology and Behavioral Assessment · doi:10.1023/a:1016014818163 · Cited by 508 · see citing works
Psychometric properties of the Depression Anxiety and Stress Scale-21 in older primary care patients
Gloster, A. T., Rhoades, H. M., Novy, D., Klotsche, J., Senior, A., Kunik, M., Wilson, N., & Stanley, M. A. (2008) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.01.023 · Cited by 474 · see citing works
Long-term stability of depression, anxiety, and stress syndromes.
Lovibond, P. (1998) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.107.3.520 · Cited by 417 · see citing works
Ng, F., Trauer, T., Dodd, S., Callaly, T., Campbell, S., & Berk, M. (2007) · Acta Neuropsychiatrica · doi:10.1111/j.1601-5215.2007.00217.x · Cited by 406 · see citing works
Clara, I. P., Cox, B. J., & Enns, M. W. (2001) · Journal of Psychopathology and Behavioral Assessment · doi:10.1023/a:1011095624717 · Cited by 403 · see citing works
Long-term stability of depression, anxiety, and stress syndromes.
Lovibond, P. F. (1998) · Journal of Abnormal Psychology · doi:10.1037//0021-843x.107.3.520 · Cited by 403 · see citing works
Routinely administered questionnaires for depression and anxiety: systematic review
Gilbody, S. M., House, A. O., & Sheldon, T. (2001) · BMJ · doi:10.1136/bmj.322.7283.406 · Cited by 328 · see citing works
Henkel, V., Mergl, R., Kohnen, R., Maier, W., Möller, H.-J., & Hegerl, U. (2003) · BMJ · doi:10.1136/bmj.326.7382.200 · Cited by 309 · see citing works
Identifying depression in primary care: a literature synthesis of case-finding instruments
Williams, J. W., Pignone, M. P., Ramı́rez, G., & Stellato, C. P. (2002) · General Hospital Psychiatry · doi:10.1016/s0163-8343(02)00195-0 · Cited by 288 · see citing works
(2007) · Cited by 278 · see citing works
Nordin, M., & Nordin, S. (2013) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12071 · Cited by 252 · see citing works
Rasch model analysis of the Depression, Anxiety and Stress Scales (DASS)
Shea, T. L., Tennant, A., & Pallant, J. (2009) · BMC Psychiatry · doi:10.1186/1471-244x-9-21 · Cited by 184 · see citing works
The Depression Anxiety and Stress Scale (DASS): The Study of Validity and Reliability.
Ahmet Cumhur, A. K. I. N., & Çeti̇n, B. (2007) · Cited by 170 · see citing works
Coventry, P. A., Goulding, R., Dickens, C. M., Bundy, C., Garrett, C., Cherrington, A., & Chew-Graham, C. A. (2011) · BMC Family Practice · doi:10.1186/1471-2296-12-10 · Cited by 157 · see citing works
Henkel, V., Mergl, R., Kohnen, R., Allgaier, A., Möller, H., & Hegerl, U. (2004) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2004.02.003 · Cited by 131 · see citing works
Shakespeare, J., Blake, F., & Garcia, J. (2003) · Europe PMC (PubMed Central) · Cited by 121 · see citing works
Interformat Reliability of Digital Psychiatric Self-Report Questionnaires: A Systematic Review
Alfonsson, S., Maathz, P., & Hursti, T. J. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3395 · Cited by 94 · see citing works
Self-citationAlfonsson, S., Olsson, E. M. G., & Hursti, T. J. (2015) · Internet Interventions · doi:10.1016/j.invent.2015.07.005 · Cited by 14 · see citing works
Self-citation
Flagged first, then by citations
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Sorted by citations
Lee, J., Lee, E., & Moon, S. H. (2019) · Quality of Life Research · doi:10.1007/s11136-019-02177-x · Cited by 276 · see citing works
Gato, J., Barrientos, J., Tasker, F., Miscioscia, M., Cerqueira-Santos, E., Malmquist, A., Seabra, D., Leal, D., Houghton, M., Poli, M., et al. (2021) · Journal of Homosexuality · doi:10.1080/00918369.2020.1868186 · Cited by 155 · see citing works
Psychometric Properties of the Depression, Anxiety, Stress Scales-21 (DASS-21) in a Greek Sample
Pezirkianidis, C., Karakasidou, E., Lakioti, A., Stalikas, A., & Galanakis, M. (2018) · Psychology · doi:10.4236/psych.2018.915170 · Cited by 124 · see citing works
Yusoff, M. S. B., Hadie, S. N. H., & Yasin, M. A. M. (2021) · BMC Medical Education · doi:10.1186/s12909-021-02733-5 · Cited by 108 · see citing works
Lian, S.-L., Sun, X., Niu, G., Yang, X., Zhou, Z., & Yang, C. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.10.005 · Cited by 103 · see citing works
Chen, I., Chen, C., Liao, X.-L., Chen, X.-M., Zheng, X., Tsai, Y., Lin, C., Griffiths, M. D., & Pakpour, A. H. (2023) · Acta Psychologica · doi:10.1016/j.actpsy.2023.104042 · Cited by 97 · see citing works
Psychological inflexibility explains distress in parents whose children have chronic conditions
Sairanen, E., Lappalainen, P., & Hiltunen, A. (2018) · PLoS ONE · doi:10.1371/journal.pone.0201155 · Cited by 60 · see citing works
Sairanen, E., Lappalainen, R., Lappalainen, P., Kaipainen, K., Carlstedt, F., Anclair, M., & Hiltunen, A. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.07.004 · Cited by 57 · see citing works
Edlund, B., Johansson, F., Lindroth, R., Bergman, L. E., Sundberg, T., & Skillgate, E. (2022) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-022-01374-x · Cited by 47 · see citing works
Johansson, F., Côté, P., Hogg‐Johnson, S., Rudman, A., Holm, L. W., Grotle, M., Jensen, I. B., Sundberg, T., Edlund, B., & Skillgate, E. (2021) · Scandinavian Journal of Public Health · doi:10.1177/14034948211015814 · Cited by 44 · see citing works
Laranjeira, C., Querido, A., de Sousa, P. M. L., & Dixe, M. D. A. (2023) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe13110177 · Cited by 34 · see citing works
Caregiver burden, psychological well-being, and support needs among Swedish informal caregivers
Malki, S. T., Johansson, P., Andersson, G., Andréasson, F., & Mourad, G. (2025) · BMC Public Health · doi:10.1186/s12889-025-22074-y · Cited by 33 · see citing works
Measuring online and offline social rejection sensitivity in the digital age.
Andrews, J. L., Khin, A. C., Crayn, T., Humphreys, K., & Schweizer, S. (2022) · Psychological Assessment · doi:10.1037/pas0001136 · Cited by 34 · see citing works
Manole, A., Cârciumaru, R., Brînzaș, R., & Manole, F. (2024) · Information · doi:10.3390/info16010011 · Cited by 34 · see citing works
Abrahamsson, N., Ahlund, L., Ahrin, E., & Alfonsson, S. (2018) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2018.06.010 · Cited by 30 · see citing works
Self-citationDepression, anxiety and stress in Swedish midwives: A cross-sectional survey
Båtsman, A., Fahlbeck, H., & Hildingsson, I. (2020) · European Journal of Midwifery · doi:10.18332/ejm/124941 · Cited by 27 · see citing works
Kosmas, J. A., Wildes, J. E., Graham, A. K., & O’Connor, S. M. (2023) · Eating Behaviors · doi:10.1016/j.eatbeh.2023.101709 · Cited by 26 · see citing works
Alkalbani, M., Al‐Adawi, S., & Alshekaili, W. (2022) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2022.100451 · Cited by 22 · see citing works
Muttaqin, D., & Ripa, S. (2021) · Psikohumaniora Jurnal Penelitian Psikologi · doi:10.21580/pjpp.v6i1.7815 · Cited by 29 · see citing works
Uji Reliabilitas dan Validitas Depression Anxiety Stress Scales 21 (DASS-21) pada Mahasiswa
Arjanto, P. (2022) · Jurnal Psikologi Perseptual · doi:10.24176/perseptual.v7i1.6196 · Cited by 18 · see citing works
DASS-21: assessment of psychological distress through the Bifactor Model and item analysis
Peixoto, E. M., Oliveira, K. D. S., Campos, C. R., Gagnon, J., Zanini, D. S., Nakano, T. D. C., & Bueno, J. M. H. (2021) · Psico-USF · doi:10.1590/1413-82712021260413 · Cited by 17 · see citing works
Al-Dassean, K. A., & Murad, O. S. (2024) · Neuropsychopharmacology Reports · doi:10.1002/npr2.12442 · Cited by 16 · see citing works
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 · see citing works
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 · see citing works
Bern, R., Persdotter, T., Harte, C., & Barnes‐Holmes, D. (2020) · The Psychological Record · doi:10.1007/s40732-020-00414-1 · Cited by 15 · see citing works
Wijk, I., Amsberg, S., Johansson, U.-B., Livheim, F., Toft, E., & Anderbro, T. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-072061 · Cited by 15 · see citing works
Johansson, F., Côté, P., Hogg‐Johnson, S., & Skillgate, E. (2021) · Scandinavian Journal of Public Health · doi:10.1177/14034948211031402 · Cited by 14 · see citing works
Siljeholm, O., Edvardsson, K., Bergström, M., & Hammarberg, A. (2024) · Addiction · doi:10.1111/add.16429 · Cited by 11 · see citing works
Sairanen, E., Lappalainen, R. I., Lappalainen, P., & Hiltunen, A. J. (2019) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2019.11.010 · Cited by 15 · see citing works
Salinas‐Rodríguez, A., Argumedo, G., Hernández-Alcaraz, C., Contreras‐Manzano, A., & Jáuregui, A. (2023) · Revista Latinoamericana de Psicología · doi:10.14349/rlp.2023.v55.10 · Cited by 13 · see citing works
Depression and bedtime procrastination: Chain mediation of brooding and perceived stress
Hou, X., & Hu, J. (2023) · Heliyon · doi:10.1016/j.heliyon.2023.e22672 · Cited by 12 · see citing works
The COVID-19 pandemic, psychologists’ professional quality of life and mental health
Kercher, A., Rahman, J., & Pedersen, M. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1339869 · Cited by 12 · see citing works
Schubert, E., Smith, E., Brydevall, M., Lynch, C., Ringin, E., Dixon, H., Kashima, Y., Wakefield, M. A., & Bode, S. (2021) · Appetite · doi:10.1016/j.appet.2021.105141 · Cited by 12 · see citing works
Siljeholm, O., Lindner, P., Johansson, M., & Hammarberg, A. (2022) · Addiction Science & Clinical Practice · doi:10.1186/s13722-022-00332-3 · Cited by 12 · see citing works
Un recurso para atención primaria de la salud mental. DASS-21, propiedades psicométricas
Olano, M. O. V., Ojeda, S. P. C., & Herrera-Delgado, C. (2022) · Revista Peruana de Investigación en Salud · doi:10.35839/repis.6.3.1481 · Cited by 11 · see citing works
Vázquez, I., Gato, J., Coimbrã, S., Tasker, F., Barrientos, J., Miscioscia, M., Cerqueira-Santos, E., Malmquist, A., Seabra, D., Leal, D., et al. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20043188 · Cited by 11 · see citing works
Psychometric evaluation of the 21-item Depression, Anxiety and Stress Scale (DASS-21) among Afghans
Neyazi, A., Rahimi, B. A., Mohammadi, A. Q., Satapathy, P., Shikhulislamy, Y., Qaderi, F., Qarizada, B. S., Afzali, H., Neyazi, M., & Griffiths, M. D. (2025) · BMC Psychiatry · doi:10.1186/s12888-025-07613-6 · Cited by 11 · see citing works
Edlund, B., Sundberg, T., Johansson, F., Onell, C., Rudman, A., Holm, L. W., Grotle, M., Jensen, I. B., Côté, P., & Skillgate, E. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-056489 · Cited by 11 · see citing works
Successful implementation of parenting support at preschool: An evaluation of Triple P in Sweden
Dahlberg, A., Salari, R., Fängström, K., Fabian, H. M., & Sarkadi, A. (2022) · PLoS ONE · doi:10.1371/journal.pone.0265589 · Cited by 12 · see citing works
Johansson, F., Edlund, B., Sundgot-Borgen, J. K., Björklund, C., Côté, P., Onell, C., Sundberg, T., & Skillgate, E. (2024) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-024-02688-0 · Cited by 10 · see citing works
Woodford, J., Månberg, J., Cajander, Å., Enebrink, P., Harila‐Saari, A. H., Hagström, J., Karlsson, M., Solimena, H. P., & von Essén, L. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-041350 · Cited by 10 · see citing works
Sanmartín, R., Suria-Martínez, R., López, M. D. L. L., Vicent, M., Gonzálvez, C., & García-Fernández, J. M. (2022) · Professional Psychology Research and Practice · doi:10.1037/pro0000442 · Cited by 12 · see citing works
Yusoff, M. S. B., Hadie, S. N. H., & Yasin, M. A. M. (2021) · Research Square · doi:10.21203/rs.3.rs-144736/v1 · Cited by 9 · see citing works
[Retracted] Psychological Nursing Effect of Patients with Gynecological Malignant Tumor
Wang, H., Gao, X., & Chen, N. (2022) · BioMed Research International · doi:10.1155/2022/1569656 · Cited by 8 · see citing works
RetractedLangegård, U., Cajander, Å., Carlsson, M., von Essén, L., Ahmad, A., Laurell, G. F. E., Ehrsson, Y. T., & Johansson, B. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-057442 · Cited by 8 · see citing works
Effects of Reduced and Altered Use of Social Networking Sites— A Randomized Controlled Study
Wolgast, M., Lundberg, K., Palmqvist, E., & Wolgast, S. N. (2023) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2023.42.6.558 · Cited by 7 · see citing works
Effects of an Online Acceptance and Commitment Therapy Intervention on Children’s Quality of Life
Sairanen, E., Lappalainen, R. I., Lappalainen, P., & Hiltunen, A. J. (2022) · Journal of Child and Family Studies · doi:10.1007/s10826-022-02234-z · Cited by 10 · see citing works
Translation and Initial Validation of the Depression Anxiety and Stress Scale (DASS-21) in Ilokano
Bengwasan, P. D., Bernardo, A. B. I., & Maximo, S. I. (2022) · Psychological Studies · doi:10.1007/s12646-022-00696-1 · Cited by 7 · see citing works
Claréus, B., & Daukantaité, D. (2023) · Journal of Clinical Psychology · doi:10.1002/jclp.23533 · Cited by 7 · see citing works
Weiss, N., Skillgate, E., & Axén, I. (2023) · Chiropractic & Manual Therapies · doi:10.1186/s12998-023-00511-2 · Cited by 7 · see citing works
Lian, S.-L., Sun, X., Liu, Q., Chu, X., Zhou, Z., & Lei, Y. (2021) · Current Psychology · doi:10.1007/s12144-021-01512-1 · Cited by 7 · see citing works
Jansson‐Fröjmark, M., & Sunnhed, R. (2024) · Journal of Sleep Research · doi:10.1111/jsr.14363 · Cited by 6 · see citing works
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Gutiérrez-Hernández, M. E., Fanjul, L. F., Díaz, A., Oyanadel, C., & Castro, W. P. (2022) · Social Sciences · doi:10.3390/socsci11040151 · Cited by 6 · see citing works
Buils, R. F., Andrés‐Roqueta, C., & Mateu‐Pérez, R. (2023) · International Journal of Developmental Disabilities · doi:10.1080/20473869.2023.2272402 · Cited by 5 · see citing works
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Eisenberg, K. N., Leiter, E., May, R. T., Reinfeld, T., & Zwas, D. R. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.02135 · Cited by 5 · see citing works
Johansson, F., Côté, P., Hogg‐Johnson, S., Rudman, A., Holm, L. W., Grotle, M., Jensen, I. B., Sundberg, T., Edlund, B., & Skillgate, E. (2021) · doi:10.21203/rs.3.rs-70620/v2 · Cited by 5 · see citing works
Luigi, G. D., Claréus, B., Nihlén, T. M., Malmquist, A., Wurm, M., & Lundberg, T. (2023) · Journal of Homosexuality · doi:10.1080/00918369.2023.2284809 · Cited by 4 · see citing works
Vural, B. K., & Yiğitoğlu, G. T. (2022) · Journal of Basic and Clinical Health Sciences · doi:10.30621/jbachs.871615 · Cited by 4 · see citing works
Johansson, F., Billquist, J., Andreasson, H., Jensen, I. B., Onell, C., Berman, A. H., & Skillgate, E. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-072178 · Cited by 4 · see citing works
Castillo-Díaz, M. A., & Periañez, C. A. H. (2025) · BMC Psychology · doi:10.1186/s40359-025-03742-5 · Cited by 3 · see citing works
Kerstis, B., Jönsson, P., Derwig, M., Nilsson, K. W., Hallström, I., & Lindeberg, S. (2025) · Child: Care, Health and Development · doi:10.1111/cch.70099 · Cited by 3 · see citing works
Um, B., & Bardhoshi, G. (2022) · Measurement and Evaluation in Counseling and Development · doi:10.1080/07481756.2022.2051189 · Cited by 2 · see citing works
Johansson, F., Côté, P., Onell, C., Källberg, H., Sundberg, T., Edlund, B., & Skillgate, E. (2022) · Journal of Sleep Research · doi:10.1111/jsr.13745 · Cited by 3 · see citing works
Behnampour, A., Ebrahimi, S., Bazrafshan, A., Kamyab, A., Pakdin, M., & Ebrahimi, A. (2023) · medRxiv · doi:10.1101/2023.05.20.23290269 · Cited by 3 · see citing works
Wijk, I., Amsberg, S., Johansson, U., Toft, E., Hagquist, C., & Anderbro, T. (2023) · Journal of Nursing Measurement · doi:10.1891/jnm-2022-0071 · Cited by 4 · see citing works
Edlund, B., Nigicser, I., Sansone, M., Identeg, F., Hedelin, H., Forsberg, N., & Tranæus, U. (2023) · BMJ Open · doi:10.1136/bmjopen-2023-074631 · Cited by 2 · see citing works
Lindeberg, S. I., Tedgård, E., Kerstis, B., Tedgård, U., Taylor, A., & Jönsson, P. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-024-01699-x · Cited by 2 · see citing works
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Ebrahimi, S., Bazrafshan, A., Kamyab, A., Pakdin, M., & Ebrahimi, A. (2024) · Iranian Journal of Psychiatry and Behavioral Sciences · doi:10.5812/ijpbs-146570 · Cited by 2 · see citing works
Zekja, I., Kamberi, F., Bruijn, R., Kokuri, T., & Asimakopoulou, E. (2023) · OBM Neurobiology · doi:10.21926/obm.neurobiol.2302166 · Cited by 2 · see citing works
Johansson, F., Côté, P., Hogg‐Johnson, S., Rudman, A., Holm, L. W., Grotle, M., Jensen, I. B., Sundberg, T., Edlund, B., & Skillgate, E. (2020) · doi:10.21203/rs.3.rs-70620/v1 · Cited by 2 · see citing works
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Murad, O. (2022) · Research Square · doi:10.21203/rs.3.rs-1300714/v1 · Cited by 2 · see citing works
Wurm, M., Bergbom, S., Luigi, G. D., Casa, V. D., & Malmquist, A. (2025) · Scandinavian Journal of Psychology · doi:10.1111/sjop.13122 · Cited by 1 · see citing works
Tian, S., Wu, P., Huang, J., Yao, Y., & Pan, Y. (2026) · Cogent Psychology · doi:10.1080/23311908.2026.2631223 · Cited by 1 · see citing works
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Klinteberg, M. A., Seyer, A., & Andersson, N. (2026) · International Journal of STD & AIDS · doi:10.1177/09564624261438901 · Cited by 1 · see citing works
Cano-Ramírez, H., García-Torres, E., & Hoffman, K. L. (2024) · Research Square · doi:10.21203/rs.3.rs-3838241/v1 · Cited by 1 · see citing works
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Alvarenga, M. A. S., Bandeira, P. F. R., 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. (2022) · medRxiv · doi:10.1101/2022.07.29.22274386
Winterling, J., & Wengström, Y. (2022) · Journal of Psychosocial Oncology Research and Practice · doi:10.1097/or9.0000000000000078
Miladinović, P., & Mitić, A. (2022) · Engrami · doi:10.5937/engrami44-36516 · Cited by 1 · see citing works
Li, S. (2022) · Applied & Educational Psychology · doi:10.23977/appep.2022.030303
Sain, S., Dey, I., & Ghosh, S. (2023) · Asian Journal of Medical Sciences · doi:10.3126/ajms.v14i4.49772
The COVID-19 pandemic effect on psychologists’ professional quality of life and mental healthPreprint
Kercher, A., Rahman, J., & Pedersen, M. (2023) · doi:10.31234/osf.io/xfdsc
The COVID-19 pandemic effect on psychologists’ professional quality of life and mental healthPreprint
Kercher, A., Rahman, J., & Pedersen, M. (2023) · Research Square · doi:10.21203/rs.3.rs-3314999/v1
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Onwuegbuzie, A. J., Zapata, S. M., & Manríquez, J. U. (2024) · International Journal of Multiple Research Approaches · doi:10.29034/10.29034/ijmra.v16n2a2
The contribution of residential situations to mental health during COVID-19: A longitudinal survey
de Paredes, P. G., Ghio, S. C., Baron, M., LeBlanc, A., & Després, C. (2025) · Wellbeing Space and Society · doi:10.1016/j.wss.2025.100273
Hoffman, K. L., García‐Torres, E., Basurto, E., & Cano-Ramírez, H. (2025) · Journal of Global Health Neurology and Psychiatry · doi:10.52872/001c.138831
Siljeholm, O., & Hammarberg, A. (2025) · Addiction Science & Clinical Practice · doi:10.1186/s13722-025-00582-x
Weiss, N., Skillgate, E., & Axén, I. (2024) · Figshare · doi:10.6084/m9.figshare.26616985
Bilgaiyan, S., Ghosh, D., Chakraborty, S., Kumar, P. A., Sinha, S., & Parida, C. (2025) · DMIHER International Conference on Artificial Intelligence in Healthcare, Education and Industry (IDICAIHEI) · doi:10.1109/idicaihei65991.2025.11377853
Weiss, N., Axén, I., Hoekstra, T., & Skillgate, E. (2026) · Scientific Reports · doi:10.1038/s41598-026-42074-1
Relationship between athletic coping skills and depression, anxiety, stress among badminton players
Yadava, S., & Chanu, N. D. (2026) · Sustainability and Sports Science Journal · doi:10.55860/jykz1452
Kerstis, B., Jönsson, P., Taylor, A., Nilsson, K. W., Hofvander, B., Rubertsson, C., & Lindeberg, S. I. (2026) · Healthcare · doi:10.3390/healthcare14121636
Nanteza, M., Johansson, F., Lindfors, P., Côté, P., & Skillgate, E. (2026) · BMJ Public Health · doi:10.1136/bmjph-2025-003159
Einarsson, S., Almståhl, A., Gyllensten, H., Sjöström, M., Mårell, L., Björ, O., Marklund, L., Farnebo, L., Laurell, G. F. E., & Ehrsson, Y. T. (2026) · BMC Cancer · doi:10.1186/s12885-026-16865-8
Claréus, B., Klysing, A., Wurm, M., Malmquist, A., & Lundberg, T. (2026) · Journal of Career Assessment · doi:10.1177/10690727261485962
Christidis, N., Lärfars, M., Khattar, P., Markus, D., Canales, G. D. L. T., & Christidis, M. (2026) · BMC Medical Education · doi:10.1186/s12909-026-10445-x
Chen, X., Zhang, W., Hu, C., Yuan, Y., & Gary, J. M. (2026) · Behavioral Sciences · doi:10.3390/bs16091706
Chen, X., Li, Y., Pramukti, I., Ahorsu, D. K., Kukreti, S., Chen, J.-K., Gan, W. Y., Ruckwongpatr, K., Gupta, R., Lin, C.-K., et al. (2026) · PeerJ · doi:10.7717/peerj.21745
Nordlund, L., Lundberg, T., Malmquist, A., & Wurm, M. (2026) · Acta Psychologica · doi:10.1016/j.actpsy.2026.107942
- Authors
- Alfonsson, S., Wallin, E., & Maathz, P.
- Affiliations
- Uppsala University (SE)
- Corresponding author
- Alfonsson, S.
- Venue
- Journal of Psychiatric and Mental Health Nursing
- Publisher
- Wiley
- Published
- 2017-01-25
- Volume
- 24
- Issue
- 2-3
- Pages
- 154-162
- ISSN
- 1351-0126 (ISSN-L)
- 1365-2850
- OpenAlex
- W2582949416
- Cited by
- 98
- References
- 40
- Citations by year
- 2026: 12 · 2025: 9 · 2024: 12 · 2023: 20 · 2022: 22 · 2021: 11 · 2020: 6 · 2019: 3 · 2018: 3
- FWCI
- 4.27
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychiatric and Mental Health Nursing (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, Swedish translation, factor structure, bifactor model, convergent validity, depression, anxiety, stress, psychological distress, self-report measures, mental health screening, primary care, psychotherapy, students, psychiatric nurses, mental health services evaluation, cross-cultural adaptation, psychometric validation
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Anxiety, Depression, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Stress, Psychological, Sweden, Translating, Reproducibility of Results, Young Adult
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