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Factor Structure and Reliability of the Depression, Anxiety and Stress Scales in a Large Portuguese Community Sample

Published online by Cambridge University Press:  07 June 2013

José Vasconcelos-Raposo ,
Helder Miguel Fernandes  and
Carla M. Teixeira
José Vasconcelos-Raposo
Affiliation:
Universidade de Trás-os-Montes e Alto Douro (Portugal)
Helder Miguel Fernandes*
Affiliation:
Universidade de Trás-os-Montes e Alto Douro (Portugal)
Carla M. Teixeira
Affiliation:
Universidade de Trás-os-Montes e Alto Douro (Portugal)
*
*Correspondence concerning this article should be addressed to Helder Miguel Fernandes. Centro de Investigação em Desporto, Saúde e Desenvolvimento Humano, Universidade de Trás-os-Montes e Alto Douro. Rua Dr. Manuel Cardona, 5000-558 Vila Real (Portugal). Phone: +351-259330100. Fax: +351-259330167. E-mail: hmfernandes@gmail.com.
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Abstract

The purpose of the present study was to assess the factor structure and reliability of the Depression, Anxiety and Stress Scales (DASS-21) in a large Portuguese community sample. Participants were 1020 adults (585 women and 435 men), with a mean age of 36.74 (SD = 11.90) years. All scales revealed good reliability, with Cronbach’s alpha values between .80 (anxiety) and .84 (depression). The internal consistency of the total score was .92. Confirmatory factor analysis revealed that the best-fitting model (*CFI = .940, *RMSEA = .038) consisted of a latent component of general psychological distress (or negative affectivity) plus orthogonal depression, anxiety and stress factors. The Portuguese version of the DASS-21 showed good psychometric properties (factorial validity and reliability) and thus can be used as a reliable and valid instrument for measuring depression, anxiety and stress symptoms.

Keywords

depressionanxietystressDASS-21
Type
Research Article
Information
The Spanish Journal of Psychology , Volume 16 , 2013 , E10
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2013 

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Footnotes

The authors would like to thank the three anonymous reviewers for their valuable comments and suggestions on the manuscript.

References

Abell, N., Springer, D. W., & Kamata, A. (2009). Developing and validating rapid assessment instruments. New York, NY: Oxford University Press.CrossRefGoogle Scholar
Antony, M. M., & Swinson, R.P. (1996). Anxiety disorders: Future directions for research and treatment: A discussion paper. Ottawa, Canada: Health Canada.Google Scholar
Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-Item and 21-Item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10, 176–181. http://dx.doi.org/10.1037/1040-3590.10.2.176 CrossRefGoogle Scholar
Apóstolo, J. L. A., Mendes, A. C., & Azeredo, Z. A. (2006). Adaptação para a língua portuguesa da Depression, Anxiety and Stresse Scales (DASS) [Adaptation to Portuguese of the Depression, Anxiety and Stress Scales (DASS)]. Revista Latino-Americana de Enfermagem, 14, 863–871. http://dx.doi.org/10.1590/S0104-11692006000600006 Google Scholar
Apóstolo, J. L. A., Mendes, A. C., & Rodrigues, M. A. (2007). Propriedades psicométricas da Escala de Depressão, Ansiedade e Stresse (DASS-21), numa amostra não clínica [Psychometric properties of the Depression, Anxiety and Stress Scales (DASS), in a non-clinical sample]. Revista Investigação em Enfermagem, 15, 66–76.Google Scholar
Apóstolo, J. L. A., Rodrigues, M. A., & Oliveira, J. P. (2007). Evaluacion de los estados emocionales de estudiantes de enfermería [Assessment of the nursing students’ emotional states]. Index de Enfermeria, 56, 26–29.Google Scholar
Apóstolo, J., Ventura, A., Caetano, C., & Costa, S. (2009). Depressão, ansiedade e stresse em utentes de cuidados de saúde primários [Depression, anxiety and stress in primary care settings]. Revista Referência, 2(8), 45–49.Google Scholar
Bados, A., Solanas, A., & Andrés, R. (2005). Psychometric properties of the Spanish version of Depression, Anxiety and Stress Scales (DASS). Psicothema, 17, 679–683.Google Scholar
Beck, R., & Perkins, T. S. (2001). Cognitive content-specificity for anxiety and depression: A meta-analysis. Cognitive Therapy and Research, 25, 651–663. http://dx.doi.org/10.1023/A:1012911104891 Google Scholar
Bentler, P. M. (1990). Comparative fit indices in structural models. Psychological Bulletin, 107, 238–246. http://dx.doi.org/10.1037/0033-2909.107.2.238 Google Scholar
Bollen, K. A. (1989). Structural equations with latent variables. New York, NY: Wiley.Google Scholar
Brown, T. A., Chorpita, B. F., Korotitsch, W., & Barlow, D. H. (1997). Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behaviour Research and Therapy, 35, 79–89. http://dx.doi.org/10.1016/S0005-7967(96)00068-X Google Scholar
Browne, M. W., & Cudek, R. (1993). Alternate ways of assessing model fit. In Bollen, K. A. & Long, J. S. (Eds.), Testing structural equation models (pp. 136–162). Newbury Park, CA: Sage.Google Scholar
Bhugra, D. (2004). Migration and mental health. Acta Psychiatrica Scandinavica, 109, 243–258. http://dx.doi.org/10.1046/j.0001-690X.2003.00246.x CrossRefGoogle ScholarPubMed
Caldas de Almeida, J. (2010). Estudo epidemiológico nacional de saúde mental [National epidemiological study of mental health] . Lisboa, Portugal: Faculdade de Ciências Médicas.Google Scholar
Clara, I. P., Cox, B. J., & Enns, M. W. (2001). Confirmatory factor analysis of the Depression Anxiety Stress Scales in depressed and anxious patients. Journal of Psychopathology and Behavioral Assessment, 23, 61–67. http://dx.doi.org/10.1023/A:1011095624717 Google Scholar
Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100, 316–336. http://dx.doi.org/10.1037//0021-843X.100.3.316 Google Scholar
Crawford, J. R., & Henry, J. D. (2003). The Depression Anxiety Stress Scales (DASS): Normative data and latent structure in a large non-clinical sample. British Journal of Clinical Psychology, 42, 111–131. http://dx.doi.org/10.1348/014466503321903544 CrossRefGoogle Scholar
Crawford, J. R., & Henry, J. D. (2004). The Positive and Negative Affect Schedule (PANAS): Construct validity, measurement properties and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 43, 245–265. http://dx.doi.org/10.1348/0144665031752934 Google Scholar
Crawford, J. R., Cayley, C., Wilson, P. H., Lovibond, P. F., & Hartley, C. (2011). Percentile norms and accompanying interval estimates for self report mood scales (BAI, BDI, CRSD, CES-D, DASS, DASS-21, STAI-X, STAI-Y, SRDS, and SRAS). Australian Psychologist, 46, 3–14. http://dx.doi.org/10.1111/j.1742-9544.2010.00003.x CrossRefGoogle Scholar
Crawford, J. R., Garthwaite, P. H., & Slick, D. J. (2009). On percentile norms in neuropsychology: Proposed reporting standards and methods for quantifying the uncertainty over the percentile ranks of test scores. The Clinical Neuropsychologist, 23, 1173–1195. http://dx.doi.org/10.1080/13854040902795018 CrossRefGoogle ScholarPubMed
Crawford, J. R., Garthwaite, P. H., Lawrie, C. J., Henry, J. D., MacDonald, M. A., Sutherland, J., & Sinha, P. (2009). A convenient method of obtaining percentile norms and accompanying interval estimates for self-report mood scales (DASS, DASS-21, HADS, PANAS, and sAD). British Journal of Clinical Psychology, 48, 163–180. http://dx.doi.org/10.1348/014466508X377757 Google Scholar
Curran, P. J., West, S. G., & Finch, J. F. (1996). The robustness of test statistics to nonnormality and specification error in confirmatory factor analysis. Psychological Methods, 1, 16–29. http://dx.doi.org/10.1037//1082-989X.1.1.16 Google Scholar
Daza, P., Novy, D. M., Stanley, M. A., & Averill, P. (2002). The Depression Anxiety Stress Scale-21: Spanish translation and validation with a Hispanic sample. Journal of Psychopathology and Behavioral Assessment, 24, 195–205. http://dx.doi.org/10.1023/A:1016014818163 Google Scholar
Duffy, C. J., Cunningham, E. G., & Moore, S. M. (2005). The factor structure of mood states in an early adolescent sample. Journal of Adolescence, 28, 677–680. http://dx.doi.org/10.1016/j.adolescence.2005.08.013 Google Scholar
Eurobarometer (2007). Health in the European Union, special Eurobarometer (Wave 66.2). Retrieved from http://ec.europa.eu/health/ph_publication/eb_health_en.pdf Google Scholar
Fawcett, J., Cameron, R. P., & Schatzberg, A. F. (2010). Mixed anxiety-depressive disorder: An undiagnosed and undertreated severity spectrum? In Stein, D. J., Hollander, E., & Rothbaum, B. O. (Eds.), Textbook of anxiety disorders (2 nd Ed., pp. 241–257). Washington, DC: American Psychiatric Press, Inc.Google Scholar
Good, B. J., & Kleinman, A. M. (1985). Culture and anxiety: Cross-cultural evidence for the patterning of anxiety disorders. In Tuma, A. H., & Maser, J. D. (Eds.), Anxiety and anxiety disorders (pp. 297–323). Hillsdale, NJ: Erlbaum.Google Scholar
Gwynn, R. C., McQuistion, H. L., McVeigh, K. H., Garg, R. K., Frieden, T. R., & Thorpe, L. E. (2008). Prevalence, diagnosis, and treatment of depression and generalized anxiety disorder in a diverse urban community. Psychiatric Services, 59, 641–647. http://dx.doi.org/10.1176/appi.ps.59.6.641 Google Scholar
Henry, J. D., & Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44, 227–239.Google Scholar
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modelling, 6(1), 1–55. http://dx.doi.org/10.1080/10705519909540118 Google Scholar
Kline, R. B. (2010). Principles and practice of structural equation modelling ( 3 rd Ed.). New York, NY: The Guilford Press.Google Scholar
Lovibond, P. F. (1998). Long-term stability of depression, anxiety, and stress syndromes. Journal of Abnormal Psychology, 107, 520–526. http://dx.doi.org/10.1037//0021-843X.107.3.520 Google Scholar
Lovibond, S. H., & Lovibond, P. F. (1995a). Manual for the Depression Anxiety Stress Scales. Sydney, Australia: Psychology Foundation.Google Scholar
Lovibond, P. F., & Lovibond, S. H. (1995b). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33, 335–343. http://dx.doi.org/10.1016/0005-7967(94)00075-U Google Scholar
Lu, A., Bond, M. H., Friedman, M., & Chan, C. (2010). Understanding cultural influences on depression by analyzing a measure of its constituent symptoms. International Journal of Psychological Studies, 2, 55–70.Google Scholar
Ng, F., Trauer, T., Dodd, S., Callaly, T., Campbell, S., & Berk, M. (2007). The validity of the 21-item version of the Depression Anxiety Stress Scales (DASS-21) as a routine clinical outcome measure. Acta Neuropsychiatrica, 19, 304–310. http://dx.doi.org/10.1111/j.1601-5215.2007.00217.x Google Scholar
Norton, P. J. (2007). Depression Anxiety and Stress Scales (DASS-21): Psychometric analysis across four racial groups. Anxiety, Stress, and Coping, 20, 253–265. http://dx.doi.org/10.1080/10615800701309279 Google Scholar
Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory ( 3 rd Ed.). New York, NY: McGraw-Hill.Google Scholar
Page, A. C., Hooke, G. R., & Morrison, D. L. (2007). Psychometric properties of the Depression Anxiety Stress Scales (DASS) in depressed clinical samples. British Journal of Clinical Psychology, 46, 283–297.Google Scholar
Pais-Ribeiro, J., Honrado, A., & Leal, I. (2004a). Contribuição para o estudo da adaptação portuguesa das Escalas de Depressão Ansiedade Stress de Lovibond e Lovibond [Contribution to the adaptation study of the Lovibond and Lovibond Depression, Anxiety, Stress Scales to the Portuguese population]. Psychologica, 36,235–246.Google Scholar
Pais-Ribeiro, J., Honrado, A., & Leal, I. (2004b). Contribuição para o estudo da adaptação portuguesa das Escalas de Ansiedade, Depressão e Stress (EADS) de 21 itens de Lovibond e Lovibond [Contribution for the study of the Anxiety and Depression Stress Scales of Lovibond and Lovibond, version of 21 items]. Psicologia, Saúde & Doenças, 5, 229–239.Google Scholar
Satorra, A., & Bentler, P. M. (1994). Corrections to test statistics and standard errors in covariance structure analysis. In von Eye, A. & Clogg, C. C. (Eds.), Latent variables analysis: Applications for developmental research (pp. 399–419). Thousand Oaks, CA: Sage.Google Scholar
Satorra, A., & Bentler, P. M. (2001). A scaled difference chi-square test statistic for moment structure analysis. Psychometrika, 66, 507–514. http://dx.doi.org/10.1007/BF02296192 Google Scholar
Schumacker, R. E., & Lomax, R. G. (2004). A beginner’s guide to structural equation modeling (2 nd Ed.). Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
Selye, H. (1974). Stress without distress. Philadelphia: J. B. Lippincott.Google Scholar
Szabó, M. (2010). The short version of the Depression Anxiety Stress Scales (DASS-21): Factor structure in a young adolescent sample. Journal of Adolescence, 33, 1–8. http://dx.doi.org/10.1016/j.adolescence.2009.05.014 Google Scholar
Tully, P. J., Zajac, I. T., & Venning, A. J. (2009). The structure of anxiety and depression in a normative sample of younger and older Australian adolescents. Journal of Abnormal Child Psychology, 37, 717–726. http://dx.doi.org/10.1007/s10802-009-9306-4 Google Scholar
Watson, D., Weber, K., Assenheimer, J. S., Clark, L. A., Strauss, M. E., & McCormick, R. A. (1995). Testing a tripartite model: I. Evaluating the convergent and discriminant validity of Anxiety and Depression Symptom Scales. Journal of Abnormal Psychology, 104, 3–14. http://dx.doi.org/10.1037//0021-843X.104.1.3 Google Scholar
WHO International Consortium in Psychiatric Epidemiology (2000). Cross-national comparisons of the prevalences and correlates of mental disorders. Bulletin of the World Health Organization, 78, 413–426.Google Scholar
Widiger, T. A., & Coker, L. A. (2003). Mental disorders as discrete clinical conditions: Dimensional versus categorical classification. In Hersen, M. & Turner, S. M. (Eds.), Adult psychopathology and diagnosis (4 th Ed., pp. 3–35). New York, NY: John Wiley & Sons.Google Scholar