Skip to main content
Log in

Can adolescents differentiate between depression, anxiety and stress? Testing competing models of the Depression Anxiety Stress Scales (DASS-21)

  • Published:
Current Psychology Aims and scope Submit manuscript

Abstract

The present study used the Exploratory Structural Equation Modeling (ESEM) procedure and a bifactor-ESEM framework to evaluate the construct validity of the Depression Anxiety Stress Scales (DASS-21) among adolescents. We also evaluated measurement invariance and latent mean differences across gender and age, and investigated the convergent validity of DASS-21 by examining relationships with positive and negative affect. A total of 1906 adolescents (60.7% females, Mage = 16.54) completed the DASS-21, whereas 998 adolescents (62.6% females; Mage = 16.98) completed both the DASS-21 and a measure of positive and negative affect. The results showed that the bifactor-ESEM model was the best representation of the data and this model proved to be invariant across gender and age. The findings indicated a strong general factor of emotional distress underlying responses to all DASS-21 items, but also suggested that Depression and Anxiety subscales possess substantial amount of specificity over and above the general factor. The Stress subscale showed little specificity after partialling out the general factor. Depression subscale explained variance of both positive and negative affect over and above the variance already explained by the general factor, whereas the Anxiety and Stress subscales did not. Our findings show that a bifactor-ESEM framework is a valuable tool for examining structural validity of DASS-21.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Angold, A., Costello, E. J., & Erkanli, A. (1999). Comorbidity. Journal of Child Psychology and Psychiatry and Allied Disciplines, 40, 57–87.

    Google Scholar 

  • Anderson, E. R., & Hope, D. A. (2008). A review of the tripartite model for understanding the link between anxiety and depression in youth. Clinical Psychology Review, 28, 275–287.

    PubMed  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.

    Google Scholar 

  • Asparouhov, T., & Muthén, B. O. (2009). Exploratory structural equation modeling. Structural Equation Modeling, 16, 397–438.

    Google Scholar 

  • Barrett, P. (2007). Structural equation modelling: Adjudging model fit. Personality and Individual Differences, 42, 815–824.

    Google Scholar 

  • Brown, T. A. (2015). Confirmatory factor analysis for applied research (2nded.). New York: The Guildford Press.

    Google Scholar 

  • Camacho, A., Cordero, E. D., & Perkins, T. (2016). Psychometric properties of the DASS-21 among Latina/o college students by the US-Mexico border. Journal of Immigrant and Minority Health, 18, 1017–1023.

    PubMed  Google Scholar 

  • Chen, F. F. (2007). Sensitivity of goodness of fit indices to lack of measurement invariance. Structural Equation Modeling, 14, 464–504.

    Google Scholar 

  • Cheung, G. W., & Rensvold, R. B. (2002). Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling, 9, 233–255.

    Google Scholar 

  • Chorpita, B. F. (2002). The tripartite model and dimensions of anxiety and depression: An examination of structure in a large school sample. Journal of Abnormal Child Psychology, 30, 177–190.

    PubMed  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.

    PubMed  Google Scholar 

  • Cole, D. A., Truglio, R., & Peeke, L. G. (1997). Relation between symptoms of anxiety and depression in children: A multitrait-multimethod-multigroup assessment. Journal of Consulting and Clinical Psychology, 65, 110–119.

    PubMed  Google Scholar 

  • Duffy, C. J., Cunningham, E. G., & Moore, S. M. (2005). Brief report: The factor structure of mood states in an early adolescent sample. Journal of Adolescence, 28, 677–680.

    PubMed  Google Scholar 

  • Dumenci, L., & Achenbach, T. M. (2008). Effects of estimation methods on making trait-level inferences from ordered categorical items for assessing psychopathology. Psychological Assessment, 20, 55–62.

    PubMed  Google Scholar 

  • Dyck, M. J., Jolly, J. B., & Kramer, T. (1994). An evaluation of positive affectivity, negative affectivity, and hyperarousal as markers for assessing between syndrome relationships. Personality and Individual Differences, 17, 637–646.

    Google Scholar 

  • Garber, J., & Weersing, V. R. (2010). Comorbidity of anxiety and depression in youth: Implications for treatment and prevention. Clinical Psychology, 17, 293–306.

    PubMed  PubMed Central  Google Scholar 

  • Godfrey, K., Yung, A., Killackey, E., Cosgrave, E., Pan Yuen, H., Stanford, C., et al. (2005). Patterns of current comorbidity in young help-seekers: Implications for service planning and delivery. Australasian Psychiatry, 13, 379–383.

    PubMed  Google Scholar 

  • Gomez, R., Summers, M., Summers, A., Wolf, A., & Summers, J. (2014). Depression anxiety stress Scales-21: Measurement and structural invariance across ratings of men and women. Assessment, 21, 418–426.

    PubMed  Google Scholar 

  • Hankin, B. L., Abramson, L. Y., Moffitt, T. E., Silva, P. A., McGee, R., & Angell, K. E. (1998). Development of depression from preadolescence to young adulthood: Emerging gender differences in a 10-year longitudinal study. Journal of Abnormal Psychology, 107, 128–140.

    PubMed  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 

  • Hranov, L. G. (2007). Comorbid anxiety and depression: Illumination of a controversy. International Journal of Psychiatry in Clinical Practice, 11, 171–189.

    PubMed  Google Scholar 

  • Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.

    Google Scholar 

  • Jolly, J. B., Dick, M. J., Kramer, T. A., & Wherry, J. N. (1994). Integration of positive and negative affectivity and cognitive content-specificity: Improved discrimination of anxious and depressive symptoms. Journal of Abnormal Psychology, 103, 544–552.

    PubMed  Google Scholar 

  • Johnson, A. R., Lawrence, B. J., Corti, E. J., Booth, L., Gasson, N., Thomas, M. G., et al. (2016). Suitability of the depression, anxiety, and stress scale in Parkinson’s disease. Journal of Parkinson’s Disease, 6, 609–616.

    PubMed  Google Scholar 

  • Jovanović, V., & Gavrilov-Jerković, V. (2016). The structure of adolescent affective well-being: The case of the PANAS among Serbian adolescents. Journal of Happiness Studies, 17, 2097–2117.

    Google Scholar 

  • Jovanović, V., Gavrilov-Jerković, V., Žuljević, D., & Brdarić, D. (2014). Psihometrijska evaluacija Skale depresivnosti, anksioznosti i stresa-21 (DASS-21) na uzorku studenata u Srbiji [Psychometric evaluation of the Depression Anxiety Stress Scales-21 (DASS-21) in a Serbian student sample]. Psihologija, 47, 93–112.

  • Julian, L. J. (2011). Measures of anxiety: State-trait anxiety inventory (STAI), Beck anxiety inventory (BAI), and hospital anxiety and depression scale-anxiety (HADS-A). Arthritis Care & Research, 63(S11), S467–S472.

  • Kendler, K. S., Heath, A. C., Martin, N. G., & Eaves, L. J. (1987). Symptoms of anxiety and symptoms of depression: Same genes, different environments? Archives of General Psychiatry, 44, 451–457.

    PubMed  Google Scholar 

  • Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62, 617–627.

    PubMed  PubMed Central  Google Scholar 

  • Lee, J., Lee, E. H., & Moon, S. H. (2019). Systematic review of the measurement properties of the depression anxiety stress scales–21 by applying updated COSMIN methodology. Quality of Life Research, 28, 2325–2339.

    PubMed  Google Scholar 

  • Li, C. H. (2014). The performance of MLR, USLMV, and WLSMV estimation in structural regression models with ordinal variables (unpublished doctoral dissertation). Michigen State University: East Lansing, MI.

  • Lovibond, S. H., & Lovibond, P. F. (1995a). Manual for the depression anxiety stress scales. Sydney: Psychology Foundation.

    Google Scholar 

  • Lovibond, S. H., & Lovibond, P. F. (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.

    PubMed  Google Scholar 

  • Marsh, H. W., Lüdtke, O., Muthén, B., Asparouhov, T., Morin, A. J. S., Trautwein, U., & Nagengast, B. (2010). A new look at the big-five factor structure through exploratory structural equation modeling. Psychological Assessment, 22, 471–491.

    PubMed  Google Scholar 

  • Marsh, H. W., Morin, A. J. S., Parker, P. D., & Kaur, G. (2014). Exploratory structural equation modeling: An integration of the best features of exploratory and confirmatory factor analysis. Annual Review of Clinical Psychology, 10, 85–110.

    PubMed  Google Scholar 

  • Martin, N. G., Jardine, R., Andrews, G., & Heath, A. C. (1988). Anxiety disorders and neuroticism: Are there genetic factors specific to panic? Acta Psychiatrica Scandinavica, 77, 698–706.

    PubMed  Google Scholar 

  • Mellor, D., Vinet, E. V., Xu, X., Mamat, N. H. B., Richardson, B., & Román, F. (2015). Factorial invariance of the DASS-21 among adolescents in four countries. European Journal of Psychological Assessment, 31, 138–142.

    Google Scholar 

  • Millsap, R. E., & Yun-Tein, J. (2004). Assessing factorial invariance in ordered categorical measures. Multivariate Behavioral Research, 39, 479–515.

    Google Scholar 

  • Mineka, S., Watson, D., & Clark, L. A. (1998). Comorbidity of anxiety and unipolar mood disorders. Annual Review of Psychology, 49, 377–412.

    PubMed  Google Scholar 

  • Moore, S. A., Dowdy, E., & Furlong, M. J. (2017). Using the depression, anxiety, stress scales–21 with US adolescents: An alternate models analysis. Journal of Psychoeducational Assessment, 35, 581–598.

    Google Scholar 

  • Morin, A. J. S., Marsh, H. W., & Nagengast, B. (2013). Exploratory structural equation modeling. In G. R. Hancock & R. O. Mueller (Eds.), Structural equation modeling: A second course (2nd ed., pp. 395–436). Charlotte, NC: Information Age Publishing.

    Google Scholar 

  • Morin, A. J. S., Arens, A. K., & Marsh, H. W. (2016a). A bifactor exploratory structural equation modeling framework for the identification of distinct sources of construct-relevant psychometric multidimensionality. Structural Equation Modeling, 23, 116–139.

    Google Scholar 

  • Morin, A. J., Arens, A. K., Tran, A., & Caci, H. (2016b). Exploring sources of construct-relevant multidimensionality in psychiatric measurement: A tutorial and illustration using the composite scale of Morningness. International Journal of Methods in Psychiatric Research, 25, 277–288.

    PubMed  Google Scholar 

  • Murray, A. L., & Johnson, W. (2013). The limitations of model fit in comparing the bi-factor versus higher-order models of human cognitive ability structure. Intelligence, 41, 407–422.

    Google Scholar 

  • Muthén, B. O., & Christoffersson, A. (1981). Simultaneous factor analysis of dichotomous variables in several groups. Psychometrika, 46, 407–419.

    Google Scholar 

  • Muthén, L. K., & Muthén, B. (2012). Mplus user’s guide (7th ed.). Los Angeles, CA: Muthén & Muthén.

    Google Scholar 

  • Norman, G. (2010). Likert scales, levels of measurement and the “laws” of statistics. Advances in Health Sciences Education, 15, 625–632.

    PubMed  Google Scholar 

  • Norton, P. (2007). Depression anxiety and stress scales (DASS-21): Psychometric analysis across four racial groups. Anxiety, Stress & Coping: An International Journal, 20, 253–265.

    Google Scholar 

  • Oei, T. P. S., Sawang, S., Wah Goh, Y., & Mukhtar, F. (2013). Using the depression anxiety stress scale 21 (DASS-21) across cultures. International Journal of Psychology, 48, 1018–1029.

    PubMed  Google Scholar 

  • Osman, A., Wong, J. L., Bagge, C. L., Freedenthal, S., Gutierrez, P. M., & Lozano, G. (2012). The depression anxiety stress Scale-21 (DASS-21): Further examination of dimensions, scale reliability, and correlates. Journal of Clinical Psychology, 68, 1322–1338.

    PubMed  Google Scholar 

  • Patrick, J., Dyck, M., & Bramston, P. (2010). Depression anxiety stress scale: Is it valid for children and adolescents? Journal of Clinical Psychology, 66, 996–1007.

    PubMed  Google Scholar 

  • Perry, J. L., Nicholls, A. R., Clough, P. J., & Crust, L. (2015). Assessing model fit: Caveats and recommendations for confirmatory factor analysis and exploratory structural equation modeling. Measurement in Physical Education and Exercise Science, 19, 12–21.

    Google Scholar 

  • Price, M., Higa-McMillan, C., Ebesutani, C., Okamura, K., Nakamura, B. J., Chorpita, B. F., & Weisz, J. (2013). Symptom differentiation of anxiety and depression across youth development and clinic-referred/nonreferred samples: An examination of competing factor structures of the child behavior checklist DSM-oriented scales. Development and Psychopathology, 25, 1005–1015.

    PubMed  Google Scholar 

  • Reise, S. P. (2012). The rediscovery of bifactor measurement models. Multivariate Behavioral Research, 47, 667–696.

    PubMed  PubMed Central  Google Scholar 

  • Sass, D. (2011). Testing measurement invariance and comparing latent factor means with a confirmatory factor analysis framework. Journal of Psychoeducational Assessment, 29, 347–363.

    Google Scholar 

  • Schmitt, N., & Kuljanin, G. (2008). Measurement invariance: Review of practice and implications. Human Resource Management Review, 18, 210–222.

    Google Scholar 

  • Shankman, S. A., & Klein, D. N. (2003). The relation between depression and anxiety: An evaluation of the tripartite, approachwithdrawal and valence-arousal models. Clinical Psychology Review, 23, 605–637.

    PubMed  Google Scholar 

  • Shaw, T., Campbell, M. A., Runions, K. C., & Zubrick, S. R. (2017). Properties of the DASS-21 in an Australian community adolescent population. Journal of Clinical Psychology, 73, 879–892.

    PubMed  Google Scholar 

  • Silk, J. S., Shaw, D. S., Forbes, E. E., Lane, T. L., & Kovacs, M. (2006). Maternal depression and child internalizing: The moderating role of child emotion regulation. Journal of Clinical Child and Adolescent Psychology, 35, 116–126.

    PubMed  Google Scholar 

  • Sinclair, S. J., Siefert, C. J., Slavin-Mulford, J. M., Stein, M. B., Renna, M., & Blais, M. A. (2012). Psychometric evaluation and normative data for the depression, anxiety, and stress scales-21 (DASS-21) in a nonclinical sample of U.S. adults. Evaluation and the Health Professions, 35, 259–279.

    PubMed  Google Scholar 

  • Sloman, L., Farvolden, P., Gilbert, P., & Price, J. (2006). The interactive functioning of anxiety and depression in agonistic encounters and reconciliation. Journal of Affective Disorders, 90, 93–99.

    PubMed  Google Scholar 

  • Steinberg, L. (2005). Cognitive and affective development in adolescence. Trends in Cognitive Sciences, 9, 69–74.

    PubMed  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.

    PubMed  Google Scholar 

  • Szabó, M., & Lovibond, P. (2006). Anxiety, depression, and tension/stress in children. Journal of Psychopathology and Behavioral Assessment, 28, 195–205.

    Google Scholar 

  • Tellegen, A. (1985). Structures of mood and personality and their relevance to assessing anxiety, with an emphasis on self-report. In A. H. Tuma & J. D. Master (Eds.), Anxiety and the anxiety disorders (pp. 681–706). Hillsdale, NJ: Erlbaum.

    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.

    PubMed  Google Scholar 

  • Turner, C. M., & Barrett, P. M. (2003). Does age play a role in the structure of anxiety and depression in children and youths? An investigation of the tripartite model in three age cohorts. Journal of Consulting and Clinical Psychology, 71, 826–833.

    PubMed  Google Scholar 

  • Watson, D. (2005). Rethinking the mood and anxiety disorders: A quantitative hierarchical model for DSM-IV. Journal of Abnormal Psychology, 114, 522–536.

    PubMed  Google Scholar 

  • Watson, D., & Clark, L. A. (1984). Negative affectivity: The disposition to experience aversive emotional states. Psychological Bulletin, 96, 465–490.

    PubMed  Google Scholar 

  • Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.

    PubMed  Google Scholar 

  • Watson, D., & Tellegen, A. (1985). Toward a consensual structure of mood. Psychological Bulletin, 98, 219–235.

    PubMed  Google Scholar 

  • Willemsen, J., Markey, S., Declercq, F., & Vanheule, S. (2011). Negative emotionality in a large community sample of adolescents: The factor structure and measurement invariance of the short version of the depression anxiety stress scales (DASS-21). Stress and Health, 27, e120–e128.

    Google Scholar 

Download references

Acknowledgements

This work was supported by the Ministry of Education, Science and Technological Development of the Republic of Serbia (Grant No. 179006).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Veljko Jovanović.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jovanović, V., Gavrilov-Jerković, V. & Lazić, M. Can adolescents differentiate between depression, anxiety and stress? Testing competing models of the Depression Anxiety Stress Scales (DASS-21). Curr Psychol 40, 6045–6056 (2021). https://doi.org/10.1007/s12144-019-00540-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12144-019-00540-2

Keywords

Navigation