The Depression Anxiety Stress Scale-21: Spanish Translation and Validation with a Hispanic Sample

Abstract

The English-language version of the Depression Anxiety Stress Scale-21 (DASS-21) was professionally translated into Spanish and field-tested among 98 bilingual Hispanic adults. Participants who were diagnosed with an anxiety disorder on the Anxiety Disorders Interview Schedule-IV completed the DASS-21, the Beck Depression Inventory-II, and the Beck Anxiety Inventory. Results indicated strong indices of internal consistency and expected patterns of discriminant, convergent, and structural validity. A confirmatory factor analysis compared a model fit of a first order 1-factor model, a first order 3-factor model, and a second order factor model. The latter 2 models were significantly better than the 1-factor model. Psychometric data were comparable to those of an English version. Clinicians and researchers in need of a brief, Spanish-language, screening measure of general psychopathology may want to consider this newly translated DASS-21.

This is a preview of subscription content, access via your institution.

REFERENCES

  1. 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 version of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176–181.

    Google Scholar 

  2. Arbuckle, J. L. (1997). AMOS users' guide version 3.6. Chicago: Smallwaters Corporation.

    Google Scholar 

  3. Ardila, A. (2000). Testing Hispanic populations. Texas Psychologist, Winter, 25–30.

  4. Barrera, M. (1978). Mexican-American mental health service utilization: A critical examination of some proposed variables. Community Mental Health Journal, 14(1), 35–45.

    Google Scholar 

  5. Beck, A.T., &; Steer, R.A. (1990). Manual for the Beck Anxiety Inventory. San Antonio, TX: Psychological Corporation.

    Google Scholar 

  6. Beck, A. T., Steer, R. A., &; Brown, G. K. (1996). Manual for the revised Beck Depression Inventory. San Antonio, TX: Psychological Corporation.

    Google Scholar 

  7. Bernal, M. E., &; Castro, F. G. (1994). Are clinical psychologists prepared for service and research with ethnic minorities? Report of a decade of progress. American Psychologist, 49, 797–805.

    Google Scholar 

  8. Bonicatto, S., Dew, A. M., &; Soria, J. J. (1998). Analysis of the psychometric properties of the Spanish version of the Beck Depression Inventory in Argentina. Psychiatry Research, 77, 277–285.

    Google Scholar 

  9. Brown, T. A., Chorpita, B. F., &; Barlow, D. H. (1998). Structural relationships among dimensions of the DSM-IV anxiety and mood disorders and dimensions of negative affect, positive affect, and autonomic arousal. Journal of Abnormal Psychology, 107(2), 179–192.

    Google Scholar 

  10. Brown, T. A., Chorpita, B. F., Korotitsch, W., &; Barlow, D. H. (1997). Psychometric properties of the Depression Anxiety Stress Scale (DASS) in clinical samples. Behavior Research and Therapy, 35(1), 79–89.

    Google Scholar 

  11. Brown, T. A., Di Nardo, P. A., &; Barlow, D. H. (1994). Anxiety disorders interview schedule for DSM-IV. Albany, NY: Graywind Publications.

    Google Scholar 

  12. Browne, M. W., &; Cudeck, R. (1992). Alternative ways of assessing model fit. Sociological Methods and Research, 21, 230–258.

    Google Scholar 

  13. Burnam, M. A., Hough, R. L., Karno, M., Escobar, J. I., &; Telles, C. A. (1987). Acculturation and lifetime prevalence of psychiatric disorders among Mexican Americans in Los Angeles. Journal of Health and Social Behavior, 28, 89–102.

    Google Scholar 

  14. Canales, S., Ganz, P. A., &; Coscarelli, C. A. (1995). Translation and validation of a quality of life instrument for Hispanic-American cancer patients: Methodological considerations. Quality of Life Research, 4,3–11.

    Google Scholar 

  15. Chapman, D.W., &; Carter, J. F. (1979). Translation procedures for crosscultural use of measurement instruments. Educational Evaluation and Policy Analysis, 1, 71–76.

    Google Scholar 

  16. Cheung, F. K., &; Snowden, L. R. (1990). Community mental health and ethnic minority populations. Community Mental Health Journal, 26, 277–291.

    Google Scholar 

  17. Clara, I. P., Cox, B. J., &; Enns, M.W. (2001). Confirmatory factor analysis of the Depression-Anxiety-Stress Scale in depressed and anxious patients. Journal of Psychopathology and Behavioral Assessment, 23(1), 61–67.

    Google Scholar 

  18. Di Nardo, P. A., &; Barlow, D. H. (1990). Syndrome and symptom comorbidity in the anxiety disorders. In J. D. Maser &; C. R. Cloninger (Eds.), Comorbidity in anxiety and mood disorders (pp. 205–320). Washington, DC: American University Press.

    Google Scholar 

  19. Di Nardo, P. A., Moras, K., Barlow, D. H., Rapee, R. M., &; Brown, T. A. (1993). Reliability of the DSM-III-R anxiety disorder categories using the Anxiety Disorders Interview Schedule-Revised. Archives of General Psychiatry, 50, 251–256.

    Google Scholar 

  20. Di Nardo, P. A., O'Brien, G. T., Barlow, D. H., Waddell, M. T., &; Blanchard, E. B. (1983). Reliability of the DSM-III anxiety disorder categories using a newstructured interview. Archives of General Psychiatry, 35, 837–844.

    Google Scholar 

  21. Fabrigar, L. R., Wegener, D. T., MacCallum, R. C., &; Strahan, E. J. (1999). Evaluating the use of exploratory factor analysis in psychological research. Psychological Methods, 4(3), 277–299.

    Google Scholar 

  22. Fydrich, T., Dowdall, D., &; Chambless, D. C. (1992). Reliability and validity of the Beck Anxiety Inventory. Journal of Anxiety Disorders, 6, 55–61.

    Google Scholar 

  23. Gatewood-Colwell, G., Kaczmarek, M., &; Ames, M. H. (1989). Reliability and validity of the Beck Depression Inventory for a White and Mexican-American gerontic population. Psychological Reports, 65, 1163–1166.

    Google Scholar 

  24. Ginzberg, E. (1991). Access to health care for Hispanics. JAMA, 265(2), 238–241.

    Google Scholar 

  25. Gorsuch, R. L. (1983). Factor analysis (2nd ed.). Hillsdale, NJ: Erlbaum.

    Google Scholar 

  26. Gotlib, I. H., &; Cane, D. B. (1989). Self-report assessment of depression and anxiety. In P. C. Kendall &; D. Watson (Eds.), Anxiety and depression: Distinctive and overlapping features (pp. 131–169). New York: Academic Press.

    Google Scholar 

  27. Griffith,6J., &; Villavicencio, S. (1985). Relationships among acculturation, sociodemographic characteristics, and social supports in Mexican American adults. Hispanic Journal of Behavioral Sciences, 7(1), 75–92.

    Google Scholar 

  28. Hoppe, S. K., Leon, R. L., &; Realini, J. P. (1998). Depression and anxiety among Mexican Americans in a family health center. Social Psychiatry and Psychiatric Epidemiology, 24, 63–68.

    Google Scholar 

  29. Karno, M., Golding, J. M., Burnam, A., Hough, R. L., Escobar, J., Wells, K. M., et al. (1989). Anxiety disorders among Mexican Americans and non-Hispanic Whites in Los Angeles. Journal of Nervous and Mental Disease, 177(4), 202–209.

    Google Scholar 

  30. Karno, M., Hough, R. L., Burnam, A., Escobar, J., Timbers, S. M., Santana, F., et al. (1987). Lifetime prevalence of specific psychiatric disorders among Mexican Americans and non-Hispanic Whites. General Psychiatry, 44, 695–701.

    Google Scholar 

  31. Kessler, R. C., McGonagle, K. A., Zhao, S., Nelson, C. B., Hughes, M., Eshelman, S., et al. (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Archive of General Psychiatry, 51, 8–19.

    Google Scholar 

  32. Kinzie, J. D., &; Manson, S. M. (1987). The use of self-rating scales in cross-cultural psychiatry. Hospital and Community Psychiatry, 38(2), 190–196.

    Google Scholar 

  33. Lovibond, P. F., &; Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scale (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343.

    Google Scholar 

  34. Lovibond, S. H., &; Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scale. Sydney: The Psychological Foundation of Australia.

    Google Scholar 

  35. Malgady, R. G., &; Constantino, G. (1998). Symptom severity in bilingual Hispanics as a function of clinician's ethnicity and language of Interview. Psychological Assessment, 10, 120–127.

    Google Scholar 

  36. Marcos, L. R., Urcuyo, L., Kesselman, M., &; Alpert, M. (1973). The language barrier in evaluating Spanish-American patients. General Psychiatry, 29, 655–659.

    Google Scholar 

  37. Masten, W. G., Caldwell-Colbert, A. T., Alcala, S. J., &; Mijares, B. E. (1986). Confiabilidad y validez de la escuela de depresi´on del centro de estudios epidemiol´ogicos. Hispanic Journal of Behavioral Sciences, 8(1), 77–84.

    Google Scholar 

  38. Mezzich, J. E., Ruiz, P., &; Muñnoz, R. A. (1999). Mental health care for Hispanic Americans. Cultural Diversity and Ethnic Minority Psychology, 5(2), 91–102.

    Google Scholar 

  39. Novy, D. M., Nelson, D. V., Berry, L. A., &; Averill, P. M. (1995). What does the Beck Depression Inventory measure in chronic pain? A reappraisal. Pain, 61, 261–270.

    Google Scholar 

  40. Novy, D. M., Rintala, D. H., &; Garza, H. (1998). The role of a lay panel in foreign language instrument development. The American Translation Association Chronicle, 17, 25–30.

    Google Scholar 

  41. Novy, D. M., Stanley, M. A., Averill, P. M., &; Daza, P. (2001). Psychometric comparability of English and Spanish-language measures of anxiety and related affective disorders. Psychological Assessment, 13(3), 347–355.

    Google Scholar 

  42. O'sullivan, M. J., &; Lasso, B. (1992). Community mental health services for Hispanics: A test of the culture compatibility hypothesis. Hispanic Journal of Behavioral Sciences, 14, 455–468.

    Google Scholar 

  43. Poma, P. A. (1983). Hispanic cultural influences on medical practice. Journal of the National Medical Association, 75, 941–946.

    Google Scholar 

  44. Quintana, S. M., &; Maxwell, S. E. (1999). Implications of recent developments of structural equation modeling to counseling psychology. The Counseling Psychologist, 27(4), 485–527.

    Google Scholar 

  45. Roberts, R. E. (1981). Prevalence of depressive symptoms among Mexican Americans. Journal of Nervous and Mental Disease, 169(4), 213–219.

    Google Scholar 

  46. Rodriguez, O. (1987). Hispanics and human services: Help-seeking in the inner city. Bronx, NY: Fordham University, Hispanic Research Center.

    Google Scholar 

  47. Rogler, L. H. (1989). The meaning of culturally sensitive research in mental health. American Journal of Psychiatry, 146(3), 296–303.

    Google Scholar 

  48. Rogler, L. H., Cooney, R. S., Constantino, G., Earley, B. F., Grossman, B., Gurak, D. T., et al. (1983). A conceptual framework for mental health research on Hispanic populations (Hispanic Research Center Monograph No. 10). New York: Fordham University, Hispanic Research Center.

    Google Scholar 

  49. Rogler, L. H., Malgady, R. G., Constantino, G., &; Blumenthal, R. (1987). What do culturally sensitive mental health services mean? The case of Hispanic Americans. American Psychologist, 42, 565–570.

    Google Scholar 

  50. Salmán, E., Diamond, K., Jusino, C., Sánchez-LaCay, A., &; Liebowitz, M. R. (1997). Hispanic Americans. In S. Friedman (Ed.), Cultural issues in the treatment of anxiety (pp. 59–80). New York: Guilford.

    Google Scholar 

  51. Secretaria de Educación Pública, Mexico. (1982). Teacher's manual of sixth grade word list. Mexico City, México: Author.

    Google Scholar 

  52. Solis, M. L., &; Abidin, R. R. (1991). The Spanish version Parenting Stress Index: A psychometric study. Journal of Clinical Child Psychology, 20(4), 372–378.

    Google Scholar 

  53. State of California. (1979). Multicultural issues in mental health services: Strategies toward equity. Sacramento, CA: Department of Mental Health, Health and Welfare Agency.

    Google Scholar 

  54. Steer, R. A., Ranieri, W. F., Beck, A. T., &; Clark, D. A. (1993). Further evidence for the validity of the Beck Anxiety Inventory with psychiatric outpatients. Journal of Anxiety Disorders, 7, 195–205.

    Google Scholar 

  55. Suárez-Mendoza, A., Cardiel, M. H., Caballero-Uribe, C. V., Ortega-Soto, H. A., &; Márquez-Marín, M. (1997). Measurement of depression in Mexican patients with rheumatoid arthritis: Validity of the Beck Depression Inventory. Arthritis Care and Research, 10(3), 194–199.

    Google Scholar 

  56. Sue, S., Fujino, D. C., Hu, L., &; Takeuchi, D. T. (1991). Community mental health services for ethnic minority groups: A test of the cultural responsiveness hypothesis. Journal of Consulting and Clinical Psychology, 59, 533–540.

    Google Scholar 

  57. United States Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity-A supplement to the mental health: A report of the Surgeon General. Rockville, MD: Author.

    Google Scholar 

  58. U.S. Census Bureau. (1990). The Hispanic population in the United States: March 1989. Current Population Report (Series P-20, No. 444). Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  59. U.S. Census Bureau. (2001a). Profiles of general demographic characteristics: 2000 Census of Population and Housing, United States. Washington, DC: U.S. Government Printing Office.

    Google Scholar 

  60. U.S. Census Bureau. (2001b). The Hispanic population: Census 2000 briefs. Retrieved December 12, 2001, from http://www.census.gov

  61. Vega, W. A., Kolody, B., Aguilar-Gaxiola, S., Alderete, E., Catalano, R., &; Caraveo-Anduaga, J. (1998). Lifetime prevalence of DSMIII-R psychiatric disorders among urban and rural Mexican Americans in California. Archives of General Psychiatry, 55, 771–778.

    Google Scholar 

  62. Vega, W. A., Kolody, B., Aguilar-Gaxiola, S., &; Catalano, R. (1999). Gaps in service utilization by Mexican Americans with mental health problems. American Journal of Psychiatry, 156, 928–934.

    Google Scholar 

  63. Werner, O., &; Campbell, D. T. (1970). Translating, working through interpreters, and the problem of decentering. In R. Naroll &; R. Cohen (Eds.), A handbook of method in cultural anthropology. New York: American Museum of Natural History.

    Google Scholar 

  64. Williams, S., &; Kohut, J. L. (1999). A survey of licensed practitioners of psychology: Activities, roles, and services. Washington, DC: American Psychological Association.

    Google Scholar 

  65. Woodward, A. M., Dwinell, A. D., &; Arons, B. S. (1992). Barriers to mental health care for Hispanic Americans: A literature review and discussion. The Journal of Mental Health Administration, 19(3), 224–236.

    Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Patricia Daza.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Daza, P., Novy, D.M., Stanley, M.A. et al. The Depression Anxiety Stress Scale-21: Spanish Translation and Validation with a Hispanic Sample. Journal of Psychopathology and Behavioral Assessment 24, 195–205 (2002). https://doi.org/10.1023/A:1016014818163

Download citation

  • anxiety
  • depression
  • stress
  • Spanish
  • assessment