Reliability, convergent validity and factor structure of the DASS-21 in a sample of Vietnamese adolescents

PLoS One. 2017 Jul 19;12(7):e0180557. doi: 10.1371/journal.pone.0180557. eCollection 2017.

Abstract

Objectives: To assess the internal consistency, latent structure and convergent validity of the Depression, Anxiety and Stress Scale-21 (DASS-21) among adolescents in Vietnam.

Method: An anonymous, self-completed questionnaire was conducted among 1,745 high school students in Hanoi, Vietnam between October, 2013 and January, 2014. Confirmatory factor analyses were performed to assess the latent structure of the DASS-21. Factorial invariance between girls and boys was examined. Cronbach alphas and correlation coefficients between DASS-21 factor scores and the domain scores of the Duke Health Profile Adolescent Vietnamese validated version (ADHP-V) were calculated to assess DASS-21 internal consistency and convergent validity.

Results: A total of 1,606/ 1,745 (92.6%) students returned the questionnaire. Of those, 1,387 students provided complete DASS-21 data. The scale demonstrated adequate internal consistency (Cronbach α: 0.761 to 0.906). A four-factor model showed the best fit to the data. Items loaded significantly on a common general distress factor, the depression, and the anxiety factors, but few on the stress factor (p<0.05). DASS-21 convergent validity was confirmed with moderate correlation coefficients (-0.47 to -0.66) between its factor scores and the ADHP-V mental health related domains.

Conclusions: The DASS-21 is reliable and suitable for use to assess symptoms of common mental health problems, especially depression and anxiety among Vietnamese adolescents. However, its ability in detecting stress among these adolescents may be limited. Further research is warrant to explore these results.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Anxiety Disorders / diagnosis*
  • Depression / diagnosis*
  • Depressive Disorder / diagnosis*
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Psychiatric Status Rating Scales*
  • Psychometrics
  • Reproducibility of Results
  • Stress, Psychological / diagnosis*
  • Surveys and Questionnaires
  • Vietnam

Grants and funding

This study was supported by a Monash International Postgraduate Research Scholarship and a Monash Graduate Scholarship from Monash University and a Scholarship for International Students from Graduate Women Victoria to ML. JF is supported by a Monash Professorial Fellowship and the Jean Hailes Professorial Fellowship, which receives funding from the L and H Hecht Trust managed by Perpetual Trustees. The funders, however, did not have any role in study design, data collection, data analyses, interpretation of the results and decision to submit the paper for publication.