Application of DASS-21 in Chinese students: invariance testing and network analysis

• Published in: BMC public health 2024-10, Vol.24 (1), p.2934-11, Article 2934
• Main Authors: Zhang, Zheng, Lin, Ruoheng, Qiu, Andi, Wu, Huifeng, Wu, Shuo, Zhang, Le, Wu, Zijun, Li, Mengna, Zhang, Xiangbin, Zhou, Jiansong
• Format: Article
• Language: English
• Subjects: Academic achievement; Adolescent; Adult; Analysis; Anxiety; Anxiety - psychology; Asian students; China; Cluster analysis; Data collection; Depression; Depression - diagnosis; Depression - psychology; Discriminant analysis; East Asian People; Education; Educational attainment; Factor analysis; Factor Analysis, Statistical; Female; Health aspects; Humans; Invariance; Male; Mental depression; Mental health; Network analysis; Pattern analysis; Physiology; Psychiatric Status Rating Scales; Psychological aspects; Psychological factors; Psychological tests; Psychometrics; Public health; Quality control; Quantitative psychology; Questionnaires; Research methodology; Social aspects; Stress; Stress (Psychology); Stress, Psychological - psychology; Students; Students - psychology; Students - statistics & numerical data; University students; Variables; Well being; Young Adult
• ISSN: 1471-2458; 1471-2458
• DOI: 10.1186/s12889-024-20123-6

The Depression Anxiety Stress Scale-21 Items (DASS-21) is commonly used to assess the mental health of students, but there is a need for further clarification regarding its equivalence, structure, and core items. We conducted a confirmatory factor analysis (CFA) on a sample of 7943 Chinese students to examine the performance of the DASS-21 and assess measurement invariance. Additionally, we utilized network analysis to investigate the structure and centrality of students' mental health. Our findings revealed a stable three-factor structure for the DASS-21, characterized by high correlations among depression, anxiety, and stress. The DASS-21 demonstrated strict invariance across genders and weak invariance across levels of education. Network analysis indicated that symptoms of depression, anxiety, and stress form clusters, with some symptoms exhibiting strong correlations with each other. Our study highlights a substantial interrelation among depression, anxiety, and stress, revealing a structurally clustered pattern. Network analysis underscores the interconnectedness and centrality of these symptoms, recommending a shorter version of the DASS, and emphasizing the imperative for targeted interventions aimed at improving the psychological well-being of students.