Testing Measurement Invariance of the Depression, Anxiety, and Stress Scales (DASS-21) Across Four Countries

The rising burden of mental and behavioral disorders has become a global challenge (Murray et al., 2012). Measurement invariant clinical instruments are necessary for the assessment of relevant symptoms across countries. The present study tested the measurement invariance of the 21-item version of the Depression, Anxiety, and Stress Scales (DASS; Lovibond & Lovibond, 1995b) in Poland, Russia, the United Kingdom (U.K.), and the United States of America (U.S.). Telephone interviews were conducted with population-based samples (n(PL) = 1003, n(RU) = 3020, n(U.K.) = 1002, n(U.S.) = 1002). The DASS-21 shows threshold measurement invariance. Comparisons of latent means did not indicate differences between U.K. and U.S. samples. However, Polish and Russian samples reported more depressive symptoms compared with U.K. and U.S. samples; the Russian sample had the highest levels of anxiety symptoms and the Polish sample demonstrated the highest stress levels. The DASS-21 can be recommended to meaningfully compare the relationships between variables across groups and to compare latent means in Polish-, Russian-, and English-speaking populations. Public Significance Statement This study underlines the importance to test equivalence and examine potential bias in cross-cultural research frameworks. We successfully tested the cross-cultural applicability of a questionnaire for symptoms of depression, anxiety, and stress and found that the populations in Poland and Russia reported more symptoms of depression, anxiety, and stress than the populations in the U.K. and the U.S.