Factor structure of the Depression, Anxiety and Stress Scale among caregivers in Southeastern Europe

Objective: This study aimed to evaluate the factor structure of the Depression Anxiety and Stress Scale (DASS-21) among caregivers of young children in Southeastern Europe. Background: The DASS-21 is a widely used measure in prevention and intervention research with families. Studies regarding the scale's psychometric properties among caregivers, particularly from non-Western countries, are limited and additional research is required. Method: The DASS-21 was administered to N = 835 primary caregivers from North Macedonia, the Republic of Moldova, and Romania. Competing models were tested with confirmatory factor analysis (CFA). Measurement invariance was assessed using multigroup CFA (MGCFA). Bifactor dimensionality and reliability indices were used to evaluate the validity of the composite and subscale scores. Results: A tripartite bifactor model with two specific factors (depression and anxiety) and one general factor (negative affectivity) represented the data well. This model showed cross-country configural and partial metric invariance. Dimensionality and reliability indices supported a unidimensional interpretation of the measure, with the general negative affectivity factor accounting for a substantial share of the variance (82%) compared to the specific factors of depression (10%) and anxiety (8%). Conclusion: The tripartite model best represented the data. Configural and partial metric invariance were verified for this model. Dimensionality and reliability indices, however, indicate that the DASS-21 functions best as a general measure of negative affectivity.