Examining the Dimensionality, Reliability, and Invariance of the Depression, Anxiety, and Stress Scale–21 (DASS-21) Across Eight Countries

© The Author(s) 2020. This study evaluated the dimensionality, invariance, and reliability of the Depression, Anxiety, and Stress Scale–21 (DASS-21) within and across Brazil, Canada, Hong Kong, Romania, Taiwan, Turkey, United Arab Emirates, and the United States (N = 2,580) in college student samples. We used confirmatory factor analyses to compare the fit of four different factor structures of the DASS-21: a unidimensional model, a three-correlated-factors model, a higher order model, and a bifactor model. The bifactor model, with three specific factors (depression, anxiety, and stress) and one general factor (general distress), presented the best fit within each country. We also calculated ancillary bifactor indices of model-based dimensionality of the DASS-21 and model-based reliability to further examine the validity of the composite total and subscale scores and the use of unidimensional modeling. Results suggested the DASS-21 can be used as a unidimensional scale. Finally, measurement invariance of the best fitting model was tested across countries indicating configural invariance. The traditional three-correlated-factors model presented scalar invariance across Canada, Hong Kong, Romania, Taiwan, and the United States. Overall, these analyses indicate that the DASS-21 would best be used as a general score of distress rather than three separate factors of depression, anxiety, and stress, in the countries studied

Cross-Cultural Validation of the Perceptions of Stigmatization by Others for Seeking Help (PSOSH) Scale

Social network stigma refers to the perceived negative views about seeking help for mental health problems that are held by those closest to an individual, such as family and friends. This form of stigma predicts help-seeking attitudes and intentions beyond other forms of stigma, and is predominantly measured using the Perceptions of Stigmatization by Others for Seeking Help scale (PSOSH; Vogel, Wade, & Ascheman, 2009). However, the PSOSH was normed using samples from the United States and, until the cross-cultural validity of this measure is established, it cannot reliably be used within other countries (Miller & Sheu, 2008). As such, the current study (N = 3,440) examined the cross-cultural measurement invariance of the PSOSH using the sequential constraint imposition approach across 11 countries/regions: Australia, Brazil, Canada, Hong Kong, Portugal, Romania, Taiwan, Turkey, the United Arab Emirates (UAE), the United Kingdom (U.K.), and the United States (U.S.). Overall, findings indicate that the PSOSH measures a meaningful construct (i.e., configural and metric invariance) across the 11 countries/regions and that future cross-cultural research could use the PSOSH to examine relationships between social network stigma and other variables. Scalar invariance results also supported the examination of mean differences in Australia, Brazil, Canada, Portugal, Turkey, the U.K., and the U.S., but not in Hong Kong, Romania, Taiwan, and UAE. Implications for future cross-cultural research are discussed

Stigma of Seeking Psychological Services: Examining College Students Across Ten Countries/Regions

© Division of Counseling Psychology of the American Psychological Association. Stigma is an important barrier to seeking psychological services worldwide. Two types of stigma exist: public stigma and self-stigma. Scholars have argued that public stigma leads to self-stigma, and then self-stigma is the primary predictor of attitudes toward seeking psychological services. However, this assertion is largely limited to U.S. samples. The goal of this research was to provide a first step in understanding the relationship between public stigma, self-stigma, and attitudes toward seeking psychological services in international contexts (N = 3,276; Australia, Brazil, Canada, Hong Kong, Portugal, Romania, Taiwan, Turkey, United Arab Emirates, and United States). Using structural equation modeling, we found that self-stigma mediated the relationship between public stigma and attitudes toward seeking services among college students in each country and region. However, differences in path strengths emphasize the need to pay attention to the role of public and self-stigma on attitudes toward seeking psychological services throughout the world

Cross-Cultural Validation of the Perceptions of Stigmatization by Others for Seeking Help (PSOSH) Scale.

Social network stigma refers to the perceived negative views about seeking help for mental health problems that are held by those closest to an individual, such as family and friends. This form of stigma predicts help-seeking attitudes and intentions beyond other forms of stigma, and is predominantly measured using the Perceptions of Stigmatization by Others for Seeking Help scale (PSOSH; Vogel, Wade, & Ascheman, 2009). However, the PSOSH was normed using samples from the United States and, until the cross-cultural validity of this measure is established, it cannot reliably be used within other countries (Miller & Sheu, 2008). As such, the current study (N = 3,440) examined the cross-cultural measurement invariance of the PSOSH using the sequential constraint imposition approach across 11 countries/regions: Australia, Brazil, Canada, Hong Kong, Portugal, Romania, Taiwan, Turkey, the United Arab Emirates (UAE), the United Kingdom (U.K.), and the United States (U.S.). Overall, findings indicate that the PSOSH measures a meaningful construct (i.e., configural and metric invariance) across the 11 countries/regions and that future cross-cultural research could use the PSOSH to examine relationships between social network stigma and other variables. Scalar invariance results also supported the examination of mean differences in Australia, Brazil, Canada, Portugal, Turkey, the U.K., and the U.S., but not in Hong Kong, Romania, Taiwan, and UAE. Implications for future cross-cultural research are discussed

Mental illness stigma among Romanian adolescents

Revista de Psicologia da Criança e do Adolescente. - ISSN 1647-4120. - N. 3 (2011). - p. 67-76.Research concerning adolescents is scarce, and we are far from understanding how adolescents stigmatize, and why. The objectives of the present study were to assess the extent to which adolescents from Romania stigmatize people with mental illness and to evaluate the strength and direction of the linear relationships between stigma subcomponents and willingness to seek help. Tenth grade students (N=232) completed questionnaires on familiarity with mental illness, mental health literacy, stereotypes, prejudice, emotional reactions, discrimination, and help-seeking behaviors. Participants scored low on familiarity with mental illness and mental health literacy. Also, they believed most people would devalue or discriminate against a psychiatric patient. Moreover, adolescents marginally endorsed the responsability and dangerousness stereotypes, they marginally experienced anger and fear but they strongly experienced pity, while manifesting acts of help avoidance, coercion and segregation. When it comes to help-seeking behaviors, adolescents were willing to seek hel in the form of family care, psychological treatment, and folk medicine. However, they are not willing to seek medical treatment. Furthermore, endorsing the responsibility stereotype, experiencing pity, manifesting help and coercion, are all associated with higher levels of willingness to seek help. Tailoring interventions to address these stigma subcomponents and stigma-related concepts should be a priority in order to improve mental health and mental health care, mainly because the rejecting behavior of others may bring greater disadvantage to the afflicted individuals than the mental condition itself. (Alina Zlati, Jennifer Oh, Adriana Baban