Validating Constructs of the Depression, Anxiety, and Stress Scale-21 and Exploring Health Indicators to Predict the Psychological Outcomes of Students Enrolled in the Pacific Islands Cohort of College Students

Rebecca H. Kim (), Yvette C. Paulino and Yoshito Kawabata
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Rebecca H. Kim: College of Natural and Applied Sciences, University of Guam, Mangilao, GU 96923, USA
Yvette C. Paulino: School of Health, University of Guam, Mangilao, GU 96923, USA
Yoshito Kawabata: College of Liberal Arts and Social Sciences, University of Guam, Mangilao, GU 96923, USA

IJERPH, 2024, vol. 21, issue 4, 1-17

Abstract: The Depression, Anxiety, and Stress Scale-21 (DASS-21) has been used in various countries to assess the mental states of individuals. The objectives of this study were to validate the DASS-21 for use in Guam, an island that endures a high burden of mental health challenges, such as suicide, and examine the predictive impact of selected health indicators on DASS-21 variables. Three years of data (2017–2019) were pooled from the Pacific Islands Cohort of College Students (PICCS) study conducted annually at the University of Guam. In total, 726 students were included in the secondary data analysis. MPlus statistical software was used to perform a confirmatory factor analysis (CFA) for the validation and structural equation modeling (SEM) for the predictive modeling. The results from the CFA suggested an acceptable model fit (RMSEA: 0.073, CFI: 0.901, TLI: 0.889, RMR: 0.044), while SEM suggested that sleep quality and physical activity were significant predictors of DASS-21 variables. Therefore, the DASS-21 is a valid instrument for measuring depression, anxiety, and stress among emerging adults in Guam.

Keywords: DASS-21; construct validation; health indicators; psychological outcomes; Guam college students (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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