Construct validity and Reliability of Amharic version of DASS-21 scale among Ethiopian Defense University College of Health Science Students

doi:10.21203/rs.3.rs-3572835/v1

Download PDF

Research Article

Construct validity and Reliability of Amharic version of DASS-21 scale among Ethiopian Defense University College of Health Science Students

https://doi.org/10.21203/rs.3.rs-3572835/v1

This work is licensed under a CC BY 4.0 License

Version 1

posted

You are reading this latest preprint version

Background

DASS-21 is the common and widely used tool for assessing depression, anxiety and stress. However, its validity and Reliability in Ethiopian Amharic language is not assessed.

Objective

To translate the DASS-21 and assess its validity and reliability among Ethiopian Defense University college of health science students in Bishoftu, Ethiopia.

Method

An anonymous, self-administered questionnaire was used to collect the data on 435 undergraduate health science students. Confirmatory factor analyses were employed to assess the factor structure and construct validity of Amharic version of the DASS-21. Cronbach alpha coefficient and corrected item total correlation was calculated to assess the internal consistency of Amharic version of DASS-21.

Result

Confirmatory factor analysis indicates a good model fit of the three correlated factors (Comparative fit index (CFI) = 0.92 with root mean square error of approximation (RMSEA) = 0.059[0.063–0.066] and standardize root mean residual SRMR = 0.045). The internal consistency of overall DASS-21 and each sub scale were in acceptable range (0.82, 0.77and 0.77) respectively.

Conclusion

Amharic version of DASS-21 was found to be a valid and reliable instrument to measure the mental problem especially, Depression, Anxiety and Stress among university students.

DASS-21 Scale

Validity

Reliability

University Students

Ethiopia

The world health organization described mental health as fundamental to human health. According to reports mental health problems are the first cause of disability and a major public health issue worldwide due to progression, difficulties in therapeutic management and increasing prevalence.[1]

As it is known depression, anxiety and stress are important indictors for mental health which, if untreated, can have a negative effect on individuals. For early treatment and prevention, it is important to conduct screening, which needs valid and reliable tool to measure in clinical and non-clinical setting. [2]

The Depression Anxiety and Stress Scale (DASS) is a commonly used self-report questionnaire to measure symptoms of depression, anxiety, and stress. It is designed to provide a comprehensive assessment of these psychological constructs in individuals. When using the DASS for research or clinical purposes, it is essential to consider the validity and reliability of the scale. [3] Since its introduction in 1995, the original version DASS-42 and its short form DASS-21 have been widely used to assess depression, anxiety and stress among different population. [4]

Validity refers to the extent to which test measures what it is intended to measure.[5] In the case of the DASS, studies have found strong evidence of its validity. Numerous studies have shown that the DASS has good convergent validity, meaning it correlates strongly with other established measures of depression, anxiety, and stress. Additionally, the DASS demonstrates good discriminant validity, as it shows a distinctive pattern of scores for each construct.[6–8] This indicates that the scale is measuring distinct and separate constructs of depression, anxiety, and stress.

DASS-21 has been translated into more than 30 languages, such as Vietnamese, Hindi, Polish and Persian. [9–13] Confirmatory factor analysis was conducted to validate the translated version both in clinical and non-clinical samples. In line with the original study which propose a three-factor model, most translated study revealed the validity and reliability of the three-factor model. [14–16] But depending on background information and type of population in which the test was employed, a number of literatures results were found to be inconsistent when observed among adults ranging between one to four factors.[3, 17, 18]

Reliability refers to the consistency and stability of the scale's measurement across different situations and times. [19] The DASS has been found to have good internal consistency, as demonstrated by high Cronbach's alpha coefficients for all three subscales (depression, anxiety, and stress), Cronbach’s alpha coefficients, which range from 0.83 to 0.94 for depression, 0.76 to 0.87 for anxiety, and 0.79 to 0.91 for stress. This result was supported by subsequent studies conducted in both clinical and non-clinical samples. [6, 10, 20] This suggests that the items within each subscale are strongly related to each other, indicating that the scale is measuring the intended construct reliably.

According to previously conducted research, DASS have demonstrated a consistent result about its psychometric property among university students. It has been shown to be reliable and valid with three-factor structure. [16, 21, 22]

In recent years, researchers from Ethiopia have used the DASS in their studies on different samples. [23, 24] To date, none of the published articles that adopted the DASS-21, tested the validity and reliability of the translated version. Therefore, this study aimed to test the validity and reliability of the DASS- 21 Amharic version.

Study design and participants

This cross-sectional study has been conducted among Ethiopian defense university college of health science students. A convenience sample of 435 health science students were invited to participate into the study on August 2023.

Procedure

Two trained academic staff distributed the Amharic version of the DASS-21 instrument along with a consent form to students before administering the questioner. The students who intended to participate into the study signed the consent form, completed the Amharic versions of the DASS-21 and submitted individually to one of the distributers to ensure confidentiality.

Data collection

The English version of the DASS-21 questionnaire was translated into Amharic by using standard guidelines, including independent forward and back translation by using language experts.

This 21-item questionnaire contains three subscales including depression (seven items), anxiety (seven items), and stress (seven items). The students responded to the items on a 4-point Likert scale (0 = never a problem, 1 = sometimes a problem, 2 = often a problem, and 3 = almost always a problem). According to the DASS-21 scoring algorithm, higher scores indicated higher depression, anxiety and stress. Total score is calculated by summing the scores for each subscale. Moreover, DASS scoring manual have provided cut-off scores for defining normal (0–4 for depression, 0–3 for anxiety and 0–7 for stress), mild (5–6 for depression, 4–5 for anxiety and 8–9 for stress), moderate (7–10 for depression, 6–7 for anxiety and 10–12 for stress), severe (11–13 for depression, 8–9 for anxiety and 13–14 for stress) and extremely severe (> 14 for depression, > 10 for anxiety, > 17 for stress) scores. [4, 25]

Statistical analysis

The reliability of the DASS-21 was examined by Cronbach’s alpha coefficient. A coefficient equal to or greater than 0.7 was considered to be a satisfactory level of reliability. Corrected Item total correlation also computed. [19]

In order to evaluate the construct validity of the scale, confirmatory factor analysis (CFA) was used. Generally, CFA investigates the relationship between a set of observed variables (the items of the DASS-21) and a set of latent constructs (depression, anxiety, and stress subscales). In the present study, we investigated whether or not the hypothesized three-factor model fit the data well for the sample. Several criteria were used to assess the goodness of fit of the model, including chi-square statistics, root mean square error of approximation (RMSEA), Tuker-Lewise index (TLI), comparative fit index (CFI) and Standardize root mean residual (SRMR). Since chi-square statistics are known to be sensitive to large samples, this test may not be a realistic fit index, and therefore, the other above-mentioned fit indices were considered for assessing goodness of fit of the model. Values of CFI and TLI ≥ 0.90, and RMSEA ≤ 0.08 can support acceptable model fit. Stata version 18 were used to conduct CFA. [5, 26]

Demographic characteristics of respondents

Among 435 undergraduate students who participated in the study, 246(56.6%) were the age of 18–25 year and majority 663 (87.4%) were males. Regarding their year of study; 200 (46.0%), 74(17.0%), 107(24.6%), 52(12.0%) and 2(0.5%) of the participants were first year, second year, third year, fourth year and fifth year students, respectively. Overall mean Depression, Anxiety and Stress score of the whole study participants were 4.7 ± 3.8[CI: 4.3–5.1], 3.5 ± 3.3[CI: 3.1–3.8],

4.6 ± 3.8[CI: 4.2–4.9] respectively.

Internal consistency of Amharic of DAAS-21

The Cronbach’s alpha coefficient was 0.91for the total score of the Amharic version of DASS-21; it was 0.82 for depression, 0.77 for anxiety, and 0.77 for stress, indicating acceptable internal consistency of the scale. [27] The corrected item-total correlations for the DASS 21 were ranged from .51-.70 and in an acceptable range. (Table.1)

Construct validity of Amharic of DAAS-21

The CFA was used to evaluate the goodness of fit of the three-factor models of Amharic version of DAAS-21. The analysis yielded a 21-item three-factor model that fit the data of Amharic version of DAAS-21 (Fig. 1) The CFA revealed the acceptable fit indexes of the three-factor model. The goodness-of-fit indices in the CFA showed RMSEA 0.059, TLI 0.91, CFI 0.92 and SMRS of 0.045 (Table.3). The factor loadings ranged from 0.46 to 0.71 for all items except one item which was 0.31(Table.2). Accordingly, the goodness of fit of the three-factor model was established, suggesting the stability of this instrument.

Correlations between the subscales of Amharic version of DASS-21

Table presents the correlations (r) between the subscales of Amharic version of DASS-21.

The subscales of Amharic version of DASS-21 were found to be significantly correlated. The coefficients for the correlations of subscales were, 0.92 for depression and anxiety, 0.98 for depression and stress, and 0.92 for anxiety and stress.

The aim of the present study was to evaluate the Amharic version DASS-21 with regard to its construct validity and reliability among health science students. It is known that DASS-21 has been translated in different language and among different culture.[16, 28, 29] As to the knowledge of the author is concerned, Amharic version of this scale has not been validated among students but the instrument was used widely for research.

The study findings support the three-factor model as also reported in previous studies and as the original study proposed. the standardized factor loading ranged from 0.46–0.71, only one item factor loading was 0.31 otherwise, the study identified the same factor structure and pattern with the tripartite model of the DASS-21 and support the theoretical perspective for the three dimensions of scale.[4, 18]

In order to test the construct validity of the Amharic version of DASS-21, we have conducted confirmatory factor analysis using Stata version 18. We have tested the three-factor model. fit indexes of the CFA model showed that the three-factor structure of DASS-21 was a good fit for the present data. this result was in line with the original three-factor model and also it is consistent with previous reported validation studies in different language and population segment.[4, 12, 15, 30]

As far as factor structure of DASS-21 concerned disagreement of results was observed. This may be due to cultural difference and the population segment involved in study. A study conducted among Korean university students and among adolescent in North Macedonia, in both studies result demonstrated a bi-factor model [17, 18], Another study conducted among a sample of Vietnamese adolescents, the data supported a four-factor model. [20]

We have examined the internal consistency of Amharic version of DASS-21 using Cronbach alpha. In the original study, the internal reliability of the DASS-21 has been established through the examination of Cronbach’s alpha coefficients, which range from 0.83 to 0.94 for depression, 0.76 to 0.87 for anxiety, and 0.79 to 0.91 for stress.[4] In line with the original study, our finding demonstrated acceptable internal consistency reliability of the total scale and each sub-scale, with Cronbach alpha coefficient of 0.91for total scale, 0.82 for depression, 0.77 for anxiety and 0.77 for stress. Similarly, the internal consistency of this scale was good, as evidenced by the corrected item –total correlation for the entire scale ranging from 0.4–0.7. The results also in line with other previously conducted validation studies of DASS-21.[28, 31, 32] accordingly, the result suggest that we can use three scales measured in DASS-21 separately or as a combined form in order to assess symptoms of depression, anxiety and stress.

Strength and limitation

The strength of this study is that it is the first study which examine the validity and reliability of Amharic version of DASS-21 in a sample of health science students in Ethiopia. There are some limitations in this study. Firstly, the study was cross sectional and the data can’t show test-retest reliability overtime. Secondly the study only tests the construct validity. finally, only undergraduate health sciences students were involved in the study which compromised generalization.

In summary, the results from this study provide evidence that the Amharic version DASS-21 is valid and reliable and suitable for use as a screening tool for symptoms of mental health problems, Depression, Anxiety and Stress among University students.

As the DASS-21 has now been translated to more than 30 languages, the use of Amharic version DASS-21 will provide additional opportunities for cross-cultural comparison. However, to further support the validity and reliability of DASS-21 additional study is recommended.

DASS-21: Depression Anxiety Stress Scale; EDU: Ethiopian Defense University EFA: Exploratory Factor Analysis; CFA: Confirmatory Factor Analysis; RMSEA: Root mean square error of approximation; SRMR: Standardize root mean residual; CFI: Comparative fit index

Acknowledgements

We acknowledge the support we have received from the participating University staff and students.

Authors’ contributions

BST conceived the study, analyzed and wrote the initial draft of the study. HBH and MMA revised the report and edited and rewrote the report. All authors approved the final draft of the manuscript.

Funding

Not applicable

Availability of data and materials

Pertinent data are available in this manuscript. Additional data can be requested from the corresponding author upon reasonable request.

Ethical approval and Consent to participate

Ethical clearance for this study was obtained from the Ethiopian Defense University, Health Science college before actual data collection. The objective and purpose of the study were verified briefly to the study participants and confidentiality was assured. Finally, informed consent was obtained from all study participants before conducting data collection. All methods were performed in accordance with relevant guidelines and regulations.

Consent for publication

Not applicable

Competing interests

The author declare that they have not competing interests.

Authors details

¹Ethiopian Defense University, College of Health Sciences, Bishoftu, Ethiopia.

Nochaiwong S, Ruengorn C, Thavorn K, Hutton B, Awiphan R, Phosuya C, Ruanta Y, Wongpakaran N, Wongpakaran T: Global prevalence of mental health issues among the general population during the coronavirus disease-2019 pandemic: a systematic review and meta-analysis. Sci Rep 2021, 11(1):10173.
Santomauro DF, Mantilla Herrera AM, Shadid J, Zheng P, Ashbaugh C, Pigott DM, Abbafati C, Adolph C, Amlag JO, Aravkin AY et al: Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. The Lancet 2021, 398(10312):1700-1712.
Crawford JDHaJR: The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology (2005), 44, 227–239 2005.
S.H. LOVIBOND PFLa: THE STRUCTURE OF NEGATIVE EMOTIONAL STATES: COMPARISON OF THE DEPRESSION ANXIETY STRESS SCALES (DASS) WITH THE BECK DEPRESSION AND ANXIETY INVENTORIES. Beha Res Ther Vol 33, No 3, pp 335-343, 1995 1995.
Bengwasan PD, Bernardo ABI, Maximo SI: Translation and Initial Validation of the Depression Anxiety and Stress Scale (DASS-21) in Ilokano. Psychol Stud (Mysore) 2022, 67(4):594-604.
Kumar K, Kumar S, Mehrotra D, Tiwari SC, Kumar V, Dwivedi RC: Reliability and psychometric validity of Hindi version of Depression, Anxiety and Stress Scale-21 (DASS-21) for Hindi speaking Head Neck Cancer and Oral Potentially Malignant Disorders Patients. J Cancer Res Ther 2019, 15(3):653-658.
Makara-Studzinska M, Tyburski E, Zaluski M, Adamczyk K, Mesterhazy J, Mesterhazy A: Confirmatory Factor Analysis of Three Versions of the Depression Anxiety Stress Scale (DASS-42, DASS-21, and DASS-12) in Polish Adults. Front Psychiatry 2021, 12:770532.
Mojtaba Habibi MD, Minoo Pooravari, and Somaieh Salehi: Confirmatory Factor Analysis of Persian Version of Depression, Anxiety and Stress (DASS-42): Non-Clinical Sample. Razavi Int J Med 2017 December; 5(4).
Zawislak D Z-WK, Habera M, Skrzypiec K, Pac Agnieszka and Cebula G: Evaluation of a Polish Version of the Depression Anxiety Stress Scales (DASS-21). Journal of Neuroscience and Cognitive Studies 2020 | Volume 4 | Issue 1 | Article 1015.
Christos Pezirkianidis EK, Agathi Lakioti, Anastassios Stalikas, Michael Galanakis: Psychometric Properties of the Depression, Anxiety, Stress Scales-21 (DASS-21) ina Greek Sample. http://wwwscirporg/journal/psych Dec. 25, 2018.
Hoang Thi Quynh Lan NTLNVH: Validation of depression, anxiety and stress scales (DASS-21): Immediate psychological responses of students in the e-learning environment. International Journal of Higher Education http://ijhesciedupresscom, Vol. 9, No. 5; 2020.
Wittayapun Y, Summart U, Polpanadham P, Direksunthorn T, Paokanha R, Judabood N, A'La M Z: Validation of depression, anxiety, and stress scales (DASS-21) among Thai nursing students in an online learning environment during the COVID-19 outbreak: A multi-center study. PLoS One 2023, 18(6): e0288041.
Kim BLYE: Validity of the depression, anxiety, and stress scale (DASS-21) in a sample of Korean university students. Current Psychology https://doiorg/101007/s12144-020-00914-x 2020.
Naumova K: Dimensionality and reliability of the Depression Anxiety Stress Scales 21 among adolescents in North Macedonia. Front Psychol 2022, 13:1007594.
Ahmed O, Faisal RA, Alim S, Sharker T, Hiramoni FA: The psychometric properties of the Depression Anxiety Stress Scale-21 (DASS-21) Bangla version. Acta Psychol (Amst) 2022, 223:103509.
Le MTH, Tran TD, Holton S, Nguyen HT, Wolfe R, Fisher J: Reliability, convergent validity and factor structure of the DASS-21 in a sample of Vietnamese adolescents. PLoS One 2017, 12(7): e0180557.
Irene Sia Siew Thing ZAZ, Izyan Abdul Wahab, Muhammad Najib Mohamed Alwi: Comparison of Depression Anxiety Stress Scale (Dass) Scores Among University Students in Cyberjaya: An Online Survey. Journal of Positive School Psychology http://journalppwcom 2022, Vol 6, No 7, 5477-5487.
Noorlila Ahmad SR, Shamsuddin Othman, Shureen Faris Abdul Shukor & Abu Yazid Abu Bakar: The Validity and Reliability of Psychometric Profile for Depression, Anxiety and Stress Scale (DASS21) Instrument among Malaysian Undergraduate Students. International Journal of Academic Research in Business and Social Sciences 05 July 2018, http://dx.doi.org/10.6007/IJARBSS/v8-i6/4275 DOI: 10.6007/IJARBSS/v8-i6/4275.
Dachew BA, Bifftu BB, Tiruneh BT, Anlay DZ, Wassie MA: Prevalence of mental distress and associated factors among university students in Ethiopia: a meta-analysis. J Ment Health 2022, 31(6):851-858.
Leta Melaku GB, and Deresa Worku: The Prevalence and Severity of Depression, Anxiety, and Stress among Medical Undergraduate Students of Arsi University and Their Association with Substance Use, Southeast Ethiopia. Hindawi Education Research International 2021, Volume 2021, Article ID 9936157, 12 pages. https://doi.org/10.1155/2021/9936157.
Medvedev ON: Depression Anxiety Stress Scales (DASS-21) in International Contexts. International Handbook of Behavioral Health Assessment 101007/978-3-030-89738-3_15-1.
McNeish D: Thanks Coefficient Alpha, We’ll Take It from Here. Psychological methods May 29, 2017.
Fornell C LD: Evaluating-Structural Equation Models with Unobservable Variables and Measurement Error. JMedSci 17:2:61-67.
TOPOLSEK DDaD: Introduction to Structural Equation Modeling: Review, Methodology and Practical Applications. University of Maribar 2014.
Raykov T: Estimation of Composite Reliability for Congeneric Measures. Applied Psychological Measurement 2016, 21(2):173-184.
Organization WHO: Depression and Other Common Mental Disorders: Global Mental Disorder 2017.
Rose Claudia Batistelli Vignola AMT: Adaptation and validation of the depression, anxiety and stress scale (DASS) to Brazilian Portuguese. Journal of Affective Disorders 155 (2014) 104–109 2014.
Thapa DK, Visentin D, Kornhaber R, Cleary M: Psychometric properties of the Nepali language version of the Depression Anxiety Stress Scales (DASS-21). Nurs Open 2022, 9(6):2608-2617.
Tonsing KN: Psychometric properties and validation of Nepali version of the Depression Anxiety Stress Scales (DASS-21). Asian Journal of Psychiatry 8 (2014) 63–66 2014.
Nadeem MU, Kulich SJ, Bokhari IH: The assessment and validation of the depression, anxiety, and stress scale (DASS-21) among frontline doctors in Pakistan during fifth wave of COVID-19. Front Public Health 2023, 11:1192733.
Martin M.Antony PB, Brian J. Cox and Murray W. Enn, Richard P. Swinson: Psychometric Properties of the 42-Item and 21-Item Versions of the Depression Anxiety Stress Scales in Clinical Groups and a Community Sampl. Psychological Assessment by the American Psychological Association, 1998 Vol 10, No 2 176-181.
Li X, Shek DTL, Shek EYW: Psychological Morbidity among University Students in Hong Kong (2014-2018): Psychometric Properties of the Depression Anxiety Stress Scales (DASS) and Related Correlates. Int J Environ Res Public Health 2021, 18(16).
Kyriazos TA, Stalikas A, Prassa K, Yotsidi V: Can the Depression Anxiety Stress Scales Short Be Shorter? Factor Structure and Measurement Invariance of DASS-21 and DASS-9 in a Greek, Non-Clinical Sample. Psychology 2018, 09(05):1095-1127.
Koh YCTAHYWPALNBGHARNLD: Validation of DASS-21 among nursing and midwifery students in Brunei. Journal of Public Health: From Theory to Practice (2019) 27:387–391 https://doiorg/101007/s10389-018-0947-z.
Jafari P, Nozari F, Ahrari F, Bagheri Z: Measurement invariance of the Depression Anxiety Stress Scales-21 across medical student genders. Int J Med Educ 2017, 8:116-122.
Hariyati Shahrima Abdul Majid HSAHAHA, Muhamad Karimi Sulaiman: Psychometric Properties of the English Version of DASS in a Sample of Malaysian Nurses. Jurnal Psikologi Malaysia 33 (1) (2019): 65-69 ISSN-2289-817.
Gonzalez-Rivera JA, Pagan-Torres OM, Perez-Torres EM: Depression, Anxiety and Stress Scales (DASS-21): Construct Validity Problem in Hispanics. Eur J Investig Health Psychol Educ 2020, 10(1):375-389.
Gomez R, Stavropoulos V, Griffiths MD: Confirmatory factor analysis and exploratory structural equation modelling of the factor structure of the Depression Anxiety and Stress Scales-21. PLoS One 2020, 15(6):e0233998.
Cui-Hong Cao C-YD, Xia Zheng, Wang-Guang Chen, I-Hua Chen, and Jeffrey H. Gamble the Psychometric Properties of the DASS-21 and Its Association with Problematic Internet Use among Chinese College Freshmen. Healthcare 2023, 11, 700 https://doiorg/103390/healthcare11050700 https://wwwmdpicom/journal/healthcare.

Table 1. Reliability and Corrected Item-Total correlation for DASS-21 items and subscales (n = 435)
Items	Corrected Item-Total correlation	Cronbach Alpha
DAS-Depression
I found it difficult to work up the initiative	0.7	0.79
I felt that I had nothing to look forward to	0.6	0.81
I felt down-hearted and blue	0.7	0.80
I was unable to become enthusiastic about anything	0.7	0.79
I felt I was not worth much as a person	0.7	0.79
I felt that life was meaningless	0.6	0.80
I could not seem to experience any positive feeling	0.7	0.79
Total		0.82
DAS-Anxiety
I was aware of dryness of my mouth	0.6	0.74
I experienced breathing difficulty	0.6	0.74
I experienced trembling	0.5	0.75
I was worried about situations in which I might panic and make a fool of myself	0.7	0.73
I felt I was close to panic	0.6	0.74
I was aware of the action of my heart in the absence of physical exertion 9	0.6	0.75
I felt scared without any good reason	0.7	0.73
Total		0.77
DAS-Stress
I found it hard to wind down	0.6	0.74
I tended to over-react to situations	0.4	0.78
I felt I was using a lot of nervous energy	0.6	0.75
I found myself getting agitated	0.7	0.72
I found it difficult to relax	0.7	0.72
I was intolerant of anything that kept from getting on with what I was doing	0.6	0.73
I felt that I was rather touchy	0.6	0.76
Total		0.77

Table 2. Confirmatory factor analysis of the three-factor model of Amharic version DAS-21
Items	Factor loading
DAS-Depression
I found it difficult to work up the initiative	.68
I felt that I had nothing to look forward to	.54
I felt down-hearted and blue	.59
I was unable to become enthusiastic about anything	.70
I felt I was not worth much as a person	.61
I felt that life was meaningless	.56
I could not seem to experience any positive feeling	.70
Total
DAS-Anxiety
I was aware of dryness of my mouth	.52
I experienced breathing difficulty	.51
I experienced trembling	.46
I was worried about situations in which I might panic and make a fool of myself	.66
I felt I was close to panic	.64
I was aware of the action of my heart in the absence of physical exertion	.52
I felt scared without any good reason	.63
Total
DAS-Stress
I found it hard to wind down	.31
I tended to over-react to situations	.62
I felt I was using a lot of nervous energy	.56
I found myself getting agitated	.71
I found it difficult to relax	.70
I was intolerant of anything that kept from getting on with what I was doing	.60
I felt that I was rather touchy	.51

Table 3. Fit indices of confirmatory factor analysis for Amharic version DASS-21
Model	X² (df)	CFI	RMSEA(95%CI)	TLI	SRMR
Three factors model with correlated error	445.5(184)	0.92	0.059(0.052-0.066)	0.91	0.046
*RMSEA: root mean square error of approximation CFI: Comparative fit index SRMR: standardize root mean residual*

No competing interests reported.

Download PDF

Version 1

posted

You are reading this latest preprint version

Construct validity and Reliability of Amharic version of DASS-21 scale among Ethiopian Defense University College of Health Science Students

Status:

Version 1

Abstract

Background

Objective

Method

Result

Conclusion

Figures

Background

Method

Study design and participants

Procedure

Data collection

Statistical analysis

Result

Demographic characteristics of respondents

Internal consistency of Amharic of DAAS-21

Construct validity of Amharic of DAAS-21

Correlations between the subscales of Amharic version of DASS-21

Discussion

Strength and limitation

Conclusion

Abbreviations

Declarations

References

Tables

Additional Declarations

Status:

Version 1