Validating the Depression Anxiety Stress Scales-21 in Community Mothers and Fathers Across the Infant's First Year.
Birgitta Kerstis, Peter Jönsson, Mariette Derwig and 3 others
PMID 40472855WHAT IT FOUND
The Depression Anxiety Stress Scales-21 works well for spotting depression in new parents, but its anxiety and stress subscales are less reliable.
The stress scale best separated mothers from fathers, while depression and anxiety scores were too low in many parents to be useful.
Key findings
01The DASS-21 depression scale showed good internal consistency and convergent validity with the standard Edinburgh Postnatal Depression Scale in both mothers and fathers.
02The DASS-21 anxiety scale had unsatisfactory convergent and discriminant validity in both parent groups, despite good internal consistency.
03Only the stress subscale of the DASS-21 significantly distinguished distress levels between mothers and fathers across the first year.
STILL TO COME
How it was doneWhat they found
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What it does not show
The sample was small (66 mothers, 58 fathers) and drawn from a single region in Sweden, limiting generalisability. Structural validity (factor analysis) was not assessed due to sample size constraints. The comparator for anxiety (EPDS-3A) is itself insufficiently validated for perinatal use, making it difficult to judge the DASS-A's true accuracy. Pronounced floor effects for depression and anxiety subscales mean the tool may fail to detect mild or moderate symptoms in community populations. Data collection was terminated early due to the COVID-19 pandemic, leading to declining participant numbers over time.
Declared interests
The authors declare no conflicts of interest. Funding was provided by the Swedish Research Council for Health, Working Life and Welfare and Mälardalen University.
The easy way to misread this
Do not assume the DASS-21 is a reliable screening tool for parental anxiety in this context. The study found unsatisfactory validity for the anxiety subscale, and the comparator instrument used to test it was also poorly validated. A low anxiety score on this scale may not mean the parent is free of anxiety.