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The Depression, Anxiety, Stress Scales-21: Principal component analysis and evaluation of abbreviated versions in young adults with temporomandibular disorders

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  • Yinghao Xiong
  • Adrian Ujin Yap
  • Carolina Marpaung
  • May Chun Mei Wong

Abstract

Background: The Depression, Anxiety, Stress Scales-21 (DASS-21) contain three subscales measuring depression, anxiety, and stress. Several abbreviated DASS-21 versions have been developed, demonstrating better clinical utility and measurement properties than the original instrument. This study explored the factor structure of various abbreviated DASS-21 versions and identified/validated the optimal one for assessing young adults with temporomandibular disorders (TMDs). Methods: A total of 974 university-attending young adults were recruited in two waves (wave 1: 519; wave 2: 455). Demographic information, the DASS-21, and quintessence five TMD symptoms (5Ts) of the Diagnostic Criteria for TMDs were collected. Principal component analysis (PCA) was employed to condense the DASS-21 (wave 1 data), while confirmatory factor analysis (CFA) was used to determine maximum likelihood estimates and compare different abbreviated DASS-21 versions (wave 2 data). Known-group, concurrent (criterion) validity and reliability were subsequently evaluated. Results: The mean age of the study participants was 21 (SD = 0.1) years and 80.4% were women. Twelve DASS-21 items were identified from the PCA. However, the Korean DASS-12 provided the best-fit model (χ2/df = 2.07, CFI = 0.975, TLI = 0.960, RMSEA = 0.049, SRMR = 0.033) among the seven abbreviated versions in the CFA. The Korean DASS-12 showed good known-group and concurrent (rs = 0.959) validity and reliability when contrasted to the DASS-21. Conclusion: The Korean DASS-12 possessed a good fit, known-group, as well as concurrent (criterion) validity and reliability, and was the best abbreviated DASS-21 version for screening young adults with TMD symptoms for psychological distress.

Suggested Citation

  • Yinghao Xiong & Adrian Ujin Yap & Carolina Marpaung & May Chun Mei Wong, 2025. "The Depression, Anxiety, Stress Scales-21: Principal component analysis and evaluation of abbreviated versions in young adults with temporomandibular disorders," PLOS ONE, Public Library of Science, vol. 20(1), pages 1-14, January.
    • Handle: RePEc:plo:pone00:0316703
    DOI: 10.1371/journal.pone.0316703
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    1. Wayne Velicer, 1976. "Determining the number of components from the matrix of partial correlations," Psychometrika, Springer;The Psychometric Society, vol. 41(3), pages 321-327, September.
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