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Peer-reviewedCC BYPLOS One

Cross-national validation of the Depression, Anxiety and Stress Scale for Youth (DASS-Y) in Lebanese and Chinese adolescents

  • Changhong Huang1,2
  • Xiu-Mei Chen3
  • Feten Fekih-Romdhane4,5
  • Sahar Obeid6
  • I-Hua Chen7,8
  • Xiao-Ling Liao9
  • Ping Xu8,10
  • Zeng-Han Lee11,12
  • Souheil Hallit13,14
  • Olga Malas15
15 affiliations
  1. 1Faculty of Education, Qufu Normal University, Qufu, China.
  2. 2Center of Teaching Quality Monitoring and Assessment, Jining University, Jining, China.
  3. 3School of Information Engineering, Shandong Youth University of Political Science, Jinan, China.
  4. 4The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, Manouba, Tunisia.
  5. 5Tunis El Manar University, Faculty of Medicine of Tunis, Tunis, Tunisia.
  6. 6Department of Social and Education Sciences, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
  7. 7Chinese Academy of Education Big Data, Faculty of Education, Qufu Normal University, Qufu, China.
  8. 8Graduate School, Stamford International University, Bangkok, Thailand.
  9. 9Faculty of Education, Jiangxi Science and Technology Normal University, Nanchang, China.
  10. 10Sports Psychology Department, Guangzhou Sport University, Guangdong, China.
  11. 11School of Education and Psychology, Minnan Normal University, Zhangzhou, Fujian, China.
  12. 12Stamford International University, Bangkok, Thailand.
  13. 13School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.
  14. 14Applied Science Research Center, Applied Science Private University, Amman, Jordan.
  15. 15Department of Psychology, Sociology and Social Work, University of Lleida, Lleida, Spain.
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Abstract

Background: The Depression, Anxiety and Stress Scale for Youth (DASS-Y) has been validated in several countries, but its measurement equivalence between Middle Eastern and East Asian adolescents remains untested, and prior validations primarily relied on single analytic approaches without examining complex factor structures or brief screening forms. This study evaluated the DASS-Y in Lebanese adolescents enduring sociopolitical strain and Chinese adolescents under comparatively stable conditions. Methods: The sample comprised 758 Lebanese (M age = 15.95, SD = 1.78; 63.2% female) and 1,062 Chinese adolescents (M age = 16.83, SD = 0.59; 47.5% female). Psychometric properties were examined using confirmatory factor analysis, exploratory structural equation modeling (ESEM), and bifactor variants of both. Differential item functioning was assessed using Rasch analysis. Reliability was indexed by composite reliability (CR), average variance extracted (AVE), and person separation reliability. Results: Lebanese adolescents showed a largely unidimensional pattern, whereas an ESEM solution better represented the Chinese data. Reliability was strong in both samples (subscale CR = 0.91 to 0.95, AVE = 0.58 to 0.71, person separation reliability = 0.79 to 0.85; total CR = 0.97 in both samples; total AVE = 0.63 for the Lebanese and 0.61 for the Chinese sample). Several items, mainly in the stress subscale, functioned non-equivalently across samples. The 12-item short form performed comparably (subscale CR = 0.88 to 0.92, AVE = 0.65 to 0.73; total CR = 0.96 and 0.94; total AVE = 0.64 and 0.57, respectively). Conclusions: Lebanese adolescents’ responses reflected a unitary distress construct, whereas Chinese adolescents’ responses showed greater differentiation among depression, anxiety, and stress, though a general distress factor remained dominant in both samples. Reliability was high throughout, so this divergence is structural rather than a matter of measurement precision. The 12-item form offers a practical screening option pending further cross-national confirmation.

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Cite

BibTeXRIS
BibTeX
@article{huang2026crossnational,
  title = {{Cross-national validation of the Depression, Anxiety and Stress Scale for Youth (DASS-Y) in Lebanese and Chinese adolescents}},
  author = {Changhong Huang and Xiu-Mei Chen and Feten Fekih-Romdhane and Sahar Obeid and I-Hua Chen and Xiao-Ling Liao and Ping Xu and Zeng-Han Lee and Souheil Hallit and Olga Malas},
  journal = {PLOS One},
  year = {2026},
  month = oct,
  doi = {10.1371/journal.pone.0360807},
  url = {https://doi.org/10.1371/journal.pone.0360807},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Cross-national validation of the Depression, Anxiety and Stress Scale for Youth (DASS-Y) in Lebanese and Chinese adolescents
AU  - Changhong Huang
AU  - Xiu-Mei Chen
AU  - Feten Fekih-Romdhane
AU  - Sahar Obeid
AU  - I-Hua Chen
AU  - Xiao-Ling Liao
AU  - Ping Xu
AU  - Zeng-Han Lee
AU  - Souheil Hallit
AU  - Olga Malas
PY  - 2026
DA  - 2026/10/21
JO  - PLOS One
DO  - 10.1371/journal.pone.0360807
UR  - https://doi.org/10.1371/journal.pone.0360807
AB  - Background: The Depression, Anxiety and Stress Scale for Youth (DASS-Y) has been validated in several countries, but its measurement equivalence between Middle Eastern and East Asian adolescents remains untested, and prior validations primarily relied on single analytic approaches without examining complex factor structures or brief screening forms. This study evaluated the DASS-Y in Lebanese adolescents enduring sociopolitical strain and Chinese adolescents under comparatively stable conditions. Methods: The sample comprised 758 Lebanese (M age = 15.95, SD = 1.78; 63.2% female) and 1,062 Chinese adolescents (M age = 16.83, SD = 0.59; 47.5% female). Psychometric properties were examined using confirmatory factor analysis, exploratory structural equation modeling (ESEM), and bifactor variants of both. Differential item functioning was assessed using Rasch analysis. Reliability was indexed by composite reliability (CR), average variance extracted (AVE), and person separation reliability. Results: Lebanese adolescents showed a largely unidimensional pattern, whereas an ESEM solution better represented the Chinese data. Reliability was strong in both samples (subscale CR = 0.91 to 0.95, AVE = 0.58 to 0.71, person separation reliability = 0.79 to 0.85; total CR = 0.97 in both samples; total AVE = 0.63 for the Lebanese and 0.61 for the Chinese sample). Several items, mainly in the stress subscale, functioned non-equivalently across samples. The 12-item short form performed comparably (subscale CR = 0.88 to 0.92, AVE = 0.65 to 0.73; total CR = 0.96 and 0.94; total AVE = 0.64 and 0.57, respectively). Conclusions: Lebanese adolescents’ responses reflected a unitary distress construct, whereas Chinese adolescents’ responses showed greater differentiation among depression, anxiety, and stress, though a general distress factor remained dominant in both samples. Reliability was high throughout, so this divergence is structural rather than a matter of measurement precision. The 12-item form offers a practical screening option pending further cross-national confirmation.
SN  - 1932-6203
ER  -