TY - JOUR
T1 - Depression and anxiety symptoms in adolescents across 30 countries
T2 - Cross-national measurement invariance and relationships with subjective well-being
AU - Jovanović, Veljko
AU - Adams, Sabirah
AU - Aritio-Solana, Rebeca
AU - Aryanto, Christ Billy
AU - Avsec, Andreja
AU - Bakhshi, Ali
AU - Baldassarre, Martina
AU - Bender, Michael
AU - Berjot, Sophie
AU - Zambrano, Sonia Betancourth
AU - Brajša-Žganec, Andreja
AU - Broche-Pérez, Yunier
AU - Buzea, Carmen
AU - Cabello, Rosario
AU - Cassibba, Rosalinda
AU - Cavazos-Arroyo, Judith
AU - Daemi, Fatemeh
AU - Díaz-Guerra, Diego D.
AU - Džida, Marija
AU - Eidelsburger, Mona
AU - Fernández-Berrocal, Pablo
AU - Fernández-Castillo, Evelyn
AU - Fonseca-Pedrero, Eduardo
AU - Frackowiak, Tomasz
AU - Freire, Teresa
AU - Gavrilov-Jerković, Vesna
AU - Gjoneska, Biljana
AU - Guerrero-Alcedo, Jesús
AU - Hillekens, Jessie
AU - Höfer, Stefan
AU - Hossain, Md Jamil
AU - Iqbal, Naved
AU - Jámbori, Szilvia
AU - Joshanloo, Mohsen
AU - Lipovčan, Ljiljana Kaliterna
AU - Kavčič, Tina
AU - Kowal, Marta
AU - Taseva, Marija Krstevska
AU - Kuan, Sok Ian
AU - Lazić, Milica
AU - Mahmud, Tareq
AU - Manrique-Millones, Denisse
AU - Misiak, Michal
AU - Musso, Pasquale
AU - Obradović, Vojana
AU - Ortuño-Sierra, Javier
AU - Orzea, Ioana
AU - Özaslan, Ahmet
AU - Park, Joonha
AU - Pašić, Marija
AU - Valickienė, Rasa Pilkauskaitė
AU - Puente-Díaz, Rogelio
AU - Puerta-Sierra, Lizbeth
AU - Dimitrovska, Gordana Ristevska
AU - Roberts, S. Craig
AU - Ronauli, Puji Tania
AU - Savahl, Shazly
AU - Serapinas, Danielius
AU - Sorokowska, Agnieszka
AU - Sorokowski, Piotr
AU - Sulejmanović, Dijana
AU - Sultana, Mst Sadia
AU - Szél, Erzsébet
AU - Šakan, Dušana
AU - Tilga, Henri
AU - Tomašević, Aleksandar
AU - Tong, Kwok Kit
AU - Unanue, Wenceslao
AU - Unanue, Jesús
AU - van Egmond, Marieke
AU - Yıldırım, Murat
AU - Yuen, Sze Man
AU - Kocjan, Gaja Zager
AU - Zamarian, Laura
AU - Zotović-Kostić, Marija
PY - 2026/3
Y1 - 2026/3
N2 - Cross-cultural empirical evidence on the validity of measures of depression and anxiety symptoms in adolescents is scarce and inconclusive. The present study investigated the cross-national measurement invariance and convergent validity evidence of the Depression and Anxiety scales of the Depression Anxiety and Stress Scales (DASS-21). We sampled 16,802 adolescents (58.1% female) aged 14–19 years across 30 countries from five continents. Both exact and approximate measurement invariance were tested. The results provided evidence for the exploratory structural equation model (ESEM) as the best representation of the data in most countries. Full scalar invariance was not supported when tested across all countries, but only among two Southern Asian countries (Bangladesh, India), two Northern European countries (Estonia, Lithuania), the six former republics of Yugoslavia, and European and American countries grouped by UN subregions. Results of the alignment method supported the approximate invariance of the ESEM model across 29 countries. Associations between Depression and Anxiety ESEM factors and life satisfaction, positive affect, and negative affect conformed to the theoretical expectations in most countries. Our findings indicate that the Depression and Anxiety scales of the DASS-21 have potential for use in cross-national research on adolescent internalizing symptoms, but we highlight issues of using it outside of Western (European, North American) settings.
AB - Cross-cultural empirical evidence on the validity of measures of depression and anxiety symptoms in adolescents is scarce and inconclusive. The present study investigated the cross-national measurement invariance and convergent validity evidence of the Depression and Anxiety scales of the Depression Anxiety and Stress Scales (DASS-21). We sampled 16,802 adolescents (58.1% female) aged 14–19 years across 30 countries from five continents. Both exact and approximate measurement invariance were tested. The results provided evidence for the exploratory structural equation model (ESEM) as the best representation of the data in most countries. Full scalar invariance was not supported when tested across all countries, but only among two Southern Asian countries (Bangladesh, India), two Northern European countries (Estonia, Lithuania), the six former republics of Yugoslavia, and European and American countries grouped by UN subregions. Results of the alignment method supported the approximate invariance of the ESEM model across 29 countries. Associations between Depression and Anxiety ESEM factors and life satisfaction, positive affect, and negative affect conformed to the theoretical expectations in most countries. Our findings indicate that the Depression and Anxiety scales of the DASS-21 have potential for use in cross-national research on adolescent internalizing symptoms, but we highlight issues of using it outside of Western (European, North American) settings.
KW - depression
KW - anxiety
KW - culture
KW - adolescenec
KW - measurement invariance
KW - exploratory structural equation modeling
U2 - 10.1016/j.jad.2026.121693
DO - 10.1016/j.jad.2026.121693
M3 - Article
C2 - 41903762
SN - 0165-0327
VL - 406
JO - Journal of Affective Disorders
JF - Journal of Affective Disorders
M1 - 121693
ER -