ArticleBMC psychiatry2025
Psychometric evaluation of the 21-item Depression, Anxiety and Stress Scale (DASS-21) among Afghans.
Article in BMC psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Validation of the multi-dimensional scale for Anti-Social Behavior in a higher education setting (ASB) in a sample of Afghan students.BMC psychology · 2026Article
- Eating patterns and psychological distress among young women: the moderating role of cognitive reappraisal.BMC women's health · 2026Article
- Validation of the Penn State Worry Questionnaire in a sample of Afghan students.Frontiers in psychology · 2026Article
- Memory-focused therapy: an integrated intervention to reduce trauma symptoms, maladaptive cognitive processes, and emotional distress in Afghan youth.Frontiers in psychiatry · 2026Article
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10 authors.
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Abstract
backgroundDepression, anxiety, and stress are psychological mood states that have close relationships. Moreover, they are influenced by situational factors such as living in conflict zones (e.g., Afghanistan). The World Health Organization’s assessment suggests that a significant proportion, specifically one-tenth, of the population residing in areas of conflict endure varying degrees of mental health disorders, ranging from moderate to severe. The most used psychometric instrument to assess these mood states is the 21-item Depression, Anxiety and Stress Scale (DASS-21). However, the scale has not been validated in Dari, the most spoken language in Afghanistan.
methodsA cross-sectional investigation was undertaken between June and September of 2023 across various locales within Afghanistan, aiming to assess the psychometric attributes of the Dari iteration of the DASS-21. The sample comprised 1318 participants (69% females) with mean age of 32 years.
resultsThe total scale demonstrated excellent internal consistency (Cronbach’s α = 0.94), with strong reliability for the depression (α = 0.860), anxiety (α = 0.832), and stress (α = 0.883) subscales. Test–retest reliability was high for all subscales (ICC range: 0.784–0.916). Significant positive correlations were observed between DASS-21 subscales and scores on the 20-item Center for Epidemiologic Studies Depression Scale (CES-D-20) and the 28-item General Health Questionnaire (GHQ-28), supporting convergent validity.
conclusionsThe findings provide strong evidence that the Dari version of the DASS-21 is a psychometrically sound instrument for assessing depression, anxiety, and stress among Dari-speaking Afghan adults. The scale demonstrated excellent internal consistency, good test–retest reliability, and strong convergent validity, supporting its use in research and public health contexts for screening psychological distress. However, given the non-clinical and predominantly female sample, further studies in clinical populations and more diverse sociocultural groups are recommended to confirm its generalizability and diagnostic utility.
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