Depression, Anxiety and Stress Scales (DASS-21): Construct Validity Problem in Hispanics

Health survey on anxiety, depression, and stress in Afghanistan: A large-scale cross-sectional study amid ongoing challenges

BACKGROUND

One of the most significant events in recent Afghan history is the rise of the Taliban and the war that followed, which had profound impacts on the lives of Afghans. The present study examined the mental health of Afghans living under the Taliban government.

METHODS

Between June 5, 2023 and February 12, 2024, a cross-sectional study was conducted among the Afghan population in three key regions of Afghanistan. Data were collected using a pre-tested structured questionnaire. The 21-item Depression, Anxiety and Stress scale (DASS-21) was utilized to assess depression, anxiety and stress of the Afghan population. Ethical permission for this study was granted by the Afghanistan Center for Epidemiological Studies (ACES). Logistic regression models were employed to explore the relationship between socio-demographic characteristics and depression, anxiety, and stress among 2,698 participants.

RESULTS

The prevalence of depression was 72.05%, anxiety was 71.94%, and stress was 66.49%. Multiple regression analysis indicated that gender (being female), economic status (being poor), residency (living in rural areas), education level (being illiterate), being a cigarette smoker, and having experienced a bad event during the past month were significantly associated with depression, anxiety and stress.

CONCLUSION

The findings of the present study show very high levels of anxiety, depression, and stress, most likely reflecting the profound impact of recent political, social, and economic changes. Notably, a significant majority of participants, particularly females and individuals above 35 years of age, reported severe to extremely severe mental health symptoms. The mental health crisis in Afghanistan is a complex and urgent issue that requires a comprehensive and compassionate response.

Construct validity and reliability of Amharic version of DASS-21 scale among Ethiopian Defense University College of Health Science students

BACKGROUND

DASS-21 is the common and widely used tool for assessing depression, anxiety and stress. However, its validity and Reliability in Ethiopian Amharic language is not assessed.

OBJECTIVE

To translate the DASS-21 and assess its validity and reliability among Ethiopian Defense University college of health science students in Bishoftu, Ethiopia.

METHOD

An institutional based cross-sectional study was conducted using a self-administered questionnaire. A total of 435 students from different departments in accordance with their proportional size were participated in this study. As to the sampling technique, the study units were selected from each department and year of study using simple random sampling proportional to size. Confirmatory factor analyses were employed to assess the factor structure and construct validity of Amharic version of the DASS-21. Cronbach alpha coefficient and corrected item total correlation was calculated to assess the internal consistency of Amharic version of DASS-21.

RESULT

Among 435 undergraduate students who participated in the study, 246(56.6%) were the age of 18-25 year and majority 347(79.8%) were males. Regarding their year of study; 200 (46.0%) were first year students. Confirmatory factor analysis indicates a good model fit of the three correlated factors (Comparative fit index (CFI) = 0.92 with root mean square error of approximation (RMSEA) = 0.059[0.052-0.066] and standardize root mean residual SRMR = 0.045). The internal consistency of overall DASS-21 and each sub scale were in acceptable range (0.91, 0.82, 0.77 and 0.77) respectively.

CONCLUSION

Amharic version of DASS-21 was found to be a valid and reliable instrument to measure the mental problem especially, Depression, Anxiety and Stress among university students.

Assessment of the impact of social media addiction on psychosocial behaviour like depression, stress, and anxiety in working professionals

OBJECTIVE

Social media (SM), with its addictive nature and the accompanying psychosocial challenges such as stress, anxiety, and depression, is the primary factor exacerbating mental health problems and adversely impacting individuals' wellbeing. Our study's goal was to determine how SM affects employees' psychosocial behaviours and assess the various factors that contributed to the employee's excessive use of SM.

METHODS

A cross-sectional correlational analysis was conducted. Using a relevant questionnaire on employees, the study was assessed to establish the relationship or association between SM addiction and psychosocial disorders like depression, anxiety, and stress. 200 people with a minimum age of 24 were enrolled in the study. The questionnaire contained the social networking addiction scale (SNAS) and the depression, anxiety, and stress-21 (DASS-21) scales; the data were statistically assessed.

RESULTS

The association between SM addiction and psychosocial behaviours has been examined using statistical tools including descriptive statistics and the Chi-square analysis. SM addiction has a strong, statistically significant correlation with depression (p = 0.001), stress (p = 0.001), and anxiety (p = 0.001).

CONCLUSION

This study discovered a connection between SM use and depression, stress, and anxiety among working employees, raising questions regarding worries about overuse and addiction to SM. Various factors influencing excessive usage included revealed that employees also majorly over used SM for entertainment, boredom avoidance, constant knowledge sharing, and relationship-building.

Factor structure and psychometric properties of the Jordanian version of the depression anxiety stress scale (DASS-21)

AIM

Early diagnosis of health conditions such as depression, anxiety, and stress, which have been recognized as global health issues, is essential for providing psychological support to people who experience negative emotions. Therefore, it is important to identify a reliable method for diagnosing depression, anxiety, and stress. To this end, this study investigated the factor structure and evaluated the psychometric properties of the Depression Anxiety Stress Scale-21 (DASS-21) in Jordan.

METHODS

A university sample of 336 Jordanians completed the Arabic version of the DASS-21 and several psychopathology measures. Cross-sectional study and confirmatory factor analysis (CFA) were applied to achieve the study's aims.

RESULTS

CFA favored the bifactor model compared to the other four models. In contrast, the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory-II (BDI-II) strongly correlated with the DASS-21, indicating that the DASS-21 has adequate convergent and divergent validity. Subsequently, the scale's discriminant validity was tested using the heterotrait-monotrait (HTMT) correlation ratio, which was found to be relatively insufficient. While DASS-21 showed strong reliability, Cronbach's α and McDonald's omega values ranged between 0.83 and 0.93.

CONCLUSION

The bifactor model best fits the Jordanian sample data. The DASS-21 has optimum psychometric properties; therefore, it can be used to assess the general distress experienced by the Jordanian community during research investigations and in non-clinical settings.

Impact of Hair Transplantation on Quality of Life

BACKGROUND

Alopecia is defined as partial or complete hair loss. The most common form is androgenetic alopecia, which occurs in both men and women. Despite the nonsurgical options available for treatment, the only permanent solution is hair transplantation. Hair loss has been shown to have significant psychological consequences associated with loss of self-confidence, poor self-image and difficulties in social functioning. We aim to examine the effect of hair transplantation on quality of life and psychosocial functioning.

METHODS

Forty-eight patients with androgenetic alopecia were enrolled in this two-center prospective study and underwent hair transplantation by the Follicular Unit Extraction method. Different questionnaires were used to assess their quality of life and other psychosocial parameters before and after hair transplantation.

RESULTS

According to SF-36 Physical and Mental Health Score patients showed significant improvement in life quality after hair transplantation. Diener's Life Satisfaction Scale (DASS-21) revealed increased life satisfaction after the procedure. Stress and anxiety DASS-21 subscales showed significantly reduced results; while, the DASS-21 depression scale and MSPSS were not significantly changed.

CONCLUSION

Taken together, quality of life and psychosocial functioning increased after hair transplantation. Structured abstract is required. Please provide.I insert name of paragraphs within abstract as follows: background, methods, results, conclusion Level of Evidence II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Depression, anxiety, and stress and adverse pregnancy outcomes in pregnant women with history of recurrent pregnancy loss in Nigeria

OBJECTIVE

The primary purpose of this study was to examine whether pregnant women with a history of recurrent pregnancy loss (RPL) are more likely to experience moderate-to-severe depression, anxiety, or stress symptoms than pregnant women without a history of RPL. The secondary purpose was to determine whether women with prior RPL experienced more unfavorable pregnancy outcomes if they had depression, anxiety, or stress.

METHODS

A prospective case-control study was conducted that included 47 pregnant women with a history of RPL and 94 pregnant women without prior RPL. Participants 20 weeks of gestation or earlier were included. Both groups completed the Depression, Anxiety, and Stress Scale (DASS-21), and were followed up until delivery to determine the pregnancy outcomes. Multivariate logistic regression was used to compare adverse pregnancy outcomes.

RESULT

Among the 47 women with prior RPL, 10 had primary RPL (two or more miscarriages without a successful pregnancy) and 37 secondary RPL (two or more miscarriages with a history of successful pregnancy). RPL was significantly associated with moderate-to-severe levels of depression (P < .001), anxiety (P < .001), and stress (P < .001). Among the RPL group, high stress level was significantly associated with repeat miscarriage (adjusted odds ratio (AOR) = 5.28, 95%CI = 1.25-100.0, P = .03) and preterm labor (AOR = 6.07, 95%CI = 1.61-100.0, P = .04). Depression and anxiety were not associated with adverse pregnancy outcomes.

CONCLUSION

Pregnant women with a history of RPL had considerably higher rates of moderate-to-severe depression, anxiety, and stress. Repeat miscarriage and preterm labor were considerably higher among pregnant women with RPL who were experiencing high stress levels at baseline.

A Longitudinal Study of the Psychological State of Teachers Before and During the COVID-19 Outbreak in Mexico

The COVID-19 outbreak significantly impacted people's lives. Within the education system, the teaching mode drastically changed to adapt to the social distancing restrictions due to the pandemic. Consequently, teachers have been facing challenges associated with remote learning in addition to those of the pandemic. The aim of the present study was to assess the psychological state among teachers at two stages: pre-pandemic (November 2019) and during the pandemic (June-July 2020 and June-July 2021). Information regarding demographic data, depression, anxiety, and stress (DASS-21), and burnout syndrome (MBI-ES) was collected using validated questionnaires. Results showed a significantly higher scores as well as a higher prevalence in the DASS-21 and the MBI-ES scales, on the second measurement taken during the pandemic compared to the pre-pandemic period and the first evaluation during the pandemic. During the second evaluation on pandemic stage, female teachers of ≥45 years of age with a college-level of education, 11 years of teaching experience, and currently teaching at preschools and primary schools were significantly associated with higher anxiety, stress, EE, and burnout scores. In addition, female teachers aged ≥45 years reported higher PD and PA scores. Finally, an association between burnout syndrome and depression was identified in the evaluations carried out during the pandemic considering both the total sample and the analysis per gender. The study shows that teachers' mental health has been negatively affected by the pandemic. Efforts from the education system and health authorities are crucial to design and implement strategies to improve teachers' mental health during the fight against COVID-19.

Gender-Based Analysis of the Association Between Mental Health, Sleep Quality, Aggression, and Physical Activity Among University Students During the COVID-19 Outbreak

COVID-19 has spread throughout the world, resulting in significant morbidity, mortality, and negative psychological effects among general population. However, university students are particularly vulnerable in terms of mental health. The present study evaluated the association between mental health, quality of sleep, aggression, and physical activity in university students in Mexico after 1 year of dealing with the COVID-19 pandemic in Mexico, including a gender-sensitive analysis. Participants (935 university students) completed an online questionnaire which collected information regarding demographic data, psychological distress (IES-R scale), depression, anxiety, and stress (DASS-21), aggressiveness Buss-Perry Aggressive Questionnaire, sleep quality (PSQI) and physical activity (IPAQ-S). Findings showed that female students showed significantly higher scores in psychological distress, anxiety, stress scores and sleep quality, as compared to male students. By contrast, male students showed significantly higher scores on aggressiveness than female students. In addition, on physical activity, females performed significantly higher MET-min/week on moderate and high levels. Finally, liner regression model accounted for approximately 73.5% of the variance in DASS-21 scores, with the body mass index, IES-R, Pittsburgh Sleep Quality Index, and IPAQ subscales, emerging as significant individual (positive) predictors. Therefore, the pandemic affected female and male students differently. Female students reported more psychological distress, anxiety, and stress while male students reported higher aggressiveness. The differences observed may be due to physiological differences, the response to stress, and differences in sensitivity to life events.

Use of the Depression Anxiety Stress Scale-21 in young people with temporomandibular disorders: Reliability and dimensionality

OBJECTIVE

The reliability and dimensionality of the Depression Anxiety Stress Scale-21 (DASS-21) were explored in adolescents/young adults with temporomandibular disorders (TMDs).

METHODS

TMD presence was established with the Fonseca Anamnestic Index. Reliability of the DASS-21 for participants with (WT) and without (NT) TMDs was assessed by the Cronbach alpha test, while dimensionality was examined using exploratory factor analysis.

RESULTS

Data from 400 participants (mean age 18.8 ± 1.5 years; 52.2% women) comprising 47.0% with and 53.0% without TMDs were evaluated. Total-DASS and the 3 subscales showed acceptable to high internal consistencies for the WT and NT groups, with alphas of 0.78-0.94 and 0.66-0.92, respectively. Although 3 factors contributed to about half the variance for both groups, scalar and item discrepancies in the primary anxiety-stress factor existed.

CONCLUSION

The DASS-21 has good reliability but may comprise only 2 dimensions, specifically anxiety-stress and depression, instead of the 3 originally asserted.

The short form endometriosis health profile questionnaire (EHP-5): psychometric validity assessment of a Croatian version

PURPOSE

To translate, adapt and validate the Endometriosis Health Profile-5 (EHP-5) in Croatian population.

METHODS

This validation study is a part of a prospective, observational study (EHP-5 CRO) with aim of implementation of EHP-5 and to provide better insight in quality of life consideration of women with endometriosis in Croatian clinical practice. A 150 consecutive patients with surgically proven endometriosis were enrolled. The translation to Croatian followed standardized procedure. Cronbach's Alpha was calculated to calculate internal consistency reliability of EHP-5. The test-retest reliability was calculated using intraclass correlation coefficient (ICC). The t test for independent samples was used to assess known-groups validity.

RESULTS

Both EHP-5 core and EHP-5 modular parts of the questionnaire had good internal consistency, assessed by the Cronbach's Alpha coefficient (α = 0.793 and α = 0.842, respectively). Obtained results indicate very good reliability for core as well as for modular part of EHP-5 questionnaire (ICC = 0.896 and 0.936, respectively). The independent t test showed that women who reported their pain with VAS scale 7 or more had significantly higher results (p < 0.001) on EHP-5 (M = 50.63) compared with women who reported their pain 6 or less (M = 26.91). Furthermore, we found statistically significant difference between women who are infertile with women who are fertile (p < 0.001), whereby infertile women had higher average result on EHP-5 (M = 49.55) compared with fertile women (M = 34.36).

CONCLUSIONS

The Croatian version of the EHP-5 have very good psychometric characteristics and can be used as a reliable tool for assessing patients with endometriosis in everyday clinical practice.

A measurement method for mental health based on dynamic multimodal feature recognition

Introduction

The number of college students with mental problems has increased significantly, particularly during COVID-19. However, the clinical features of early-stage psychological problems are subclinical, so the optimal intervention treatment period can easily be missed. Artificial intelligence technology can efficiently assist in assessing mental health problems by mining the deep correlation of multi-dimensional data of patients, providing ideas for solving the screening of normal psychological problems in large-scale college students. Therefore, we propose a mental health assessment method that integrates traditional scales and multimodal intelligent recognition technology to support the large-scale and normalized screening of mental health problems in colleges and universities.

Methods

Firstly, utilize the psychological assessment scales based on human-computer interaction to conduct health questionnaires based on traditional methods. Secondly, integrate machine learning technology to identify the state of college students and assess the severity of psychological problems. Finally, the experiments showed that the proposed multimodal intelligent recognition method has high accuracy and can better proofread normal scale results. This study recruited 1,500 students for this mental health assessment.

Results

The results showed that the incidence of moderate or higher stress, anxiety, and depression was 36.3, 48.1, and 23.0%, which is consistent with the results of our multiple targeted tests.

Conclusion

Therefore, the interactive multimodality emotion recognition method proposed provides an effective way for large-scale mental health screening, monitoring, and intervening in college students' mental health problems.

Dorsolateral Prefrontal Activation in Emotional Autobiographical Task in Depressed and Anxious College Students: An fNIRS Study

OBJECTIVE

The dorsolateral prefrontal cortex (dlPFC) is strongly associated with mood symptoms. This study used functional near-infrared spectroscopy (fNIRS) technology to explore the features of brain neural activity in the dlPFC of anxious and depressed college students, during an emotional autobiographical memory task, and to understand the differences in brain cognitive mechanisms caused by anxiety and depression.

METHODS

A simple random sampling method was used to test 440 college students at a university with a healthy control group (HC, 220 participants), a pure depression group (PD, 92 participants), and a pure anxiety group (PA, 128 participants). The average oxyhemoglobin in the dlPFC of the subjects during the emotional autobiographical memory task was collected by a 53-channel functional near-infrared spectroscopy imaging device.

RESULTS

The activation of the left dlPFC (ch13) in the pure depression group was significantly higher than in the pure anxiety group. The activation of the right dlPFC (ch48) was significantly higher under positive emotions than under negative emotions. The interaction between emotion valence and group was marginally significant, and the activation of the right dlPFC (ch41) in the pure depression group was significantly higher under positive emotion than in negative emotion. The activation of the pure depression group under positive emotions was significantly higher than that of the pure anxiety group. In comparison, the activation of the pure depression group under negative emotions was significantly lower than that of the healthy control group. The results of correlation analysis showed that the activation of the left dlPFC (ch13) was significantly negatively correlated with anxiety in positive emotions, but the activation of the right dlPFC (ch34, ch42) was significantly positively correlated with anxiety in positive and negative emotions.

CONCLUSIONS

The right dlPFC was insensitive to positive emotions in college students with high-anxiety symptoms, whereas this region was insensitive to negative emotions in college students with high depressive symptoms, which might be one of the critical differences in the cognitive mechanisms of anxiety and depression. Furthermore, left and right dlPFC activation correlated differently with anxiety. The higher the anxiety level, the lower the activation on the left side, and the higher the activation on the right side. The results suggested that anxiety might reduce the function of the left dlPFC.

Impact of caregiver depression on child asthma outcomes in Mexicans and Puerto Ricans

OBJECTIVE

Examine whether caregiver depressive symptoms at baseline predict longitudinal child asthma outcomes in the two populations with the largest asthma disparities: Mexicans and Puerto Ricans.

METHODS

Two hundred and sixty-seven Hispanic caregiver-child dyads (Mexican = 188, Puerto Rican = 79; children 5-12 years) were recruited from clinics and hospitals in Phoenix, AZ and the Bronx, NY. The Center for Epidemiological Studies Depression Scale assessed caregiver depressive symptoms; higher scores indicate greater depressive symptomology. Medical records verified child asthma diagnosis. Assessments for outcome variables occurred at baseline, 3, 6, 9, and 12-month follow-ups. Pulmonary function was measured by spirometry, asthma control was measured by the Asthma Control Test, steroid bursts and acute healthcare utilization were assessed by caregiver report and medical records, and adherence was measured by doser devices on controller medications. Structural equation modeling analyzed baseline caregiver depressive symptoms as a predictor of longitudinal child asthma outcomes, and differences between subgroups.

RESULTS

Higher caregiver depressive symptoms predicted better pulmonary function (β = .02, p = .001) in Mexican children, and fewer steroid bursts (β = -.41, p = .01) and better medication adherence (β = .02, p = .07) in Puerto Rican children. Caregiver depressive symptoms did not predict pediatric asthma control or acute healthcare utilization in either subgroup.

CONCLUSIONS

Caregiver depressive symptomology had unexpected effects on child asthma outcomes. Results may be explained by the Hispanic paradox, caregiver resilience, acculturation, and the study's longitudinal nature. Further research is needed on social determinants of health that may influence differences in child asthma outcomes in heterogeneous Hispanic communities.

A cross-sectional survey of sleep patterns and quality and its association with psychological symptoms among doctors working in a COVID-19 care facility

CONTEXT

The coronavirus disease 2019 (COVID-19) outbreak has led to several psychological symptoms among frontline doctors of which sleep disturbances are common. Stress due to isolation and disease-related factors are known to be associated with sleep disturbances.

AIM

The aim of this study is to establish the prevalence of poor sleep and its association with psychological symptoms among doctors working in COVID-19 tertiary hospital.

SETTINGS AND DESIGN

A cross-sectional online survey was conducted among 150 doctors who were treating COVID-19 patients.

MATERIALS AND METHODS

The survey contained a semi-structured questionnaire including sociodemographic details, Depression Anxiety Stress Scale 21, and Pittsburgh Sleep Quality Index scale. Analysis was done using the SPSS v20.

RESULTS

Of 150 doctors, we found 67 (44.67%) and 83 (55.33%) doctors were poor sleepers and good sleepers, respectively. Those who were married (P = 0.001), had higher working hours per month (P = 0.001), the presence of family history of psychiatric illness (P = 0.008), and history of substance use (P = 0.007) were associated with poor sleep. Furthermore, poor sleep was associated with higher stress (P = 0.001), anxiety (P = 0.001), and depression (P = 0.001). A multiple logistic regression revealed that family history of psychiatric illness (odds ratio [OR]-5.44, P = 0.01) and the presence of substance use (OR-7.77, P = 0.01) predicted poor sleep.

CONCLUSION

Sleep pattern abnormalities were present in 45% of the frontline COVID-19 doctors studied. Family history of psychiatric illness and substance use was associated with higher chances of having poor sleep. It is important to recognize and manage sleep abnormalities as these could be initial signs of a psychiatric disorder or manifestations of underlying stress, especially in the vulnerable population.

COVID-19 Pandemic Psychological Impact and Volunteering Experience Perceptions of Medical Students after 2 Years

Undergraduate healthcare students were mobilized to support healthcare systems during the COVID-19 pandemic, but we have scarce information regarding their experience and its impact on their wellbeing. An anonymous online survey was conducted among undergraduate students and recently graduated physicians of a medical university in Spain, regarding their symptoms and volunteering experience during the initial months of the Spanish COVID-19 pandemic. Respondents showed a high prevalence of perceived stress, anxiety, and depressive symptoms, measured by the PHQ-9 and GAD-7. 14.5% reported healthcare-related volunteering tasks. Volunteering was a satisfactory experience for most of the respondents and the majority felt ready to do volunteering tasks (66.6%). Yet, 16.6% acknowledged not getting appropriate specific-task education before starting, 20.8% reported not having appropriate supervision, and 33.3% feel they did not have proper protective equipment. More than half of volunteers feared getting infected, more than 70% feared infecting their relatives or friends, and 54.2% reported stigmatization. Volunteers showed significantly higher stress, anxiety, and depression scores than the rest of the respondents, and 32% reported a highly traumatic event during volunteering, with high scores on the IES-R in the 16% of volunteers. Our results should help guide future potential volunteering processes in emergencies, enhance academic programs at medical schools and provide valuable data for psychological support services.

Psychological status and physical performance are independently associated with autonomic function

Background

Falls among older adults have become a global concern. While previous studies have established associations between autonomic function indicator; heart rate variability (HRV) and blood pressure variability (BPV) with fall recurrence, as well as physical inactivity and psychological disorders as risk factors for falls, the influence of physical activity and psychological status on autonomic dysfunction observed among older fallers has not been adequately investigated. The aim of this study was to evaluate the relationship between psychological disorder and physical performance on the autonomic nervous system (ANS) in older fallers. We hypothesised that older fallers have poorer autonomic function, greater dependency on others and were associated with psychological disorders. Furthermore, we hypothesised that both physical performance and psychological status can contribute to the worsening of the autonomic function among the elderly.

Methods

In this cross-sectional survey, adults aged ≥ 60 years were recruited. Continuous non-invasive BP was monitored over 5 min of supine and 3 min of standing. Psychological status was assessed in terms of depression, anxiety, stress, and concern about falling, while functional status was measured using time-up-and-go, functional reach, handgrip and Lawton’s Instrumental Activities of Daily Life (IADL) scale.

Results

A total of 62 participants were recruited consisting of 37 fallers and 25 non-fallers. Multivariate analysis revealed that Lawton IADL was independently associated with systolic blood pressure variability (SBPV) and diastolic blood pressure variability (DBPV) during both supine (SBPV: r² = 0.080, p = 0.025; DBPV: r² = 0.064, p = 0.046) and standing (SBPV: r² = 0.112, p = 0.008; DBPV: r² = 0.105, p = 0.011), while anxiety score was independently associated with SBPV and DBPV during standing (SBPV: r² = 0.112, p = 0.009; DBPV: r² = 0.105, p = 0.011) as compared to the other parameters.

Conclusion

Our findings suggest that fallers had poorer ANS, greater dependence in IADLs, and were more anxious. IADL dependency and anxiety were the most predictive of autonomic dysfunction, and can be used in practice to identify poor autonomic function for the prevention of falls and cardiovascular diseases among older adults.

The psychometric properties of the Depression Anxiety Stress Scale-21 (DASS-21) Bangla version

The Bangla version of the Depression Anxiety Stress Scale-21 (DASS-21-BV) draws huge attention among the researchers to assess the mental health status in various situations among the Bangladeshi adults. Since no published research article to date has assessed the psychometric properties of the scale (Bangla version), this study (n = 980 Bangladeshi adults) aimed to assess the psychometric characteristics of this scale utilizing both classical test theory (CTT) and item response theory (IRT) approaches. Item analysis results (item-total correlations in CTT and slope coefficients of the graded response model in IRT) suggested that items had satisfactory discrimination indices. The confirmatory factor analysis results supported the three-factor correlated model of the DASS-21-BV. This scale had good internal consistency reliabilities (alpha, omega, Rho coefficient, etc.) in both approaches. Additionally, multigroup confirmatory factor analysis results suggested strict invariance of this scale between males and females. Although the convergent and divergent validity of the DASS-21-BV were not assessed in this study, it was still proposed as a psychometrically sound tool to assess depression, anxiety, and stress in the non-clinical sample Bangladesh.

Psychosocial perception of health-care workers in a COVID-19-designated hospital in eastern India

BACKGROUND

COVID-19 pandemic has changed the life of people in many facets, economic, social, and psychological. Frontline health-care workers (HCWs) fighting against this pandemic faced some psychological as well as social issues which are of major concern. The objective of the study is to evaluate the magnitude of mental health problems, namely depression, anxiety, and stress among frontline HCWs as well as their perception on ongoing events and surroundings.

MATERIALS AND METHODS

It was a prospective, observational study on n = 85 HCWs over a 4-month period. Study participants were sampled purposively in accordance with inclusion and exclusion criteria; data were collected by online survey method. A semi-structured scale was used: Part A of which assessed the demography and perception of HCWs on surrounding along with ongoing social events and Part B consisted of the Depression, Anxiety, and Stress Scale-21 that was used to assess mental health issues. All the associations were tested in percentages and proportions. Statistics was calculated by using SPSS 24^th version.

RESULTS

Majority of the participants were female doctors and belonged to 21-30 years' age group. Most of them were marginally worried of contacting infection (73%) but were substantially apprehensive of transmitting infection to their family (56.5%) and hoped positive outcome ultimately in the form of recovery from infection. Majority (96.4%) gathered information from authentic sources and were confident of adequacy of their knowledge. Majority (88.3%) were satisfied about their occupational safety and responded on scientific solution of pandemic. However, we got a mixed result about their professional appreciation. Depression symptom score was higher than anxiety and stress symptom score in our participants.

CONCLUSIONS

Doctors and nurses both were suffering from mental health issues, and provision of adequate information and occupational safety may lessen these burdens.

Coping Strategies as a Mental Health Protection Factor of Spanish Nurses during COVID-19

Background: Due to the healthcare crisis caused by COVID-19, nurses have been exposed to stressful, uncertain situations. In such situations, emotional coping strategies are especially important due to their repercussion on health. The purpose of this study is analyze the relationships between nurses’ coping strategies and health, with attention to factors related to perceived threat and/or someone close to them is COVID-19 positive. Methods: This descriptive cross-sectional study was done with a sample of 351 nurses in Spain. In addition to the questionnaire on perception of threat from COVID-19, the Cognitive Emotion Regulation Questionnaire and the General Health Questionnaire, an ad hoc question asked them whether someone close to them was COVID-19 positive. Results: Perceived threat and use of negative coping strategies were related, and these strategies were related to a greater presence of somatic symptoms, anxiety, social dysfunction, and depression. Conclusions: Given the work and personal influence of coping on nurses, interventions must be designed to promote adaptive strategies.

Psychological impact of COVID-19 on health workers in Ghana: A multicentre, cross-sectional study

INTRODUCTION

The COVID-19 pandemic has exacted an appreciable burden on health systems globally including adverse psychological impacts on health workers. This study sought to assess COVID-19-related fear, depression, anxiety and stress among hospital staff, potential factors that may help reduce its psychological effects and their personal coping strategies. The study will help to highlight the psychological impact of COVID-19 on Ghanaian health workers and indirectly serve as a needs assessment survey for input to support affected staff and the broader health system.

METHODS

A cross-sectional survey was conducted among health workers in three hospitals in the Ashanti Region of Ghana from 11 July 2020 to 12 August 2020. Demographic data and scores from the validated DASS-21 and Fear of COVID-19 scales and two other scales developed de novo were entered from 272 self-administered questionnaires and analyzed for means, frequencies and proportions. Fisher's exact test analysis was done to ascertain associations between selected independent variables and depression, anxiety, stress and fear. Parametric and non-parametric tests were used to compare the mean and median scores of the outcome variables across the three study hospitals.

RESULTS AND CONCLUSION

Over 40% of respondents had fear while 21.1%, 27.8% and 8.2% had depression, anxiety and stress, respectively. Positive attitudes from colleagues and the government's tax-free salary relief were some factors said to reduce the psychological effects while over half of participants indicated praying more often as a coping strategy. There is a need for the health system to recognize the presence of these adverse psychological effects in health workers and take pragmatic steps to address them.

Confirmatory Factor Analysis of Three Versions of the Depression Anxiety Stress Scale (DASS-42, DASS-21, and DASS-12) in Polish Adults

Background: The Depression Anxiety Stress Scales (DASS) are designed to identify quickly and differentiate between the symptoms of depression and anxiety in the non-clinical population. Different versions (original and short) were validated in many cultures. Nevertheless, there are no data of factorial validity of the different versions of this scale in Polish culture. Thus, the aim of this study was to evaluate the factor structure using confirmatory factor analysis (CFA) and internal consistency of DASS-42 (original version) and two short versions (DASS-21 items and DASS-12 items) in the Polish population. Methods: The DASS-42 was administered to a non-clinical sample, broadly representative of the general Polish adult population (n = 1,021) in terms of demographic variables. The DASS-21 and DASS-12 version used in this study comprise seven and four items from each of the following corresponding three subscales of the Polish version of DASS-42. Results: There were two models that fitted best for DASS-42: (a) modified three correlated factors (depression, anxiety, and stress) with cross-loadings and (b) second order (general factor of psychological distress) and three factors with cross-loadings. There were also two models that fitted best for DASS-21 and DASS-12: (a) modified three correlated factors (depression, anxiety, and stress) and (b) second order (general factor of psychological distress) and three factors. Conclusions: All three versions of DASS appear to have an acceptable factorial structure. However, the shorter versions (DASS-21 and DASS-12) may be more feasible to use in general medical practice and also be less burdensome to participants.