Validating the Depression Anxiety Stress Scales-21 in Community Mothers and Fathers Across the Infant's First Year

Background: To investigate the effects of different types of parental health status on child development and health, valid parental distress measurement instruments are needed. The aim was to assess the psychometric measurement properties of the 21-item Depression Anxiety Stress Scales (DASS-21) used during the postnatal year in community samples of Swedish mothers and fathers.

Methods: Data were collected at postnatal months 1, 6 and 12 from 66 mothers (mean age 31 years) and 58 fathers (mean age 32 years). Psychometric measurement properties were assessed with interitem analysis and intra-individual measurements cross-correlations. As part of assessing construct validity, the hypotheses that the levels of the different types of postnatal distress as measured by the DASS-21 would be higher in mothers than in fathers were tested. 

Results: The DASS-21 internal consistencies were good for both parent groups. The DASS-21 depression scale correlated strongly with the Edinburgh Postnatal Depression Scale (EPDS) in mothers and moderately strongly in fathers at each timepoint. Correlations between the DASS-21 anxiety scale and the EPDS ‘anxiety component’ were mostly in the low-to-moderate range. The DASS-21 stress scale significantly distinguished parental distress levels in the expected direction, as did the total DASS-21 scale. 

Conclusions: Similar DASS-21 psychometric properties to those demonstrated for non-perinatal adult populations were indicated. The results suggest the usefulness of the DASS-21 during the early, middle and late postnatal periods for measuring types of as well as general maternal and paternal distress. Further analysis in larger perinatal parental samples for more conclusive results is warranted.