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Depression and anxiety symptoms in adolescents across 30 countries: Cross-national measurement invariance and relationships with subjective well-being

  • Veljko Jovanović
    ,
  • Sabirah Adams
    ,
  • Rebeca Aritio-Solana
    ,
  • Christ Billy Aryanto
    ,
  • Andreja Avsec
    ,
  • Ali Bakhshi
  • University of Novi Sad
    ,
  • University of Cape Town
    ,
  • Universidad de La Rioja
    ,
  • Atma Jaya Catholic University of Indonesia
    ,
  • University of Ljubljana
    ,
  • State Welfare Organization of Iran
Research Output: Contribution to journal Article Peer-review

Open access

Publication Information

Output type

Research Output: Contribution to journal Article Peer-review

Original language

English

Article number

121693

Journal (Volume, Issue Number)

Journal of Affective Disorders (Volume 406)

Publication milestones

  • Published - 01/08/2026

Publication status

Published - 01/08/2026

ISSN

0165-0327

Publication IDs

  • Scopus: 105034513220

Abstract

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.

Sustainable Development Goals

  • SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well