What Happens When Individuals Answer Questionnaires in Two Different Languages

"Infeliz" or "Triste": A Paradigm for Mixed Methods Exploration of Outcome Measures Adaptation Across Language Variants

The literature on measure translation tends to hold, overtly or covertly, a questionable assumption about the possibility of exact translation and almost completely ignores issues of within language variation. Equally, psychometric methods used to assess cross-cultural validity after translation focus on large sample tests of cross-sectional measurement invariance. Such invariance is often not found and is of dubious pertinence to change/outcome measures usually used in psychotherapy research. We present a sequential process of three substudies using quantitative and qualitative procedures to explore whether an outcome measure needs to be changed when used across language variation. Qualitative data confirmed that an item was not ideal in the new context. However, quantitative exploration showed that, although statistically significant and affected by gender and item order, the impact of changing the item in the overall score was small, allowing retention of the existing Spanish translation. We argue that the myth of perfect translation and over-reliance on large-sample psychometric testing pursuing measurement invariance limit exploration of language effects. We recommend that these be used in the companion of user-based, sequential, mixed-method exploration to support the development of a richer field of understanding of outcomes and change self-report measures across languages and cultures and both across and within languages.

Psychological Morbidity among University Students in Hong Kong (2014-2018): Psychometric Properties of the Depression Anxiety Stress Scales (DASS) and Related Correlates

Although mental health problems among Hong Kong university students are serious, there is a lack of studies examining the psychometric properties of related assessment scales and correlates. This study attempted to validate the Depression Anxiety Stress Scales (DASS) in Hong Kong university students and examine the demographic (gender), time (cohort), and well-being correlates (positive youth development attributes and life satisfaction) of psychological morbidity. Confirmatory factor analysis (CFA) was used to examine the factor structure of the DASS (n = 6704). Gender and cohort invariance were further established using a multigroup CFA. The three-factor model of the DASS showed a superior fit and factorial invariance across gender and five different cohorts. Regarding gender and cohort correlates of psychological morbidity, males exhibited more depression, anxiety, and stress symptoms than their female counterparts. The intensity of psychological distress also escalated after the Umbrella Movement in 2014. Furthermore, well-being measures (positive youth development and life satisfaction) were negatively associated with depression, anxiety, and stress. In short, the Chinese DASS demonstrated good psychometric properties. This study also showed that gender, cohort (occurrence of political events), and well-being were associated with psychological morbidity indexed by the DASS measures.