Psychometric properties of the Danish PSS-10 in adolescents

The 10-item Perceived Stress Scale (PSS-10) is widely used internationally, but its measurement properties have not been evaluated in Danish adolescents. The aim of this study was to assess the structural, construct, and criterion validity, internal consistency, test-retest reliability, and measurement precision of the Danish PSS-10, and to explore its ability to discriminate between adolescents with and without clinically assessed psychiatric diagnoses. A random sample of 5,699 adolescents aged 15–20 years was invited to participate. Of these, 667 completed the PSS-10 questionnaire in the first round (test sample), and 182 completed it a second time after approximately one week (retest sample). Structural validity was assessed using confirmatory factor analysis (CFA) using one- and two-factor models. Internal consistency was evaluated using Cronbach’s alpha. Test-retest reliability ( n = 182) was evaluated using intraclass correlation coefficients (ICC) and the standard error of measurement (SEM). Construct and criterion validity was assessed in a subsample ( n = 38) who completed a Schedules for Clinical Assessment in Neuropsychiatry (SCAN) interview. Receiver operating characteristic (ROC) analysis was used to examine the discriminative ability of the PSS-10 in relation to clinically assessed psychiatric diagnoses and to explore a potential threshold score. The two-factor model showed the best statistical fit, although the overall pattern of findings supported use of the total PSS-10 score. Internal consistency was excellent, as indicated by a Cronbach’s alpha = 0.90. Test-retest reliability was high with a ICC(2,1) = 0.89 and SEM = 2.65 resulting in a minimal detectable change of 7.34, which corresponds to an 18% change in score. The PSS-10 score showed strong correlations with psychiatric symptom scores, supporting construct validity. The ROC analysis showed good discriminative ability (AUC = 0.88). Exploratory analyses identified a threshold score of ≥ 24 that optimally discriminated between adolescents with and without a psychiatric diagnosis. The Danish PSS-10 demonstrated good structural validity, internal consistency, test-retest reliability, measurement precision, and construct and criterion validity in adolescents. The findings support the use of the total PSS-10 score for assessing perceived stress in this population. Exploratory analyses suggested a potential threshold score of ≥ 24, however larger validation studies are needed before this threshold can be recommended. The data collection was registered and approved by the regional register of research projects (#788218) on 3 January 2023. Not applicable.