Psychometric properties of the Chinese version of the adolescent Distress-Eustress Scale (ADES) in healthy adolescents and adolescents with mood disorders

This study aimed to validate the psychometric properties of the Chinese Version of the Adolescent Distress-Eustress Scale (ADES) in Healthy Adolescents and Adolescents with Mood Disorders. From December 2024 to May 2025, we recruited 359 healthy adolescents and 356 adolescents with mood disorders who completed the measurements. We evaluated the psychometric properties of the scale in accordance with the Consensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklist, including item analysis (critical ratio, item-total correlation), item response theory (discrimination parameters, threshold parameters, item characteristic curves, and item information curves), validity analyses (content validity index, EFA, CFA, multi-group measurement invariance testing, and criterion-related validity), and reliability analysis (Cronbach’s α, split-half reliability, test–retest reliability). The Depression-Anxiety-Stress Scale (DASS-21) was used as a validity criterion. The Chinese ADES retained the original two-factor structure with 10 items. The results were as follows: Delphi consultation (Cs = 0.733, Ca = 0.933, Cr = 0.830) and content validity (I-CVI range = 1.000, S-CVI/UA = 0.95, S-CVI/Ave = 1.000). For the school and hospital samples, the KMO values were 0.851 and 0.842, respectively (P < 0.001); the Cronbach’s α was 0.839 and 0.721, respectively; and the test-retest reliability was 0.940 and 0.837, respectively. All model fit indices (χ²/df, RMSEA, AGFI, GFI, NFI, TLI, IFI, CFI, PNFI, and PCFI) were ideal in both samples. The results of multi-group measurement invariance testing showed that configural, metric, and scalar invariance across gender was supported in both the school and hospital samples, and that measurement invariance was also established across the two samples. Overall, the Chinese version of the ADES demonstrates sound psychometric properties and thus is a reliable, valid tool for assessing two-dimensional stress experiences in Chinese adolescents.