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Validating the Swedish STOP-D : a brief tool for depression, anxiety, stress, anger and social support

Larsson, Andreas LU orcid ; Milos Nymberg, Veronica LU orcid ; Nymberg, Peter LU orcid and Sundström, Felicia T.A. (2026) In Frontiers in Psychology 16.
Abstract

Psychological distress, including depression, anxiety, and stress, requires time-efficient assessment tools suited for digital and momentary settings. The Screening Tool for Psychological Distress (STOP-D) is a five-item scale developed for brief mental health screening, but it has not yet been validated in Swedish. This study aimed to evaluate the psychometric properties and diagnostic accuracy of the Swedish STOP-D in a non-clinical adult sample. A total of 427 Swedish-speaking adults (mean age = 49.42, SD = 16.34 years) completed the STOP-D, the Patient Health Questionnaire-4 (PHQ-4), the Single-Item Stress Scale (SISE), and the Need Satisfaction and Frustration Scale (NSFS). ROC analyses were conducted using PHQ-2 and GAD-2 (cut-off... (More)

Psychological distress, including depression, anxiety, and stress, requires time-efficient assessment tools suited for digital and momentary settings. The Screening Tool for Psychological Distress (STOP-D) is a five-item scale developed for brief mental health screening, but it has not yet been validated in Swedish. This study aimed to evaluate the psychometric properties and diagnostic accuracy of the Swedish STOP-D in a non-clinical adult sample. A total of 427 Swedish-speaking adults (mean age = 49.42, SD = 16.34 years) completed the STOP-D, the Patient Health Questionnaire-4 (PHQ-4), the Single-Item Stress Scale (SISE), and the Need Satisfaction and Frustration Scale (NSFS). ROC analyses were conducted using PHQ-2 and GAD-2 (cut-off ≥ 3) and the SISE (cut-off ≥ 6 and 7). Feature importance was examined using the Boruta algorithm. Exploratory Graph Analysis (EGA) assessed the internal structure. The STOP-D items for Sadness and Anxiety showed excellent classification accuracy for depression and anxiety (AUC = 0.87–0.89). Stress showed lower accuracy (AUC = 0.65–0.67). EGA supported a two-factor model, with STOP-D items for Sad, Anxiety and Stress clustering separately from Anger and Lack of Social Support. The Swedish STOP-D is a valid brief tool for assessing core psychological distress. Items for anger and social support may add clinical value and represent distinct processes relevant for future individualized and ecological assessment.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Ange single item, anxiety single item, depression single item, screening mental health, social support, stress single item, validating Swedish translation
in
Frontiers in Psychology
volume
16
article number
1649601
publisher
Frontiers Media S. A.
external identifiers
  • scopus:105027908693
  • pmid:41567452
ISSN
1664-1078
DOI
10.3389/fpsyg.2025.1649601
language
English
LU publication?
yes
id
5a055b08-91cc-409c-8a1a-acca22c39ea5
date added to LUP
2026-02-25 15:30:15
date last changed
2026-06-04 05:36:21
@article{5a055b08-91cc-409c-8a1a-acca22c39ea5,
  abstract     = {{<p>Psychological distress, including depression, anxiety, and stress, requires time-efficient assessment tools suited for digital and momentary settings. The Screening Tool for Psychological Distress (STOP-D) is a five-item scale developed for brief mental health screening, but it has not yet been validated in Swedish. This study aimed to evaluate the psychometric properties and diagnostic accuracy of the Swedish STOP-D in a non-clinical adult sample. A total of 427 Swedish-speaking adults (mean age = 49.42, SD = 16.34 years) completed the STOP-D, the Patient Health Questionnaire-4 (PHQ-4), the Single-Item Stress Scale (SISE), and the Need Satisfaction and Frustration Scale (NSFS). ROC analyses were conducted using PHQ-2 and GAD-2 (cut-off ≥ 3) and the SISE (cut-off ≥ 6 and 7). Feature importance was examined using the Boruta algorithm. Exploratory Graph Analysis (EGA) assessed the internal structure. The STOP-D items for Sadness and Anxiety showed excellent classification accuracy for depression and anxiety (AUC = 0.87–0.89). Stress showed lower accuracy (AUC = 0.65–0.67). EGA supported a two-factor model, with STOP-D items for Sad, Anxiety and Stress clustering separately from Anger and Lack of Social Support. The Swedish STOP-D is a valid brief tool for assessing core psychological distress. Items for anger and social support may add clinical value and represent distinct processes relevant for future individualized and ecological assessment.</p>}},
  author       = {{Larsson, Andreas and Milos Nymberg, Veronica and Nymberg, Peter and Sundström, Felicia T.A.}},
  issn         = {{1664-1078}},
  keywords     = {{Ange single item; anxiety single item; depression single item; screening mental health; social support; stress single item; validating Swedish translation}},
  language     = {{eng}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Psychology}},
  title        = {{Validating the Swedish STOP-D : a brief tool for depression, anxiety, stress, anger and social support}},
  url          = {{http://dx.doi.org/10.3389/fpsyg.2025.1649601}},
  doi          = {{10.3389/fpsyg.2025.1649601}},
  volume       = {{16}},
  year         = {{2026}},
}