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<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Psychol.</journal-id>
<journal-title-group>
<journal-title>Frontiers in Psychology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Psychol.</abbrev-journal-title>
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<issn pub-type="epub">1664-1078</issn>
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<publisher-name>Frontiers Media S.A.</publisher-name>
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<article-meta>
<article-id pub-id-type="doi">10.3389/fpsyg.2025.1648070</article-id>
<article-version article-version-type="Corrected Version of Record" vocab="NISO-RP-8-2008"/>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Original Research</subject>
</subj-group>
</article-categories>
<title-group>
<article-title>Measurement invariance and cross-linguistic validation of the PSS-4 in university context: multidimensional analysis and associations with psychological and behavioral outcomes</article-title>
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<contrib-group>
<contrib contrib-type="author">
<name><surname>Ca&#x00F1;ete-Mass&#x00E9;</surname> <given-names>Cristina</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
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<contrib contrib-type="author" corresp="yes">
<name><surname>Krieger</surname> <given-names>Virginia</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
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<contrib contrib-type="author">
<name><surname>Per&#x00F3;-Cebollero</surname> <given-names>Maribel</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
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<contrib contrib-type="author">
<name><surname>Amador-Campos</surname> <given-names>Juan Antonio</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
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<contrib contrib-type="author">
<name><surname>Gu&#x00E0;rdia-Olmos</surname> <given-names>Joan</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
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<aff id="aff1"><label>1</label><institution>Departament de Psicologia Social i Psicologia Quantitativa, Secci&#x00F3; Psicologia Quantitativa, Facultat de Psicologia, Universitat de Barcelona</institution>, <city>Barcelona</city>, <country country="es">Spain</country></aff>
<aff id="aff2"><label>2</label><institution>Institut de Neurociencies, Universitat de Barcelona</institution>, <city>Barcelona</city>, <country country="es">Spain</country></aff>
<aff id="aff3"><label>3</label><institution>Departament de Psicologia Cl&#x00ED;nica i Psicobiologia, Secci&#x00F3; Personalitat, avaluaci&#x00F3; i tractament psicol&#x00F2;gic, Facultat de Psicologia, Universitat de Barcelona</institution>, <city>Barcelona</city>, <country country="es">Spain</country></aff>
<aff id="aff4"><label>4</label><institution>Institut de Sistemes Complexos (UBICS), Universitat de Barcelona</institution>, <city>Barcelona</city>, <country country="es">Spain</country></aff>
<author-notes>
<corresp id="c001"><label>&#x002A;</label>Correspondence: Virginia Krieger, <email xlink:href="mailto:v.krieger@ub.edu">v.krieger@ub.edu</email></corresp>
</author-notes>
<pub-date publication-format="electronic" date-type="pub" iso-8601-date="2025-09-25">
<day>25</day>
<month>09</month>
<year>2025</year>
</pub-date>
<pub-date publication-format="electronic" date-type="corrected" iso-8601-date="2026-01-12">
<day>12</day>
<month>01</month>
<year>2026</year>
</pub-date>
<pub-date publication-format="electronic" date-type="collection">
<year>2025</year>
</pub-date>
<volume>16</volume>
<elocation-id>1648070</elocation-id>
<history>
<date date-type="received">
<day>16</day>
<month>06</month>
<year>2025</year>
</date>
<date date-type="accepted">
<day>12</day>
<month>09</month>
<year>2025</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2025 Ca&#x00F1;ete-Mass&#x00E9;, Krieger, Per&#x00F3;-Cebollero, Amador-Campos and Gu&#x00E0;rdia-Olmos.</copyright-statement>
<copyright-year>2025</copyright-year>
<copyright-holder>Ca&#x00F1;ete-Mass&#x00E9;, Krieger, Per&#x00F3;-Cebollero, Amador-Campos and Gu&#x00E0;rdia-Olmos</copyright-holder>
<license>
<ali:license_ref start_date="2025-09-25">https://creativecommons.org/licenses/by/4.0/</ali:license_ref>
<license-p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="https://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License (CC BY)</ext-link>. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</license-p>
</license>
</permissions>
<abstract>
<sec>
<title>Background</title>
<p>Although prior research supports the use of the Spanish version of the PSS-4 using classical psychometric methods, further analysis of its dimensionality, reliability, and response patterns is warranted. Sociodemographic factors such as gender and health behaviors (e.g., sleep, diet, physical activity) may influence perceived stress.</p>
</sec>
<sec>
<title>Objectives</title>
<p>This study aimed to: (1) evaluate the reliability and validity of the PSS-4 in Spanish, English, and, for the first time, Catalan; (2) test measurement invariance across language, university groups, and gender; and (3) examine associations between stress and psychological (depression, anxiety, wellbeing) and behavioral outcomes (sleep, internet use, physical activity).</p>
</sec>
<sec>
<title>Methods</title>
<p>Participants included 1,810 students and 1,060 university staff, who completed surveys in Spanish, Catalan, or English. Demographic data included gender identity, marital status, education, and lifestyle behaviors. Measures included the PSS-4, WHO-5 Wellbeing Index, GAD Questionnaire, and PHQ. Dimensionality was examined using PCA, followed by invariance testing. The English group comprised a comparatively smaller sample.</p>
</sec>
<sec>
<title>Results</title>
<p>The PSS-4 showed a unidimensional structure, high reliability, and strong correlations with psychological outcomes. Measurement invariance was supported at the configural and metric levels but not at the scalar level across languages, university communities, and gender.</p>
</sec>
<sec>
<title>Conclusion</title>
<p>The PSS-4 demonstrates validity and reliability for assessing perceived stress in Spanish, English, and Catalan university settings, with this study providing the first validation of the Catalan version and a cross-language invariance test. However, the absence of scalar invariance limits the comparability of stress mean scores across languages.</p>
</sec>
</abstract>
<kwd-group>
<kwd>university students and staff</kwd>
<kwd>psychometric validation PSS-4</kwd>
<kwd>Catalan</kwd>
<kwd>Spanish</kwd>
<kwd>English</kwd>
</kwd-group>
<funding-group>
<funding-statement>The author(s) declare that no financial support was received for the research and/or publication of this article.</funding-statement>
</funding-group>
<counts>
<fig-count count="0"/>
<table-count count="7"/>
<equation-count count="0"/>
<ref-count count="63"/>
<page-count count="10"/>
<word-count count="8861"/>
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<custom-meta-group>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Quantitative Psychology and Measurement</meta-value>
</custom-meta>
</custom-meta-group>
</article-meta>
</front>
<body>
<sec id="S1" sec-type="intro">
<title>Introduction</title>
<p>Stress is an unavoidable experience that is part of the normal pressures of everyday life and it&#x2019;s a key variable for human health. Research has emphasized the long-term implications of stress on mental health outcomes, psychological wellbeing, and tear on quality of life (<xref ref-type="bibr" rid="B8">Charles et al., 2013</xref>; <xref ref-type="bibr" rid="B48">Seo et al., 2018</xref>). <xref ref-type="bibr" rid="B26">Lazarus and Folkman (1984)</xref> define psychological stress as &#x201C;a particular relationship between the person and the environment that is appraised by the person as taxing or exceeding his or her resources and endangering his or her wellbeing&#x201D; (p.19). Thus, although stress is not always a negative experience (<xref ref-type="bibr" rid="B18">Folkman, 2013</xref>), it is the subjective perception of the uncontrollability and unpredictability of stressors, along with one&#x2019;s personality, coping resources, and support factors, that determines whether coping strategies are initiated and whether the stressor is ultimately resolved (<xref ref-type="bibr" rid="B4">Biggs et al., 2017</xref>; <xref ref-type="bibr" rid="B36">Phillips, 2020</xref>).</p>
<p>Perceived stress in adults may be linked to several life outcomes, including psychological outcomes (i.e., depression and anxiety) (<xref ref-type="bibr" rid="B17">Fassett-Carman et al., 2020</xref>; <xref ref-type="bibr" rid="B48">Seo et al., 2018</xref>), social adjustment difficulties (<xref ref-type="bibr" rid="B63">Yildirim and Green, 2023</xref>) and challenges in maintaining a work-life balance (<xref ref-type="bibr" rid="B62">Xu and Wang, 2023</xref>). Researchers have also confirmed that female suffer higher levels of stress response than male, with more prevalent emotional exhaustion (<xref ref-type="bibr" rid="B11">Costa et al., 2021</xref>; <xref ref-type="bibr" rid="B19">Graves et al., 2021</xref>). Recent research has confirmed links between health-related behaviors like physical activity and healthy diet with perceived stress (<xref ref-type="bibr" rid="B5">Bremner et al., 2020</xref>; <xref ref-type="bibr" rid="B61">Wright et al., 2023</xref>). Moreover, the hours connected to online social interactions seems also a key variable that may influence stress (<xref ref-type="bibr" rid="B53">Tibbetts et al., 2021</xref>). Additionally, psychological stress is becoming an established risk factor for academic, social, and personal adjustment challenges faced by university students (<xref ref-type="bibr" rid="B2">Asif et al., 2020</xref>; <xref ref-type="bibr" rid="B21">Harris et al., 2023</xref>; <xref ref-type="bibr" rid="B55">Trigueros et al., 2020</xref>). Research also suggests that university staff experience high stress levels due to job demands and workloads (<xref ref-type="bibr" rid="B23">Jayman et al., 2022</xref>; <xref ref-type="bibr" rid="B31">Mark and Smith, 2012</xref>). All in all, it is well-demonstrated that stress is influenced by sociodemographic factors (i.e., gender and occupation), health behaviors and internalizing psychopathology.</p>
<p>Since life outcomes are potentially sensitive to factors such as stress, it is imperative to reliably and validly assess an individual&#x2019;s perception of their overall stressfulness and their ability to handle it (<xref ref-type="bibr" rid="B27">Lee, 2012</xref>; <xref ref-type="bibr" rid="B36">Phillips, 2020</xref>). From a psychological assessment perspective, stress responses are commonly measured using specific self-report scales (e.g., <xref ref-type="bibr" rid="B13">Crosswell and Lockwood, 2020</xref>; <xref ref-type="bibr" rid="B21">Harris et al., 2023</xref>), such as the Perceived Stress Scale, which allows for both accurate measurement and the definition of specific intervention targets (<xref ref-type="bibr" rid="B7">Chan and La Greca, 2020</xref>). In this framework, the Perceived Stress Scale (PSS; <xref ref-type="bibr" rid="B9">Cohen et al., 1983</xref>), has become one of the most widely used tools to assess the effects of stress in both clinical and non-clinical populations (<xref ref-type="bibr" rid="B20">Harkness and Monroe, 2016</xref>; <xref ref-type="bibr" rid="B21">Harris et al., 2023</xref>; <xref ref-type="bibr" rid="B52">Taylor, 2015</xref>). The PSS measures &#x201C;the degree to which respondents found their lives unpredictable, uncontrollable, and overloading (<xref ref-type="bibr" rid="B9">Cohen et al., 1983</xref>, p. 387) in the past month, on a five-point Likert scale ranging from &#x201C;never&#x201D; to &#x201C;very often.&#x201D; It is available in three standard versions: the 14-item scale (PSS-14), the 10-item scale (PSS-10), and the short form 4-item scale (PSS-4). The shorter scale includes items 2, 6, 7, and 14 from the original scale and was designed for situations with time constraints on data collection and large samples (<xref ref-type="bibr" rid="B9">Cohen et al., 1983</xref>). The PSS-14 and PSS-10 scales have been translated, adapted, and validated in multiple languages, including Spanish (<xref ref-type="bibr" rid="B27">Lee, 2012</xref>; <xref ref-type="bibr" rid="B32">Maroufizadeh et al., 2018</xref>; <xref ref-type="bibr" rid="B47">Schneider et al., 2020</xref>). The PSS-4 scale, on the other hand, has only been adapted into a few languages, for instance, Spanish (<xref ref-type="bibr" rid="B56">Vallejo et al., 2018</xref>), French (<xref ref-type="bibr" rid="B28">Lesage et al., 2012</xref>) or Swedish (<xref ref-type="bibr" rid="B42">Rozental et al., 2023</xref>). Additionally, it&#x2019; has been used in different populations, including graduate and postgraduate students, workers or teachers, among others (<xref ref-type="bibr" rid="B27">Lee, 2012</xref>; <xref ref-type="bibr" rid="B46">Schmalbach et al., 2025</xref>).</p>
<p>An extensive body of research has confirmed the PSS&#x2019;s good internal consistency and test&#x2013;retest reliability across a wide range of samples and linguistic backgrounds (<xref ref-type="bibr" rid="B27">Lee, 2012</xref>; <xref ref-type="bibr" rid="B49">Soares et al., 2020</xref>; <xref ref-type="bibr" rid="B59">Warttig et al., 2013</xref>). Studies analyzing the psychometric properties of the PSS show that in general PSS-14 and PSS-10 exhibited adequate to high internal consistency reliability, as measured by Cronbach&#x2019;s alpha (&#x03B1; &#x003E; 0.70) and test-retest reliability (Pearson&#x2019;s, Spearman&#x2019;s or intraclass correlation coefficient &#x003E; 0.70) (<xref ref-type="bibr" rid="B27">Lee, 2012</xref>; <xref ref-type="bibr" rid="B42">Rozental et al., 2023</xref>; <xref ref-type="bibr" rid="B52">Taylor, 2015</xref>). The results for the PSS-4 are mixed; some studies report relatively low Cronbach&#x2019;s alphas (&#x03B1; &#x003C; 0.70) (<xref ref-type="bibr" rid="B27">Lee, 2012</xref>), while others report high Cronbach&#x2019;s alphas and omega coefficients (&#x03B1; = 0.82 and &#x03C9; = 0.78) (<xref ref-type="bibr" rid="B34">Mitchell et al., 2008</xref>; <xref ref-type="bibr" rid="B43">Ruisoto et al., 2020</xref>). Furthermore, studies conducted with Spanish-speaking samples have reported acceptable reliability of the PSS-4 (&#x03B1; = 0.70 and &#x03B1; = 0.73; <xref ref-type="bibr" rid="B44">Sanabria-Mazo et al., 2024</xref>; <xref ref-type="bibr" rid="B56">Vallejo et al., 2018</xref>).</p>
<p>Regarding the factorial structure, studies indicate that for the PSS-14 and PSS-10, a bifactor structure representing positive and negative stress items is more dominant than a one-factor structure (e.g., <xref ref-type="bibr" rid="B22">Hore-Lacy et al., 2024</xref>; <xref ref-type="bibr" rid="B39">Reis et al., 2019</xref>). Studies analyzing the factor structure of the PSS-4 have yielded mixed results. While some studies suggest that an unifactorial model is inadequate (<xref ref-type="bibr" rid="B35">Mondo et al., 2021</xref>), others support it as a viable alternative with satisfactory statistical properties (<xref ref-type="bibr" rid="B27">Lee, 2012</xref>; <xref ref-type="bibr" rid="B28">Lesage et al., 2012</xref>; <xref ref-type="bibr" rid="B43">Ruisoto et al., 2020</xref>). It is important to highlight that the consistent identification of a one-factor structure in the PSS-4 is likely due to the reduced number of items, which limits the detection of multiple dimensions, and the limited variation in item wording effects (<xref ref-type="bibr" rid="B27">Lee, 2012</xref>; <xref ref-type="bibr" rid="B28">Lesage et al., 2012</xref>). Furthermore, the translation and back-translation process, as well as the characteristics of the sample, can reinforce a unified perception of stress, which, together with the use of brief administration formats (e.g., online), may support a one-dimensional structure (e.g., <xref ref-type="bibr" rid="B27">Lee, 2012</xref>; <xref ref-type="bibr" rid="B28">Lesage et al., 2012</xref>; <xref ref-type="bibr" rid="B43">Ruisoto et al., 2020</xref>).</p>
<p>Furthermore, regarding measurement invariance (MI), evidence suggests high MI across gender for the PSS-10 (<xref ref-type="bibr" rid="B39">Reis et al., 2019</xref>) and configural, metric, and scalar invariance between groups according to sociodemographic variables such as income level and work status for the PSS-4 (<xref ref-type="bibr" rid="B44">Sanabria-Mazo et al., 2024</xref>). These results may help to understand the importance of assessing dimensionality of PSS in different groups and languages.</p>
<p>Although previous psychometric studies of the PSS-4 in Spanish using classical psychometric approaches have contributed to its widespread use, its dimensionality requires further evaluation. We need to assess its reliability and identify any potential response patterns that could impact the scores. In this sense, sociodemographic variables as gender along with health-related behaviors like physical activity, hours of sleep, and type of diet, could influence the perceived stress. Moreover, examining the convergent validity with other psychological outcomes could highlight the protective and risk factors of stress, helping to assess it before it appears.</p>
<p>In light of the results of the aforementioned studies, we hypothesized that the PSS-4, administered in three languages and evaluated using the classical psychometric approach, will show reliability and validity. In this sense, Spanish and English versions have already demonstrated validity and reliability (<xref ref-type="bibr" rid="B56">Vallejo et al., 2018</xref>; <xref ref-type="bibr" rid="B59">Warttig et al., 2013</xref>) but it is the first time to validate the Catalan version of the PSS-4. We also hypothesized that measurement invariance would be met across language, university community, and gender, as these factors may be key to ensuring fair comparisons between groups, enhancing the validity of the results, and improving the precision of psychological assessment. Only one study (<xref ref-type="bibr" rid="B44">Sanabria-Mazo et al., 2024</xref>) has studied measurement invariance in a Colombian sample using the PSS-4 with sociodemographic information, and they found measurement invariance for gender and age, but not for income level and working status. It is relevant to study the results with a Spanish and English language, as well as for Catalan. Additionally, we hypothesized that the PSS-4 scale would show validity through its expected associations with both traditional psychological outcomes (i.e., depression, anxiety, and wellbeing) and health-related behaviors (i.e., hours of sleep, time spent online, and physical activity).</p>
</sec>
<sec id="S2" sec-type="materials|methods">
<title>Materials and methods</title>
<sec id="S2.SS1">
<title>Participants</title>
<p>The present study was part of a bigger project which aimed to study the mental health and the emotional wellbeing of the students and workers of the Catalonian universities. The sample was comprized of 2.870 participants of the University of Barcelona., 1.810 university students (mean age = 22.91, SD = 6.6; 74.8% females, 21.7% males, 2.4% non-binary, 0.2% others, and a 1.0% preferred not to answer). A 55.5% answered the survey in Spanish, a 39.8% in Catalan and a 4.6% in English) and 1,060 university staff (mean age = 47.21, SD = 11.38; 64.9% females, 32.8% males, 1.2% non-binary and 1.0% preferred not to answer. A 31.2% answered in Spanish, a 65.1% in Catalan and a 3.7% in English).</p>
<p>The inclusion criteria required participants to be over 18 years of age, affiliated with the University of Barcelona as either students or university staff, to be speakers of one of the three target languages (i.e., Catalan, Spanish, or English), and to have fully completed one or more of the measures included in the online survey.</p>
</sec>
<sec id="S2.SS2">
<title>Instruments</title>
<p><italic>Ad hoc</italic> questionnaires were developed to assess age, gender, marital status, university community, education level, physical activity, sleeping, and diet, measured through the following question:</p>
<list list-type="bullet">
<list-item><p>How many hours of physical activity do you do in a week? 30 min or less/1&#x2013;2/3&#x2013;4/5 h or more.</p></list-item>
<list-item><p>How many hours do you sleep on average every day? 5 h or less, 6, 7, 8, 9 h or more.</p></list-item>
<list-item><p>How many hours do you connect every day to the internet (mobile, PC, tablet, smart watch) for purposes other than working or studying? Between 0 and 1 h, between 1 and 2 h, between 3 and 4 h, between 4 and 5 h, more than 5 h.</p></list-item>
<list-item><p>Do you think your diet is healthy? Yes/No.</p></list-item>
</list>
<p>Perceived Stress Scale (PSS-4; <xref ref-type="bibr" rid="B9">Cohen et al., 1983</xref>): short version of the PSS-10, with 4-item self-report questionnaire to assess stress. Each item is rated on a five-point Likert scale (0 = never, 1 = Almost never, 2 = Sometimes, 3 = Fairly often, 4 = Very often). The score ranges from 0 to 16. The PSS-4 has no clinical cut-off scores, so individual scores are compared with normative values (averaged stress scores &#x2265; 6), with higher scores reflecting higher levels of perceived stress (<xref ref-type="bibr" rid="B59">Warttig et al., 2013</xref>). In this study, the Cronbach&#x2019;s alpha of this questionnaire was 0.802 indicating good reliability.</p>
<p>Before data collection, two clinical psychologist investigators with training and experience in psychological assessment, as well as in the translation, adaptation, and validation of questionnaires translated, the original English version of the PSS-4 and the four equivalent items of the Spanish version into Catalan. A trilingual (English, Catalan and Spanish) expert panel reviewed the Catalan translation of the PSS-4 and provided detailed and comprehensive feedback. The committee was composed of two psychologists with experience in mental health and public health researchers. An investigator of the team compiled and synthesized the feedback provided by the committee members and drafted the final Catalan version of the PSS-4. All discrepancies were discussed by the panel and resolved until they reached a formal consensus. Subsequently, a pilot test of the first Catalan version of the PSS-4 was distributed to a selected sample of students and university staff, who were invited to provide comments and suggestions regarding the clarity and comprehensibility of the items. The three versions (Catalan, English, and Spanish) used in this study are presented in <xref ref-type="supplementary-material" rid="TS1">Supplementary Table 1</xref>.</p>
<p>Five Wellbeing Index (WHO-5; <xref ref-type="bibr" rid="B3">Bech, 2004</xref>). The WHO-5 is a five-item self-report questionnaire to assess subjective psychological wellbeing (<xref ref-type="bibr" rid="B54">Topp et al., 2015</xref>). Each item is rated on a five-point Likert scale (0 = at no time, 1 = Some of the time, 2 = less than half of the time, 3 = more than half of the time, 4 = Most of the time, 5 = All of the time). The total score ranges from 0 to 25, and a score below 13 may suggest poor wellbeing. In this study, Cronbach&#x2019;s alpha of this questionnaire was 0.883 indicating good reliability.</p>
<p>Patient Health Questionnaire (PHQ-9, <xref ref-type="bibr" rid="B15">Diez-Quevedo et al., 2001</xref>; <xref ref-type="bibr" rid="B50">Spitzer et al., 1999</xref>): The PHQ-9 includes 9 items designed to screen for depression symptoms based in DSM-IV criteria for depressive disorders. Each item is rated on a four-point Likert scale (0 = none, 1 = less than half the time, 2 = more than half the time, and 3 = almost every day) with total scores ranging from 0 to 27. Higher scores indicate more depressive symptoms. In this study, the Cronbach&#x2019;s alpha of this questionnaire was 0.881 indicating good reliability.</p>
<p>Generalized Anxiety Disorder Questionnaire (GAD-7; <xref ref-type="bibr" rid="B33">Mart&#x00ED;nez-V&#x00E1;zquez et al., 2022</xref>; <xref ref-type="bibr" rid="B51">Spitzer et al., 2006</xref>): The GAD-7 is a seven-item self-report scale designed to assess anxiety symptoms. Each item is rated on a four-point Likert scale (0 = not at all, 1 = several days, 2 = more than half the days, 3 = nearly every day), with total scores ranging from 0 to 21. Higher scores indicate more anxiety symptoms. In this study, the GAD-7 demonstrates excellent internal reliability, with a Cronbach&#x2019;s alpha of 0.915.</p>
</sec>
<sec id="S2.SS3">
<title>Procedure</title>
<p>The present project was approved by the ethics committee of the Catalonian universities. All the students and university staff received a link to the online survey sent by the vice-rectorate of the University. The whole assessment was performed online using Qualtrics and the data recollection was performed from 27 March 2023 until 28 April 2023. The informed consent was obtained by all the participants in the same survey. The participants could answer the survey in Catalan, Spanish, or English. Participation was voluntary and participants did not receive financial compensation for their participation. Questionnaires that contained incomplete responses to key items, or that were duplicated, or that exhibited straight-line answering patterns were excluded. Specifically, participants with missing data on all four PSS items were not considered in the analysis for the current study. In total, 461 questionnaires from students and 281 from university staff were removed due to missing responses on the PSS-4. No imputation was performed for missing data in this instrument. We did not assess baseline differences between included and excluded participants, as those who were excluded due to incomplete PSS-4 responses had not provided sufficient data on the variables of interest t, because most of them only entered to the questionnaire and did not answer any question. As such, potential selection bias could not be formally evaluated. As such, potential selection bias could not be formally evaluated. This study was carried out in accordance with the Helsinki Declaration on Ethical Principles for Medical Research Involving Human Subjects, approved by the Ethics Committees of all the Catalan universities.</p>
</sec>
<sec id="S2.SS4">
<title>Data analysis</title>
<p>Firstly, the construct validity of the PSS-4 was tested using Principal Component Analysis (PCA). Given the extremely small number of items (only four), PCA is more appropriate than Exploratory or Confirmatory Factor Analysis (EFA/CFA), which require a larger number of variables to produce stable and meaningful factor structures (<xref ref-type="bibr" rid="B16">Fabrigar et al., 1999</xref>; <xref ref-type="bibr" rid="B30">MacCallum et al., 1999</xref>). PCA serves as a descriptive data reduction technique that can offer preliminary insights into dimensionality without imposing strong model assumptions (<xref ref-type="bibr" rid="B12">Costello and Osborne, 2005</xref>). EFA and CFA involve latent variable modeling and error estimation, which are not feasible or theoretically justified with such a limited number of observed variables (<xref ref-type="bibr" rid="B30">MacCallum et al., 1999</xref>). Therefore, PCA is a pragmatic choice for assessing unidimensionality in short scales consisting of very few items (<xref ref-type="bibr" rid="B16">Fabrigar et al., 1999</xref>). Moreover, as the structure has already been assessed, we want to confirm the unidimensional structure. In addition to the estimation of the PCA, the factor loadings and their 95% confidence intervals (CI) have been also calculated using a the percentile bootstrap with 1,000 samples. The reliability was tested using Cronbach&#x2019;s alpha and McDonald&#x2019;s &#x03C9;. The principal aim of this analysis was to demonstrate the unidimensional structure as it has been demonstrated in other studies: Spanish (<xref ref-type="bibr" rid="B56">Vallejo et al., 2018</xref>) and English (<xref ref-type="bibr" rid="B59">Warttig et al., 2013</xref>). In this case, it is the first time that a validation of the PSS-4 is presented in Catalan language, so it is important to assess the construct validity and reliability as key psychometric analyses. The one-dimensionality of the scale and the reliability had to be demonstrated for each language, therefore, the analyses were performed separately for each language: for the Spanish validation, a total sample of <italic>n</italic> = 1,336 was used. For Catalan version, a total of <italic>n</italic> = 1,411 was used, and finally, for English version, a total of <italic>n</italic> = 123 was used.</p>
<p>Once the one-dimensionality of the scale was demonstrated, measurement invariance was assessed. In this sense, only one very recent Colombian validation (<xref ref-type="bibr" rid="B44">Sanabria-Mazo et al., 2024</xref>) has tested measurement invariance regarding sociodemographic characteristics. It is crucial to study measurement invariance in a Spanish population to guarantee fair comparisons between groups and to increase the results validity, as well as to increase the precision of the psychological evaluation. This analysis was performed for languages (Spanish, <italic>n</italic> = 1,336; Catalan, <italic>n</italic> = 1,411; English, <italic>n</italic> = 123), for community (1,810 university students and 1,060 university staff members) and for gender (1,353 females and 541 men).</p>
<p>As the configural and the metrical invariance was confirmed, the next step was to demonstrate the relationships between PSS-4 and other psychological outcomes and health-related behaviors. The relationships between the PSS-4 and anxiety and depression have already been demonstrated in the Spanish version (<xref ref-type="bibr" rid="B56">Vallejo et al., 2018</xref>). In this regard, the aim of this study was to explore the relationships of stress with both anxiety and depression, as well as with psychological wellbeing and health-related behaviors (type of diet, number of hours of sleep, number of hours of physical activity, number of hours connected to the internet outside of working/studying hours). This analysis was performed for the whole sample, as it has been mentioned above, once the configural and the metrical invariance is accomplished, the relationship between variables can be compared. In this case, correlations were performed for the quantitative variables, whereas ANOVAS with Tuckey <italic>post hoc</italic> comparisons were performed for the multiple answer questions.</p>
<p>All the analysis were performed with R studio, using lavaan package (<xref ref-type="bibr" rid="B41">Rosseel, 2012</xref>) and psych (<xref ref-type="bibr" rid="B40">Revelle, 2025</xref>) for the bootstrap estimation in the CI.</p>
</sec>
</sec>
<sec id="S3" sec-type="results">
<title>Results</title>
<sec id="S3.SS1">
<title>Structural validity and reliability</title>
<p>For the Spanish version (<italic>n</italic> = 1,336), PCA was carried out to determine the factor structure of PSS-4. Both the Kaiser-Meyer-Olkin test (0.787) and Barlett&#x2019;s test of sphericity (&#x03C7;<sup>2</sup> = 1807.218; <italic>df</italic> = 6; <italic>p</italic> &#x003C; 0.001) indicate that a reduction in dimensionality is appropriate. On the other hand, the scree plot indicates that a single component with an eigenvalue of 2.55 is a good solution and therefore explains 63.9% of the total variability of the scale.</p>
<p>For the Catalan version (<italic>n</italic> = 1,411), PCA was carried out to determine the factorial structure of PSS-4. Both the Kaiser-Meyer-Olkin test (0.784) and Barlett&#x2019;s test of sphericity (&#x03C7;<sup>2</sup> = 2123.910; <italic>df</italic> = 6; <italic>p</italic> &#x003C; 0.001) indicate that a reduction in dimensionality is appropriate. On the other hand, the scree plot indicates that a single component with an eigenvalue of 2.61 is a good solution and therefore explains 65.4% of the total variability of the scale.</p>
<p>For the English version (<italic>n</italic> = 123), PCA was carried out to determine the factor structure of PSS-4. Both the Kaiser-Meyer-Olkin test (0.693) and Barlett&#x2019;s test of sphericity (&#x03C7;<sup>2</sup> = 110.49; <italic>df</italic> = 6; <italic>p</italic> &#x003C; 0.001) indicate that a reduction in dimensionality is appropriate. On the other hand, the scree plot indicates that a single component with an eigenvalue of 2.20 is a good solution and therefore explains 55.5% of the total variability of the scale. <xref ref-type="table" rid="T1">Table 1</xref> presents the factor loadings and associated standard errors for each item across languages.</p>
<table-wrap position="float" id="T1">
<label>TABLE 1</label>
<caption><p>Factor loadings and their confidence interval for each item for each language.</p></caption>
<table cellspacing="5" cellpadding="5" frame="box" rules="all">
<thead>
<tr>
<th valign="top" align="left">Languages</th>
<th valign="top" align="center">Catalan</th>
<th valign="top" align="center">English</th>
<th valign="top" align="center">Spanish</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Item 1 FL (95% CI)</td>
<td valign="top" align="center">0.823 (0.800&#x2013;0.844)</td>
<td valign="top" align="center">0.730 (0.547&#x2013;0.831)</td>
<td valign="top" align="center">0.823 (0.803&#x2013;0.841)</td>
</tr>
<tr>
<td valign="top" align="left">Item 2 FL (95% CI)</td>
<td valign="top" align="center">0.760 (0.727&#x2013;0.789)</td>
<td valign="top" align="center">0.655 (0.438&#x2013;0.790)</td>
<td valign="top" align="center">0.753 (0.718&#x2013;0.786)</td>
</tr>
<tr>
<td valign="top" align="left">Item 3 FL (95% CI)</td>
<td valign="top" align="center">0.803 (0.782&#x2013;0.822)</td>
<td valign="top" align="center">0.757 (0.655&#x2013;0.830)</td>
<td valign="top" align="center">0.802 (0.778&#x2013;0.823)</td>
</tr>
<tr>
<td valign="top" align="left">Item 4 FL (95% CI)</td>
<td valign="top" align="center">0.846 (0.829&#x2013;0.861)</td>
<td valign="top" align="center">0.817 (0.749&#x2013;0.873)</td>
<td valign="top" align="center">0.817 (0.796&#x2013;0.836)</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn><p>FL, factor loading; 95% CI, percentile bootstrap 95% confidence interval in 1,000 samples.</p></fn>
</table-wrap-foot>
</table-wrap>
<p><xref ref-type="table" rid="T2">Table 2</xref> presents the reliability measures for the three languages. As it can be seen, the three languages present good internal consistency following <xref ref-type="bibr" rid="B37">Prinsen et al. (2018)</xref>.</p>
<table-wrap position="float" id="T2">
<label>TABLE 2</label>
<caption><p>Measures of reliability for each language.</p></caption>
<table cellspacing="5" cellpadding="5" frame="box" rules="all">
<thead>
<tr>
<th valign="top" align="center">Language</th>
<th valign="top" align="left">McDonald&#x2019;s &#x03C9; (95% CI)</th>
<th valign="top" align="left">Cronbach&#x2019;s &#x03B1; (95% CI)</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="center">Spanish version</td>
<td valign="top" align="left">0.814 (0.794&#x2013;0.832)</td>
<td valign="top" align="left">0.810 (0.793&#x2013;0.825)</td>
</tr>
<tr>
<td valign="top" align="center">Catalan version</td>
<td valign="top" align="left">0.829 (0.811&#x2013;0.845)</td>
<td valign="top" align="left">0.821 (0.806&#x2013;0.835)</td>
</tr>
<tr>
<td valign="top" align="center">English version</td>
<td valign="top" align="left">0.735 (0.628&#x2013;0.813)</td>
<td valign="top" align="left">0.724 (0.637&#x2013;0.794)</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn><p>CI, confidence interval.</p></fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="S3.SS2">
<title>Measurement invariance</title>
<p><xref ref-type="table" rid="T3">Table 3</xref> summarizes the results of the measurement invariance for language. As it can be seen, the metric model is accomplished (no significant differences with the configural model). This means that the items can be grouped in the same factorial structure and that the factorial loadings are equal across languages, allowing for comparisons between variables. However, there are significant differences between the metric and the scalar model. This means that the intercepts are not equal and therefore, mean comparisons between groups are not strictly comparable.</p>
<table-wrap position="float" id="T3">
<label>TABLE 3</label>
<caption><p>Measurement invariance for language.</p></caption>
<table cellspacing="5" cellpadding="5" frame="box" rules="all">
<thead>
<tr>
<th valign="top" align="center">Model</th>
<th valign="top" align="left">&#x03C7;<sup>2</sup> (df)</th>
<th valign="top" align="left">CFI</th>
<th valign="top" align="left">RMSEA</th>
<th valign="top" align="left">SRMR</th>
<th valign="top" align="left">&#x0394;X<sup>2</sup></th>
<th valign="top" align="left"><italic>P</italic> (&#x0394;X<sup>2</sup>)</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="center">Configural</td>
<td valign="top" align="left">50.48 (6)</td>
<td valign="top" align="left">0.966</td>
<td valign="top" align="left">0.087</td>
<td valign="top" align="left">0.026</td>
<td valign="top" align="left">&#x2013;</td>
<td valign="top" align="left">&#x2013;</td>
</tr>
<tr>
<td valign="top" align="center">Metric</td>
<td valign="top" align="left">56.84 (12)</td>
<td valign="top" align="left">0.966</td>
<td valign="top" align="left">0.06</td>
<td valign="top" align="left">0.030</td>
<td valign="top" align="left">6.36</td>
<td valign="top" align="left">0.3839</td>
</tr>
<tr>
<td valign="top" align="center">Scalar</td>
<td valign="top" align="left">102.63 (18)</td>
<td valign="top" align="left">0.936</td>
<td valign="top" align="left">0.07</td>
<td valign="top" align="left">0.034</td>
<td valign="top" align="left">45.78</td>
<td valign="top" align="left">&#x003C; 0.001</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn><p>&#x03C7;<sup>2</sup>, chi squared; CFI, comparative fit index; RMSEA, root mean square error of approximation; SRMR, Standardized Root Mean Square Residual.</p></fn>
</table-wrap-foot>
</table-wrap>
<p><xref ref-type="table" rid="T4">Table 4</xref> summarizes the results of the measurement invariance for university communities. As it can be seen, the metric model is accomplished (no significant differences with the configural model). However, there are significant differences between the metric and the scalar model. Similarly, as in language, the intercepts are not equal and therefore, mean comparisons between groups are not strictly comparable.</p>
<table-wrap position="float" id="T4">
<label>TABLE 4</label>
<caption><p>Measurement invariance for university communities.</p></caption>
<table cellspacing="5" cellpadding="5" frame="box" rules="all">
<thead>
<tr>
<th valign="top" align="center">Model</th>
<th valign="top" align="left">&#x03C7;<sup>2</sup> (df)</th>
<th valign="top" align="left">CFI</th>
<th valign="top" align="left">RMSEA</th>
<th valign="top" align="left">SRMR</th>
<th valign="top" align="left">&#x0394;X<sup>2</sup></th>
<th valign="top" align="left"><italic>P</italic> (&#x0394;X<sup>2</sup>)</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="center">Configural</td>
<td valign="top" align="left">50.085 (4)</td>
<td valign="top" align="left">0.966</td>
<td valign="top" align="left">0.09</td>
<td valign="top" align="left">0.032</td>
<td valign="top" align="left">&#x2013;</td>
<td valign="top" align="left">&#x2013;</td>
</tr>
<tr>
<td valign="top" align="center">Metric</td>
<td valign="top" align="left">55.704 (7)</td>
<td valign="top" align="left">0.960</td>
<td valign="top" align="left">0.07</td>
<td valign="top" align="left">0.033</td>
<td valign="top" align="left">5.6192</td>
<td valign="top" align="left">0.131</td>
</tr>
<tr>
<td valign="top" align="center">Scalar</td>
<td valign="top" align="left">77.618 (10)</td>
<td valign="top" align="left">0.944</td>
<td valign="top" align="left">0.069</td>
<td valign="top" align="left">0.037</td>
<td valign="top" align="left">21.914</td>
<td valign="top" align="left">&#x003C; 0.001</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn><p>&#x03C7;<sup>2</sup>, chi squared; CFI, comparative fit index; RMSEA, root mean square error of approximation; SRMR, Standardized Root Mean Square Residual.</p></fn>
</table-wrap-foot>
</table-wrap>
<p><xref ref-type="table" rid="T5">Table 5</xref> summarizes the results of the measurement invariance for gender. As it can be seen, the metric model is accomplished (no significant differences with the configural model). However, there are significant differences between the metric and the scalar model. Analogous to the case of language and university communities, the intercepts are not invariant, implying that mean-level comparisons between groups should be interpreted with caution.</p>
<table-wrap position="float" id="T5">
<label>TABLE 5</label>
<caption><p>Measurement invariance for gender.</p></caption>
<table cellspacing="5" cellpadding="5" frame="box" rules="all">
<thead>
<tr>
<th valign="top" align="left">Model</th>
<th valign="top" align="center">&#x03C7;<sup>2</sup> (df)</th>
<th valign="top" align="center">CFI</th>
<th valign="top" align="center">RMSEA</th>
<th valign="top" align="center">SRMR</th>
<th valign="top" align="center">&#x0394;X<sup>2</sup></th>
<th valign="top" align="center"><italic>P</italic> (&#x0394;X<sup>2</sup>)</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">Configural</td>
<td valign="top" align="center">52.803 (4)</td>
<td valign="top" align="center">0.963</td>
<td valign="top" align="center">0.093</td>
<td valign="top" align="center">0.027</td>
<td valign="top" align="center">&#x2013;</td>
<td valign="top" align="center">&#x2013;</td>
</tr>
<tr>
<td valign="top" align="left">Metric</td>
<td valign="top" align="center">53.12 (7)</td>
<td valign="top" align="center">0.965</td>
<td valign="top" align="center">0.068</td>
<td valign="top" align="center">0.027</td>
<td valign="top" align="center">0.317</td>
<td valign="top" align="center">0.956</td>
</tr>
<tr>
<td valign="top" align="left">Scalar</td>
<td valign="top" align="center">69.74 (10)</td>
<td valign="top" align="center">0.955</td>
<td valign="top" align="center">0.065</td>
<td valign="top" align="center">0.031</td>
<td valign="top" align="center">16.62</td>
<td valign="top" align="center">&#x003C; 0.001</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn><p>&#x03C7;<sup>2</sup>, chi squared; CFI, comparative fit index; RMSEA, root mean square error of approximation; SRMR, Standardized Root Mean Square Residual.</p></fn>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="S3.SS3">
<title>Relationships between PSS-4 and other psychological outcomes and health-related behaviors</title>
<p>This analysis was performed for the whole sample, as noted earlier, once the configural and the metrical invariance is accomplished, the relationship between variables can be compared. It is important to highlight that the sample size differs across questionnaires, as some participants did not complete them in full. <xref ref-type="table" rid="T6">Table 6</xref> shows the correlations between PSS-4 and other measures. There were high and significant negative correlations, with a high effect size, between scores of PSS-4 and WHO-5 highlighting an indirect relationship between stress and wellbeing. There were high and significant correlations, with a high effect size, between scores of PSS-4 and scores of PHQ-9 and GAD-7 indicating a direct relationship between stress, anxiety and depression.</p>
<table-wrap position="float" id="T6">
<label>TABLE 6</label>
<caption><p>Correlations of Perceived Stress Scale (PSS-4) with Five Wellbeing Index (WHO-5), Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder Questionnaire (GAD-7).</p></caption>
<table cellspacing="5" cellpadding="5" frame="box" rules="all">
<thead>
<tr>
<th valign="top" align="left"/>
<th valign="top" align="center">WHO-5</th>
<th valign="top" align="center">PHQ-9</th>
<th valign="top" align="center">GAD-7</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left" rowspan="4">PSS-4</td>
<td valign="top" align="center"><italic>r</italic> = &#x2212;0.673</td>
<td valign="top" align="center"><italic>r</italic> = 0.707</td>
<td valign="top" align="center"><italic>r</italic> = 0.649</td>
</tr>
<tr>
<td valign="top" align="center"><italic>n</italic> = 2,841</td>
<td valign="top" align="center"><italic>n</italic> = 2,769</td>
<td valign="top" align="center"><italic>n</italic> = 2,739</td>
</tr>
<tr>
<td valign="top" align="center"><italic>r</italic><sup>2</sup> = 0.453</td>
<td valign="top" align="center"><italic>r</italic><sup>2</sup> = 0.500</td>
<td valign="top" align="center"><italic>r</italic><sup>2</sup> = 0.421</td>
</tr>
<tr>
<td valign="top" align="center"><italic>p</italic> = &#x003C; 0.001</td>
<td valign="top" align="center"><italic>p</italic> = &#x003C; 0.001</td>
<td valign="top" align="center"><italic>p</italic> = &#x003C; 0.001</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn><p>r, pearson correlation; <italic>n</italic>, sample size; <italic>r</italic><sup>2</sup>, effect size; p, <italic>p</italic>-value.</p></fn>
</table-wrap-foot>
</table-wrap>
<p><xref ref-type="table" rid="T7">Table 7</xref> shows the descriptive statistics regarding stress linked to hours doing physical activity, hours sleeping and hours connecting. Regarding physical activity, significant differences were found in students (F = 27.5; <italic>df</italic> = 3,2866; <italic>p</italic> = &#x003C; 0.001; &#x03C9;<italic><sup>2</sup></italic> = 0.027), with little effect size. <italic>Post hoc</italic> analyses revealed significant differences between doing 30 min or less of physical activity and the rest of hours (<italic>p<sub><italic>scheff</italic>&#x00E9;</sub></italic> &#x003C; 0.001). Regarding hours sleeping, significant differences were found between workers (F = 35.5; <italic>df</italic> = 4,2865; <italic>p</italic> = &#x003C; 0.001; &#x03C9;<italic><sup>2</sup></italic> = 0.046), with a little-mean effect size. Post-hoc analyses revealed significant differences between students sleeping 5 h or less and 6 h (<italic>p<sub><italic>scheff</italic>&#x00E9;</sub></italic> &#x003C; 0.001), 7 h (<italic>p<sub><italic>scheff</italic>&#x00E9;</sub></italic> &#x003C; 0.001), and 8 h (<italic>p<sub><italic>scheff</italic>&#x00E9;</sub></italic> &#x003C; 0.001). There were also significant differences between students sleeping 6 and 7 h (<italic>p<sub><italic>scheff</italic>&#x00E9;</sub></italic> &#x003C; 0.001) and 8 h (<italic>p<sub><italic>scheff</italic>&#x00E9;</sub></italic> &#x003C; 0.001). Regarding hours connected to the internet, significant differences were found (F = 26.3; <italic>df</italic> = 5,2864; <italic>p</italic> = &#x003C; 0.001; &#x03C9;<italic><sup>2</sup></italic> = 0.042), with little-mean effect size. <italic>Post hoc</italic> analyses revealed significant differences between stay connected 0&#x2013;1 and 1&#x2013;2 h (<italic>p<sub><italic>scheff</italic>&#x00E9;</sub></italic> = 0.015); 2&#x2013;3 h (<italic>p<sub><italic>scheff</italic>&#x00E9;</sub></italic> &#x003C; 0.001), 3&#x2013;4 h (<italic>p<sub><italic>scheff</italic>&#x00E9;</sub></italic> &#x003C; 0.001), 4&#x2013;5 h (<italic>p<sub><italic>scheff</italic>&#x00E9;</sub></italic> &#x003C; 0.001) and more than 5 h (<italic>p<sub><italic>scheff</italic>&#x00E9;</sub></italic> &#x003C; 0.001); between stay connected 1&#x2013;2 h and the rest of categories (<italic>p<sub><italic>scheff</italic>&#x00E9;</sub></italic> &#x003C; 0.001) except 2&#x2013;3 h; between stay connected 2, 3, and 4&#x2013;5 h (<italic>p<sub><italic>scheff</italic>&#x00E9;</sub></italic> = 0.009) and more than 5 h (<italic>p<sub><italic>scheff</italic>&#x00E9;</sub></italic> = 0.003). Finally, regarding the type of diet, significant differences were found in students between those who thought they had a healthy diet and those who not (<italic>t</italic> = 11.90, <italic>df</italic> = 2,868; <italic>p</italic> &#x003C; 0.001; <italic>Cohen&#x2019;s d</italic> = 0.523; <inline-formula><mml:math id="INEQ16"><mml:msub><mml:mover accent="true"><mml:mi>x</mml:mi><mml:mo>&#x00AF;</mml:mo></mml:mover><mml:mrow><mml:mi>h</mml:mi><mml:mo>&#x2062;</mml:mo><mml:mi>e</mml:mi><mml:mo>&#x2062;</mml:mo><mml:mi>a</mml:mi><mml:mo>&#x2062;</mml:mo><mml:mi>l</mml:mi><mml:mo>&#x2062;</mml:mo><mml:mi>t</mml:mi><mml:mo>&#x2062;</mml:mo><mml:mi>h</mml:mi><mml:mo>&#x2062;</mml:mo><mml:mi>y</mml:mi></mml:mrow></mml:msub></mml:math></inline-formula> = 7.12 (<italic>n</italic> = 2,190, SD = 3.19); <inline-formula><mml:math id="INEQ17"><mml:msub><mml:mover accent="true"><mml:mi>x</mml:mi><mml:mo>&#x00AF;</mml:mo></mml:mover><mml:mrow><mml:mi>n</mml:mi><mml:mo>&#x2062;</mml:mo><mml:mi>o</mml:mi><mml:mo>&#x2062;</mml:mo><mml:mpadded width="+5pt"><mml:mi>t</mml:mi></mml:mpadded><mml:mo>&#x2062;</mml:mo><mml:mi>h</mml:mi><mml:mo>&#x2062;</mml:mo><mml:mi>e</mml:mi><mml:mo>&#x2062;</mml:mo><mml:mi>a</mml:mi><mml:mo>&#x2062;</mml:mo><mml:mi>l</mml:mi><mml:mo>&#x2062;</mml:mo><mml:mi>t</mml:mi><mml:mo>&#x2062;</mml:mo><mml:mi>h</mml:mi><mml:mo>&#x2062;</mml:mo><mml:mi>y</mml:mi></mml:mrow></mml:msub></mml:math></inline-formula> = 8.79 (<italic>n</italic> = 680, SD = 3.17), indicating a medium effect size.</p>
<table-wrap position="float" id="T7">
<label>TABLE 7</label>
<caption><p>Descriptives of hours doing physical activity and hours sleeping linked to stress among students and university staff.</p></caption>
<table cellspacing="5" cellpadding="5" frame="box" rules="all">
<thead>
<tr>
<th valign="top" align="center">Hours doing physical activity</th>
<th valign="top" align="center"><italic>n</italic></th>
<th valign="top" align="center">Mean PSS-4 (SD)</th>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="center">30 min or less</td>
<td valign="top" align="center">767</td>
<td valign="top" align="center">8.39 (3.31)</td>
</tr>
<tr>
<td valign="top" align="center">1&#x2013;2 h</td>
<td valign="top" align="center">897</td>
<td valign="top" align="center">7.36 (3.14)</td>
</tr>
<tr>
<td valign="top" align="center">3&#x2013;4 h</td>
<td valign="top" align="center">783</td>
<td valign="top" align="center">7.16 (3.23)</td>
</tr>
<tr>
<td valign="top" align="center">5 h or more</td>
<td valign="top" align="center">423</td>
<td valign="top" align="center">6.91 (3.23)</td>
</tr>
<tr>
<td valign="top" align="center"><bold>Hours sleeping</bold></td>
<td valign="top" align="center"><bold><italic>n</italic></bold></td>
<td valign="top" align="center"><bold>Mean PSS-4 (<italic>SD</italic>)</bold></td>
</tr>
<tr>
<td valign="top" align="center">5 h or less</td>
<td valign="top" align="center">292</td>
<td valign="top" align="center">9.37 (3.32)</td>
</tr>
<tr>
<td valign="top" align="center">6 h</td>
<td valign="top" align="center">837</td>
<td valign="top" align="center">7.74 (3.14)</td>
</tr>
<tr>
<td valign="top" align="center">7 h</td>
<td valign="top" align="center">1163</td>
<td valign="top" align="center">7.08 (3.22)</td>
</tr>
<tr>
<td valign="top" align="center">8 h</td>
<td valign="top" align="center">516</td>
<td valign="top" align="center">6.99 (3.13)</td>
</tr>
<tr>
<td valign="top" align="center">9 h or more</td>
<td valign="top" align="center">62</td>
<td valign="top" align="center">8.24 (3.28)</td>
</tr>
<tr>
<td valign="top" align="center"><bold>Hours connected to the internet</bold></td>
<td valign="top" align="center"><bold><italic>n</italic></bold></td>
<td valign="top" align="center"><bold>Mean PSS-4 (SD)</bold></td>
</tr>
<tr>
<td valign="top" align="center">Between 0 and 1 h</td>
<td valign="top" align="center">292</td>
<td valign="top" align="center">6.14 (3.21)</td>
</tr>
<tr>
<td valign="top" align="center">Between 1 and 2 h</td>
<td valign="top" align="center">711</td>
<td valign="top" align="center">6.97 (3.32)</td>
</tr>
<tr>
<td valign="top" align="center">Between 2 and 3 h</td>
<td valign="top" align="center">626</td>
<td valign="top" align="center">7.43 (3.13)</td>
</tr>
<tr>
<td valign="top" align="center">Between 3 and 4 h</td>
<td valign="top" align="center">413</td>
<td valign="top" align="center">8.04 (3.27)</td>
</tr>
<tr>
<td valign="top" align="center">Between 4 and 5 h</td>
<td valign="top" align="center">347</td>
<td valign="top" align="center">8.27 (3.13)</td>
</tr>
<tr>
<td valign="top" align="center">More than 5 h</td>
<td valign="top" align="center">481</td>
<td valign="top" align="center">8.26 (3.06)</td>
</tr>
</tbody>
</table></table-wrap>
</sec>
</sec>
<sec id="S4" sec-type="discussion">
<title>Discussion</title>
<p>Mental health prevention is crucial in current times, therefore early detection of stress with valid and reliable measures could help to promote positive wellbeing and resilience and consequently, improve the quality of life among adults. In particular, early detection of stress can serve as a protective factor in preventing the onset of stress-related psychopathologies, such as anxiety disorders and depression (<xref ref-type="bibr" rid="B60">Weger and Sandi, 2018</xref>). Therefore, regarding the first hypothesis, which proposed that the PSS-4, administered in Spanish, English, and Catalan to a sample of students and university staff, would demonstrate good psychometric properties, the results supported this assumption. Specifically, the PSS-4 demonstrated a clear unidimensional structure across all three language versions, with higher variance explained by one factor than in other studies in Spanish (<xref ref-type="bibr" rid="B56">Vallejo et al., 2018</xref>). It should be noted that the one-factor structure observed across the three versions of the PSS-4 may be partly related to the small number of items. When a scale includes fewer items with good internal coherence, it makes it easier for a single dimension to account for a high proportion of the variance. Likewise, both the translation and back-translation process and the use of brief administration formats (i.e., online) may contribute to the emergence of a one-factor structure (e.g., <xref ref-type="bibr" rid="B27">Lee, 2012</xref>; <xref ref-type="bibr" rid="B44">Sanabria-Mazo et al., 2024</xref>). Additionally, to our knowledge, this is the first time a PCA has been performed on the PSS-4 in Catalan. Regarding reliability, the three version of PSS-4 showed high reliability measured with Cronbach&#x2019;s &#x03B1; and McDonald&#x2019;s &#x03C9;, having similar results as the English version (<xref ref-type="bibr" rid="B59">Warttig et al., 2013</xref>). In the Spanish version used in our study, the PSS-4 demonstrated higher reliability compared to the findings reported by <xref ref-type="bibr" rid="B56">Vallejo et al. (2018)</xref>, <xref ref-type="bibr" rid="B44">Sanabria-Mazo et al. (2024)</xref>, the latter conducted on a sample of university students.</p>
<p>Concerning the second hypothesis, which proposed that measurement invariance would be established across languages, university community, and gender, the findings offer only partial support. Indeed, as mentioned, the configural and the metrical invariance was met, whereas the scalar invariance was not accomplished for the three variables.</p>
<p>The absence of scalar invariance indicates that mean comparisons of stress scores across language, university communities, and gender should be approached with caution, as the equality of intercepts is a prerequisite for valid group comparisons (<xref ref-type="bibr" rid="B57">Vandenberg and Lance, 2000</xref>; <xref ref-type="bibr" rid="B45">Sass, 2011</xref>). In this sense, the results support that the items can be grouped in the same factorial structure (configural invariance), and that the factor loadings are equivalent across groups (metrical invariance). These levels of invariance support the analysis of relationships between variables. However, the lack of scalar invariance, which reflects unequal intercepts, limits the interpretability of mean-level comparisons. In the case of language, several factors may underlie this non-invariance, despite it is the first time to our knowledge that has been assessed. For instance, linguistic differences may alter how items are interpreted, since translations often fail to capture cultural nuances in the expression of stress (<xref ref-type="bibr" rid="B14">Cruz-Gonzalez et al., 2021</xref>). In the case of university communities, another time it is the first time to be assessed. This finding is particularly relevant given that both students and staff within university settings are consistently reported to experience significant levels of stress (<xref ref-type="bibr" rid="B25">La Fauci et al., 2023</xref>; <xref ref-type="bibr" rid="B29">Li and Kou, 2018</xref>). The lack of scalar invariance may reflect differences in how stress is experienced or reported across these groups. Students are exposed to numerous stressors, including frequent evaluations, high academic workload, and financial difficulties (<xref ref-type="bibr" rid="B2">Asif et al., 2020</xref>; <xref ref-type="bibr" rid="B55">Trigueros et al., 2020</xref>). University staff, meanwhile, face high demands and pressure to demonstrate competence, as well as challenges related to job satisfaction (<xref ref-type="bibr" rid="B1">Agyapong et al., 2022</xref>; <xref ref-type="bibr" rid="B31">Mark and Smith, 2012</xref>). Therefore, this may also reflect differing norms regarding what is perceived as stressful, influencing the relationship between items and the latent construct (<xref ref-type="bibr" rid="B6">Byrne and van de Vijver, 2010</xref>). Finally, regarding gender, to date, only one study has evaluated the PSS-4 with respect to measurement invariance and gender in a Colombian sample (<xref ref-type="bibr" rid="B44">Sanabria-Mazo et al., 2024</xref>), showing inconsistent results with ours, as they found the PSS-4 to be invariant across gender. However, significant differences in stress by gender have been already demonstrated in other studies (<xref ref-type="bibr" rid="B11">Costa et al., 2021</xref>; <xref ref-type="bibr" rid="B19">Graves et al., 2021</xref>) which could justify this invariance.</p>
<p>The fact that scalar invariance is not supported, while metric and configural invariance are, has some practical and clinical implications that worth mentioning when using the PSS-4 for assessment. In reality, these findings align with prior research showing that psychological measures often fail to achieve full scalar invariance across diverse populations, underscoring the need for cautious interpretation and reliance on invariant items for cross-group comparisons. In practice, the lack of scalar invariance in the PSS-4 across language, university communities, and gender implies that mean comparisons between groups cannot be interpreted unambiguously, as differences may reflect measurement bias rather than true disparities in perceived stress. This limits the validity of using raw total scores to compare groups directly. A pragmatic approach is to explore partial invariance models, where equality constraints are retained for invariant items and relaxed for those showing non-invariance (<xref ref-type="bibr" rid="B38">Putnick and Bornstein, 2016</xref>). Such models allow for more accurate latent mean comparisons while retaining the usefulness of the instrument. Alternatively, researchers may focus on relations between stress and external variables, since metric invariance is generally sufficient for comparing structural associations across groups. These strategies enable continued use of the PSS-4 while acknowledging its measurement limitations in cross-group contexts, in other words, clinically, it undermines the validity of cross-group assessments and may lead to unfair or inaccurate conclusions.</p>
<p>Finally, the results related to the third hypothesis, which proposed that the PSS-4 scale would be associated with both traditional psychological outcomes and health-related behaviors, provided only partial support. Precisely, despite the low effect size the PSS-4 showed a strong association with measures of anxiety and depression, consistent with previous findings (<xref ref-type="bibr" rid="B56">Vallejo et al., 2018</xref>), indicating a linear relationship with both constructs. Regarding wellbeing, to our knowledge, this study is the first to measure the relationship between this construct and the PSS-4. The findings reveal a strong, indirect relationship between the two measures, with higher stress levels indicating lower personal wellbeing. Thus, the significant and strong correlations observed between PSS-4 scores and measures of anxiety, depression, and well-being are consistent with findings reported in the established literature (<xref ref-type="bibr" rid="B27">Lee, 2012</xref>). These results suggest that the PSS-4 effectively captures the core dimensions of perceived stress in relation to these key psychological constructs.</p>
<p>Stress demonstrated to have also relationships with other relevant health-related behaviors. Concerning hours of physical activity, hours of sleep, hours spent connected to the internet, and type of diet variables, statistically significant differences were observed also with very few effect size, in line with other studies (<xref ref-type="bibr" rid="B5">Bremner et al., 2020</xref>; <xref ref-type="bibr" rid="B53">Tibbetts et al., 2021</xref>; <xref ref-type="bibr" rid="B61">Wright et al., 2023</xref>). However, these differences are considered negligible, as indicated by the effect size measures in the four cases and as can be further supported by <xref ref-type="table" rid="T7">Table 7</xref>, which shows that means are nearly identical across groups.</p>
<p>In summary, we found higher levels of stress to be associated with more mental health problems as well as poorer personal wellbeing.</p>
<p>The results of this study need to be interpreted in light of a number of limitations. First, a key limitation is the use of a cross-sectional design, that makes difficult make a causal inference for the direction of the associations (<xref ref-type="bibr" rid="B58">Wang and Cheng, 2020</xref>). Further studies should be conducted on university population using longitudinal approaches to analyze the predictability of relationships and the possible causality between subdimensions. In this regard, <xref ref-type="bibr" rid="B10">Cook et al. (2024)</xref> reported adequate model fit supporting a unidimensional structure of the PSS-4 across three timepoints, spaced 6 months apart, over a 1 year period in a sample of 361 mental health counselors.</p>
<p>Additionally, it should be noted that behavioral variables (e.g., sleep, physical activity) may both influence and be influenced by perceived and reported stress. Future research should consider incorporating standardized and validated behavioral instruments to strengthen the findings related to behavioral variables such as sleep, physical activity and sedentary time (i.e., screen activities). Second, given that the pilot testing phase to provide initial item validation was carried out via convenience groups rather than randomized groups, caution is warranted regarding the generalizability of the results (<xref ref-type="bibr" rid="B24">Kalkbrenner, 2021</xref>). Third, the relatively small validation sample size of the English group (<italic>n</italic> = 123) compared to the Spanish (<italic>n</italic> = 1,336) and Catalan (<italic>n</italic> = 1,411) groups makes it challenging to accurately understand the nature of the differences between them. The difference in the sample size may reduce the stability of factor loadings and the power of invariance tests in the smaller samples. Nonetheless, the factorial structure was consistent across languages, and the main loadings proved robust. These findings suggest that the observed results are not solely an artifact of sample size, although future studies with larger and more balanced groups would be valuable to confirm them.</p>
<p>Finally, it must be borne in mind that, although the Catalan version of the PSS-4 has shown good psychometric properties, it may contain cultural and linguistic nuances that influence item interpretation. Despite careful efforts to ensure semantic equivalence through translation and back-translation procedures, subtle differences in meaning and cultural context may affect participants&#x2019; understanding and responses. Future research is encouraged to further validate the Catalan version using culturally sensitive research methods.</p>
<p>Even so, these limitations, to our knowledge, this is the first study to analyze the psychometric properties of the PSS-4 using a mixed analysis strategy that combines classical psychometric methods with recent theoretical approaches in psychology. Indeed, on the one hand, the classical psychometric approach allowed for accurate structural validity and reliability delimitation of the PSS-4 for university population. Lastly, it is worth highlighting the development and analysis of the Catalan version of PSS-4, which, as far as we know, is being done for the first time.</p>
<p>The findings of this study align with previous research demonstrating the adequate psychometric properties of the PSS-4 in a Spanish-speaking sample (<xref ref-type="bibr" rid="B56">Vallejo et al., 2018</xref>). These results are consistent with other recent studies indicating that the PSS-4 is highly reliable and valid for detecting perceived stress levels in adults in a very quick and efficient manner (e.g., <xref ref-type="bibr" rid="B46">Schmalbach et al., 2025</xref>).</p>
<p>In summary, this study provides robust evidence supporting the psychometric properties of the PSS-4 in Spanish, English, and Catalan within a university population. The scale demonstrated a consistent unidimensional structure and high reliability. Although configural and metric invariance were established, the absence of scalar invariance suggests meaningful differences in how stress is perceived and reported across groups. From a clinical perspective, these findings underscore the utility of the PSS-4 as a rapid, accessible, and effective screening measure for stress assessment. Its ease of administration makes it particularly suitable for integration into the assessment, prevention, and intervention protocols of university counseling services. Furthermore, the findings emphasize the importance of culturally sensitive assessment approaches in promoting mental health and psychological wellbeing among university population. From a research perspective, the study highlights the need for longitudinal designs, standardized behavioral measures, and further validation of the Catalan version to enhance generalizability and deepen understanding of stress dynamics in diverse academic settings.</p>
</sec>
</body>
<back>
<sec id="S5" sec-type="data-availability">
<title>Data availability statement</title>
<p>The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.</p>
</sec>
<sec id="S6" sec-type="author-contributions">
<title>Author contributions</title>
<p>CC-M: Conceptualization, Data curation, Formal analysis, Methodology, Writing &#x2013; original draft, Writing &#x2013; review &#x0026; editing. VK: Conceptualization, Data curation, Formal analysis, Methodology, Writing &#x2013; original draft, Writing &#x2013; review &#x0026; editing. MP-C: Methodology, Supervision, Writing &#x2013; review &#x0026; editing. JA-C: Methodology, Supervision, Writing &#x2013; review &#x0026; editing. JG-O: Methodology, Supervision, Writing &#x2013; review &#x0026; editing.</p>
</sec>
<sec id="S8" sec-type="COI-statement">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec id="S9" sec-type="ai-statement">
<title>Generative AI statement</title>
<p>The authors declare that no Generative AI was used in the creation of this manuscript.</p>
<p>Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.</p>
</sec>
<sec id="S12" sec-type="correction-note">
<title>Correction note</title>
<p>A correction has been made to this article. Details can be found at: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fpsyg.2025.1767664">10.3389/fpsyg.2025.1767664</ext-link>.</p>
</sec>
<sec id="S10" sec-type="disclaimer">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<sec id="S11" sec-type="supplementary-material">
<title>Supplementary material</title>
<p>The Supplementary Material for this article can be found online at: <ext-link ext-link-type="uri" xlink:href="https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1648070/full#supplementary-material">https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1648070/full#supplementary-material</ext-link></p>
<supplementary-material xlink:href="Table_1.docx" id="TS1" mimetype="application/vnd.openxmlformats-officedocument.wordprocessingml.document"/>
</sec>
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<fn-group>
<fn id="n1" fn-type="custom" custom-type="edited-by"><p>Edited by: <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/538412/overview">Rodrigo Assar</ext-link>, University of Chile, Chile</p></fn>
<fn id="n2" fn-type="custom" custom-type="reviewed-by"><p>Reviewed by: <ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/538252/overview">Yamil Quevedo</ext-link>, University of Chile, Chile</p>
<p><ext-link ext-link-type="uri" xlink:href="https://loop.frontiersin.org/people/1651514/overview">Juan P. Sanabria-Mazo</ext-link>, Universitat Rovira i Virgili, Spain</p></fn>
</fn-group>
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