Depression, Anxiety and Stress Scales (DASS)

Abstract

The Depression Anxiety Stress Scales (DASS) was created as a multifaceted screening instrument for depression, anxiety, and stress with the overall score representing an overarching psychological distress. Globally, the DASS has become one of the most extensively used assessment tool for depression, anxiety, and stress within both general and clinical populations. In this chapter, the theoretical background of anxiety, depression, and stress are outlined, followed by an account of the scale’s development and inceptive validation. The original exploratory and confirmatory factor analysis results are then presented to support the original validation of the scale, and its psychometric properties; more recent studies are also examined which generally support robustness of the DASS. Rasch analysis and ordinal-to-interval tables are provided, demonstrating good reliability and robust psychometric properties of the scale’s overarching distress construct as well as of each of the subscales. Overall, the DASS has been shown to demonstrate good psychometric properties across cultures with versions translated and validated in several languages.

Appendix 1

Depression Anxiety Stress Scales (DASS-21)

Over the Past Week….
1) I found it hard to wind down	0	1	2	3
2) I was aware of dryness of my mouth	0	1	2	3
3) I couldn’t seem to experience any positive feeling at all	0	1	2	3
4) I experienced breathing difficulty (e.g., excessively rapid breathing, breathlessness in the absence of physical exertion)	0	1	2	3
5) I found it difficult to work up the initiative to do things	0	1	2	3
6) I tended to over-react to situations	0	1	2	3
7) I experienced trembling (e.g., in the hands)	0	1	2	3
8) I felt that I was using a lot of nervous energy	0	1	2	3
9) I was worried about situations in which I might panic and make a fool of myself	0	1	2	3
10) I felt that I had nothing to look forward to	0	1	2	3
11) I found myself getting agitated	0	1	2	3
12) I found it difficult to relax	0	1	2	3
13) I felt down-hearted and blue	0	1	2	3
14) I was intolerant of anything that kept me from getting on with what I was doing	0	1	2	3
15) I felt I was close to panic	0	1	2	3
16) I was unable to become enthusiastic about anything	0	1	2	3
17) I felt I wasn’t worth much as a person	0	1	2	3
18) I felt that I was rather touchy	0	1	2	3
19) I was aware of the action of my heart in the absence of physical exertion (e.g., sense of heart rate increase, heart missing a beat)	0	1	2	3
20) I felt scared without any good reason	0	1	2	3
21) I felt that life was meaningless	0	1	2	3

Please read each statement and circle a number 0, 1, 2 or 3 which indicates how much the statement applied to you over the past week. There are no right or wrong answers. Do not spend too much time on any statement. The rating scale is as follows:

• 0 Did not apply to me at all - NEVER

• 1 Applied to me to some degree, or some of the time - SOMETIMES

• 2 Applied to me to a considerable degree, or a good part of time - OFTEN

• 3 Applied to me very much, or most of the time - ALMOST ALWAYS

DASS-21 Scoring

The depression subscale comprises items 3, 5, 10, 13, 16, 17, and 21, the anxiety subscale contains items 2, 4, 7, 9, 15, 19, and 20, and the stress subscale includes items 1, 6, 8, 11, 12, 14, and 18. The scale uses a four-point Likert- type scale format, with responses ranging from 0 = “Did not apply to me at all” to 3 = “Applied to me very much, or most of the time”.

Interpretation	Depression	Anxiety	Stress
Normal	0–4	0–3	0–7
Mild	5–6	4–5	8–9
Moderate	7–10	6–7	10–12
Severe	11–13	8–9	13–16
Extremely severe	14 +	10 +	17+

Scores from the DASS-21 can be multiplied by two and converted back to the original 42-item scale format (Lovibond & Lovibond, 1995).