Depression, Anxiety and Stress Scale - 21 (DASS-21)
What it is
The DASS-21 (Depression, Anxiety and Stress Scale – 21 items) is a short form version of the DASS-42, a self-report scale designed to measure the severity of a range of symptoms across depression, anxiety and stress. The DASS-21 is not a categorical measure of clinical diagnosis as it provides a dimensional measure of symptoms rather than a clinical cut-off with scores reflecting how much an individual is experiencing symptoms. Therefore, it is a helpful measure to assist in diagnosis and monitoring outcomes in individuals. It can also be helpful in assessing distress in people who might not reach a clinical cut-off for diagnosis but experience considerable symptoms and might be at risk of future problems. The measure can also be used for routine outcome monitoring and to assess treatment response.
How is it used
- Can be used with adults (18yrs+)
- Takes approximately 5mins to complete
- Asks about symptoms over the last week
- Used at the beginning of treatment and routinely to assess treatment response
What do the scores mean?
Individuals are required to read each of the 21 statements of the DASS-21 and indicate the presence of symptoms over the past week using 0-3 from ‘does not apply’ to ‘applies very much or most of the time’. The DASS-21 can be used to examine the presence and severity of a patient’s symptoms and can be re-administered to evaluate change in symptoms and response to treatment. Each of the three sub-scales of the DASS-21 includes 7 items:
- Depression subscale (dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest / involvement, anhedonia and inertia)
- Anxiety sub-scale (autonomic arousal, skeletal muscle effects, situational anxiety, and subjective experience of anxious affect)
- Stress sub-scale (difficulties in relaxing, nervous arousal, and being easily upset / agitated, irritable / over-reactive and impatient)
Scores for the depression, anxiety and stress sub-scales are calculated by summing the scores for each of the relevant items. Scores are then doubled to give a score from 0 to 42 with higher scores reflect worse symptoms. Scores can also be directly compared with the DASS-42. The subscale scores are across five ranges of severity of normal, mild, moderate, severe and extremely severe (ranges differ for each subscale). When administered more than once, change in symptoms can be monitored over time.
Developer
Lovibond SH & Lovibond PF (1995). Manual for the Depression Anxiety & Stress Scales. (2nd Ed.)Sydney: Psychology Foundation.
References
Antony et al. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10: 176–181.
Brown et al., (1997). Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behaviour Research and Therapy, 35: 79–89.