Depression Anxiety and Stress Scales

Eric K. Mason

Depression Anxiety and Stress Scales (DASS)

The DASS is primarily used to measure three emotional states, which are regarded as unpleasant or undesirable—depression, anxiety, and stress. The DASS consist of 42 items whose aim is to measure 14 primary symptoms on a scale from zero to three. Although all 42 items are listed together, essentially the DASS is divided into three parts—a section that measures anxiety, a section that measures depression, and a section that measures stress. Each section contains 14 items respectively (Fischer & Corcoran, 2000).

In addition to the original DASS, a shorter version called the DASS-21 is also available. As the name implies, it contains 21 items instead of the standard 42. The DASS has been found to be slightly more reliable than the DASS-21. However, the DASS and the DASS-21 have been found to yield similar results. In general, the DASS is recommended over the DASS-21 in clinical settings, while the DASS-21 may be more appropriate in research settings (Ahmet & Bayram, 2007).

The DASS first began development in 1979 and was normed on a population of 2,914 adults. Since then it has been found to be reliable and valid by multiple studies. In addition, it has been found to be useful in various clinical settings, easily administered and scored with a useful manual, as well as being available to the public domain. Although the DASS is not intended for use with children, it is deemed appropriate for adolescents as young as 14 years old. Currently, the DASS has been officially translated into the following languages: Arabic,  Bangla, Chinese, Danish, Dari, Dutch, Filipino, Finnish, French, German, Greek, Hebrew  Hindi, Hungarian, Icelandic, Indonesian, Italian, Japanese, Korean, Malaysian, Marathi Norwegian, Pashto, Persian, Polish, Portuguese, Romanian, Russian, Serbian, Sinhala, Slovak, Slovenian, Spanish, Swedish, Taiwanese, Tamil, Thai, Turkish, Urdu, Vietnamese (Fischer & Corcoran, 2000).

The DASS assumes that psychological disturbances are dimensional rather than categorical. This assumption, that the difference between those who experience distress by their symptoms and those who do not experience distress is a matter of degree or intensity for which these symptoms are experienced, has been supported by independent research. In other words, those who are distressed by their depression, anxiety, or stress experience the causal symptoms at a greater intensity than those who are not distressed. The DASS is not used to diagnosis disorders, such as depression or anxiety disorders, but rather to help identify areas in which an individual may be experiencing some difficulties. However, there are cutoff levels listed in the DASS Manual which assist clinicians in categorizing test takers (to a certain extent), such as enabling them to be categorize test takers as normal, moderate, or severe (Ahmet & Bayram, 2007).

The test takers are told to rate themselves on each item from zero to three, regarding how much the item applies to them over the past seven days. For example, item one states “I found myself getting upset by quite trivial things,” for which test takers are told to rate themselves in the following way: 0 = Did not apply to me at all; 1 = Applied to me to some degree, or some of the time; 2 = Applied to me to a considerable degree, or a good part of the time; 3 = Applied to me very much or part of the time. Test takers are supposed to rate the remaining 41 items in the same way (Fischer & Corcoran, 2000).

Although rating each item with only the last seven days in mind assumes that anxiety, depression, and stress are not enduring traits and may vary from week to week, it can also be used to measure these emotional states as more enduring traits by asking test takers to rate how they typically or most often feel (Fischer & Corcoran, 2000).

The DASS can identify people as falling high on the depression scale by those who had high scores on the items which identified them as people with the following characteristics: self-disparaging, dispirited, gloomy, blue, convinced that life has no meaning or value, pessimistic about the future, unable to experience enjoyment or satisfaction, unable to become interested or involved, lacking in initiative. In regards to anxiety, people who scored on this scale are those who scored high on items that characterizes them as the following: apprehensive, panicky, trembly, shaky, aware of dryness of the mouth, breathing difficulties, pounding of the heart, sweatiness of the palms, worried about performance and possible loss of control. Lastly, the DASS may identify those who score high on the stress scale by those who had high scores on items that identified them as people with the following symptoms: over-aroused, tense unable to relax touchy, easily upset irritable easily startled nervy, jumpy, fidgety intolerant of interruption or delay (Ahmet & Bayram, 2007).

The items for the DASS appear below:

1. I found myself getting upset by quite trivial things.
2. I was aware of dryness of my mouth.
3. I couldn’t seem to experience any positive feeling at all.
4. I experienced breathing difficulty (e.g., excessively rapid breathing breathlessness in the absence of physical exertion).
5. I just couldn’t seem to get going.
6. I tended to overreact to situations.
7. I had feelings of shakiness (e.g., legs going to give way).
8. I found it difficult to relax.
9. I found myself in situations that made me so anxious I was most relieved when they ended.
10. I felt that I had nothing to look forward to.
11. I found myself getting upset rather easily.
12. I felt that I was using a lot of nervous energy.
13. I felt sad and depressed.
14. I found myself getting impatient when I was delayed in any way (e.g., elevators, traffic lights, being kept waiting).
15. I had a feeling of faintness.
16. I felt that I had lost interest in just about everything.
17. I felt I wasn’t worth much as a person.
18. I felt that I was rather touchy.
19. I perspired noticeably (e.g., hands sweaty in the absence of high temperatures or physical exertion.
20. I felt scared without any good reason.
21. I felt that life wasn’t worthwhile.
22. I found it hard to wind down.
23. I had difficulty in swallowing.
24. I couldn’t seem to get any enjoyment out of the things I did.
25. 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).
26. I felt downhearted and blue.
27. I found that I was very irritable.
28. I felt I was close to panic.
29. I found it hard to come down after something upset.
30. I feared that I would be “thrown” by some trivial but unfamiliar task.
31. I was unable to become enthusiastic about anything.
32. I found it difficult to tolerate interruptions to what I was doing.
33. I was in a state of nervous tension.
34. I felt I was pretty worthless.
35. I was intolerant of anything that kept me from getting on with what I was doing.
36. I felt terrified.
37. I could see nothing in the future to be hopeful about.
38. I felt that life was meaningless.
39. I found myself getting agitated.
40. I was worried about situations in which I might panic and make a fool of myself.
41. I experienced trembling (e.g., in the hands).
42. I found it difficult to work up the initiative to do things (Fischer & Corcoran, 2000).

The DASS is a self-report instrument, and no special skills are required to administer it. However, interpretation of the DASS should be carried out by individuals with appropriate training in psychological science, including emotion, psychopathology and assessment. When the DASS is administered to individuals who have sought professional help, or who are displaying high levels of distress, interpretation should be carried out by an appropriately qualified professional such as a clinical psychologist (http://www2.psy.unsw.edu.au).

The DASS is scored by summing the total points scored on each scale—depression, anxiety, and stress, respectively. The general guidelines and recommendations for cutoff scores for the DASS appear below:

Depression scores are the sum of the responses to items 3, 5, 10, 13, 16, 17, 21, 24, 26, 31, 34, 37, 38, and 42. Anxiety scores are the sum of items 2, 4, 7, 9, 15, 19, 20, 23, 25, 28, 30, 36, 40, and 41. Stress scores are the sum of 1, 6, 8, 11, 12, 14, 18, 22, 27, 29, 32, 33, 35, and 39.

Although the items on the DASS are supposed to distinctly measure depression, anxiety, and stress (i.e., as if they were distinct psychological traits), some research points out that items claiming to measure these states tend to cross load with one another when they are put through a factor analysis. In other words, these items may measure the same thing. Therefore, some researchers propose that a better way to conceptualize the utility of such items as being effective in identifying negative emotional states in general.

The usefulness of the DASS remains, however, as people who score high in negative emotional states on such measure as the DASS are more likely to be depressed, anxious, or stressed. It may be difficult, though, to determine exactly which negative emotional state a person is expressing by relying solely on the DASS (e.g., if the person is depressed, anxious, or stressed). In addition, those who report experiencing chronic pain tend have high scores on the DASS, which may make it applicable to identifying psychosomatic complaints. On the other hand, of course, one would expect people in chronic pain to be in a negative emotional state, as well (Ahmet & Bayram, 2007).

Other psychological tests used to measure depression and anxiety include the following: Beck Depression Inventory, Beck Anxiety Inventory, the Zung Self-Rating Scale, the Costello-Comrey Scales for Depression and Anxiety, the Minnesota Multiphasic Personality Inventory Depression Scale, and the Rosen Depression Scale. Although there are multiple tests that measure depression and anxiety, the DASS is unique in that it measures these constructs (as well as stress) on one scale. In one study, the DASS was found to be highly correlated with the Beck Depression and Beck Anxiety Inventories at .74 and .81, respectively (Ahmet & Bayram, 2007).

Bibliography

Ahmet, A.& Bayram, E. (2007). The Depression Anxiety and Stress Scale (DASS): The

study of Validity and Reliability. Educational Sciences: Theory & Practice, 7, 260-268.

Corcoran, K., & Fischer, J. (2000). Measures for Clinical Practice: A Source Book, Volume 2

Adults 3^rd ed. The Free Press.  

UNSW School of Psychology. The Depression Anxiety and Stress Scale (DASS)

http://www2.psy.unsw.edu.au  (2015, May 1). Retrieved May 1, 2015.