DASS 21 Depression Anxiety Stress Scale

Evaluates the severity of depressive and anxious disorder symptoms and stress manifestations.

In the text below the scale calculator, you can find out more about the result interpretation method.

The DASS 21 is a self report evaluation scale aimed at revealing the severity of symptoms that the patient suffers from and which can be associated with depression or anxiety or are consistent with stress manifestations.

The scale can be used for screening, however, for diagnosis, the patient should be referred for specialist consultation.

Each of the three dimensions in DASS 21 is interpreted in a different way:

Level/Disorder	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

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DASS 21 explained

This is a mental health questionnaire aimed at revealing the severity of behavioural and emotional symptoms correlated with anxious and depressive disorder and with stress.

The scale consists of 21 items and takes around 5 minutes to complete.

The main instruction given to the patient is to consider what they are currently experiencing and what they have experienced in the past week, when selecting the answer choices.

The questions in the DASS21 are listed below, with reference to the domain they belong:

■ Depression symptoms related items (d): 3, 5, 10, 13, 16, 17, 21.

■ Anxiety disorder related items (a): 2, 4, 7, 9, 15, 19, 20.

■ Stress related items (s): 1, 6, 8, 11, 12, 14, 18.

1. (s) I found it hard to wind down.

2. (a) I was aware of dryness of my mouth.

3. (d) I couldn’t seem to experience any positive feeling at all.

4. (a) I experienced breathing difficulty.

5. (d) I found it difficult to work up the initiative to do things.

6. (s) I tended to over-react to situations.

7. (a) I experienced trembling (e.g. in the hands).

8. (s) I felt that I was using a lot of nervous energy.

9. (a) I was worried about situations in which I might panic and make a fool of myself.

10. (d) I felt that I had nothing to look forward to.

11. (s) I found myself getting agitated.

12. (s) I found it difficult to relax.

13. (d) I felt down-hearted and blue.

14. (s) I was intolerant of anything that kept me from getting on with what I was doing.

15. (a) I felt I was close to panic.

16. (d) I was unable to become enthusiastic about anything.

17. (d) I felt I wasn’t worth much as a person.

18. (s) I felt that I was rather touchy.

19. (a) I was aware of the action of my heart in the absence of physical exertion.

20. (a) I felt scared without any good reason.

21. (d) I felt that life was meaningless.

It is important to note that this is not a diagnostic tool and should be followed by specialist evaluation if suspicion of a mental disorder persists.

Score interpretation

Each of the questions in DASS 21 is awarded a number of points, varying from 0 to 3. There are three dimensions evaluated:

■ Depression;

■ Anxiety;

■ Stress reactions.

Each question has the same four answer choices available:

■ Never – did not apply to me at all, awarded 0 points;

■ Sometimes – applied to me to some degree, or some of the time, awarded 1 point;

■ Often – applied to me to a considerable degree, or a good part of time, awarded 2 points;

■ Almost always – applied to me very much, or most of the time, awarded 3 points.

Each of these dimensions is awarded a partial score between 0 and 18 to 24, depending on how many questions are assigned to the dimension (see in above section).

The table below introduces the score interpretation for each dimension:

Level/Disorder	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

Original source

Lovibond PF, Lovibond SH. The Structure of Negative Emotional States: Comparison of the Depression Anxiety Stress Scale (DASS) with the Beck Depression and Anxiety Inventories, Behav. Res. Ther., Vol 33: No 3, 335-343, 1995.

Other references

1. Henry JD, Crawford JR. The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample. Br J Clin Psychol. 2005; 44(Pt 2):227-39.

2. Wiseman TA, Curtis K, Lam M, Foster K. Incidence of depression, anxiety and stress following traumatic injury: a longitudinal study. Scand J Trauma Resusc Emerg Med. 2015; 23:29.

Specialty: Psychiatry

System: Nervous

Objective: Evaluation

Type: Scale

No. Of Items: 21

Year Of Study: 1995

Abbreviation: DASS 21

Article By: Denise Nedea

Published On: August 28, 2017 · 08:56 AM

Last Checked: August 28, 2017