All About DASS-21: The Depression, Anxiety & Stress Scale

Updated: Mar 15

Every visitor to 360 Wellness Hub undergoes a thorough mental health assessment.

Step one of our assessment process involves answering several psychometric tests.

In this blog post, we will guide you through the DASS-21 psychometric test, a 21 item questionnaire which will measure your levels of depression, anxiety and stress.

You will learn what is the DASS-21 test, be guided as you take the test, find out what your results mean, and discover the research that has been done to confirm the test's appropriateness and reliability.




What Is The DASS-21?

The DASS-21 is a self-report test which measures your level of Depression, Anxiety and Stress.

At the end of the test, you will receive a severity rating of Normal, Mild, Moderate, Severe or Extremely Severe, for each of those 3 negative emotional states.

Research has confirmed that the only difference between the depression, anxiety, and stress experienced by mentally healthy individuals versus that experienced by the clinically disturbed, is in the degree of severity.


Do note that DASS-21 is a screening tool and not a diagnostic tool. In other words, high scores on this test are an indicator that you are most likely experiencing a poor quality of life and emotional disturbances.

However, this test does not provide a diagnosis of mental health disorders nor help discover the underlying causes of these negative emotional states.

Thus, the developers of the test state that for complete interpretation of its results, one should consult a trained professional in psychology.


How Do I Take The DASS-21?

1. Download a copy of the test below

DASS-21_ENGLISH
.pdf
Download PDF • 80KB

2. Think about how much each statement applied to you over the past week.

Circle according to the rating scale of 0 for Never, 1 for Sometimes, 2 for Often and 3 for Almost Always

3. Write down the number you circled in the corresponding blank FOR OFFICE USE box

4. Sum up all the numbers along the D column for your Depression score

Sum up all the numbers along the A column for your Anxiety score

Sum up all the numbers along the S column for your Stress score

5. Note the severity of your Depression, Anxiety and Stress by referring to the table below



What Can I Learn About Myself From The DASS-21?

You would learn:

1. Your levels of depression, anxiety and stress

2. Whether those levels are a concern

3. Whether your depression, anxiety and stress are causing physical symptoms eg. difficulty breathing, increased heart rate

4. If retaking the test, improvement in your mental state after treatment

On the part of your psychologist, we will incorporate knowledge of your DASS-21 results as part of your broader mental health assessment


Research Confirms The Validity and Reliability of the DASS-21

All psychometric tests must be both valid(measures what it is supposed to measure) and reliable(accurate and consistent)

For example, the DASS-21 should measure depression, anxiety and stress, not anger.

And it should accurately measure the levels of everyone who takes it: a highly stressed individual is graded severely stressed while a relaxed individual is graded normal.


To ensure the validity and reliability of a test, statistical testing is conducted to generate a coefficient value for their reliability and validity.

The coefficient has a value that ranges between zero and one; the closer the value is to one, the stronger the evidence of reliability or validity.


Validity of DASS-21

DASS-21's initial baseline data was obtained from 717 people between the ages of 17-69 years.

The DASS has since been widely used internationally, with over 25 translations available (Oei, Sawang, Yong, & Mukhtar, 2013) and it has been validated across numerous countries, racial groups and age groups (Norton, 2007).

Some sample groups include adolescents, average city dwellers, military veterans (MacDonell, Bhullar & Thorsteinsson, 2016) and rural workers in northern Vietnam (Tran, Tran & Fisher, 2013).


Many negative emotional states share some common symptoms eg sleep and appetite issues.

To ensure the test is able to isolate one particular emotional state, each DASS-21 item focuses on a core symptom unique to that state:

  • The Depression scale assesses the core symptoms of depression: dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest/involvement, anhedonia, and inertia.

  • The Anxiety scale assesses the core symptoms of anxiety: autonomic arousal, skeletal muscle effects, situational anxiety, and subjective experience of anxious affect.

  • The Stress scale assesses the core symptoms of stress: chronic difficulty relaxing, nervous arousal, being easily upset/agitated, being irritable/over-reactive and being impatient.

Reliability of DASS-21

The internal consistency among all DASS-21 items has been found to be reliably high: Depression 0.81, Anxiety 0.73, Stress 0.81.

In other words, a highly depressed but not stressed person would give similarly high scores to all 7 Depression-measuring questions and similarly low scores to all 7 Stress-measuring questions.


Besides that, the DASS-21's ability to measure Depression and Anxiety was also compared with another popular test that was known to be reliable, the Beck Depression and Anxiety Inventories.

It was found that a person's scores on both tests correlated highly, ie. they were similar (Lovibond & Lovibond,1995).


Conclusion

Congratulations on completing the DASS-21 psychometric test!

If your DASS-21 scores showed Moderate or higher levels in any of the 3 emotional states, it is an indicator that you are experiencing a poor quality of life or emotional disturbances.

The developers of the test recommend that in such cases, you should consult a trained professional for further interpretation of your results.

Thus, do contact us at 018-471 0020 to discover the underlying causes of these negative emotional states and treat them.


#DASS21 #mentalhealthtest #areyouokay



Sources:

Official DASS-21 test creator's website by: http://www2.psy.unsw.edu.au/dass/over.htm


Depression Anxiety and Stress Scales (DASS): Psychometric analysis across four racial groups by Norton (2007). https://pubmed.ncbi.nlm.nih.gov/17999228/


Using the Depression Anxiety Stress Scale 21 (DASS-21) across cultures by Oei, Sawang, Yong, & Mukhtar (2013).

https://pureportal.coventry.ac.uk/en/publications/using-the-depression-anxiety-stress-scale-21-dass-21-across-cultu


The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories by Lovibond & Lovibond (1995).

https://www.sciencedirect.com/science/article/abs/pii/000579679400075U


Article written by Melissa Ong, 04/11/2020.