1. What does the DASS measure,
and what are its intended uses?
2. Who can administer and
interpret the DASS?
3. How do I get permission to use
the DASS?
4. Where can I get norms and psychometric data
(reliability/validity) for the DASS?
5. Where can I get clinical cutoffs
and/or severity labels for the DASS?
6. How can I get the DASS manual?
7. What if I can’t afford the manual – do I
really need it?
8. What are the advantages and
disadvantages of the short (21-item) version of the DASS?
9. Can the DASS be administered
online or via a computer?
10. What is the lower age limit for the DASS?
11. Are the three DASS scales independent from
each other?
12. What is the relationship between the DASS and
the tripartite model of Watson & Clark?
13. What is the relationship between the DASS and
DSM diagnoses?
14. What does the Stress scale measure?
15. Can I just administer one or two scales from
the DASS?
16. If I am interested in measuring stress,
should I only administer the DASS Stress scale?
17. Can I change the timeframe for the DASS?
18. Can the DASS be used to measure momentary
(“right now”) emotional state?
19. What reference do I cite for the DASS?
20. How do I refer people to the DASS on my
website or in a publication?
21. Can I administer the DASS on a website or
app?
22. Can I charge for administering the DASS?
23. Is the DASS resistant to respondents faking
good or bad?
24. Has the DASS been validated in XXXX
population?
25. Has the DASS been translated into language
XXXX? Can I translate the DASS into
language XXXX?
26. Is the total DASS score a useful measure?
27. What do I do with missing scores?
29. Who do I contact if I have a query about the
DASS?
30. How do I use the
scoring key?
Please see the Overview page.
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 health professional such as a clinical
psychologist.
The
DASS questionnaire is public domain, and so permission is not needed to use it. The
DASS questionnaires and scoring key may be downloaded from the DASS website and
copied without restriction (go to Download page).
The
psychometric properties of the DASS and normative data for the DASS are
described in detail in the DASS manual (see FAQ6).
Additional
information is available through published articles (see FAQ7).
Note
1: When interpreting alpha coefficients
(internal consistency), remember that alpha is strongly determined by the
number of items in a test. The more
items, the higher alpha will be. So it is not appropriate to compare alphas between tests
that have different numbers of items.
Note
2: The DASS is a state measure, not a
trait measure. Therefore
it is not desirable to have a high test-retest correlation – the size of the
correlation should reflect the actual stability or change in emotional states
experienced by the sample over the period in question.
Emotional
syndromes like depression and anxiety are intrinsically dimensional - they vary
along a continuum of severity. Hence the
selection of a single cutoff score to represent
“clinical” severity is necessarily arbitrary.
This is one of the fundamental differences between the DASS and
categorical measures based on psychiatric diagnosis (see FAQ13).
Understanding
the dimensional nature of emotional syndromes leads to a more sophisticated
assessment of disturbance. For example,
individuals who fall just short of a clinical cutoff
are correctly recognised as experiencing considerable symptoms and as being at
high risk of developing more extreme symptoms.
For most research purposes, it is much better to use DASS scores rather
than attempt to divide a sample into “normal” vs “clinical” or “high” vs “low”.
However,
for clinical purposes, we recognise that it can be helpful to have conventional
labels to help characterise degree of severity relative to the population. Therefore we have
developed a set of cut-off scores for defining mild/moderate/severe/extremely
severe scores for each DASS scale. To
avoid misinterpretation and reification of these (arbitrary) labels, they are
only provided in the DASS manual – see FAQ6 and FAQ7.
Tip: The DASS severity labels are used to
characterise the full range of scores in the population, so "mild"
for example means that the person is above the population mean but still well
below the typical severity of people seeking help – ie it does not mean a mild level of a “disorder”.
The
DASS manual can be ordered for AUS$55 from the DASS website (go to Order page). Many University departments and clinical
services hold a copy of the DASS manual.
The
manual contains an extensive discussion of the theoretical background to the
DASS, as well as detailed information about DASS norms and interpretation.
However,
for many projects, the DASS can be used and interpreted without reference to
the detailed norms. Considerable
information about the DASS is available through published articles (see Publications page).
The
full DASS gives somewhat more reliable scores, and more information about
specific symptoms, but the DASS 21 has the advantage of taking only half the
time to administer. There are several
published studies showing that the DASS21 has the same factor structure and
gives similar results to the full DASS (see Publications
page). In general, the full DASS is often
preferable for clinical work, and the DASS21 is often best for research
purposes.
The
items in the DASS21 were selected on the basis of several criteria:
-
good factor loadings
-
coverage of all subscales within each scale
-
item means, such that DASS21 scores for each scale should be very close to
exactly half the full scale score
Remember
when using the DASS21 to multiply the obtained scale scores by 2, so that they
can be compared to the DASS normative data and to other published DASS
data.
Yes the DASS can be administered by computer. One advantage of electronic administration,
especially for research studies, is that scoring can be automated.
We
do not endorse or distribute any particular programs. Whichever program you use, it is important
that computed scores are not made available to respondents, and in particular
that you do not attempt to provide automated interpretation. This can be misleading and potentially
dangerous.
If
you wish to educate users regarding depression, anxiety and stress, we suggest
instead listing some key symptoms and pointing out that a) everyone experiences
these sorts of feelings/thoughts to some degree, but b) if they are
experiencing them frequently and strongly, they should consider seeking
professional help.
The
DASS can be used down to 14 years of age, assuming typical language skills.
For
children below 14 years we recommend the Youth version of the DASS instead:
No,
they are all moderately inter-correlated (typical rs
= .5 - .7). This characteristic is shared
with other scales that have attempted to provide “pure” measures of anxiety and
depression, e.g. the Beck Depression Inventory and the
Beck Anxiety Inventory.
We
regard the inter-correlations between the three scales not as indicating
conceptual overlap between the constructs of depression, anxiety and stress,
but rather shared causes. In particular,
genetic and other vulnerability factors tend to be general across all negative
emotional states rather than specific to one.
Similarly, environmental events and circumstances that induce negative
emotion tend to be partly general and partly specific.
The structure of the DASS has both
similarities and differences from the tripartite conceptual model proposed by
Clark and Watson. Both models emphasise symptoms of autonomic arousal in defining Anxiety
and differentiating it from other emotional syndromes such as Depression. Both models give emphasis to anhedonia in
defining Depression, although the DASS gives equal weight to other features
such as hopelessness and devaluation of life.
However, the models differ with respect to symptoms of tension and
irritability. The DASS assumes that
these symptoms define a third, coherent syndrome that is distinct from both
Anxiety and Depression. The tripartite
model, by contrast, groups these symptoms together with other symptoms that
both models agree are nonspecific into a “General Distress” or “Negative
Affect” category.
Factor analysis supports the contention that the
items in the Stress scale are not simply symptoms that are common to anxiety
and depression. If they were, then under
factor analysis the Stress items would have loaded modestly on both of the
Anxiety and Depression factors, rather than forming a separate factor as they
in fact do. Furthermore, the
longitudinal stability of the Stress scale supports its existence as a
distinct, coherent syndrome; see Lovibond (1998). Long-term stability of depression, anxiety,
and stress syndromes. Journal of Abnormal Psychology, 107, 520-526.
Finally, the DASS assumes that the various
syndromes it attempts to measure are inter-correlated not because they share
common symptoms (indeed such nonspecific symptoms were excluded), but rather
because they share common causes, such as genetic and environmental
vulnerabilities, and environmental triggers – see also FAQ11.
In terms of traditional diagnostic
classifications such as DSM-IV, the DASS Anxiety scale corresponds most closely
to the symptom criteria for the various Anxiety Disorders,
with the exception of Generalized Anxiety Disorder (GAD). The DASS Depression
scale corresponds fairly closely to the Mood Disorders, although the diagnostic
criteria for those disorders include many symptoms that were rejected during
DASS development as not specific to depression (e.g., guilt, appetite change).
Finally, the DASS Stress scale corresponds quite closely to the DSM-IV symptom
criteria for GAD.
Psychometrically,
the DASS is quite different from diagnostic instruments in that it reflects the
underlying continuity of severity of symptoms in the population. DASS scale scores are dimensional rather than
categorical.
The Stress
scale, originally labelled
"tension/stress", measures a syndrome that is factorially distinct
from depression and anxiety, characterised by nervous tension, difficulty
relaxing and irritability. It is quite
similar to the DSM-IV diagnosis of Generalized Anxiety Disorder (GAD).
Although
the stress scale can be distinguished from depression and anxiety in factor
analysis, it is important to note that all three syndromes are moderately
intercorrelated (see FAQ11).
Omitting
a scale won't have any noticeable effect on scores for the remaining scales, so
if you're sure you won't need the data you can omit one or two of the primary
syndromes. However, depression, anxiety
and stress are so closely related that often it is useful to be able to
statistically control for one when assessing a relationship involving the
other. Journal editors will often insist
on such an analysis. If the intention is
to reduce administration time, it may be more cost-effective to simply use the
short version (DASS21) which has only 7 items per scale and is very quick to
administer.
As
noted in FAQ14, the DASS
Stress scale measures a relatively specific syndrome of tension/stress that is
narrower than the conventional conception of stress in terms of environmental
events triggering a wide variety of emotional symptoms.
Similarly,
the everyday use of the term “stress”, as for example in occupational stress,
is very broad and probably incorporates all three DASS syndromes.
Therefore,
in most cases all three DASS scales are relevant to the assessment of stress in
the broader sense.
There is no
problem in principle in changing the timeframe of the DASS questionnaire if you
are interested in a different time period, or if you wish to use a trait
wording (how do you feel “in general”). However the data obtained will no longer be strictly
comparable to the DASS normative data or to other published DASS data.
The DASS is
not really suitable for this purpose, because several of the items refer to
situations other than the present (testing) situation, or experiences that are
relatively infrequent.
Alternative
instruments intended to measure momentary state include the Profile of Mood
States (POMS) and the Multiple Affect Adjective Checklist (MAACL).
The correct
citation for the DASS is the manual:
Lovibond, S.H.
& Lovibond, P.F. (1995). Manual for the Depression
Anxiety Stress Scales. (2nd. Ed.)
Sydney: Psychology Foundation.
If you wish to
refer researchers/clinicians to the DASS, please cite the permanent URL for the
DASS website:
Please do not
refer clients/research participants/members of the public to the DASS website
as it is intended for professionals.
If
the website or app is intended for or open to members of the public (for
example a clinical practice website), then no.
If
the website or app is restricted to a defined group (for example enrolled
patients or research participants), and the results are fed back to the
clinician/researcher rather than the respondents, then yes.
Please
see FAQ9 on computerised
administration of the DASS for further explanation.
Yes. While it is not permissible to sell the DASS
scales themselves to another person, it is quite acceptable to charge patients
for assessment that includes the DASS.
No,
like other self-report symptom-based scales, the DASS is transparent and it is
easy for a respondent to either disguise their symptoms (faking good or social
desirability) or exaggerate their symptoms (faking bad or malingering).
There
is no lie scale built into the DASS, so if there is reason to expect bias in
responding, it may be advisable to administer another instrument specifically
designed to assess such bias.
In
general, the best way to find out if the DASS has been used previously with a
specific population is to do a literature search, for example using PsycInfo.
It
is extremely unlikely that the factor structure will vary from one group to
another. Norms are irrelevant for most
special populations (e.g., people with dementia, alcohol abuse, chronic pain
etc. etc.) because there is no way of defining the particular group in a way
that will transcend culture, health service, severity etc. Therefore, the most substantive issue to
consider is whether the group in question is capable of understanding the items
and responding to them in an unbiased way.
In this respect, the DASS is no different from other symptom-based
measures.
In
general, unless you have particular reason to believe that the DASS will not be
valid (e.g., young age, low literacy, medical symptoms, medication effects)
then you can assume that it will be valid.
See
also FAQ10 on lower age
limits for the DASS.
For
the list of DASS/DASS21 translations, please see the DASS Translations page.
For
the list of DASS-Y translations, please see the DASS-Y Translations page.
If
you are interested in carrying out a translation in a new language that is not
already listed, please let us know by sending an email to Peter Lovibond (p.lovibond@unsw.edu.au). We will try to let you know if we are aware
of another person who is already in the process of translating the DASS into
that language. However, please bear in mind that others might be carrying out a
translation without informing us, so permission to translate does not mean an exclusive
right to do so. Often we receive multiple translations in the same language,
and our policy is generally to post all of them on the website so that users
can choose which one best meets their needs.
The
only restriction on carrying out a translation is that the translated version,
like the original English DASS, must be public domain. This means that you will not be able to
copyright or sell the translation, and that you agree to make it available for
download from the DASS website. If you
are planning to translate the full (42-item) DASS, we suggest that you also
create a short (21-item) version which is straightforward as it simply involves
deleting the items that are not in common – please see the English
questionnaires to determine which items to keep.
Several
of the existing translations (e.g., Spanish, Chinese, Arabic) contain
references to papers describing the translation and validation process, which
might be useful to those planning new translations.
Please
note that we do not have the resources to undertake translations
ourselves. This means we rely on the
goodwill of others to carry out these translations and send them to us. It also means we can’t guarantee the quality
of the translations.
By
posting their translation on the website, translators are making it publicly
available, so you do NOT need to obtain their permission to use it.
However,
if you have an enquiry or comment about an existing translation, please do send
it to the person who carried out the translation, using the contact details
listed on the page for that translation.
Yes it is certainly both possible and sensible to
add (or average) the three DASS scores together to produce a composite measure
of negative emotional symptoms.
If
you have access to the DASS manual (see FAQ4), the best way to do this
while retaining a connection to the normative data is to first convert each
scale score to a Z score (i.e., subtract mean and divide by SD from the
normative data for that scale) and then average the Z scores. Then you can compare the average Z score for
an individual or group to the severity labels in the same way as for individual
scales.
The
DASS is no different from other instruments with respect to missing
scores. If there is only one missing
item, there is no problem in averaging over the remaining items for the scale
in question. If there are too many
missing items, the validity of the DASS is compromised – in a research study,
the participant should be omitted, and in clinical work, the reasons for the
missing data should be explored.
How
many missing items is too many? There
is no fixed standard here. One rule of
thumb is to allow up to 2 missing items per 14-item scale for the full DASS,
and 1 missing item per 7-item scale for the short version (DASS21). Whatever choice you make about missing data,
the most important principle is to be explicit about the criteria in any report
or publication.
Yes,
for most purposes you can simply score the first sheet as though it was the
DASS21 (remembering to multiply each scale score by 2 in the normal way for the
DASS21). This is possible because there
are 7 items from each scale on the first page of the full DASS.
If
you are conducting a research study and you are also a perfectionist, you can
adjust the scores to give the best possible estimate of DASS21 scores by
multiplying by the following correction factors (derived from the DASS
normative data set):
Depression:
1.04645
Anxiety: 1.02284
Stress:
0.98617
Please
check first to see if the answer to your query is included in this FAQ.
If
you have a query about ordering the DASS manual, please refer to the Order page.
If
you have a query about any other aspect of the DASS, please email Peter
Lovibond (p.lovibond@unsw.edu.au).
The
scoring template was designed to be copied onto an overhead transparency (i.e.,
plastic film) so that it can be placed on top of the completed questionnaire.
The
template indicates which items belong to which scale. Just add up the scores for all of the items
in each scale.
If
you are using the full DASS (42 items) there will be 14 items per scale, and
you will apply the scoring template to both sheets of the questionnaire.
If
you are using the short DASS (21 items) there will only be 7 items per scale so
you will only apply the scoring template to the single sheet; however you will then need to multiply the score you obtain
for each scale by 2 in order to make it comparable to the corresponding full
DASS score (and the DASS norms and published studies)
If
you are using the DASS-Y (21 items) there will be 7 items per scale so you will
only apply the scoring template to the single sheet; you do NOT need to
multiply the scores by 2 as per the DASS21, because the DASS-Y is a standalone
instrument with scores that cannot be directly compared to either of the adult
questionnaires (DASS and DASS21).