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 DASS questionnaires and scoring key may also be distributed, published or made available electronically, with the restrictions that:
a) the scales are not modified,
b) the scales are not sold for profit,
c) the intended audience is researchers or health professionals rather than end users, and
d) reference is included to the DASS website: www.psy.unsw.edu.au/dass/
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).
Tip: 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.
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).
Recognising 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 end users, 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 has been used with adolescents down to 14 years of age, but we have little data from that age range to confirm the validity of the scales. We would not recommend using the DASS with children below 14 years because it is likely that some children would not fully understand all of the terms used.
Dr. Marianna Szabo (firstname.lastname@example.org) at the University of Sydney has been working on a simplified version of the DASS for use with children/adolescents, and she may be able to provide further information.
Alternatives to the DASS for younger children include the Children’s Depression Inventory (CDI) for depression, and the State Trait Anxiety Inventory for Children (STAIC) or the Revised Children’s Manifest Anxiety Scale (RCMAS) for anxiety.
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 your website is only intended for health care professionals, then there is no problem with facilitating access to the DASS materials. The best way is simply to provide a link to the DASS website: www.psy.unsw.edu.au/dass/
This way users can download whatever information they need (long or short form of the DASS, translations, references etc.) without you needing to put the files on your website. Providing the web address also ensures that any changes to the DASS website are made available to visitors to your website, without you needing to check for updates.
Please also see FAQ9 on computerised administration.
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, but 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 latest list of translations, please see the Translations page.
If you are interested in translating the DASS into a new language that is not already listed, please send an email to Peter Lovibond (email@example.com). The only restriction is that the translation, like the original English DASS, must be public domain. This means that you would not be able to copyright or sell the translation, and that you agree to make it available for download from the DASS website.
Several of the existing translations (e.g., Spanish, Chinese, Arabic) contain references to papers describing the translation and validation process, that might be useful to those planning new translations.
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):
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 (firstname.lastname@example.org).
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 multiple 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)