Depression Anxiety Stress Scales – Long Form (DASS-42)
The DASS-42 is a 42 item self-report scale designed to measure the negative emotional states of depression, anxiety and stress. It is the long version of the DASS-21. It is a useful tool for routine outcome monitoring and can be used to assess the level of treatment response.
The principal value of the DASS in a clinical setting is to clarify the locus of emotional disturbance. The DASS is based on a dimensional rather than a categorical conception of psychological distress, and scores emphasise the degree to which someone is experiencing symptoms rather than diagnostic cutoff points.
While the DAS-42 was developed with individuals older than 17 year of age, due to the simplicity of language, there has been no compelling evidence against the use of the scales in children as young as 12.
As the scales of the DASS have been shown to have high internal consistency and to yield meaningful discrimination between symptoms, the scale should meet the needs of clinicians who wish to measure current state or change in state over time (e.g., in the course of treatment).
Validity and Reliability
The DASS-42 was developed by Lovibond and Lovibond (1995) using a sample of responses from the comparison of 504 sets of results from a trial by students.
The assessment was then normed on a sample of 1044 males and 1870 females aged between 17 and 69 years, across participants of varying backgrounds, including university students, nurses in training and blue and white collared employees of a major airline, bank, railway workshop and naval dockyard. The scores were subsequently checked for validity against outpatient groups including patients suffering from anxiety and depressive disorders, insomniacs, myocardial infarction patients, as well as patients undergoing treatment for sexual, menopausal and depressive disorders. While the test was not normed against samples younger than 17, due to the simplicity of language it can be used in people as young as 12.
The means and standard deviations based on the normative sample collected by Lovibond and Lovibond (1995) are as follow:
– Depression: 6.34 (6.97)
– Anxiety: 4.7 (4.91)
– Stress: 10.11 (7.91)
The mean scores in the normative sample varied slightly between genders as well as varying by age, though the threshold scores for classifications do not change by these variations.
For full psychometric information please purchase the DASS manual at http://www2.psy.unsw.edu.au/groups/dass/order.htm
Scores are presented as a total score (0 to 126) and scores for each of the three subscales (0 to 42).
In addition, the three subscales are presented as percentile ranks, comparing the respondents scores to a normative community sample (Lovibond & Lovibond 1995). A percentile of around 50 represents relatively healthy and average symptoms compared to the wider population. Scores above the 90th percentile are of clinical significance, and indicate that the respondent has higher levels of symptomatology compared to 90 percent of the community.
If the scale is administered twice or more symptoms are graphed over time.
Each of the three symptom clusters are described below:
– Depression: dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest / involvement, anhedonia and inertia.
– Anxiety: autonomic arousal, skeletal muscle effects, situational anxiety, and subjective experience of anxious affect.
– Stress: levels of chronic nonspecific arousal, difficulty relaxing, nervous arousal, and being easily upset / agitated, irritable / over-reactive and impatient.
Lovibond, S.H.; Lovibond, P.F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed.). Sydney: Psychology Foundation (Available from The Psychology Foundation, Room 1005 Mathews Building, University of New South Wales, NSW 2052, Australia
DASS-42 manual at http://www2.psy.unsw.edu.au/groups/dass/order.htm