Cited by 708Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and TestingMental Health Research Topics

The DOI matches its Crossref record; 44 of the 46 references it cites were found in a registry or an index.

Depression Anxiety and Stress Scales (DASS-21): Psychometric analysis across four racial groups

Norton, Peter J.·2007·Anxiety, Stress, & Coping

DOI 10.1080/10615800701309279

Open this paper in CoChat — free account

Abstract

Growing cross-cultural awareness has led researchers to examine frequently used research instruments and assessment tools in racially diverse populations. The present study was conducted to assess the psychometric characteristics of the 21-item version of the Depression, Anxiety, and Stress Scales (DASS-21) among different racial groups. The DASS-21 was chosen because it appears to be a reliable and easy to administer measure, ideal for both clinical and research purposes. Results suggest that the internal consistency, and convergent and divergent validity of the DASS-21 are similar across racial groups. Multigroup CFA, however, indicated that item loadings were invariant, while scale covariances were not invariant. This suggests that, although the items may load similarly on the depression, anxiety and stress constructs, these constructs may be differentially inter-related across groups. Implications for application in clinical practice are discussed.

Integrity signals

Registry

Crossref · 10.1080/10615800701309279

Cites

44 of 44 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

We couldn’t retrieve this paper’s full text, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032
Development and validation of brief measures of positive and negative affect: The PANAS scales.
Watson, D., Clark, L. A., & Tellegen, A. (1988) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.54.6.1063 · Cited by 32,433
The structure of negative emotional states: comparison of the depression anxiety stress scales (DASS) with the beck depression and anxiety inventories.
Lovibond, P. F., & Lovibond, S. H. (1995) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)00075-u · Cited by 14,523
An inventory for measuring clinical anxiety: Psychometric properties.
Beck, A. T., Epstein, N., Brown, G., & Steer, R. A. (1988) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.56.6.893 · Cited by 14,407
Sample size in factor analysis.
MacCallum, R. C., Widaman, K. F., Zhang, S., & Hong, S. (1999) · Psychological Methods · doi:10.1037/1082-989x.4.1.84 · Cited by 5,497
Psychometric properties of the 42-item and 21-item versions of the depression anxiety stress scales in clinical groups and a community sample.
Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998) · Psychological Assessment · doi:10.1037/1040-3590.10.2.176 · Cited by 4,874
Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications
Clark, L. A., & Watson, D. (1991) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.100.3.316 · Cited by 4,601
Structural Equation Modeling With Lisrel, Prelis, and Simplis
Byrne, B. M. (2013) · Psychology Press eBooks · doi:10.4324/9780203774762 · Cited by 4,330
Structural equation modeling with LISREL, PRELIS, and SIMPLIS basic concepts, applications, and programming
Byrne, B. M. (1998) · Cited by 3,873
Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples
Brown, T. A., Chorpita, B. F., Korotitsch, W., & Barlow, D. H. (1997) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(96)00068-x · Cited by 1,860

Show all 46 references

Research works printed but not linked: 9

Beck , A. T. and Steer , R. A. 1990 . Manual for the Beck Anxiety Inventory , San Antonio, TX : Psychological Corporation .
Beck , A. T. , Steer , R. A. and Brown , G. K. 1996 . Beck Depression Inventory manual , 2nd edn , San Antonio, TX : Psychological Corporation .
Bernal , G. , Bonilla , J. and Santiago , I. J. 1995 . Psychometric properties of the BDI and the SCL-36 in a Puerto Rican sample . Revista Latinoamericana de Psicología , 27 : 207 – 230 .
10.1037/0021-843X.107.2.179 · DOI · Paper page
10.1037/0021-843X.107.3.520 · DOI
Lovibond , S. H. and Lovibond , P. F. 1995 . Manual for the Depression, Anxiety and Stress Scales , 2nd edn , Sydney, , Australia : Psychology Foundation .
Muthén , L. K. and Muthén , B. O. 2004 . Mplus: The comprehensive modeling program for applied researchers. User's guide , 3rd edn , Los Angeles : Muthén & Muthén .
Peterson , R. A. and Reiss , S. 1992 . Anxiety Sensitivity Index revised test manual , Worthington, OH : International Diagnostic Services .
10.1080/08098130809478203 · DOI

Sorted by citations

Items 101–200 of 705

Cross-cultural adaptation and validation of the Depression, Anxiety and Stress Scale-21 (DASS-21) in the Korean working population
Jun, D., Johnston, V., Kim, J. M., & O’Leary, S. P. (2018) · Work · doi:10.3233/wor-172661 · Cited by 60
“These ﬁndings are consistent with previous studies [19, 20, 22, 26, 44, 45].”
Validation of the Depression Anxiety Stress Scale-21 (DASS-21) in a non-clinical sample of South African working adults
Dreyer, Z., Henn, C., & Hill, C. (2019) · Journal of Psychology in Africa · doi:10.1080/14330237.2019.1647499 · Cited by 57
“I’m a Strong Independent Black Woman”: The Strong Black Woman Schema and Mental Health in College-Aged Black Women
Castelin, S., & White, G. (2022) · Psychology of Women Quarterly · doi:10.1177/03616843211067501 · Cited by 89
“The internal consistency of the DASS-21 has been supported with reliability coefficients of .84, .81, and .88 for depression, anxiety, and stress, respectively (Norton, 2007).”
Method
Acceptance, and Not Its Interaction with Attention Monitoring, Increases Psychological Well-Being: Testing the Monitor and Acceptance Theory of Mindfulness
Simione, L., Raffone, A., & Mirolli, M. (2021) · Mindfulness · doi:10.1007/s12671-021-01607-7 · Cited by 52
Peer relationship increasing the risk of social media addiction among Chinese adolescents who have negative emotions
Huang, L., Zhang, J., Duan, W., & He, L. (2023) · Current Psychology · doi:10.1007/s12144-021-01997-w · Cited by 55
“The internal consistency and three-factor structures of DASS were accepted in four races: African-American, Caucasian, Hispanic, and Asian (Norton, 2007).”
Background
A systematic review of mental health measurement scales for evaluating the effects of mental health prevention interventions
Breedvelt, J., Zamperoni, V., South, E., Uphoff, E., Gilbody, S. M., Bockting, C., Churchill, R. C., & Kousoulis, A. A. (2019) · European Journal of Public Health · doi:10.1093/eurpub/ckz233 · Cited by 54
Maternal and family factors and child eating pathology: risk and protective relationships
Allen, K. L., Gibson, L. Y., McLean, N. J., Davis, E. A., & Byrne, S. M. (2014) · Journal of Eating Disorders · doi:10.1186/2050-2974-2-11 · Cited by 54
The moderation effect of mindfulness on the relationship between adult attachment and wellbeing
Davis, T. J., Morris, M., & Drake, M. M. (2016) · Personality and Individual Differences · doi:10.1016/j.paid.2016.02.080 · Cited by 52
Is scrupulosity behind the relationship between problematic pornography viewing and depression, anxiety, and stress?
Borgogna, N. C., Duncan, J., & McDermott, R. C. (2018) · Sexual Addiction & Compulsivity The Journal of Treatment and Prevention · doi:10.1080/10720162.2019.1567410 · Cited by 64
“The DASS has been validated across genders, races, and cultures, and has demonstrated adequate construct, convergent, and discriminate validity (Crawford & Henry, 2003; Norton, 2007).”
Bridges over Troubled Waters: Mapping the Interplay Between Anxiety, Depression and Stress Through Network Analysis of the DASS-21
den Bergh, N. V., Marchetti, I., & Koster, E. H. W. (2020) · Cognitive Therapy and Research · doi:10.1007/s10608-020-10153-w · Cited by 58
“Unlike 1 3 previous factor studies (Henry and Crawford 2005; Norton 2007; Osman et al.”
BackgroundMethodInfluential
Psychotherapeutic Outcomes Measures: A Critical Review for Practitioners
Tarescavage, A. M., & Ben‐Porath, Y. S. (2014) · Journal of Clinical Psychology · doi:10.1002/jclp.22080 · Cited by 54
A Comparison of Three Brief Depression Measures in an Acute Psychiatric Population: CES-D-10, QIDS-SR, and DASS-21-DEP
Weiss, R. B., Aderka, I. M., Lee, J., Beard, C., & Björgvinsson, Þ. (2014) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-014-9461-y · Cited by 62
Depression Anxiety Stress Scales-21: Factor Structure and Test-Retest Invariance, and Temporal Stability and Uniqueness of Latent Factors in Older Adults
Gomez, R., Summers, M. J., Summers, A., Wolf, A., & Summers, J. J. (2013) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-013-9391-0 · Cited by 53
“For the DASS-21, a few studies examined this by analyzing the DASS-21 items obtained from participants’ ratings of the DASS (Clara et al. 2001; Henry and Crawford 2005; Norton 2007).”
MethodResultInfluential
Predictors of psychological adaptation of South Asian immigrants in Hong Kong
Tonsing, K. N. (2013) · International Journal of Intercultural Relations · doi:10.1016/j.ijintrel.2013.01.002 · Cited by 53
Past Discrimination, Race-Related Vigilance, and Depressive Symptoms: the Moderating Role of Mindfulness
Watson‐Singleton, N. N., Hill, L. K., & Case, A. D. (2019) · Mindfulness · doi:10.1007/s12671-019-01143-5 · Cited by 62
Spiritual well-being and spiritual distress predict adjustment in adolescent and young adult cancer survivors
Park, C. L., & Cho, D. (2016) · Psycho-Oncology · doi:10.1002/pon.4145 · Cited by 53
Depression and perceived stress as mediators between racial microaggressions and somatic symptoms in college students of color.
Torres‐Harding, S., Torres, L., & Yeo, E. (2019) · American Journal of Orthopsychiatry · doi:10.1037/ort0000408 · Cited by 54
“Further, the DASS has shown to consistently measure these constructs across four U.S. racial groups: African Americans, Whites, Latinos, and Asian Americans (Norton, 2007).”
BackgroundInfluential
Problem-Focused Vs. Meaning-Focused Coping as Mediators of the Appraisal-Adjustment Relationship in Chronic Stressors
Riley, K. E., & Park, C. L. (2014) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2014.33.7.587 · Cited by 54
“Good psychometric properties have been reported for the DASS-21 (Norton, 2007).”
Can adolescents differentiate between depression, anxiety and stress? Testing competing models of the Depression Anxiety Stress Scales (DASS-21)
Jovanović, V., Gavrilov‐Jerković, V., & Lazić, M. (2019) · Current Psychology · doi:10.1007/s12144-019-00540-2 · Cited by 50
“In line with previous studies (e.g., Norton 2007), the specific depression factor was associated with both NA and PA, but it was more closely related to PA than NA.”
Result
The Psychometric Properties of the DASS-21 and Its Association with Problematic Internet Use among Chinese College Freshmen
Cao, C.-H., Dang, C.-Y., Zheng, X., Chen, W.-G., Chen, I., & Gamble, J. H. (2023) · Healthcare · doi:10.3390/healthcare11050700 · Cited by 55
Adult attachment and reports of pain in experimentally‐induced pain
Andrews, N. E., Meredith, P. J., & Strong, J. (2010) · European Journal of Pain · doi:10.1016/j.ejpain.2010.10.004 · Cited by 49
The Buffering Effects of Emotion Regulation in the Relationship Between Experiences of Racism and Anxiety in a Black American Sample
Graham, J., Calloway, A. L., & Roemer, L. (2015) · Cognitive Therapy and Research · doi:10.1007/s10608-015-9682-8 · Cited by 45
“In addition, the DASS-21 has demonstrated convergent and divergent validity and internal reliability in African American, Latino, and Asian samples as well as international samples (Crawford et al. 2009; Norton 2007).”
Background
Comparing stress prediction models using smartwatch physiological signals and participant self-reports
Dai, R., Lu, C., Yun, L., Lenze, E. J., Avidan, M. S., & Kannampallil, T. (2021) · Computer Methods and Programs in Biomedicine · doi:10.1016/j.cmpb.2021.106207 · Cited by 54
Cognitive vulnerability to comorbidity: Looming cognitive style and depressive cognitive style as synergistic predictors of anxiety and depression symptoms
Kleiman, E. M., & Riskind, J. H. (2012) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2012.05.008 · Cited by 46
Gender Differences in Pathways to Compulsive Buying in Chinese College Students in Hong Kong and Macau
Ching, T. H. W., Tang, C., Wu, A., & Yan, E. (2016) · Journal of Behavioral Addictions · doi:10.1556/2006.5.2016.025 · Cited by 36
“…reliability, as well as satisfactory convergent and discriminant validity in various clinical and college or community samples of diverse ages, ethnicities, and nationalities (e.g., see Antony, Bieling, Cox, Enns, & Swinson, 1998; Gloster et al., 2008; Gong, Xie, Xu, & Luo, 2010; Norton, 2007).”
Background
The impact of disease duration in persistent postural-perceptual dizziness (PPPD) on the quality of life, dizziness handicap and mental health
Teh, C. S.-L., & Prepageran, N. (2021) · Journal of Vestibular Research · doi:10.3233/ves-210087 · Cited by 47
“The Depression Anxiety and Stress Scales or DASS-21 [14] was used to assess the psychometric characteristics with 21 items.”
Factor Structure and Reliability of the Depression, Anxiety and Stress Scales in a Large Portuguese Community Sample
Vasconcelos-Raposo, J., Fernandes, H. M., & Teixeira, C. M. (2013) · The Spanish Journal of Psychology · doi:10.1017/sjp.2013.15 · Cited by 46
“…for the scales and for the total score (Apóstolo, Mendes, & Rodrigues, 2007; Bados et al., 2005; Crawford & Henry, 2003; Henry & Crawford, 2005; Norton, 2007; Page et al., 2007; Pais-Ribeiro, Honrado, & Leal, 2004a) and presented adequate convergent and discriminant validity among clinical…”
BackgroundResultInfluential
Sexual Satisfaction Among Men Living with HIV in Europe
The Eurosupport Study Group, Ryck, I. D., Laeken, D. V., Nöstlinger, C., Platteau, T., & Colebunders, R. (2011) · AIDS and Behavior · doi:10.1007/s10461-011-9987-x · Cited by 45
The interaction between stress and positive affect in predicting mortality
Okely, J. A., Weiß, A., & Galé, C. R. (2017) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2017.07.005 · Cited by 46
“Similar DASS items include: “I found it difficult to relax”, “I found it hard to wind down”, “I was in a state of nervous tension”, and “I found myself getting upset rather easily”.”
BackgroundMethod
Fulfilling the psychological and information need of the family members of critically ill patients using interactive mobile technology: A randomised controlled trial
Chiang, C. L. V., Lee, R. L. P., Ho, F. M., Leung, C. K., Tang, Y., Wong, W. S., Ho, Y. S., Tung, W. Y., & Louie, L. H. (2017) · Intensive and Critical Care Nursing · doi:10.1016/j.iccn.2017.03.006 · Cited by 43
“EF-T (n = 39) EF-R (n = 35) Overall (n = 74) F-statistics Instrument T0 T1 T0 T1 T0 T1 Main effect Interaction effect 2 Mean (SD) Mean (SD) Mean (SD) DASS Stress 13.33 (9.41) 11.69 (9.49) 13.26 (9.82) 11.37 (10.68) 13.30 (9.54) 11.54 (10.00) 5.14* 0.03 0.07 Anxiety 8.21 (7.25) 7.23 (7.42) 7.54 (8.58) 7.71 (8.42) 7.89…”
MethodInfluential
Hope attenuates the negative impact of general psychological distress on goal progress
Moss, S. A., Southward, M. W., & Cheavens, J. S. (2020) · Journal of Clinical Psychology · doi:10.1002/jclp.23087 · Cited by 42
Open to interpretation? Inconsistent reporting of lifetime nonsuicidal self-injury across two common assessments.
Robinson, K., & Wilson, M. (2020) · Psychological Assessment · doi:10.1037/pas0000830 · Cited by 47
Mental health conditions of Chinese international students and associated predictors amidst the pandemic
Yu, L., Cao, Y., Wang, Y., Liu, T., MacDonald, A., Bian, F., Li, X., Wang, X., Zhang, Z., Wang, P., et al. (2023) · Journal of Migration and Health · doi:10.1016/j.jmh.2023.100185 · Cited by 48
The Effectiveness of a Mindfulness-Based Psychoeducation Programme for Emotional Regulation in Individuals with Schizophrenia Spectrum Disorders: A Pilot Randomised Controlled Trial
Lam, A. H. Y., Leung, S. F., Lin, J. J., & Chien, W. T. (2020) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s231877 · Cited by 40
Who Are We Missing? The Impact of Requiring Parental or Guardian Consent on Research With Lesbian, Gay, Bisexual, Trans, Two-Spirit, Queer/Questioning Youth
Cwinn, E., Cadieux, C., & Crooks, C. V. (2020) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2020.07.037 · Cited by 40
“All scales used have adequate internal consistency and validity [10,11,14,15].”
Method
Parental mental health and child anxiety during the COVID‐19 pandemic in Latin America
Brik, A. B., Williams, N. A., Esteinou, R., Acero, I. D. M., Mesurado, B., Debeljuh, P., Storópoli, J., Orellana, O. N., & James, S. L. (2022) · Journal of Social Issues · doi:10.1111/josi.12523 · Cited by 45
Friendships, loneliness and psychological wellbeing in older adults: a limit to the benefit of the number of friends
Thompson, A., Smith, M., McNeill, A. R., & Pollet, T. V. (2022) · Ageing and Society · doi:10.1017/s0144686x22000666 · Cited by 52
“The DASS-21 has repeatedly demonstrated a three-factor structure representing the three separate scales ( e.g. Crawford and Henry, 2003; Norton, 2007; Sinclair et al ., 2012; Scholten et al ., 2017).”
Background
Racial discrimination in healthcare services among Black individuals in Canada as a major threat for public health: its association with COVID-19 vaccine mistrust and uptake, conspiracy beliefs, depression, anxiety, stress, and community resilience
Cénat, J. M. (2024) · Public Health · doi:10.1016/j.puhe.2024.02.030 · Cited by 40
Acculturation and adaptation of first‐ and second‐generation S outh A sians in H ong K ong
Tonsing, K. N. (2014) · International Journal of Social Welfare · doi:10.1111/ijsw.12079 · Cited by 39
Gender in mental health: comparison of the rate and social factors of depression, anxiety, and stress among young adult Filipino heterosexual cisgender men and women and LGBT+ individuals
Alibudbud, R. (2023) · International Journal of Social Psychiatry · doi:10.1177/00207640221106874 · Cited by 38
“It has also shown strong associations with other anxiety and depression measures including Beck’s Depression Inventory and Beck’s Anxiety Inventory, among Asians (Alibudbud, 2021; Norton, 2007).”
BackgroundInfluential
A Tele-Behavioral Health Intervention to Reduce Depression, Anxiety, and Stress and Improve Diabetes Self-Management
Greenberger, H. M., Vue, L., Luka, A., Peters, A., & Pande, R. L. (2016) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2015.0231 · Cited by 39
Is there an app for that? A cluster randomised controlled trial of a mobile app–based mental health intervention
Kenny, R., Fitzgerald, A., Segurado, R., & Dooley, B. A. (2019) · Health Informatics Journal · doi:10.1177/1460458219884195 · Cited by 38
Coping with COVID-19 stress: Associations with depression and anxiety in a diverse sample of U.S. adults
Coiro, M. J., Watson, K. H., Ciriegio, A., Jones, M. T., Wolfson, A. R., Reisman, J., & Compas, B. E. (2021) · Current Psychology · doi:10.1007/s12144-021-02444-6 · Cited by 40
“Guided by prior research indicating a strong correlation between these two measures (e.g., Norton, 2007), raw sum scores were converted to z-scores for each sample separately and then combined to allow for pooled analyses (Gruhn et al., 2016).”
Method
Analyzing the role of resilience and life satisfaction as mediators of the impact of COVID‐19 worries on mental health
Tamarit, A., de la Barrera, U., Schoeps, K., Castro‐Calvo, J., & Montoya‐Castilla, I. (2022) · Journal of Community Psychology · doi:10.1002/jcop.22900 · Cited by 43
“The three subscales have demonstrated appropriate psychometric properties in large community samples (Henry & Crawford, 2005) and consistency across cultures (Oei et al., 2013) and racial groups (Norton, 2007).”
Background
Psychopathy and lifetime experiences of depression
Willemsen, J., Vanheule, S., & Verhaeghe, P. (2011) · Criminal Behaviour and Mental Health · doi:10.1002/cbm.812 · Cited by 37
Social media use, loneliness and psychological distress in emerging adults
Taylor, Z., Yankouskaya, A., & Panourgia, C. (2023) · Behaviour and Information Technology · doi:10.1080/0144929x.2023.2209797 · Cited by 43
“Previous studies report good psychometric properties for DASS-21 in clinical and non-clinical samples (i.e. Antony et al. 1998) and across di ﬀ erent cultures (i.e. Norton 2007).”
Result
Relationship of depression, stress and endothelial function in stable angina patients
Chen, H., Zhang, L., Zhang, M., Song, X., Zhang, H., Liu, Y., & Lv, S. (2013) · Physiology & Behavior · doi:10.1016/j.physbeh.2013.05.024 · Cited by 37
An individually-tailored multifactorial intervention program for older fallers in a middle-income developing country: Malaysian Falls Assessment and Intervention Trial (MyFAIT)
Tan, P. J., Khoo, E. M., Chinna, K., Hill, K., Poi, P. J., & Tan, M. P. (2014) · BMC Geriatrics · doi:10.1186/1471-2318-14-78 · Cited by 37
Predictors of Mental Health Among College Students in Guam: Implications for Counseling
Ran, M., Mendez, A. J., Leng, L., Bansil, B., Reyes, N., Cordero, G., Carreon, C., Fausto, M., Maminta, L., & Tang, M. (2016) · Journal of Counseling & Development · doi:10.1002/jcad.12091 · Cited by 38
Evaluation of Quality of Life and Severity of Depression, Anxiety, and Stress in Patients After Kidney Transplantation
Czyżewski, Ł., Frelik, P., Wyzgał, J., & Szarpak, Ł. (2018) · Transplantation Proceedings · doi:10.1016/j.transproceed.2018.04.026 · Cited by 37
Development and Validation of Fear of Relapse Scale for Relapsing-Remitting Multiple Sclerosis: Understanding Stressors in Patients
Khatibi, A., Moradi, N., Rahbari, N., Salehi, T., & Dehghani, M. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00226 · Cited by 36
Family Function, Quality of Life, and Well-Being in Parents of Infants With Hypoplastic Left Heart Syndrome
Mussatto, K. A., Rompay, M. I. V., Trachtenberg, F. L., Pemberton, V. L., Young-Borkowski, L., Uzark, K. C., Hollenbeck-Pringle, D., Dunbar‐Masterson, C., Infinger, P., Walter, P., et al. (2021) · Journal of Family Nursing · doi:10.1177/1074840720987309 · Cited by 37
“The Depression Anxiety and Stress Scales (DASS-21) is another reliable and easy-to-administer measure, ideal for both clinical and research purposes (Norton, 2007).”
Background
The Relationship of Low Distress Tolerance to Excessive Worrying and Cognitive Avoidance
Huang, K., Szabó, M., & Han, J. L. (2009) · Behaviour Change · doi:10.1375/bech.26.4.223 · Cited by 37
“The factor structure of the DASS is stable, and its three scales have been shown to possess good convergent and discriminant validity and high internal consistency in clinical and in nonclinical samples and in several different ethnic groups (Antony, Bieling, Cox, Enns, & Swinson, 1998; Brown et al., 1997; Lovibond, 1…”
Background
Photoplethysmography-based HRV analysis and machine learning for real-time stress quantification in mental health applications
Tsai, Y.-Y., Chen, Y.-J., Lin, K., Hsiao, F., Hsu, C., & Liao, L. (2025) · APL Bioengineering · doi:10.1063/5.0256590 · Cited by 44
Assessment of the Depression, Anxiety, and Stress Scale (DASS-21) in untreated obstructive sleep apnea (OSA).
Nanthakumar, S., Bucks, R. S., Skinner, T. C., STARKSTEIN, S. E., Hillman, D. R., James, A. L., & Hunter, M. L. (2016) · Psychological Assessment · doi:10.1037/pas0000401 · Cited by 41
Eating disorder symptoms in Asian American college students
Uri, R., Wu, Y., Baker, J. H., & Munn‐Chernoff, M. A. (2020) · Eating Behaviors · doi:10.1016/j.eatbeh.2020.101458 · Cited by 36
“Past studies show Cronbach’s alphas for the DASS ranging from 0.78-0.87; it correlates with similar constructs, demonstrating convergent validity among college samples (Norton, 2007).”
BackgroundResultInfluential
Smoking and nicotine dependence in relation to depression, anxiety, and stress in Egyptian adults: A cross-sectional study
Elsary, A. Y., & El-Sherbiny, N. A. (2022) · Journal of Family and Community Medicine · doi:10.4103/jfcm.jfcm_290_21 · Cited by 36
Psychological outcomes after hospitalization for COVID-19: data from a multidisciplinary follow-up screening program for recovered patients
Bonazza, F., Borghi, L., Marco, E. C. D. S., Piscopo, K., Bai, F., Monforte, A. D., & Vegni, E. A. M. (2021) · Research in Psychotherapy Psychopathology Process and Outcome · doi:10.4081/ripppo.2020.491 · Cited by 37
“Previous studies have found that females had higher scores than males on depression, anxiety, and stress (Crawford & Henry, 2003; Norton, 2007), even though there was no consistency across the studies (Bottesi et al., 2015).”
Result
Systematic Review of the Psychometric Evidence Supporting Use of the Depression Anxiety Stress Scales, Short Form (DASS-21) with Youth
Dwight, A. R., Briesch, A. M., Hoffman, J. A., & Rutt, C. (2024) · Child & Youth Care Forum · doi:10.1007/s10566-024-09795-8 · Cited by 35
“The original three-factor model, with three correlated factors of depression, anxiety, and stress, has been supported across three studies (Anghel, 2020; Mellor et al., 2015; Norton, 2007).”
Influential
The Influence of Forced Social Isolation on the Auditory Ecology and Psychosocial Functions of Listeners with Cochlear Implants During COVID-19 Mitigation Efforts
Dunn, C. C., Stangl, E., Oleson, J., Smith, M. P., Chipara, O., & Wu, Y.-H. (2020) · Ear and Hearing · doi:10.1097/aud.0000000000000991 · Cited by 27
“Through a survey using the Impact of Event Scale-Revised (Christianson & Marren 2012) and the Depression, Anxiety and Stress Scale-21 (Norton 2007) scale the respondents initially reported moderate to severe stress, anxiety, and depression and no significant longitudinal changes in stress, anxiety,…”
Method
Retorno ao trabalho? Indicadores de saúde mental em professores durante a pandemia da COVID-19
Cruz, R. M., da Rocha, R. E. R., Andreoni, S., & Pesca, A. D. (2020) · Revista Polyphonía · doi:10.5216/rp.v31i1.66964 · Cited by 35
Self‐compassion and savouring buffer the impact of the first year of the COVID‐19 on PhD students' mental health
Paucsik, M., Leys, C., Marais, G. A. B., Baeyens, C., & Shankland, R. (2022) · Stress and Health · doi:10.1002/smi.3142 · Cited by 37
“Few studies have investigated its benefits during the COVID‐19‐ pandemic.”
ResultInfluential
Is Physical Activity a Buffer? Gendered Racial Microaggressions and Anxiety Among African American Women
Wright, L. N., & Lewis, J. A. (2020) · Journal of Black Psychology · doi:10.1177/0095798420929112 · Cited by 42
“The measure has demonstrated convergent validity with positive correlations with the Beck Anxiety Inventory (Beck & Steer, 1990) and Beck Depression Inventory (Beck & Steer, 1987) in prior research (Norton, 2007).”
Method
What are the optimal measures to identify anxiety and depression in people diagnosed with head and neck cancer (HNC): a systematic review
Shunmugasundaram, C., Rutherford, C., Butow, P. N., Sundaresan, P., & Dhillon, H. M. (2020) · Journal of Patient-Reported Outcomes · doi:10.1186/s41687-020-00189-7 · Cited by 35
Parental Mood, Parenting Style and Child Emotional and Behavioural Adjustment: Australia-Indonesia Cross-Cultural Study
Riany, Y. E., Haslam, D. M., & Sanders, M. R. (2021) · Journal of Child and Family Studies · doi:10.1007/s10826-021-02137-5 · Cited by 33
“Crawford et al., 2009; Norton, 2007; Oei et al., 2013).”
A study of psychological health among students of gifted and nongifted high schools
Fouladchang, M., Kohgard, A., & Salah, V. (2010) · Procedia - Social and Behavioral Sciences · doi:10.1016/j.sbspro.2010.07.264 · Cited by 33
Relationships between vascular dysfunction, circulating endothelial progenitor cells, and psychological status in healthy subjects
Chen, H., Yiu, K., & Tse, H. (2011) · Depression and Anxiety · doi:10.1002/da.20839 · Cited by 33
The role of experiential avoidance in the relation between racial discrimination and negative mental health outcomes
Martinez, J. H., Eustis, E. H., Arbid, N., Graham-LoPresti, J. R., & Roemer, L. (2020) · Journal of American College Health · doi:10.1080/07448481.2020.1754221 · Cited by 39
“88).(33) Within our sample, the DASS showed strong internal consistency (Cronbach’s alpha 1⁄4 .”
Background
Confirmatory factor analysis of the depression, anxiety, and stress scale among Indian adults
Hallford, D. J., Sharma, M. K., & Anand, N. (2020) · Indian Journal of Psychiatry · doi:10.4103/psychiatry.indianjpsychiatry_313_19 · Cited by 32
Emotion dysregulation in children with autism: A multimethod investigation of the role of child and parent factors
Mills, A. S., Modica, P. T., Mazefsky, C. A., & Weiss, J. A. (2022) · Research in Autism · doi:10.1016/j.rasd.2021.101911 · Cited by 47
Preliminary evidence for a race-based stress reduction intervention for Black women at risk for cardiovascular disease
Saban, K. L., Motley, D., Shawahin, L. N., Mathews, H. L., Tell, D., de la Peña, P., & Janusek, L. W. (2021) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2021.102710 · Cited by 37
Acculturation, perceived discrimination, and psychological distress: Experiences of South Asians in Hong Kong
Tonsing, K. N., Tse, S. S.-K., & Tonsing, J. C. (2015) · Transcultural Psychiatry · doi:10.1177/1363461515617873 · Cited by 32
“The DASS-21 has been used in various studies of clinical and nonclinical populations, and the internal consistency and divergent/convergent validity were found to be similar across ethnic groups, in both clinical and nonclinical groups (e.g., Antony, Bieling, Cox, Enns, & Swinson, 1998; Henry & Crawford, 2005; Norton,…”
MethodResult
Sociodemographic characteristics, social support, and family history as factors of depression, anxiety, and stress among young adult senior high school students in metro Manila, Philippines, during the COVID-19 pandemic
Serrano, I. M. A., Cuyugan, A. M. N., Cruz, K., Mahusay, J. M. A., & Alibudbud, R. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1225035 · Cited by 32
Is Food Insecurity Associated with Psychological Distress in Undergraduate University Students? A Cross Sectional Study
Hattangadi, N., Vogel, E., Carroll, L., & Côté, P. (2021) · Journal of Hunger & Environmental Nutrition · doi:10.1080/19320248.2019.1658679 · Cited by 30
Implementasi Metode Support Vector Machine (SVM) dan t-Distributed Stochastic Neighbor Embedding (t-SNE) untuk Klasifikasi Depresi
Abimanyu, S., Bahtiar, N., & Sarwoko, E. A. (2023) · JURNAL MASYARAKAT INFORMATIKA · doi:10.14710/jmasif.14.2.59513 · Cited by 31
“DASS terdiri dari tiga skala diantaranya, depresi (menilai keadaan mood dysphoria), kecemasan (menilai keadaan gairah) dan stres (menilai labilitas emosi negatif terhadap penyebab dan ketegangan umum) [23].”
Background
Group singing improves quality of life for people with Parkinson’s: an international study
Irons, J. Y., Hancox, G., Vella-Burrows, T., Han, E., Chong, H. J., Sheffield, D., & Stewart, D. (2020) · Aging & Mental Health · doi:10.1080/13607863.2020.1720599 · Cited by 31
“DASS is a fully validated instrument in older adults (Gloster et al., 2008) and in different ethnic groups (Norton, 2007).”
Background
Associations Among Emotional State, Sleep Quality, and Resting-State EEG Spectra: A Longitudinal Study in Graduate Students
Komarov, O., Ko, L., & Jung, T. (2020) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2020.2972812 · Cited by 36
Influence of coping, self-esteem and social support on undergraduate students’ emotional distress
Wongtongkam, N. (2019) · Health Education · doi:10.1108/he-01-2019-0001 · Cited by 30
Assessing mental health status among Iranian healthcare workers in times of the COVID‐19 pandemic: A web‐based cross‐sectional study
Azizi, M., Kamali, M., Moosazadeh, M., Aarabi, M., Ghasemian, R., Reskati, M. H., & Elyasi, F. (2021) · Brain and Behavior · doi:10.1002/brb3.2304 · Cited by 30
“Overall, in each subscale, the score could range from 0 to 63 and the greater the score, the higher the severity of depression, anxiety, and stress (Asghari et al., 2008; Norton, 2007).”
Background
Depression in Australian women: The varied roles of spirituality and social support
Bennett, K., & Shepherd, J. (2012) · Journal of Health Psychology · doi:10.1177/1359105312443400 · Cited by 30
“The factor structure of the DASS-21 is stable, and it possesses strong convergent and discriminant validity and high internal consistency (Lovibond and Lovibond, 1995; Norton, 2007).”
Background
Depression diagnosis: EEG-based cognitive biomarkers and machine learning
Boby, K., & Veerasingam, S. (2024) · Behavioural Brain Research · doi:10.1016/j.bbr.2024.115325 · Cited by 34
“I Would Just Feel Really Relaxed and at Peace”: Findings From a Pilot Prison Yoga Program in Australia
Bartels, L., Oxman, L. N., & Hopkins, A. (2019) · International Journal of Offender Therapy and Comparative Criminology · doi:10.1177/0306624x19854869 · Cited by 30
“The scales of the DASS have been shown to have high internal consistency and to yield meaningful discriminations in a variety of settings (Lovibond & Lovibond, 1995; Norton, 2007).”
Background
Association of the previous history of maternal depression with post-partum depression, anxiety, and stress in the neonatal intensive care unit
Das, A., Gordon-Ocejo, G., Kumar, M., Kumar, N., & Needlman, R. D. (2019) · The Journal of Maternal-Fetal & Neonatal Medicine · doi:10.1080/14767058.2019.1647162 · Cited by 33
Teachers and Mindful Colouring to Tackle Burnout and Increase Mindfulness, Resiliency and Wellbeing
Czerwinski, N., Egan, H., Cook, A., & Mantzios, M. (2021) · Contemporary School Psychology · doi:10.1007/s40688-020-00279-9 · Cited by 29
“Reliability and validity have been assessed and shown to be satisfactory across the scales in clinical and non-clinical populations alike (Henry and Crawford 2005; Norton 2007).”
Background
Latent structure of posttraumatic stress disorder symptoms in an adolescent sample one month after an earthquake
Wang, R., Wang, L., Li, Z., Cao, C., Shi, Z., & Zhang, J. (2013) · Journal of Adolescence · doi:10.1016/j.adolescence.2013.05.008 · Cited by 30
Effects of a Brief Mindfulness Based Group Intervention On College Students
Parcover, J. A., Coiro, M. J., Finglass, E., & Barr, E. (2017) · Journal of College Student Psychotherapy · doi:10.1080/87568225.2017.1407722 · Cited by 30
“It has shown strong convergent and discriminant validity (Weiss, Aderka, Lee, Beard, & Björgvinsson, 2015), and excellent to good internal consistency (Antony et al., 1998; Norton, 2007; Osman et al., 2012; Weiss et al., 2015).”
Background
The mental health status among nurses from low‐risk areas under normalized COVID‐19 pandemic prevention and control in China: A cross‐sectional study
Chen, X., Arber, A., Gao, J., Zhang, L., Ji, M., Wang, D., Wu, J., & Du, J. (2021) · International Journal of Mental Health Nursing · doi:10.1111/inm.12852 · Cited by 31
“Mental health status was measured using the validated DASS-21 questionnaire (Norton, 2007).”
Method
Reliability and Preliminary Evidence of Validity of a Farsi Version of the Depression Anxiety Stress Scales
Bayani, A. A. (2010) · Perceptual and Motor Skills · doi:10.2466/08.13.pms.111.4.107-114 · Cited by 27
“…have been shown in a number of studies (Lovibond & Lovibond, 1995; Brown, Chorpita, Korotitsch, & Barlow, 1997; Antony, Bieling, Cox, Enns, & Swinson, 1998; Clara, Cox, & Enns, 2001; Daza, Novy, Stanley, & Averill, 2002; Crawford & Henry, 2003; Bados, Solanas, & Andres, 2005; & Norton, 2007).”
Result
Validation of an Emotion Regulation Training Program on Mental Well-Being
LeBlanc, S., Uzun, B., Aydemir, A., & Mohiyeddini, C. (2019) · Psychological Reports · doi:10.1177/0033294119878399 · Cited by 27
“DASS-21 (Norton, 2007) is a questionnaire measuring depressive symptomology, anxiety, and stress (Lovibond & Lovibond, 1995).”
Background
“Does Sexual Orientation Matter?”: A Comparative Analysis of the Prevalence and Determinants of Depression and Anxiety Among Heterosexual and Non-Heterosexual College Students in a University in Metro Manila
Alibudbud, R. C. (2023) · Journal of Homosexuality · doi:10.1080/00918369.2021.2015953 · Cited by 27
“Moreover, the DASS-21 showed a significantly strong association with other anxiety and depression measures, including Beck’s Depression Inventory and Beck’s Anxiety Inventory, among Asians (Norton, 2007).”
BackgroundInfluential
Home-based Vestibular Rehabilitation: A Feasible and Effective Therapy for Persistent Postural Perceptual Dizziness (A Pilot Study)
Teh, C. S.-L., Abdullah, N. A., Kamaruddin, N. R., Judi, K. B. M., Ismail, F., Zainun, Z., & Prepageran, N. (2022) · Annals of Otology Rhinology & Laryngology · doi:10.1177/00034894221111408 · Cited by 27
Measuring Adherence Within a Self-Guided Online Intervention for Depression and Anxiety: Secondary Analyses of a Randomized Controlled Trial
Hanano, M., Rith-Najarian, L., Boyd, M., & Chavira, D. (2022) · JMIR Mental Health · doi:10.2196/30754 · Cited by 26
“The primary outcome measure in this study was the 21-item Depression, Anxiety, and Stress Scale (DASS-21), which assesses self-reported symptoms of depression, anxiety, and stress [19].”
Method
Prevalence and determinants of depression, anxiety, and stress symptoms among Black individuals in Canada in the context of the COVID-19 pandemic
Cénat, J. M., Farahi, S. M. M. M., & Dalexis, R. D. (2023) · Psychiatry Research · doi:10.1016/j.psychres.2023.115341 · Cited by 28
“Among African Americans, internal consistency coefficients of anxiety, depression, and stress were 0.81, 0.84, and 0.88, respectively (Norton, 2007).”
Influential
Relationships of Depression, Anxiety, and Stress with Adherence to Self-Management Behaviors and Diabetes Measures in African American Adults with Type 2 Diabetes
Chlebowy, D. O., Batscha, C. L., Kubiak, N. T., & Crawford, T. N. (2018) · Journal of Racial and Ethnic Health Disparities · doi:10.1007/s40615-018-0500-3 · Cited by 52
Investigating the Impacts of Acculturation Stress on Migrant Care Workers in Australian Residential Aged Care Facilities
Adebayo, B., Nichols, P., Albrecht, M. A., Brijnath, B., & Heslop, K. (2020) · Journal of Transcultural Nursing · doi:10.1177/1043659620947810 · Cited by 29
“…21 has been used in general population studies and culturally diverse population studies including four prevalent racial groups in the United States, which are African Americans, Asians, Caucasians, and Hispanics (Norton, 2007) and migrants from South Asian backgrounds in Hong Kong (Tonsing, 2013).”
Background
Study of stress detection and proposal of stress-related features using commercial-off-the-shelf wrist wearables
de Arriba-Pérez, F., Santos-Gago, J. M., Rodríguez, M. C., & Merino, M. R. (2019) · Journal of Ambient Intelligence and Humanized Computing · doi:10.1007/s12652-019-01188-3 · Cited by 26
“There also exists a simplified version to reduce the number of questions and to improve the psychometric properties (Norton 2007).”
Background
The Validity and Reliability of Psychometric Profile for Depression, Anxiety and Stress Scale (DASS21) Instrument among Malaysian Undergraduate Students
Ahmad, N., Roslan, S. B., Othman, S., Shukor, S. F. A., & Bakar, A. Y. A. (2018) · International Journal of Academic Research in Business and Social Sciences · doi:10.6007/ijarbss/v8-i6/4275 · Cited by 26
“Offer of the two versions, namely 42 and 21-items of DASS was made, with the 21-item version comprising of a subset of items originating from the 42-item version of DASS (Norton, 2007).”
BackgroundMethod
Mediating Role of Perceived Stress in the Relationship between Facing Existential Issues and Symptoms of Depression and Anxiety
Besharat, M., Khadem, H., Zarei, V., & Momtaz, A. (2020) · Iranian Journal of Psychiatry · doi:10.18502/ijps.v15i1.2442 · Cited by 28
Effect of Happiness Counseling on Depression, Anxiety, and Stress in Women with Recurrent Miscarriage
Elsharkawy, N. B., Mohamed, S. M., Awad, M. H., & Ouda, M. M. A. (2021) · International Journal of Women s Health · doi:10.2147/ijwh.s283946 · Cited by 24
Stress and emotional distress: their associations with somatic and temporomandibular disorder-related symptoms
Yap, A. U., Sultana, R., & Natu, V. P. (2021) · Psychology Health & Medicine · doi:10.1080/13548506.2021.1908571 · Cited by 24
“It is a well-established instrument that has been translated into many languages and validated for different racial and cultural groups including Asians (Henry & Crawford, 2005; Lee, 2019; Norton, 2007; Oei et al., 2013).”
Background

Authors: Norton, P. J.
Affiliations: University of Houston (US)
Corresponding author: Norton, Peter J.
ORCID: Norton, Peter J.
Venue: Anxiety, Stress, & Coping
Publisher: Informa UK Limited
Published: 2007-08-08
Volume: 20
Issue: 3
Pages: 253-265
ISSN: 1061-5806 (ISSN-L)
1477-2205
DOI: 10.1080/10615800701309279
OpenAlex: W2088994872
Cited by: 708
References: 46
Citations by year: 2026: 33 · 2025: 64 · 2024: 76 · 2023: 73 · 2022: 74 · 2021: 78 · 2020: 70 · 2019: 41 · 2018: 39 · 2017: 26 · 2016: 27 · 2015: 16 · 2014: 31 · 2013: 18 · 2012: 18
FWCI: 7.29
Type: journal article
Language: en
Open access: closed
Locations: Anxiety Stress & Coping (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
Keywords: DASS-21, DASS, cross-cultural validity, racial groups, measurement invariance, multi-group confirmatory factor analysis, convergent and discriminant validity, internal consistency, depression, anxiety, stress
MeSH terms: Adolescent, Adult, Affect, Anxiety, Cross-Cultural Comparison, Depression, Humans, Middle Aged, Psychometrics, Surveys and Questionnaires, Severity of Illness Index, Racial Groups

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Depression Anxiety and Stress Scales (DASS-21): Psychometric analysis across four racial groups

Abstract

Overview

Integrity signals

Verification

Claims the paper makes

Claims other papers make about this one

Citations

Cites

Cited by

Related

Metadata

Record

About these checks