Depression Anxiety Stress Scales (DASS-21): Factor Structure in Traumatic Brain Injury Rehabilitation
Abstract
Objective: To confirm the construct validity of the Depression Anxiety Stress Scales-21 (DASS-21) by investigating the fit of published factor structures in a sample of adults with moderate to severe traumatic brain injury (posttraumatic amnesia > 24 hours). Participants: Archival data from 504 patient records at the Brain Injury Rehabilitation Unit at Liverpool Hospital, Australia. Participants were aged between 16 and 71 years and were engaged in a specialist rehabilitation program. Main Measure: The DASS-21. Results: Two of the 6 models had adequate fit using structural equation modeling. The data best fit Henry and Crawford's quadripartite model, which comprised a Depression, Anxiety and Stress factor, as well as a General Distress factor. The data also adequately fit Lovibond and Lovibond's original 3-factor model, and the internal consistencies of each factor were very good (α = 0.82–0.90). Conclusion: This study confirms the structure and construct validity of the DASS-21 and provides support for its use as a screening tool in traumatic brain injury rehabilitation.
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DASS-21 internal consistency was good for all three scales.
“The internal consistency was good for all three scales (Cronbach α depression scale = .90; stress scale = .89; and anxiety scale = .82) (Randall et al., 2017).”
From Acceptance and commitment therapy for individuals with depressive and anxiety symptoms following acquired brain injury: A non-concurrent multiple baseline design across four cases. (2023) · cites this paper as Randall et al., 2017
The Depression Anxiety Stress Scales-21 (DASS-21) has been validated in a TBI sample.
“The questionnaire has been validated in a TBI sample.”
From Acceptance and commitment therapy for individuals with depressive and anxiety symptoms following acquired brain injury: A non-concurrent multiple baseline design across four cases. (2023) · cites this paper as Randall et al., 2017
The Depression Anxiety Stress Scales-21 has been validated in a sample of patients with traumatic brain injury, and internal consistency was good for the three scales (Cronbach α depression 0.90; stress 0.89; anxiety 0.82).
“The questionnaire has been validated in a sample of patients with TBI. The internal consistency was good for the three scales (Cronbach α depression scale, 0.90; stress scale, 0.89; anxiety scale. 0.82) [34].”
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“The internal consistency was good for all three scales (Cronbach α depression scale = .90; stress scale = .89; and anxiety scale = .82) (Randall et al., 2017).”
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- Authors
- Randall, D., Thomas, M., Whiting, D., & McGrath, A.
- Affiliations
- Charles Sturt University (AU)
- Venue
- Journal of Head Trauma Rehabilitation
- Published
- 2017-03
- Volume
- 32
- Issue
- 2
- Pages
- 134-144
- ISSN
- 0885-9701 (ISSN-L)
- OpenAlex
- W2495311191
- Cited by
- 80
- References
- 45
- Citations by year
- 2026: 7 · 2025: 4 · 2024: 8 · 2023: 8 · 2022: 13 · 2021: 9 · 2020: 13 · 2019: 12 · 2018: 4 · 2017: 2
- FWCI
- 8.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Head Trauma Rehabilitation (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
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- DASS, DASS-21, traumatic brain injury, factor structure, construct validity, post-traumatic depression, post-traumatic stress, general distress, brain injury rehabilitation, screening tool
- MeSH terms
- Neurological Rehabilitation, Brain Injuries, Traumatic, Adolescent, Adult, Age Factors, Aged, Anxiety, Australia, Depression, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Prognosis, Psychiatric Status Rating Scales, Retrospective Studies, Sex Factors, Stress, Psychological, Reproducibility of Results, Databases, Factual, Treatment Outcome, Risk Assessment, Young Adult
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