Psychometric properties of the Depression Anxiety Stress Scales (DASS) in depressed clinical samples
Abstract
Objectives. The psychometric properties of the Depression Anxiety Stress Scales (DASS; ) were examined in depressed psychiatric hospital samples. Design and Methods. Three studies administered the DASS and other symptom measures at admission and discharge to consecutive adult hospital patients with a primary diagnosis of depression. Study 3 aimed to address problems with the DASS by extending the response options. Results. Study 1 found that the DASS had good reliability and validity, was moderately sensitive to change, but the Depression Scale exhibited a ceiling effect. In Study 2, confirmatory factor analysis supported a three‐factor structure and the DASS continued to demonstrate good psychometric properties, but the ceiling effect was replicated. Study 3 found that by extending the response scale to include an additional option, the factor structure of the instrument as a whole was maintained, the sensitivity to treatment was increased, but the ceiling effect was only marginally reduced. Conclusions. The psychometric properties of the DASS were sound in clinically depressed samples, but the Depression Scale exhibited a ceiling effect that could not be resolved with minor changes to the scale. Suggestions for revisions of the DASS are made.
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The DASS-21 Stress subscale has demonstrated good internal consistency and construct validity and is sensitive to change.
“The subscales have demonstrated good internal consistency and construct validity (Antony, Bieling, et al., 1998) and have been shown to be sensitive to change across hospitalization for clients with a primary diagnosis of depression (Page, Hooke, & Morrison, 2007).”
From Decentering as a potential common mechanism across two therapies for generalized anxiety disorder (2015) · cites this paper as Page, Hooke, & Morrison, 2007
The DASS-21 has excellent internal consistency and construct validity.
“The DASS-21 has excellent internal consistency47 and construct validity.47 48”
The DASS-21 subscales have high internal consistencies.
“The subscales of the DASS-21 have been shown to have high internal consistencies.44”
DASS-21 was described as moderately sensitive to change in a clinical sample of depressed subjects.
“The scale was described as moderately sensitive to change in a clinical sample of depressed subjects [41].”
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- Authors
- Page, A. C., Hooke, G. R., & Morrison, D. L.
- Affiliations
- The University of Western Australia (AU)
- Corresponding author
- Page, Andrew C.
- ORCID
- Page, Andrew C.
- Venue
- British Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2007-09
- Volume
- 46
- Issue
- 3
- Pages
- 283-297
- ISSN
- 0144-6657 (ISSN-L)
- 2044-8260
- OpenAlex
- W2061442569
- Cited by
- 301
- References
- 30
- Citations by year
- 2026: 7 · 2025: 12 · 2024: 22 · 2023: 23 · 2022: 29 · 2021: 25 · 2020: 30 · 2019: 18 · 2018: 17 · 2017: 14 · 2016: 18 · 2015: 24 · 2014: 20 · 2013: 13 · 2012: 9
- FWCI
- 2.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- British Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- 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, depression, psychometric properties, reliability statistics, validity, sensitivity to change, ceiling effect, factor structure, psychiatric inpatients, scale revision
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Depressive Disorder, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Psychological Tests, Psychometrics, Reproducibility of Results
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