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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 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
In the citing paper
“The DASS-21 has excellent internal consistency47 and construct validity.47 48”
In the citing paper
“The subscales of the DASS-21 have been shown to have high internal consistencies.44”
In the citing paper
“The scale was described as moderately sensitive to change in a clinical sample of depressed subjects [41].”
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Metadata
- 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
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 ›
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