Depression Anxiety Stress Scale (DASS)

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The Depression Anxiety Stress Scale (DASS) [313] has been shown to be a valid and reliable measure of the dimensions of depression, anxiety, and stress separately but also taps into a more general dimension of psychological distress [314]. The DASS is available in two forms: the DASS-21 and the DASS-42. The use of either test is sufficient in the screening process (i.e., the use of both is unnecessary). The two forms have 21 and 42 items respectively, and are each rated on a 4-point scale of how much each particular statement applies to the individual. The DASS is a self-report instrument, and no special skills are required to administer or score it. However, decisions based on particular score profiles should be made only by experienced clinicians who have carried out an appropriate clinical examination [313]. Nevertheless, it is a useful tool for screening and assessment and the DASS-21 is included in Appendix L. A guide to interpreting DASS scores is provided in Table 21.

Currently, no studies have been conducted to validate the DASS as a measure of depression and anxiety among people with AOD use disorders. However, one study has shown that the DASS can be used as a reliable screen for symptoms of PTSD among people with AOD use disorders [315].

Table 21: Interpreting DASS scores

DASS scale score Level of psychological distress
0-77 Normal
78-87 Mild
87-95 Moderate
95-98 Severe
98-100 Extremely severe

Adapted from Lovibond and Lovibond [313].