DASS-21 Scoring and Interpretation

This page covers how to score and interpret the Depression Anxiety Stress Scales - 21 (DASS-21). For an overview of what the scale measures and how to administer it in Labvanced, see the DASS-21 instrument page.

Scoring Procedure for the DASS-21

Each of the 21 items is scored 0 to 3, with a higher item response always indicating greater symptom severity. Item scores are summed separately for each of the three 7-item subscales, and each subscale sum is then multiplied by 2. This doubling brings DASS-21 subscale scores onto the same scale as the original 42-item DASS, so that the same severity bands apply to both versions (Lovibond & Lovibond, 1995). See the Sum Scoring guide for how this calculation is set up in Labvanced.

Reverse-Scored Items

None. All 21 items are scored in the same direction.

Subscale Computation

• Depression subscale: sum of items 3, 5, 10, 13, 16, 17, and 21, multiplied by 2.
• Anxiety subscale: sum of items 2, 4, 7, 9, 15, 19, and 20, multiplied by 2.
• Stress subscale: sum of items 1, 6, 8, 11, 12, 14, and 18, multiplied by 2.

There is no combined total score across all three subscales; Depression, Anxiety, and Stress are reported and interpreted separately.

Cutoff Scores and Severity Bands for the DASS-21

Cutoff scheme: Lovibond & Lovibond (1995). These severity labels reflect relative severity based on normative percentile distributions, not diagnostic thresholds: "mild," for example, is not necessarily a score typical of someone seeking clinical treatment.

Interpreting Your Score on the DASS-21

A higher score on any subscale indicates greater severity of that symptom domain over the past week. Because the three subscales are scored and interpreted independently, a respondent can score in different severity bands across Depression, Anxiety, and Stress.

The DASS-21 is a measure of depression, anxiety, and stress symptom severity, not a diagnostic instrument. A score in the Moderate, Severe, or Extremely Severe range indicates elevated symptom severity in that domain, but does not on its own constitute a diagnosis. Interpretation should be made in the context of a full clinical evaluation by a qualified professional.

Reliability and Validity of the DASS-21 (Extended)

Beyond the primary summary on the instrument page, several further findings extend the evidence base for the DASS-21 and its parent 42-item scale:

• Clinical-sample evidence, DASS-21 specifically: In a clinical sample of 258 patients across five diagnostic groups (panic disorder, obsessive-compulsive disorder, social phobia, specific phobia, major depressive disorder) plus 49 nonclinical community volunteers, patients with major depressive disorder scored highest on both the Depression and Stress subscales, while patients with panic disorder scored highest on Anxiety; the nonclinical volunteer group scored lower than every clinical group on all three subscales (Antony et al., 1998).
• Clinical-sample evidence (parent scale): In two large clinical samples (N = 437 and N = 241), the 42-item DASS showed strong internal consistency (α = 0.96 Depression, 0.89 Anxiety, 0.93 Stress; range 0.88-0.96 across six diagnostic groups) and favorable 2-week test-retest stability (r = 0.71 Depression, 0.79 Anxiety, 0.81 Stress). The scales also distinguished diagnostic groups in the predicted direction: patients with mood disorders scored highest on Depression, patients with panic disorder scored highest on Anxiety, and patients with generalized anxiety disorder or mood disorders scored highest on Stress (Brown et al., 1997).
• General distress factor: In a large UK non-clinical sample, a model adding a general psychological distress factor on top of the three specific Depression, Anxiety, and Stress factors fit the DASS-21 better than a simple three-factor model alone (RCFI = 0.94; Henry & Crawford, 2005). A bifactor analysis in two large US undergraduate samples similarly found that a general distress factor accounted for the majority of common variance in DASS-21 responses, and that a bifactor model fit the data better than the traditional three-factor model. This raised questions about the independence of the three subscales, and the authors suggested a DASS-21 total score may be better supported than the three separate subscale scores (Osman et al., 2012).
• Cross-racial invariance: Across four US racial groups (African American, Asian, Caucasian, and Hispanic/Latino), item loadings on the DASS-21's three factors were consistent, but the correlations between factors were not, so score comparisons across these groups warrant some caution (Norton, 2007).

The DASS-21 has also been independently translated and validated in numerous languages and populations beyond the original Australian sample. Reliability and factor-structure findings vary by translation and population; consult the specific translation's validation paper for population-specific figures. See the DASS-21 instrument page for the primary reliability and validity summary.

Related Resources

References

• Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176-181. https://doi.org/10.1037/1040-3590.10.2.176
• Brown, T. A., Chorpita, B. F., Korotitsch, W., & Barlow, D. H. (1997). Psychometric properties of the Depression Anxiety Stress Scales (DASS) in clinical samples. Behaviour Research and Therapy, 35(1), 79-89.
• Henry, J. D., & Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44(2), 227-239. https://doi.org/10.1348/014466505X29657
• Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed.). Sydney: Psychology Foundation of Australia.
• Norton, P. J. (2007). Depression Anxiety and Stress Scales (DASS-21): Psychometric analysis across four racial groups. Anxiety, Stress & Coping, 20(3), 253-265.
• Osman, A., Wong, J. L., Bagge, C. L., Freedenthal, S., Gutierrez, P. M., & Lozano, G. (2012). The Depression Anxiety Stress Scales-21 (DASS-21): Further examination of dimensions, scale reliability, and correlates. Journal of Clinical Psychology, 68(12), 1322-1338.