The Depression Anxiety Stress Scales-21 (DASS-21) is a widely used psychological screening tool designed to quickly assess the current state of negative emotional experiences. This instrument is a self-report measure, meaning individuals rate how much each statement applied to them over the past week. It provides a snapshot of an individual’s emotional state, distinguishing it from an official clinical diagnosis, which requires a comprehensive professional evaluation. The DASS-21 is recognized for its ability to measure a general factor of psychological distress while also separating out specific emotional components.
The Three Emotional Scales
The DASS-21 is composed of 21 items divided equally into three scales: Depression, Anxiety, and Stress, with seven items contributing to each score. This structure allows the assessment to differentiate between the symptoms of these emotional states. The Depression scale specifically attempts to measure symptoms related to low positive affect, such as anhedonia, hopelessness, devaluation of life, and inertia, which is the difficulty in getting started on tasks.
The Anxiety scale focuses on measuring physiological arousal and fear, including symptoms like autonomic arousal, skeletal muscle effects, situational fears, and the subjective experience of anxious affect. For instance, items on this scale might relate to awareness of heart action or feeling scared without a clear reason. The Stress scale assesses levels of chronic, non-specific arousal, which manifests as difficulty relaxing, nervous arousal, being easily upset or agitated, and irritability.
The scales are intentionally designed to distinguish the unique features of each emotional state, reflecting the understanding that while these conditions often occur together, they are not identical constructs. By separating them, the DASS-21 provides a more nuanced picture than a single measure of general distress.
Calculating Your Scores
Taking the DASS-21 involves rating each of the 21 statements on a four-point Likert scale to indicate how much the statement applied to you over the past week. The rating scale begins with 0, meaning “Did not apply to me at all,” and goes up to 3, meaning “Applied to me very much, or most of the time.”
To calculate your score, you must first sum the individual item responses for each of the three scales separately—Depression, Anxiety, and Stress. Since the DASS-21 is the short form of the original 42-item DASS, the raw score for each scale must be multiplied by two to achieve the final, comparable score. This multiplication step scales the scores back up to align with the severity ranges of the full DASS-42. For example, if the raw sum of the seven Depression items is 10, the final Depression score is 20.
Interpreting Severity Levels
Once the final scores are calculated for Depression, Anxiety, and Stress, they are compared to standard cut-off scores to classify the results into five severity categories: Normal, Mild, Moderate, Severe, and Extremely Severe. These categories reflect the degree of interference or distress experienced relative to a community sample. The severity labels indicate a person is above the population mean, but “mild” does not equate to a mild disorder; it is a way to describe the score’s position in the full range of possible outcomes.
For the Depression scale, a score between 0 and 9 is considered Normal, 10-13 Mild, 14-20 Moderate, 21-27 Severe, and 28 or above Extremely Severe. The Anxiety scale uses different thresholds, with 0-7 being Normal, 8-9 Mild, 10-14 Moderate, 15-19 Severe, and 20 or above Extremely Severe. Finally, the Stress scale classifies 0-14 as Normal, 15-18 Mild, 19-25 Moderate, 26-33 Severe, and 34 or above as Extremely Severe.
It is important to remember that these classifications are solely a screening outcome and are not a clinical diagnosis. The DASS-21 provides a measure of symptom severity, helping to identify when an individual’s emotional experience is significantly elevated. High scores suggest a greater need for further investigation, but only a qualified professional can provide a formal diagnosis.
Actionable Advice Post-Assessment
Individuals who complete the DASS-21 and find their scores fall into the Moderate, Severe, or Extremely Severe ranges should consider seeking professional guidance. These elevated scores indicate a level of emotional distress that is likely impacting daily functioning and well-being. A General Practitioner (GP) is a good starting point, as they can assess overall health and provide referrals to specialists.
Discussing the DASS-21 results with a qualified mental health professional, such as a therapist, counselor, or psychologist, is the appropriate next step. They can place the scores into an accurate clinical context, considering your history and current life circumstances, which the questionnaire cannot do alone. A professional uses the DASS-21 as one piece of information to help determine the most appropriate course of action, which may include further assessment, therapy, or other support resources.