Depression, Anxiety and Stress Scales DASS-42

1. Abstract

The Depression, Anxiety and Stress Scales (DASS-42) is a seminal 42-item self-report instrument developed by Syd H. Lovibond and Peter F. Lovibond (1995) designed to measure the magnitude and core negative emotional symptoms of depression, anxiety, and psychological stress. Developed through empirical test-construction procedures rather than purely nosological definitions, the DASS was specifically constructed to address the longstanding psychometric limitation of high comorbidity and symptom overlap between anxiety and depressive disorders as operationalized in conventional diagnostic manuals such as the DSM and ICD. The instrument consists of three psychometrically validated subscales of 14 items each: the Depression subscale (DASS-D), focusing on dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest/involvement, anhedonia, and inertia; the Anxiety subscale (DASS-A), assessing autonomic arousal, skeletal muscle effects, situational anxiety, and subjective experience of anxious affect; and the Stress subscale (DASS-S), capturing chronic non-specific arousal, difficulty relaxing, nervous tension, irritability, agitation, and impatience.

Each item is rated on a 4-point Likert scale ranging from 0 (“Did not apply to me at all”) to 3 (“Applied to me very much or most of the time”), assessing symptom severity experienced over the preceding week. Psychometric evaluations across diverse non-clinical, clinical, and cross-cultural cohorts consistently confirm outstanding internal consistency, with Cronbach’s alpha coefficients typically exceeding 0.90 for Depression, 0.85 for Anxiety, and 0.88 for Stress, alongside strong test-retest reliability across multiple assessment waves. Extensive confirmatory factor analyses (CFA) demonstrate that the tripartite model of distinct yet correlated latent factors provides superior fit relative to unidimensional or general negative affectivity models. The DASS-42 serves as a cornerstone in contemporary psychopathology research, routine epidemiological surveys, cognitive behavioral treatment monitoring, and differential clinical screening worldwide.

2. Keywords

Depression Anxiety Stress Scales, DASS-42, psychometrics, depression assessment, anxiety measurement, psychological stress, tripartite model, negative affectivity, factor structure, internal consistency, clinical screening

3. Authors

The Depression, Anxiety and Stress Scales were conceptualized, operationalized, and standardized by Sydney H. Lovibond, Ph.D., and Peter F. Lovibond, Ph.D., within the School of Psychology at the University of New South Wales (UNSW) in Sydney, Australia.

Sydney Harold Lovibond (1924–2014) was a prominent Australian psychologist and emeritus professor known for his foundational contributions to behavioral therapy, aversive conditioning, and clinical measurement. Peter F. Lovibond is a distinguished professor of cognitive psychology and clinical psychopathology whose research has extensively investigated human associative learning, autonomic conditioning, threat appraisal, and the differential architecture of emotional disorders.

Academic inquiries, scoring keys, and normative validation archives are officially curated by the Psychology Foundation of Australia and maintained through the School of Psychology at the University of New South Wales, Sydney, NSW 2052, Australia.

4. Purpose

The overarching clinical and scientific purpose of the DASS-42 is to provide a dimensional, reliable, and psychometrically robust measurement tool that delineates the emotional states of depression, anxiety, and tension/stress. Prior to the release of the DASS, clinical psychologists and psychiatric researchers faced a persistent empirical dilemma: existing self-report scales measuring depression (such as the Beck Depression Inventory, BDI) and anxiety (such as the Beck Anxiety Inventory, BAI, or the State-Trait Anxiety Inventory, STAI) exhibited substantial empirical overlap, frequently correlating at levels between 0.60 and 0.75. This severe psychometric collinearity often made it difficult to determine whether an intervention selectively altered depressive symptoms or generalized anxious distress.

Lovibond and Lovibond initiated an extensive empirical research program to resolve this conundrum by identifying scale items that were empirically distinct to either depression or anxiety while systematically removing items that failed to discriminate between the two conditions. In doing so, their empirical factor analyses revealed a coherent, pervasive third symptom cluster characterized by persistent state tension, mental agitation, impatience, and difficulty relaxing. This cluster could not be subsumed under either classical depression or somatic anxiety. Recognizing this distinct phenomenon as chronic non-specific nervous tension, the authors designated it as the “Stress” dimension, formalizing the tripartite structure of the DASS.

In clinical practice, the DASS-42 serves multiple vital functions:

• Dimensional Symptom Profiling: Rather than forcing patients into binary categorical diagnoses, the DASS-42 situates individuals along continuous dimensions of psychological disturbance, reflecting contemporary research frameworks such as the Hierarchical Taxonomy of Psychopathology (HiTOP) and the Research Domain Criteria (RDoC).
• Differential Diagnostic Clarification: The instrument disentangles somatic panic and autonomic arousal from cognitive anhedonia and dysphoric despair, aiding clinicians in tailoring cognitive-behavioral, pharmacological, or lifestyle interventions.
• Treatment Monitoring and Outcome Assessment: Because the DASS-42 possesses high sensitivity to weekly fluctuations in symptom severity, it is routinely utilized as a session-by-session or pre-post metric to monitor therapeutic gains in psychotherapy and psychiatric clinical trials.
• Epidemiological and Occupational Screening: The inclusion of the non-specific Stress subscale renders the tool uniquely advantageous in occupational health, academic environments, and community samples, capturing early manifestations of psychological burnout and adjustment difficulties before they evolve into severe clinical pathology.

5. Psychological Construct

The DASS-42 assesses three core psychological constructs, each operationalized through 14 systematically balanced items reflecting both subjective affective experiences and physiological or behavioral markers.

5.1 Depression Subscale (DASS-D)

The Depression scale measures low positive affectivity, loss of self-esteem, psychomotor inhibition, and anhedonic dysphoria. Drawing upon cognitive models of depression, the scale focuses heavily on the absence of pleasurable engagement with the environment and pervasive negative cognitive appraisals of the self and future. Its constituent domains include:

• Anhedonia and Lack of Positive Affect: Inability to experience joy, enthusiasm, or positive emotional arousal (e.g., Item 3: “I couldn’t seem to experience any positive feeling at all”; Item 24: “I couldn’t seem to get any enjoyment out of the things I did”; Item 31: “I was unable to become enthusiastic about anything”).
• Hopelessness and Devaluation of the Future: Bleak expectations, pessimism, and perceived lack of future prospects (e.g., Item 10: “I felt that I had nothing to look forward to”; Item 37: “I could see nothing in the future to be hopeful about”).
• Self-Deprecation and Worthlessness: Severe erosion of perceived personal value and existential self-blame (e.g., Item 17: “I felt I wasn’t worth much as a person”; Item 34: “I felt I was pretty worthless”).
• Existential Meaninglessness and Suicidal Ideation Substrate: Complete loss of purpose in living (e.g., Item 21: “I felt that life wasn’t worthwhile”; Item 38: “I felt that life was meaningless”).
• Avolition and Inertia: Psychomotor slowing and deficit in goal-directed drive (e.g., Item 5: “I just couldn’t seem to get going”; Item 42: “I found it difficult to work up the initiative to do things”).

5.2 Anxiety Subscale (DASS-A)

The Anxiety scale operationalizes acute autonomic arousal, skeletal muscle tension, situational hyper-reactivity, and subjective states of fear. It focuses on the physiological and panic-like manifestations of anxiety rather than generalized worry. Key components include:

• Autonomic Arousal: Sympathetic nervous system activation, including dry mouth, dyspnea, heart palpitations, and diaphoresis (e.g., Item 2: “I was aware of dryness of my mouth”; Item 4: “I experience breathing difficulty…”; Item 19: “I perspired noticeably…”; Item 25: “I was aware of the action of my heart…”).
• Skeletal and Motor Sensations: Peripheral somatic markers of acute alarm, such as trembling and bodily instability (e.g., Item 7: “I had a feeling of shakiness…”; Item 15: “I had a feeling of faintness”; Item 23: “I had difficulty in swallowing”; Item 41: “I experienced trembling…”).
• Panic and Acute Fear: Subjective experiences of imminent terror or loss of emotional control (e.g., Item 20: “I felt scared without any good reason”; Item 28: “I felt I was close to panic”; Item 36: “I felt terrified”).
• Apprehensive / Situational Dread: Fear of unexpected behavioral disruption or public incapacitation (e.g., Item 9: “I found myself in situations that made me so anxious I was most relieved when they ended”; Item 30: “I feared that I would be ‘thrown’ by some trivial but unfamiliar task”; Item 40: “I was worried about situations in which I might panic and make a fool of myself”).

5.3 Stress Subscale (DASS-S)

The Stress scale captures chronic, non-specific physiological and psychological hyperarousal. It measures a persistent state of tension characterized by low threshold for frustration, constant expenditure of energy, mental strain, and difficulty settling down:

• Difficulty Relaxing and Inability to Unwind: Sustained physical and mental drive with inability to reach baseline calm (e.g., Item 8: “I found it difficult to relax”; Item 22: “I found it hard to ‘wind down'”; Item 29: “I found it hard to calm down after something upset me”).
• Nervous Tension and Excessive Energy Consumption: Chronic feelings of tautness and sustained cognitive mobilization (e.g., Item 12: “I felt that I was using a lot of nervous energy”; Item 33: “I was in a state of nervous tension”; Item 39: “I found myself getting agitated”).
• Irritability and Impatience: Low tolerance for delay, cognitive interruptions, or minor hassles (e.g., Item 1: “I found myself getting upset by quite trivial things”; Item 14: “I found myself getting impatient when I was delayed in any way…”; Item 18: “I felt that I was rather touchy”; Item 27: “I found that I was very irritable”).
• Over-Reactivity and Intolerance: Hypersensitivity to ongoing cognitive interference (e.g., Item 6: “I tended to over-react to situations”; Item 11: “I found myself getting upset rather easily”; Item 32: “I found it difficult to tolerate interruptions…”; Item 35: “I was intolerant of anything that kept me from getting on with what I was doing”).

6. Theoretical Framework

The theoretical architecture of the DASS-42 is deeply rooted in contemporary affect science, cognitive-behavioral theory, and the seminal Tripartite Model of Anxiety and Depression formulated by David A. Clark and Lee Anna Watson (1991). The tripartite model addressed the massive overlap observed between depressive and anxious syndromes by positing three interrelated yet structurally distinct components:

1. General Distress / Negative Affectivity (NA): A non-specific, overarching temperamental diathesis characterized by subjective distress, worry, dissatisfaction, emotional lability, and general demoralization, shared across both mood and anxiety disorders.
2. Physiological Hyperarousal (PH): A specific biobehavioral manifestation dominated by sympathetic autonomic arousal, somatic panic, hyperventilation, and motor tension, uniquely characteristic of anxiety (specifically panic disorder and agoraphobia).
3. Low Positive Affectivity (LPA) / Anhedonia: A distinct cognitive-affective deficit characterized by lack of energy, joylessness, loss of intrinsic motivation, anhedonia, and feelings of worthlessness, uniquely characteristic of clinical depression.

While the tripartite model effectively accounted for the distinctness of anhedonic depression and autonomic panic, clinical reality frequently revealed a vast population of individuals presenting with persistent, distressing, non-panic tension who did not meet full criteria for major depressive episode or panic disorder. Lovibond and Lovibond’s empirical factor extractions aligned perfectly with this observation: their Depression subscale corresponds directly to Low Positive Affectivity (anhedonia, devaluation of life, inertia), their Anxiety subscale directly mirrors Physiological Hyperarousal (autonomic discharge, somatic trembling), and their Stress subscale isolates a distinct, high-arousal manifestation of Negative Affectivity characterized by prolonged autonomic irritability, impatience, and difficulty down-regulating psychomotor activity.

From a cognitive standpoint, Beck’s cognitive specificity hypothesis (Beck et al., 1987) further supports this differentiation. Cognitive specificity dictates that distinct cognitive themes govern distinct disorders: depression is characterized by themes of irrevocable personal loss, defeat, and perceived personal failure; anxiety is governed by prospective appraisals of physical or psychological vulnerability and personal threat; and stress represents the cognitive appraisal of excessive demands outstripping available coping resources (Lazarus & Folkman, 1984), producing immediate irritability and cognitive agitation.

7. Validity

The psychometric validity of the DASS-42 has been rigorously documented across clinical outpatients, psychiatric inpatients, community adults, working professionals, and university cohorts worldwide.

7.1 Construct and Structural Validity

The construct validity of the DASS-42 is evidenced by its consistent ability to differentiate between depressive, anxious, and general stress states. In the seminal psychometric investigation by Lovibond and Lovibond (1995) involving 2,914 non-clinical participants, the three factors demonstrated distinct patterns of association that accurately captured the proposed constructs. Confirmatory factor analytic studies repeatedly indicate that the tripartite factor model demonstrates superior goodness-of-fit indices (CFI > 0.93, TLI > 0.92, RMSEA < 0.05) compared to unidimensional or two-factor models.

7.2 Convergent Validity

Convergent validity is exceptionally strong across well-established benchmark criteria:

• DASS-Depression: Correlates strongly with the Beck Depression Inventory (BDI), with coefficients ranging from r = 0.74 to 0.85, and with the Center for Epidemiologic Studies Depression Scale (CES-D) at r = 0.78 to 0.83.
• DASS-Anxiety: Correlates strongly with the Beck Anxiety Inventory (BAI), with coefficients typically between r = 0.81 and 0.84, reflecting high sensitivity to physiological hyperarousal and acute fear responses.
• DASS-Stress: Demonstrates high positive correlations with the Perceived Stress Scale (PSS-14; r = 0.68 to 0.76) and the State-Trait Anxiety Inventory Trait version (STAI-T; r = 0.65 to 0.72), confirming its ability to measure chronic emotional strain and cognitive tension.

7.3 Discriminant Validity

The critical structural triumph of the DASS-42 is its superior discriminant validity compared to older self-report inventories. In a foundational comparative study by Antony, Bieling, Cox, Enns, and Swinson (1998) evaluating outpatients with DSM-defined mood and anxiety disorders:

• Patients diagnosed with Major Depressive Disorder scored significantly higher on the DASS-Depression scale than on the Anxiety or Stress scales.
• Patients with Panic Disorder scored substantially higher on the DASS-Anxiety scale relative to individuals with Generalized Anxiety Disorder (GAD) or Major Depression.
• Patients with Generalized Anxiety Disorder exhibited prominent elevations on the DASS-Stress scale, corroborating the view that GAD symptoms of chronic tension, hyperarousal, and irritability are captured more cleanly by the DASS-Stress dimension than by purely somatic anxiety inventories.
• Crucially, the correlation between DASS-Depression and DASS-Anxiety (ranging from r = 0.50 to 0.55 in non-clinical cohorts) is markedly lower than the typical inter-scale correlation between the BDI and BAI (often r > 0.70), demonstrating that the DASS successfully strips out non-discriminating common variance.

8. Reliability

The DASS-42 consistently exhibits exceptional internal consistency and substantial temporal stability across multiple populations and linguistic adaptations.

8.1 Internal Consistency

Across normative non-clinical and psychiatric clinical samples, the internal consistency of the full scale and its 14-item constituent dimensions consistently exceeds conventional psychometric thresholds for clinical decision-making:

• Depression Subscale: Cronbach’s alpha ($lpha$) coefficients routinely range from 0.91 to 0.97 (Lovibond & Lovibond, 1995: $lpha = 0.91$; Antony et al., 1998: $lpha = 0.96$; Crawford & Henry, 2003: $lpha = 0.95$). McDonald’s omega ($\omega$) values regularly match or exceed 0.95.
• Anxiety Subscale: Cronbach’s alpha values typically fall between 0.84 and 0.92 (Lovibond & Lovibond, 1995: $lpha = 0.84$; Antony et al., 1998: $lpha = 0.89$; Crawford & Henry, 2003: $lpha = 0.90$).
• Stress Subscale: Cronbach’s alpha values range from 0.90 to 0.95 (Lovibond & Lovibond, 1995: $lpha = 0.90$; Antony et al., 1998: $lpha = 0.93$; Crawford & Henry, 2003: $lpha = 0.93$).
• Full 42-Item Scale: Global internal consistency typically reaches $lpha = 0.96$ to $0.98$, indicating exceptional internal coherence among all items.

8.2 Test-Retest Reliability

Because the DASS-42 evaluates emotional states over the preceding week, test-retest reliability reflects both temporal stability and expected clinical state fluctuation. Across a 2-week to 4-week retest interval in untreated non-clinical samples, intraclass correlation coefficients (ICC) and Pearson correlation coefficients consistently range between:

• Depression: $r_{tt} = 0.71 \text{ to } 0.85$
• Anxiety: $r_{tt} = 0.74 \text{ to } 0.83$
• Stress: $r_{tt} = 0.78 \text{ to } 0.87$

These values demonstrate that while the scales capture transient, state-dependent distress, they also tap into stable psychological vulnerabilities over time. Furthermore, longitudinal sensitivity testing has confirmed that when individuals undergo successful cognitive-behavioral therapy or pharmacotherapy, DASS scores drop significantly in direct alignment with clinician-rated improvement scales, confirming the instrument’s clinical responsiveness.

9. Factor Analysis

The factorial validity of the DASS-42 has been scrutinized via both Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) across tens of thousands of participants globally.

9.1 Exploratory Factor Analysis (EFA)

During original scale development, Lovibond and Lovibond (1995) administered initial candidate item pools to university cohorts and applied principal axis factoring with oblimin (oblique) rotation to permit natural correlation between affective states. The eigenvalues-greater-than-one rule and scree plot examination decisively supported the retention of three dominant factors accounting for the majority of common variance:

• All 14 items assigned to the Depression factor yielded high primary pattern matrix loadings (predominantly ranging from 0.50 to 0.82) with negligible cross-loadings (< 0.20) onto Anxiety or Stress.
• The 14 Anxiety items clustered strongly around autonomic arousal and somatic fright, with primary factor loadings between 0.45 and 0.78.
• The 14 Stress items loaded cleanly between 0.48 and 0.75 on the third factor, characterized by items measuring nervous tension, irritability, and impatience.

9.2 Confirmatory Factor Analysis (CFA) and Fit Indices

Subsequent structural investigations have systematically compared competing factorial configurations using structural equation modeling (SEM). In a landmark study by Crawford and Henry (2003) evaluating a normative British adult sample ($N = 1,771$), the authors formally compared several rival measurement models:

1. One-Factor Model: All 42 items loading onto a single general distress factor ($\chi^2 / df > 7.8$, $\text{CFI} < 0.80$, $\text{RMSEA} > 0.08$), which exhibited exceptionally poor fit.
2. Two-Factor Model: Combining anxiety and stress into a single overarching somatic/hyperarousal construct versus depression ($\chi^2 / df > 5.2$, $\text{CFI} \approx 0.86$, $\text{RMSEA} > 0.065$).
3. Three-Factor Correlated Model: Three independent yet correlated latent dimensions representing Depression, Anxiety, and Stress. This model demonstrated robust, statistically superior fit across all benchmark criteria ($\chi^2 / df = 3.12$, $\text{CFI} = 0.94$, $\text{TLI} = 0.93$, $\text{RMSEA} = 0.044$, $90% \text{ CI } [0.042, 0.046]$, $\text{SRMR} = 0.038$).
4. Bifactor / Hierarchical Model: A general negative affectivity factor (general distress) alongside three orthogonal or specific group factors. While bifactor models often generate incrementally higher fit indices mathematically, the three correlated factors maintain distinct predictive validity across diagnostic and treatment modalities.

10. Instrument / Measurement Tool

• Complete Test Name: Depression, Anxiety and Stress Scales (DASS-42)
• Abbreviated Name: DASS-42 (also known simply as the DASS)
• Constructs Assessed: Tripartite negative emotional states: Depression, Anxiety, and Stress
• Test Type: Quantitative, dimensional self-report psychological screening instrument and outcome measure
• Target Population: Adults and adolescents aged 14 years and older across clinical, community, academic, and occupational settings
• Administration Format: Paper-and-pencil questionnaire, web-based digital assessment, or clinician-administered interview
• Completion Time: Approximately 8 to 12 minutes
• Number of Items: 42 items in total (14 items per subscale)
• Response Scale: 4-point ordinal severity scale evaluating symptom presence over the preceding week:
  • 0 = Did not apply to me at all
  • 1 = Applied to me to some degree or for some of time
  • 2 = Applied to me to consider degree or for a good part of time
  • 3 = Applied to me very much or most of the time
• Item Allocation Across Subscales:
  • Depression (14 Items): Items 3, 5, 10, 13, 16, 17, 21, 24, 26, 31, 34, 37, 38, 42.
  • Anxiety (14 Items): Items 2, 4, 7, 9, 15, 19, 20, 23, 25, 28, 30, 36, 40, 41.
  • Stress (14 Items): Items 1, 6, 8, 11, 12, 14, 18, 22, 27, 29, 32, 33, 35, 39.
• Scoring Rules:
  • Scores for each subscale are calculated by summing the raw responses of the 14 constituent items.
  • Possible raw score range for each subscale: 0 to 42.
  • A Total DASS-42 score can be obtained by summing all 42 items (range 0 to 126), serving as an overarching index of non-specific psychological distress or negative affectivity.
  • Note on DASS-21 comparison: Unlike the brief DASS-21 version—where subscale raw sums must be multiplied by 2 to equate to the DASS-42 scale—the DASS-42 raw scores are directly interpreted using the standard severity cut-off brackets.
• Standard Severity Cut-Off Score Benchmarks (Lovibond & Lovibond, 1995):
  • Depression: Normal (0–9), Mild (10–13), Moderate (14–20), Severe (21–27), Extremely Severe (28+).
  • Anxiety: Normal (0–7), Mild (8–9), Moderate (10–14), Severe (15–19), Extremely Severe (20+).
  • Stress: Normal (0–14), Mild (15–18), Moderate (19–25), Severe (26–33), Extremely Severe (34+).

11. Permissions & Fee and Test Year

The Depression, Anxiety and Stress Scales were originally finalized and published in manual format in 1995 by Sydney H. Lovibond and Peter F. Lovibond through the Psychology Foundation of Australia (UNSW DASS Website).

Licensing and Fee Structure: In contrast to proprietary psychometric tools (e.g., the Beck inventories), the DASS-42 is placed in the public domain for research, education, and clinical practice. It is free of charge and may be reproduced, administered, and scored without obtaining prior written permission or paying royalty fees, provided that:

1. The original scale items, formatting, and scoring systems remain unedited and unmodified.
2. Appropriate scholarly attribution and bibliographic citation are accorded to S.H. Lovibond and P.F. Lovibond (1995).
3. The scale is not resold or commercialized for profit as a standalone product.

Authorized paper scoring templates, computer administration software guides, and normative tables in over 50 languages are maintained by the Psychology Foundation of Australia.

12. 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
• Beck, A. T., Brown, G., Steer, R. A., Eidelson, J. I., & Riskind, J. H. (1987). Differentiating anxiety and depression: A test of the cognitive content-specificity hypothesis. Journal of Abnormal Psychology, 96(3), 179–183. https://doi.org/10.1037/0021-843X.96.3.179
• 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. https://doi.org/10.1016/S0005-7967(96)00068-X
• Clark, L. A., & Watson, D. (1991). Tripartite model of anxiety and depression: Psychometric evidence and taxonomic implications. Journal of Abnormal Psychology, 100(3), 316–336. https://doi.org/10.1037/0021-843X.100.3.316
• Crawford, J. R., & Henry, J. D. (2003). The Depression Anxiety Stress Scales (DASS): Normative data and latent structure in a large non-clinical sample. British Journal of Clinical Psychology, 42(2), 111–131. https://doi.org/10.1348/014466503321903544
• 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
• Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.
• Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343. https://doi.org/10.1016/0005-7967(94)00075-U
• Lovibond, S. H., & Lovibond, P. F. (1995). Manual for the Depression Anxiety Stress Scales (2nd ed.). Psychology Foundation of Australia.
• Nieuwenhuijsen, K., de Boer, A. G., Verbeek, J. H., Blonk, R. W., & van Dijk, F. J. (2003). The Depression Anxiety Stress Scales (DASS): Detecting anxiety disorder and depression in employees absent from work because of mental health problems. Occupational and Environmental Medicine, 60(Suppl 1), i77–i82. https://doi.org/10.1136/oem.60.suppl_1.i77
• Page, A. C., Hooke, G. R., & Morrison, D. L. (2007). Psychometric properties of the Depression Anxiety Stress Scales (DASS) in depressed clinical samples. British Journal of Clinical Psychology, 46(3), 283–297. https://doi.org/10.1348/014466506X158996

13. Items of the Scale