Depression Anxiety Stress Scales - 21

The Depression Anxiety Stress Scales (DASS-21) is a well-established self-report instrument that measures three related but distinct negative emotional…

Questions: 21
Duration: 5 min
Original title: DASS-21 — Depression Anxiety Stress Scales
Adaptation: Depression Anxiety Stress Scales - 21
Authors: Lovibond, S.H. & Lovibond, P.F.
Created: 1995

The Depression Anxiety Stress Scales (DASS-21) is a well-established self-report instrument that measures three related but distinct negative emotional states: depression, anxiety, and stress. Designed for both clinical and non-clinical populations, this 21-item questionnaire offers a concise snapshot of a patient's recent emotional distress profile. Its dimensional approach helps clinicians disentangle overlapping symptoms, providing clear metrics for anhedonia and dysphoria, physiological arousal, and chronic tension.

Because of its brevity and strong psychometric properties, the DASS-21 is highly valuable for initial intake screening and ongoing progress monitoring. Tracking these three core domains over time can inform a comprehensive case formulation and treatment planning, allowing practitioners to pivot interventions when necessary. It is important to note that while the DASS-21 measures symptom severity, it provides structured data to enrich clinical judgment rather than functioning as a standalone diagnostic tool.

Example result

Fictitious result, computed from a sample set of answers.

A 21-item self-report questionnaire assessing the severity of depression, anxiety, and stress symptoms experienced over the past week. Used in adults within clinical and research settings for screening and monitoring emotional distress. Short version of the DASS-42 by Lovibond & Lovibond (1995), comprising three 7-item subscales: Depression (dysphoria, self-depreciation, anhedonia, inertia), Anxiety (autonomic arousal, somatic effects, situational anxiety), and Stress (persistent tension, irritability, difficulty relaxing).

Stress

22/ 42

Finally, the Stress scale includes items that measure symptoms such as tension, irritability, and a tendency to overreact to stressful events [...] the DASS-S scale measures features of both anxiety and depression (e.g., tension or irritability).

items 1, 6, 8, 11, 12, 14, 18

0–14

Normal

15–18

Mild

19–25

Moderate

26–33

Severe

34–42

Extremely Severe

Moderate severity range (percentiles 88 to 95). Applies to the doubled DASS-21 subscale score.

Anxiety

26/ 42

The Anxiety scale [...] includes items that are primarily related to symptoms of physical arousal, panic attacks, and fear (e.g., trembling or faintness). [...] the DASS-A scale measures features proposed to be unique to anxiety (physical hyperarousal)

items 2, 4, 7, 9, 15, 19, 20

0–7

Normal

8–9

Mild

10–14

Moderate

15–19

Severe

20–42

Extremely Severe

Extremely severe range (percentile >98.1). Applies to the doubled DASS-21 subscale score.

Depression

12/ 42

The Depression scale includes items that measure symptoms typically associated with dysphoric mood (e.g., sadness or worthlessness). [...] the DASS-D scale appears to measure features that are unique to depression (low positive affect)

items 3, 5, 10, 13, 16, 17, 21

0–9

Normal

10–13

Mild

14–20

Moderate

21–27

Severe

28–42

Extremely Severe

Mild severity range (percentiles 79 to 87). 'Mild' means the person is above the population mean but probably still below the typical severity of someone seeking help. Applies to the doubled DASS-21 subscale score.

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What the test measures

The DASS-21 quantifies the severity of three distinct negative emotional syndromes experienced over the preceding week. The items cover the following clinical dimensions:

Depression: Dysphoria, hopelessness, self-deprecation, lack of interest, and anhedonia.
Anxiety: Autonomic arousal, situational panic, and subjective experiences of anxious affect.
Stress: Chronic non-specific arousal, difficulty relaxing, nervous tension, irritability, and agitation.

This measure is appropriate for adolescents and adults who can reliably reflect on their emotional experiences over a recent timeframe.

When and why to use it

Clinicians use the DASS-21 at various stages of therapy to anchor subjective distress in observable data. Regular use helps detect shifts in symptom presentation that might otherwise go unnoticed.

Intake baseline: Establishes a clear starting point across three primary dimensions of psychological distress.
Progress monitoring: Tracks whether targeted interventions, such as building emotion regulation skills, are effectively reducing symptom severity over the course of treatment.
Differential support: Helps distinguish between predominant physiological arousal and chronic tension, guiding the clinician toward either sensory grounding or confronting avoidance.
Risk screening: Identifies severe spikes in distress that may warrant an immediate pivot to coping in crisis.

Incorporating a validated measure like the DASS-21 provides an objective counterpoint to clinical impression, ensuring that treatment intensity remains aligned with the patient's actual level of distress.

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The questions

Please read each statement and indicate how much the statement applied to you over the past week. There are no right or wrong answers. Do not spend too much time on any statement.
1. I found it hard to wind down.
Probes difficulty in achieving a state of relaxation and transitioning away from active alertness.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
2. I was aware of dryness of my mouth.
Checks for autonomic nervous system arousal often associated with acute anxiety.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
3. I couldn’t seem to experience any positive feeling at all.
Evaluates the presence of anhedonia and a general absence of positive affect.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
4. I experienced breathing difficulty (e.g., excessively rapid breathing, breathlessness in the absence of physical exertion).
Assesses physiological symptoms of panic or hyperventilation independent of exercise.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
5. I found it difficult to work up the initiative to do things.
Explores avolition and a lack of motivation to begin new tasks or activities.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
6. I tended to over-react to situations.
Examines emotional reactivity and a tendency toward disproportionate responses.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
7. I experienced trembling (e.g., in the hands).
Looks for somatic markers of anxiety such as visible tremors.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
8. I felt that I was using a lot of nervous energy.
Evaluates feelings of chronic internal tension and physical restlessness.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
9. I was worried about situations in which I might panic and make a fool of myself.
Explores anticipatory anxiety and the fear of social embarrassment during a panic episode.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
10. I felt that I had nothing to look forward to.
Checks for hopelessness and a pessimistic outlook regarding the future.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
11. I found myself getting agitated.
Assesses subjective feelings of irritability and internal restlessness.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
12. I found it difficult to relax.
Probes the ongoing inability to release tension or settle down.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
13. I felt down-hearted and blue.
Evaluates the core depressive symptom of subjective sadness or dysphoria.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
14. I was intolerant of anything that kept me from getting on with what I was doing.
Examines impatience and frustration when faced with delays or interruptions.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
15. I felt I was close to panic.
Looks for the subjective sense of impending acute panic or overwhelming fear.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
16. I was unable to become enthusiastic about anything.
Assesses the loss of interest and emotional numbing characteristic of depression.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
17. I felt I wasn’t worth much as a person.
Explores self-deprecation and diminished self-worth.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
18. I felt that I was rather touchy.
Checks for heightened sensitivity and a short temper.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
19. I was aware of the action of my heart in the absence of physical exertion (e.g., sense of heart rate increase, heart missing a beat).
Evaluates cardiovascular symptoms of anxiety occurring without physical cause.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
20. I felt scared without any good reason.
Examines generalized feelings of fear lacking an apparent external trigger.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time
21. I felt that life was meaningless.
Assesses existential despair and feelings of profound emptiness.
- Did not apply to me at all
- Applied to me to some degree, or for some of the time
- Applied to me to a considerable degree, or for a good part of the time
- Applied to me very much, or for most of the time