For clinicians
The authors of the DASS-21 ask that it not be used for self-assessment on public websites, and that scores go to a clinician rather than the person answering. So on this page it is given one of two ways, and the scores only ever reach you.
Want to check on yourself? The PHQ-9 (depression) and GAD-7 (anxiety) are made for self-screening.
- Questions
- 21
- Time
- 5–10 min
- Looks back over
- The past week
- Score range
- 0–42 per scale
- Cost
- Free
What the DASS-21 measures
- Depression: Dysphoria, hopelessness, devaluation of life, self-deprecation, lack of interest/involvement, anhedonia, inertia
- Anxiety: Autonomic arousal, skeletal muscle effects, situational anxiety, subjective experience of anxious affect
- Stress: Difficulty relaxing, nervous arousal, easily upset/agitated, irritability/over-reactivity, impatience
The 21 items
Each is rated for the past week: 0 = did not apply to me at all; 1 = applied to me to some degree, or some of the time; 2 = applied to me to a considerable degree, or a good part of the time; 3 = applied to me very much, or most of the time.
- I found it hard to wind down
- I was aware of dryness of my mouth
- I couldn't seem to experience any positive feeling at all
- I experienced breathing difficulty (e.g., excessively rapid breathing, breathlessness in the absence of physical exertion)
- I found it difficult to work up the initiative to do things
- I tended to over-react to situations
- I experienced trembling (e.g., in the hands)
- I felt that I was using a lot of nervous energy
- I was worried about situations in which I might panic and make a fool of myself
- I felt that I had nothing to look forward to
- I found myself getting agitated
- I found it difficult to relax
- I felt down-hearted and blue
- I was intolerant of anything that kept me from getting on with what I was doing
- I felt I was close to panic
- I was unable to become enthusiastic about anything
- I felt I wasn't worth much as a person
- I felt that I was rather touchy
- 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)
- I felt scared without any good reason
- I felt that life was meaningless
The history of the DASS-21
Peter Lovibond and Sydney Lovibond built the DASS at the University of New South Wales in Sydney. They set out to make a better measure of anxiety and depression, two states most questionnaires of the time had trouble telling apart. As they tested items with large groups of adults, a third cluster kept appearing: tension, irritability and trouble relaxing. They called it stress, and the instrument became the Depression Anxiety Stress Scales.
The full 42-item DASS and the 21-item short form were published together in the authors' manual in 1995. The DASS-21 uses half the items, so each scale score is doubled to line up with the 42-item norms. Later studies, including one by Antony and colleagues in 1998, found the short form holds up as well as the long one in clinical groups and takes half the time.
The Lovibonds treat distress as a matter of degree rather than kind. The scales describe how much depression, anxiety or stress someone is carrying, not whether they have a disorder. The DASS is in the public domain, so no permission is needed to use it, and the authors consider it suitable from about age 14. A separate youth version, the DASS-Y, exists for younger children.
How it is used today
The DASS-21 was developed by researchers at the University of New South Wales, Australia (Lovibond & Lovibond, 1995). It is the short form of the original 42-item DASS and has become one of the most widely used measures of emotional distress in both clinical and research settings.
Unlike single-construct measures, the DASS-21 simultaneously assesses depression, anxiety, and stress, providing a more nuanced picture of an individual's emotional state. The three scales have been shown to have high internal consistency and meaningful discriminant validity, meaning they effectively distinguish between the three emotional states.
The DASS-21 scores are multiplied by 2 to allow comparison with the full DASS-42 normative data.
How the DASS-21 is scored
- Every question is answered on the same scale, from "Did not apply to me at all" (0 points) to "Applied to me very much, or most of the time" (3 points).
- The questions are split into 3 scales. Depression: questions 3, 5, 10, 13, 16, 17 and 21. Anxiety: questions 2, 4, 7, 9, 15, 19 and 20. Stress: questions 1, 6, 8, 11, 12, 14 and 18.
- Add up the answers on each scale, then double each total. The doubling makes a 21-question score comparable with the published norms for the full-length version.
- For example, if the 7 Depression questions add up to 7, the Depression score is 7 × 2 = 14, which falls in the Moderate range.
DASS-21 score ranges
The ranges this quiz uses to label a score, for each scale. They describe where a score falls, not a diagnosis.
| Result | Depression | Anxiety | Stress |
|---|---|---|---|
| Normal | 0–9 | 0–7 | 0–14 |
| Mild | 10–13 | 8–9 | 15–18 |
| Moderate | 14–20 | 10–14 | 19–25 |
| Severe | 21–27 | 15–19 | 26–33 |
| Extremely Severe | 28–42 | 20–42 | 34–42 |
How to read the results
- It is a snapshot, not a diagnosis. The score describes the past week, and a label only says where that falls compared with the people the questionnaire was tested on. A word like "mild" does not mean a mild disorder.
- Compare the scales with each other. The pattern across them says more than any one number. High stress with normal depression points somewhere different from the reverse.
- Compare with yourself over time. Taking it again in a few weeks, or after starting therapy, shows whether things are moving. Compare each score with your own earlier one, not with someone else's.
- Talk it through. A clinician will ask what no questionnaire can: how long it has been like this, what else is going on, and how much it gets in the way.
- It does not ask about suicide. The DASS-21 has no question about thoughts of death or self-harm, so a clinician should ask directly. If you are having those thoughts, call or text 988.
The DASS-21 compared with similar tests
| Test | Screens for | Questions | Looks back over | Asks about suicide |
|---|---|---|---|---|
| PHQ-9 | Depression | 9 | The past two weeks | Yes |
| EPDS | Depression in pregnancy and after birth | 10 | The past seven days | Yes |
| CESD-R | Depression, as a community screen | 20 | The past two weeks | Yes |
| HAM-D | Depression, including physical symptoms | 17 | The past week | Yes |
| MADRS | Depression, and how it changes in treatment | 10 | The past week | Yes |
| GAD-7 | Generalized anxiety | 7 | The past two weeks | No |
| OCI-R | Obsessions and compulsions | 18 | The past month | No |
| HAM-A | Anxiety, including physical symptoms | 14 | The past week | No |
| DASS-21 (this page) | Depression, anxiety and stress, scored separately | 21 | The past week | No |
Using the DASS-21 with clients
- Baseline, then repeat. Give it at intake, then at regular intervals, and compare each score with the client's own earlier ones to see whether treatment is working.
- Hand to client. Give it on your own device in session. The questions fill the screen with nothing else on it, and the scores stay hidden until you take the device back and press Show results.
- Send to client. Send a link before the session. The client answers on their phone and sends the results to your email. They are not shown the scores. Your address travels in the link itself and never reaches our servers.
- Copy summary and Print. The results screen copies a one-line summary for the session note, or prints the results on their own.
- Nothing is stored. Answers stay in the browser. Results leave it only when someone chooses to email them, and that email is not kept.
- Billing. Giving and scoring a standardized instrument like the DASS-21 is commonly billed as CPT 96127, one unit per instrument. Payers set their own limits, so check before relying on it.
Diagnosis codes often documented for this concern
For reference only. A screening score is not a diagnosis, and none of these follows from a score on its own.
Where to go from here
- Anxiety Therapy at Crown Counseling · in Brooklyn and online across New York
- Free EMDR bilateral stimulation tools · for calming between sessions, or for therapists to run remotely
- Free resources for therapists
Frequently Asked Questions
What is the DASS-21?+
The DASS-21 is a 21-item self-report questionnaire that measures three related negative emotional states: depression, anxiety, and stress. It was developed at the University of New South Wales and is widely used in clinical and research settings.
How is the DASS-21 scored?+
The 21 items are divided into three subscales of 7 items each. Each item is scored 0-3. The subscale scores are summed and then multiplied by 2 to allow comparison with the full 42-item DASS normative data.
Why does the DASS-21 measure three things?+
Depression, anxiety, and stress often co-occur but are distinct emotional experiences. The DASS-21 helps differentiate between them, which is important for understanding your emotional state and determining the most appropriate treatment approach.
How is the DASS-21 different from the PHQ-9 or GAD-7?+
The PHQ-9 focuses solely on depression and the GAD-7 on anxiety, while the DASS-21 measures all three dimensions (depression, anxiety, and stress) in a single instrument. The DASS-21 provides a broader picture of emotional distress.
Can I take the DASS-21 on my own?+
The DASS authors ask that it not be offered for self-assessment on public websites, and that scores go to a clinician rather than to the person answering, because a score with nobody to interpret it can mislead. So this page is set up for clinicians to give it. If you want to check on yourself, the PHQ-9 (depression) and GAD-7 (anxiety) are designed for self-screening and are free on this site.
Are my responses stored?+
No. Answers stay in the browser and nothing is stored. When a client takes it by link, their scores are emailed to the clinician only if the client presses Send, and that email is not kept.
References
- Lovibond SH, Lovibond PF. Manual for the Depression Anxiety Stress Scales. 2nd ed. Sydney: Psychology Foundation; 1995.
- Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335-343.
- Henry JD, Crawford JR. The short-form version of the Depression Anxiety Stress Scales (DASS-21). Br J Clin Psychol. 2005;44(Pt 2):227-239.
- Antony MM, Bieling PJ, Cox BJ, et al. Psychometric properties of the 42-item and 21-item versions of the DASS. Behav Res Ther. 1998;36(2):141-154.
- Osman A, Wong JL, Bagge CL, et al. The DASS-21 as a screening instrument for depression and anxiety. J Psychopathol Behav Assess. 2012;34(3):315-329.