Psychometric properties of the Depression Anxiety and Stress Scale-21 in older primary care patients

Abstract

The Depression Anxiety Stress Scale (DASS) was designed to efficiently measure the core symptoms of anxiety and depression and has demonstrated positive psychometric properties in adult samples of anxiety and depression patients and student samples. Despite these findings, the psychometric properties of the DASS remain untested in older adults, for whom the identification of efficient measures of these constructs is especially important.To determine the psychometric properties of the DASS 21-item version in older adults, we analyzed data from 222 medical patients seeking treatment to manage worry. Consistent with younger samples, a three-factor structure best fit the data. Results also indicated good internal consistency, excellent convergent validity, and good discriminative validity, especially for the depression scale. Receiver operating curve analyses indicated that the DASS-21 predicted the diagnostic presence of generalized anxiety disorder and depression as well as other commonly used measures.These data suggest that the DASS may be used with older adults in lieu of multiple scales designed to measure similar constructs, thereby reducing participant burden and facilitating assessment in settings with limited assessment resources. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Psychometric Properties of the Depression Anxiety and Stress Scale-21 in Older Primary Care PatientsLovibond and Lovibond (1995a) developed a single measure to assess the core symptoms of depression and anxiety while maximizing discriminant validity between these constructs. Using an empirically driven iterative process, they identified a third factor, which they labeled stress. Their research resulted in the Depression Anxiety Stress Scale (DASS), which consists of 42 items comprising three scales of 14 items. Items refer to the past week; and scores range from 0, "Did not apply to me at all," to 4, "Applied to me very much, or most of the time." The Depression scale measures hopelessness, low self-esteem, and low positive affect. The Anxiety scale assesses autonomic arousal, physiological hyperarousal, and the subjective feeling of fear. The Stress scale items measure tension, agitation, and negative affect. Brown, et al., 1997;Clara et al., 2001), , and Depression -Stress (.57 -.79). Older AdultsDespite encouraging psychometric data with the DASS in younger adults, the measure remains untested in older adults. Given the high prevalence of anxiety, depression, and comorbid anxiety-depression in older adults and the need for briefer instruments that efficiently ev...

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“…Self-administered Depression Anxiety Stress Scale (DASS-21) was used to measure psychological depression, anxiety and stress (Lovibond and Lovibond, 1995) in both clinical (Gloster et al, 2008) and non-clinical samples (Henry and Crawford, 2005). It comprises twenty-one items that are divided into three subscales measure depression, anxiety and stress.…”

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“…The scores in the three conditions were 8.9, 0.4 and 0.2, respectively. Kim et al reported that inhalation of an essential oil had immediate and continuous effects on the base systolic blood pressure, daytime blood pressure, and stress reduction (24).…”

“…The depression subscale measured items such as hopelessness, lack of motivation, low selfesteem, and blame (23). Various studies have confirmed the validity and reliability of this questionnaire (10,12,(24)(25)(26).…”

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“…Para cada escala (de sete itens cada) a pontuação mínima é de zero e a máxima de 21 pontos, estando os valores mais elevados associados a estados afetivos mais negativos . A investigação tem atribuído uma boa consistência interna à escala (Gloster et al, 2008;Willemsen, Markey, Dclercq, & Vanheule, 2010), assim como qualidades psicométricas e boa fiabilidade (Lovibond & Lovibond, 1995;, encontrando validade em diferentes culturas (Oei, Sawang, Gohe, & Mukhtar, 2013). Na nossa amostra, os valores de alfa de Cronbach para a totalidade dos itens (21) da escala revelaram uma boa consistência interna (a =.94) assim como para as subescalas de ansiedade (a = .86), depressão (a = .89) e stresse (a = .86).…”