Depression and Anxiety Stress Scale - 21

History

• UNSW (1995): Syd Lovibond and Peter Lovibond

Purpose

• designed for measuring emotional states

  • depression, anxiety, stress

• in-depth explanation of the emotional states

• measure current emotional state and changes

• evaluate the symptoms of the emotional states

Administration

• self-report

• 21-items

• experienced clinicians

• electronic administration

  • scoring can be automated

Participation

• has been used with adolescents down to 14 years old

• not recommended to use DASS with children below 14

• those who are suffering from depression, anxiety, and high levels of stress

Scoring

• Stress Questions: 1, 6, 8, 11, 12, 14, 18

• Anxiety Questions: 2, 4, 7, 9, 15, 19, 20

• Depression Questions: 3, 5, 10, 13, 16, 17, 21

Steps

• Record the circled number per question on the Office Use Only columns. Do not put the number on the shaded boxes and based on the questions and their corresponding mental problem.

• Add up the numbers per column

Beck Depression Inventory

• BDI developed by Aaron T. Beck is a 21-question self-reporting inventory for evaluating the severity of depression

• Created in 1961, it relied on the theory of negative cognitive distortions as the main point of depression. Throughout the years, it has undergone revisions in 1978 (BDI-1A) and in 1996 (BDI-II).

• BDI-II, a revision of the BDI in 1996, serves as a response to the publication of the DSM-IV, which updated and changed diagnostic criteria for Major Depressive Disorder

• It does not heavily rely on any theory of depression

• The inventory has also been translated in several languages to cater to other people who do not understand English

Aaron T. Beck

• An American psychiatrist known for developing self-report measures of depression and anxiety

• father of Cognitive Behavioral Therapy

• Created multiple assessment scales

• published more than 600 papers and 24 books

• founded the Beck Institute for Cognitive Behavioral Therapy

History

• Publication and Revisions

  • 1961: 1st publication (BDI/BDI-I)

  • 1979: extended timeframe and reworded items (BDI-1A)

  • 1987: technical manual was included (BDI-1A)

  • 1993: revision of the technical manual (BDI-1A)

  • 1996: committed items related to weight loss, body image, hypochondria, and working difficulty and replaced them with agitation, worthlessness, difficulty concentrating and energy loss; amended items on appetite and sleep change (BDI-II)

  • 2000: contained 7 items from BDI-II to assess depression in individuals with biomedical or substance abuse problems (BDI-FS/BDI-PC)

Purpose

• The test is a cost-effective questionnaire used in measuring the severity of one’s depression

• it is used to gauge the intensity of depression among patients who meet the criteria in diagnosing depressive syndromes

• It evaluates key symptoms of depression such as mood, pessimism, sense of failure, guilt, self-dislike, suicidal ideas, working difficulty, and more

• Individuals with are 13 years old and above can take this test

• It is also recommended that the client taking the test should have a fifth to sixth reading comprehension to fully understand the questionnaire

Administration

• The test was originally designed to be administered by a licensed psychometrician. However, it can now be self-administered, after which the results are reported orally in individual or group settings

• Respondents must describe their feelings over the past 2 weeks

• Answering the test itself takes about 5-10 minutes

• the self-report can be done in 15 minutes

Scoring

• How to score

  • scored by summing the ratings for the 21-items

  • each item is rated in a 4-point scale ranging from 0 to 3

• How to compute

  • computed by summing all 21 items to give a single score

  • special attention must be paid to the correct scoring of the item #16 (changes in sleeping pattern) and item #18 (changes in appetite)

  • each of these items contains seven options rated in order, 0, 1a, 1b, 2a, 2b, 3a, 3b, to differentiate between increases and decreases in behavior or motivation

  • these items indicate whether there is an increase or decrease in sleep and appetite

  • if a higher rated option is chosen by the respondent, the presence of increase or decrease in either symptom should be clinically noted for diagnostic purposes

• Interpretation of scores

  • total score

    • 0-13 indicates minimal depression

      • no treatment required

    • 14-19 indicates mild depression

      • possible medications (low dose) can be given

      • therapy can also be given to patients

    • 20-28 indicates moderate depression

      • treatment is similar with mild depression (i.e., low dose of medications and/or therapy)

    • 29-63 indicates severe depression

      • professional help must be given to provide proper treatment to patients

      • monitor the patient (e.g., providing suicide watch)