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    Depression Anxiety Stress Scales DASS3481 Survey Questionnaire

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    Trixia Almendral
    This document contains a 21-question survey called the DASS 21 that measures symptoms of depression, anxiety and stress. It instructs respondents to circle a number from 0 to 3 to indicate how much each statement applied to them over the past week, with 0 meaning "Did not apply to me at all" and 3 meaning "Applied to me very much, or most of the time." The questions ask about symptoms like difficulty relaxing, dry mouth, breathing difficulties, agitation, worthlessness, and more. Scores are totaled at the end to assess levels of depression, anxiety and stress.

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    Depression Anxiety Stress Scales DASS3481 Survey Questionnaire

    Uploaded by

    Trixia Almendral
    114 views1 page
    This document contains a 21-question survey called the DASS 21 that measures symptoms of depression, anxiety and stress. It instructs respondents to circle a number from 0 to 3 to indicate how much each statement applied to them over the past week, with 0 meaning "Did not apply to me at all" and 3 meaning "Applied to me very much, or most of the time." The questions ask about symptoms like difficulty relaxing, dry mouth, breathing difficulties, agitation, worthlessness, and more. Scores are totaled at the end to assess levels of depression, anxiety and stress.

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    This document contains a 21-question survey called the DASS 21 that measures symptoms of depression, anxiety and stress. It instructs respondents to circle a number from 0 to 3 to indicate how much each statement applied to them over the past week, with 0 meaning "Did not apply to me at all" and 3 meaning "Applied to me very much, or most of the time." The questions ask about symptoms like difficulty relaxing, dry mouth, breathing difficulties, agitation, worthlessness, and more. Scores are totaled at the end to assess levels of depression, anxiety and stress.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    114 views1 page

    Depression Anxiety Stress Scales DASS3481 Survey Questionnaire

    Uploaded by

    Trixia Almendral
    This document contains a 21-question survey called the DASS 21 that measures symptoms of depression, anxiety and stress. It instructs respondents to circle a number from 0 to 3 to indicate how much each statement applied to them over the past week, with 0 meaning "Did not apply to me at all" and 3 meaning "Applied to me very much, or most of the time." The questions ask about symptoms like difficulty relaxing, dry mouth, breathing difficulties, agitation, worthlessness, and more. Scores are totaled at the end to assess levels of depression, anxiety and stress.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    DASS 21 NAME DATE

    Please read each statement and circle a number 0, 1, 2 or 3 which indicates 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.
    The rating scale is as follows:
    0 Did not apply to me at all - NEVER
    1 Applied to me to some degree, or some of the time - SOMETIMES
    2 Applied to me to a considerable degree, or a good part of time - OFTEN
    3 Applied to me very much, or most of the time - ALMOST ALWAYS FOR OFFICE USE

    N S O AA D A S

    1 I found it hard to wind down 0 1 2 3

    2 I was aware of dryness of my mouth 0 1 2 3

    3 I couldn’t seem to experience any positive feeling at all 0 1 2 3

    I experienced breathing difficulty (eg, excessively rapid breathing,


    4 0 1 2 3
    breathlessness in the absence of physical exertion)

    5 I found it difficult to work up the initiative to do things 0 1 2 3

    6 I tended to over-react to situations 0 1 2 3

    7 I experienced trembling (eg, in the hands) 0 1 2 3

    8 I felt that I was using a lot of nervous energy 0 1 2 3

    I was worried about situations in which I might panic and make a fool of
    9 0 1 2 3
    myself

    10 I felt that I had nothing to look forward to 0 1 2 3

    11 I found myself getting agitated 0 1 2 3

    12 I found it difficult to relax 0 1 2 3

    13 I felt down-hearted and blue 0 1 2 3

    I was intolerant of anything that kept me from getting on with what I was
    14 0 1 2 3
    doing

    15 I felt I was close to panic 0 1 2 3

    16 I was unable to become enthusiastic about anything 0 1 2 3

    17 I felt I wasn’t worth much as a person 0 1 2 3

    18 I felt that I was rather touchy 0 1 2 3

    I was aware of the action of my heart in the absence of physicalexertion (eg,


    19 0 1 2 3
    sense of heart rate increase, heart missing a beat)

    20 I felt scared without any good reason 0 1 2 3

    21 I felt that life was meaningless 0 1 2 3

    This document may be freely downloaded and distributed on condition no change is made to the content. The information in this document TOTALS 0 0 0
    is not intended as a substitute for professional medical advice, diagnosis or treatment. Not to be used for commercial purposes and not to
    be hosted electronically outside of the Black Dog Institute website. www.blackdoginstitute.org.au

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