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Assessment

(PS4-8) Development of an Ultra Brief Version of the Depression, Anxiety and Stress Scales (DASS-6)

Friday, November 15, 2024
1:00 PM – 2:00 PM EST
Location: Franklin Hall, Level 4, Marriott Downtown
Abstract Text: Despite its strong psychometric properties and extensive empirical support, the Depression, Anxiety and Stress Scale (DASS) 42- and 21-item versions remain impractical for providers who wish to utilize the briefest psychiatric measures to reduce response burden on responders. Coinciding with a recent movement to develop short forms of existing measures for clinical settings, the current study sought to develop a psychometrically-sound short-form of the DASS-21 with less response burden on the patient while retaining adequate predictive utility in the identification of individuals with elevated symptomatology. 2,307 adults completed the DASS-21 and 33 questions from the Inventory of Depression and Anxiety Symptoms (IDAS) in categories relating to depression, anxiety, and stress. To derive a shortened version of the DASS-21, the IDAS served as a benchmark against which DASS items were compared. An exploratory factor analysis (EFA) was run on the IDAS items, and each scale created based on IDAS factor loadings was recorded based on a cut score for clinically significant symptomatology. Receiver operating characteristic (ROC) analyses compared DASS items to the corresponding IDAS scale at the mark of clinically significant symptomatology. Clinicians selected items for the short DASS when areas under the curve (AUC) were similar, selecting one cognitive and one behavioral item for each scale. The association between each of the three scales and the corresponding DASS-21 and IDAS scales was assessed, serving as initial validation of the newly-shortened measure. The depression (α=.81), anxiety (α= .88), and stress (α=.92) IDAS scales demonstrated excellent internal consistency. All items of the DASS-21 showed excellent prediction accuracy for high scores on corresponding IDAS scales (AUC depression = .80 to .88, anxiety = .73 to .83, stress = .71 to .76). For the 2-item DASS scales, the AUC values were .88 for depression, .80 for anxiety, and .83 for stress. Pearson’s correlation coefficients revealed strong correlations between related constructs (p < .001), with little variation between the 21- and new 6-item DASS versions. The DASS-6 may be suitable as a brief measure that primary care clinicians can use to screen for elevated levels of mental health concerns. It captures three of the most common psychiatric states (depression, anxiety, and stress) that cause functional impairment if not treated effectively. Future work is needed to validate the measure using more diverse subgroups. Other well-established measures should be considered for potential utility in brief form.