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Dass 21

This document appears to be a self-assessment questionnaire called the DASS21, which is used to measure the severity and frequency of core symptoms of depression, anxiety and stress experienced over the past week. The respondent is asked to rate 21 statements on a scale of 0 to 3 based on how much each statement applied to them in the past week, with 0 being "did not apply at all" and 3 being "applied very much". Some example statements include "I found it hard to wind down", "I felt down-hearted and blue", and "I wanted to kill myself".

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TEOFILO PALSIMON JR.
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243 views

Dass 21

This document appears to be a self-assessment questionnaire called the DASS21, which is used to measure the severity and frequency of core symptoms of depression, anxiety and stress experienced over the past week. The respondent is asked to rate 21 statements on a scale of 0 to 3 based on how much each statement applied to them in the past week, with 0 being "did not apply at all" and 3 being "applied very much". Some example statements include "I found it hard to wind down", "I felt down-hearted and blue", and "I wanted to kill myself".

Uploaded by

TEOFILO PALSIMON JR.
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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DASS21 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
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 time
3 Applied to me very much, or most of the time

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
4 I experienced breathing difficulty (eg, excessively rapid breathing, 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
9 I was worried about situations in which I might panic and make 0 1 2 3
a fool of 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
14 I was intolerant of anything that kept me from getting on with 0 1 2 3
what I was 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
19 I was aware of the action of my heart in the absence of physical 0 1 2 3
exertion (eg, 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

22 I thought about death or suicide 0 1 2 3

23 I wanted to kill myself 0 1 2 3

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