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Original

Assessing emotional status following acquired brain injury: The clinical potential of the depression, anxiety and stress scales

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Pages 858-869 | Received 14 May 2008, Accepted 02 Sep 2008, Published online: 03 Jul 2009
 

Abstract

Primary objective: To investigate the clinical potential of the Depression, Anxiety and Stress Scales (DASS 42) and its shorter version (DASS 21) for assessing emotional status following acquired brain injury.

Methods and procedures: Participants included 23 individuals with traumatic brain injury (TBI), 25 individuals with brain tumour and 29 non-clinical controls. Investigations of internal consistency, test–re-test reliability, theory-consistent differences, sensitivity to change and concurrent validity were conducted.

Main outcomes and results: Internal consistency of the DASS was generally acceptable (r > 0.70), with the exception of the anxiety scale for the TBI sample. Test–re-test reliability (1–3 weeks) was sound for the depression scale (r > 0.75) and significant but comparatively lower for other scales (r = 0.60–0.73, p < 0.01). Theory-consistent differences were only evident between the brain tumour sample and non-clinical control sample on the anxiety scale (p < 0.01). Sensitivity to change of the DASS in the context of hospital discharge was demonstrated for depression and stress (p < 0.01), but not for anxiety (p > 0.05). Concurrent validity with the Hospital Anxiety and Depression Scale was significant for all scales of the DASS (p < 0.05).

Conclusions: While the results generally support the clinical application of the DASS following ABI, further research examining the factor structure of existing and modified versions of the DASS is recommended.

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