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An evaluation of the convergent validity of and preliminary cutoff scores for the DASS-21 Total score as a measure of distress in adolescents

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Abstract

While the 21-item version of the Depression, Anxiety, and Stress Scales (DASS-21) is commonly used to measure depression, anxiety, and stress, there is emerging evidence that the DASS-21 total score can be used as a measure of distress in adolescents as well. However, little research has investigated the convergent validity of the DASS-21 as a measure of distress, and no studies have examined potential cutoffs for the DASS-21total score in adolescents. To address these gaps, the present study investigated the convergent validity of the DASS-21’s total score and determined preliminary cutoff scores that could be used to identify adolescents that are clinically distressed. After 306 high school students (mean age = 15.35) from midwestern USA high schools completed the DASS-21 and Langner Symptom Survey (LSS), a MANOVA revealed significant sex differences. In light of these differences, analyses were carried out separately for male and female adolescents. These analyses revealed that the DASS-21 total score was significantly correlated with the LSS for males (r = .80) and females (r = .76). When using adolescents’ classification on the LSS as a reference point, a cutoff score of 14 appeared to be best suited for female adolescents (sensitivity = .78; specificity = .74; AUC = .84), while a cutoff score of 17 appeared best for male adolescents (sensitivity = .72; specificity = .95, AUC = .99). These findings suggest that the DASS-21 total score demonstrates good convergent validity as a measure of distress and may be suitable for identifying adolescents that are clinically distressed. However, further validation of the present preliminary cutoff points is needed.

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Authors and Affiliations

  1. Department of Psychology, Saint Louis University, Saint Louis, MO, 63108, USA

    Luke Evans, Kristen Haeberlein, Alexander Chang & Paul Handal

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  1. Luke Evans
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  2. Kristen Haeberlein
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  3. Alexander Chang
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  4. Paul Handal
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Correspondence to Luke Evans.

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All procedures performed in the study were in accordance with the ethical standards of the Saint Louis University Institutional Review Board and the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent to participate was obtained from the parents or legal guardians for all individual participants who were under 18. Written assent to participate was also obtained for individuals who were under 18, while written consent to participate was obtained from participants who were 18 or older at the time that they participated in this study.

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Informed consent regarding potential publication of anonymous data collected during the study was obtained from parents or legal guardians for all individual participants who were under 18. Written assent or consent to publish was also obtained from participants, depending on whether they were under or over 18 (respectively).

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Evans, L., Haeberlein, K., Chang, A. et al. An evaluation of the convergent validity of and preliminary cutoff scores for the DASS-21 Total score as a measure of distress in adolescents. Curr Psychol 41, 4283–4290 (2022). https://doi.org/10.1007/s12144-020-00937-4

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