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DASS

The document appears to be a questionnaire asking respondents to rate how much 21 different statements applied to them over the past week on a scale of 0 to 3. The statements seem to assess symptoms commonly associated with anxiety such as difficulty relaxing, worrying, restlessness, panic, and feeling worthless. The respondent is asked to circle a number for each statement indicating how well it describes their experiences.

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71 views1 page

DASS

The document appears to be a questionnaire asking respondents to rate how much 21 different statements applied to them over the past week on a scale of 0 to 3. The statements seem to assess symptoms commonly associated with anxiety such as difficulty relaxing, worrying, restlessness, panic, and feeling worthless. The respondent is asked to circle a number for each statement indicating how well it describes their experiences.

Uploaded by

wcsuazo
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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Name: Age:

Instructions: 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 the 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 (e.g. excessively rapid breathing, breathlessness in the 0 1 2 3


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 (e.g. 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 a fool of myself 0 1 2 3

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 what I was doing 0 1 2 3

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 exertion (e.g. sense of heart 0 1 2 3
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

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