The Depression Anxiety Stress Scales (DASS-21)

The DASS-21 (Lovibond & Lovibond, 1995) is a self-administered scale composed of 21 items of self-assessment under three scales: depression, anxiety and stress. The subject indicates to what extent each item corresponds to it, on a scale of Likert ranging from 0 (no symptoms) to 3 (symptom present intensively). The following cutoff scores have been used for defining mild/moderate/severe/extremely severe scores for each DASS scale: depression: normal (0–4), mild (5–6), moderate (7–10), severe (11–13), extremely severe (14 +); anxiety: normal (0–3), mild (4–5), moderate (6–7), severe (8–9), extremely severe (10 +); stress: normal (0–7), mild (8–9), moderate (10–12), severe (13–16), extremely severe (17 +). Previous studies showed a good internal consistency of the validated Arabic version of the DASS-21 used in our study (Moussa et al., 2017).