Rasch Analysis of the Depression Anxiety Stress Scales-21 (DASS-21) in a Mild Traumatic Brain Injury Sample
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Taylor and Francis Group
Abstract
OBJECTIVE: In this study, we evaluated the psychometric properties of the Depression Anxiety Stress Scales 21 items (DASS-21) in a mild traumatic brain injury (mTBI) sample. METHOD: Treatment-seeking adults (n = 347) were recruited from outpatient rehabilitation services in New Zealand. Dimensionality, reliability, person separation index, and differential item functioning (DIF) of the DASS-21 were examined using Rasch analysis. RESULTS: Initial analysis of the complete 21-item DASS showed poor overall fit due to problems with individual items. Fit to the Rasch model was excellent when treated as three composite scores. The stress subscale demonstrated adequate model fit, dimensionality and good reliability. For anxiety, fit was not good, reliability was unsatisfactory and DIF was evident on one item. When this item was removed, fit to the model was still inadequate as was reliability. DIF was also evident for depression, but when this item was removed, fit to the model was adequate. CONCLUSION: The DASS-21 is a psychometrically sound measure of distress and stress for adults seeking treatment following mTBI. Ordinal to interval score conversion tables are provided to increase the precision of measurement. When assessing depression in a mTBI population, a 6-item depression subscale is recommended. Caution is advised in using the DASS-21 anxiety subscale alone.Description
Keywords
DASS-21, mental health, Mild traumatic brain injury, psychometrics, Rasch, DASS-21, Mild traumatic brain injury, Rasch, mental health, psychometrics, 4201 Allied Health and Rehabilitation Science, 5203 Clinical and Health Psychology, 42 Health Sciences, 52 Psychology, Mind and Body, Brain Disorders, Mental Illness, Behavioral and Social Science, Depression, Traumatic Brain Injury (TBI), Physical Injury - Accidents and Adverse Effects, Traumatic Head and Spine Injury, Neurosciences, Mental Health, Mental health, 11 Medical and Health Sciences, 17 Psychology and Cognitive Sciences, Rehabilitation, 3202 Clinical sciences, 4201 Allied health and rehabilitation science, 5203 Clinical and health psychology
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Brain Injury, ISSN: 0269-9052 (Print); 1362-301X (Online), Taylor and Francis Group, 39(2), 136-144. doi: 10.1080/02699052.2024.2411297
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© 2024 The Author(s). Published with license by Taylor & Francis Group, LLC. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited, and is not altered, transformed, or built upon in any way. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.