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

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.