DASS21 Form

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 a considerable degree, or a good part of the time
3 Applied to me very much, or most of the time

Name *
Question 1 - I found it hard to wind down *
Question 2 - I was aware of dryness in my mouth *
Question 3 - I could not seem to experience any positive feelings at all *
Question 4 - I experienced breathing difficulty (e.g. excessively rapid breathing, breathlessness in the absence of physical exertion) *
Question 5 - I found it difficult to work up the initiative to do things *
Question 6 - I tended to over-react to situations *
Question 7 - I experienced trembling (e.g. in the hands) *
Question 8 - I felt that I was using a lot of nervous energy *
Question 9 - I was worried about situations in which I might panic and make a fool of myself *
Question 10 - I felt that I had nothing to look forward to *
Question 11 - I found myself getting agitated *
Question 12 - I found it difficult to relax *
Question 13 - I felt downhearted and blue *
Question 14 - I was intolerant of anything that kept me from getting on with what I was doing *
Question 15 - I felt I was close to panic *
Question 16 - I was unable to become enthusiastic about anything *
Question 17 - I felt I was not worth much as a person *
Question 18 - I felt that I was rather touchy *
Question 19 - I was aware of the action of my heart in the absence of physical exertion (e.g. sense of heart rate increase, heart missing a beat) *
Question 20 - I felt scared without any good reason *
Question 21 - I felt that life was meaningless *