title: Depression Anxiety Stress Scales (DASS-21): Factor Structure in Traumatic Brain Injury Rehabilitation.
abstract: To confirm the construct validity of the Depression Anxiety Stress Scales-21 (DASS-21) by investigating the fit of published factor structures in a sample of adults with moderate to severe traumatic brain injury (posttraumatic amnesia > 24 hours).
  
  
  
  Archival data from 504 patient records at the Brain Injury Rehabilitation Unit at Liverpool Hospital, Australia. Participants were aged between 16 and 71 years and were engaged in a specialist rehabilitation program.
  
  
  
  The DASS-21.
  
  
  
  Two of the 6 models had adequate fit using structural equation modeling. The data best fit Henry and Crawford's quadripartite model, which comprised a Depression, Anxiety and Stress factor, as well as a General Distress factor. The data also adequately fit Lovibond and Lovibond's original 3-factor model, and the internal consistencies of each factor were very good (α = 0.82-0.90).
  
  
  
  This study confirms the structure and construct validity of the DASS-21 and provides support for its use as a screening tool in traumatic brain injury rehabilitation.
authors.affiliation: Charles Sturt University, Bathurst, Australia (Mss Randall, and Drs Thomas and McGrath); and Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Liverpool, Australia (Dr Whiting).
authors.forename: Diane
authors.initials: D
authors.lastname: Randall
authors.forename: Matt
authors.initials: M
authors.lastname: Thomas
authors.forename: Diane
authors.initials: D
authors.lastname: Whiting
authors.forename: Andrew
authors.initials: A
authors.lastname: McGrath
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001007:Anxiety / Q000175:diagnosis* / Q000209:etiology / Q000534:rehabilitation; D001315:Australia; D000070642:Brain Injuries, Traumatic / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation*; D016208:Databases, Factual; D003863:Depression / Q000175:diagnosis* / Q000209:etiology / Q000534:rehabilitation; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000066530:Neurological Rehabilitation / Q000379:methods; D011379:Prognosis; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult