DOI: 10.14704/nq.2018.16.12.1876

Determining the Internal and External Reliability of Depression, Anxiety and Stress Scales (DASS-21) in Assessing Psychological Symptoms Among Patients with Tinnitus

Wan Suhailah Wan Husain, Azizah Othman, Nik Adilah Nik Othman, Wan Najibah Wan Mohamad, Mohd Normani Zakaria


Tinnitus (“ringing noise in the ear”) is prevalent among adults with ear diseases. Psychological symptoms have been reported in many patients with tinnitus and research in this aspect is much relevant. The aim of the present study was to determine the internal and external reliability of Malay version of Depression, Anxiety and Stress Scales (BM DASS-21) in documenting psychological symptoms among patients with tinnitus. In this validation study, the BM DASS-21 was administered to 28 eligible Malay adults (14 males and 14 females) with main complaint of tinnitus, aged between 23 and 74 years (mean of 52.9 ± 12.8 years). After two weeks, they were instructed asked to fill in the questionnaire again. As revealed, the internal reliability of BM DASS-21 was found to be robust. Specifically, its Cronbach’s alpha values were excellent for Depression subscale (α = 0.92) and Stress subscale (α = 0.87). A good alpha value was noted for Anxiety subscale (α = 0.79). All the three subscales were significantly inter-correlated with each other (r > 0.70, p < 0.05). The test-retest (external) reliability of BM DASS-21 was found to be excellent (intraclass correlation = 0.77-0.88). In conclusion, given its high reliability, the BM DASS-21 can be used conveniently to assess psychological symptoms among patients with the complaint of tinnitus. It may guide clinicians in understanding the patients’ psychological state, so that proper management can take place.


DASS-21, Tinnitus, Psychological symptoms, Reliability,

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Supporting Agencies

Ministry of Education Malaysia

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