Psychometrische Evaluation der deutschen Version der Depressions-Angst-Stress-Skalen (DASS-21) in der ambulanten Neurorehabilitation

Background: Depression can significantly influence the course of participation after stroke. Consequently, there is a strong need for good screening instruments in this field. We performed a Rasch analysis to evaluate the psychometric properties of the Depression-Anxiety-Stress Scale (DASS-21) in outpatient neurorehabilitation. Methods: 403 poststroke rehabilitants from 17 outpatient neurological rehabilitation centers in Germany completed the DASS-21 at the beginning of their treatment. A Rasch analysis was performed to test fit of the DASS-21 regarding the requirements of the Rasch model. Results: The subscale anxiety failed to meet the criteria of the Rasch model. The subscales "stress"and "depression"as well as a scale consisting of the aggregated superitems depression and stress proved to be suitable after some modifications. Conclusion: According to this first study, the DASS-21, when applying the items of the subscales depression and stress as a screening instrument for a superordinate variable "psychological stress,"seems to be a good indicator for those rehabilitants who have special psychological care needs at the beginning of their outpatient neurorehabilitation.