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Form Structure: Depression Anxiety Stress Scales 21

This form structure is an organized set of data definitions for a copyrighted form
Resource:
FITBIR
Title:
Depression Anxiety Stress Scales 21
Short Name:
DASS21
Description:
The DASS 21 is a 21 item self report questionnaire designed to measure symptoms related to depression, anxiety, and stress. Patients are asked to rate the prescence of a symptom over the past week.
Disease:
Traumatic Brain Injury
Organization:
FITBIR
Required Program Form:
No
Standardization:
Standard
Labels:
Form Type:
Clinical Assessment
Publication Date:
2016-10-05
Version:
1.0
Date Created:
2016-09-22
Owner:
Number of Data Elements:
40
eForms:
N
Logically grouped data elements with defined frequency at which they repeat.

# Title Short Description Variable Name Required? Type
1 GUID   Global Unique ID which uniquely identifies a subject GUID Required CDE
2 Subject identifier number   An identification number assigned to the participant/subject within a given protocol or a study. SubjectIDNum Optional CDE
3 Age in years   Value for participant's subject age recorded in years. AgeYrs Recommended CDE
4 Vital status   Status of participant/subject as alive or dead VitStatus Optional CDE
5 Visit date   Actual interview or visit date VisitDate Recommended CDE
6 Site name   The name of the site for the study SiteName Recommended CDE
7 Days since baseline   The number of days since baseline DaysSinceBaseline Optional CDE
8 Case control indicator   Indicator of whether subject is in the case or control arm of the study. CaseContrlInd Optional CDE
9 General notes text   General notes GeneralNotesTxt Optional CDE

Additional Element Groups

Listed below are your additional element groups.

Form Administration (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Context type  The context to which the questions were answered ContextType Recommended CDE
2 Context type other text  The free-text related to ContextType specifying other text ContextTypeOTH Recommended CDE
3 Data source  Source of the data provided on the case report form DataSource Recommended CDE
4 Data source other text  The free-text field related to Data source specifying other text. Source of the data provided on the case report form DataSourceOTH Recommended CDE

Depression Anxiety Stress 21 Scales (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Depression Anxiety and Stress Scale (DASS 21) - Stress hard wind down scale  The scale related to stress from finding it hard to wind down as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21StressHarWinDowScl Recommended CDE
2 Depression Anxiety and Stress Scale (DASS 21) - Anxiety aware dry mouth scale  The scale related anxiety from being aware of dryness of the mouth as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21AnxAwDryMouthScl Recommended CDE
3 Depression Anxiety and Stress Scale (DASS 21) - Depression not positive experience scale  The scale related to depression from not being able to experience any positive feelings, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21DepNoPosExperScl Recommended CDE
4 Depression Anxiety and Stress Scale (DASS 21) - Anxiety difficult breath scale  The scale related to anxiety from breathing difficulty as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21AnxDiffBreScl Recommended CDE
5 Depression Anxiety and Stress Scale (DASS 21) - Depression difficult initiative scale  The scale related todepression from being difficult to work up the initiative to do things, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21DepDiffIniScl Recommended CDE
6 Depression Anxiety and Stress Scale (DASS 21) - Stress overreact situation scale  The scale related to stress for tending to over-react to sitations, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21StressOverreSitScl Recommended CDE
7 Depression Anxiety and Stress Scale (DASS 21) - Anxiety tremble body scale  The scale related to anxiety from experiencing trembling, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21AnxTremBodScl Recommended CDE
8 Depression Anxiety and Stress Scale (DASS 21) - Stress much nervous energy scale  The scale related to stress from lots of nervous energy as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21StressMuchNervEnScl Recommended CDE
9 Depression Anxiety and Stress Scale (DASS 21) - Anxiety worry situation panic scale  The scale related to anxiety from being worried about situations in which might panic and make a fool of themselves, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21AnxWorrSitPanScl Recommended CDE
10 Depression Anxiety and Stress Scale (DASS 21) - Depression nothing future interest scale  The scale related to depression from feeling that there is nothing to look forward to, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21DepNoFutIntScl Recommended CDE
11 Depression Anxiety and Stress Scale (DASS 21) - Stress agitation scale  The scale related to stress from getting agitated as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21StressAgitScl Recommended CDE
12 Depression Anxiety and Stress Scale (DASS 21) - Stress difficult relax scale  The scale related to stress from difficulty relaxing, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21DiffRelaxScl Recommended CDE
13 Depression Anxiety and Stress Scale (DASS 21) - Depression down hearted blue scale  The scale related to depression from being down-hearted and blue, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21DepDowHearBlueScl Recommended CDE
14 Depression Anxiety and Stress Scale (DASS 21) - Stress intolerant delay scale  The scale related to stress from intolerance of anything that keeps them from getting on with what they were doing, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21StressIntolDelayScl Recommended CDE
15 Depression Anxiety and Stress Scale (DASS 21) - Anxiety panic scale  The scale related to anxiety from being close to a panic, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21AnxPanicScl Recommended CDE
16 Depression Anxiety and Stress Scale (DASS 21) - Depression not enthusiastic scale  The scale related to depression from being unable to be enthusiastic about anything, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21DepNoEnthusScl Recommended CDE
17 Depression Anxiety and Stress Scale (DASS 21) - Depression no self-worth scale  The scale related to depression from lack of worth as a person, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21DepNoSelfWorthScl Recommended CDE
18 Depression Anxiety and Stress Scale (DASS 21) - Stress touchy scale  The scale related to stress from being rather touchy, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21StressTouchScl Recommended CDE
19 Depression Anxiety and Stress Scale (DASS 21) - Anxiety heart rate increase scale  The scale related to anxiety from being aware of action of the heart in the absence of physical exertion, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21AnxHrtRtIncScl Recommended CDE
20 Depression Anxiety and Stress Scale (DASS 21) - Anxiety scared no reason scale  The scale related to anxiety from feeling scared without any good reason, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21AnxScrNoRsnScl Recommended CDE
21 Depression Anxiety and Stress Scale (DASS 21) - Depression meaningless life scale  The scale related to depression from feeling life is meaningless, as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21DepMeanLifeScl Recommended CDE

DASS21 Scores (Appears Up To 1 Time)

# Title Short Description Variable Name Required? Type
1 Depression Anxiety and Stress Scale (DASS 21) - Total depression score  The score related to total depression (multiplied by 2) as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21TotalDepScore Recommended CDE
2 Depression Anxiety and Stress Scale (DASS 21) - Total depression diagnosis type  The type of diagnosis of depression, as a part of the Depression Anxiety and Stress Scale (DASS21) DASS21TotalDepDiagTyp Recommended CDE
3 Depression Anxiety and Stress Scale (DASS 21) - Total anxiety score  The score related to total anxiety (multiplied by 2) as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21TotalAnxScore Recommended CDE
4 Depression Anxiety and Stress Scale (DASS 21) - Total anxiety diagnosis type  The type of diagnosis of anxiety as a part of the Depression Anxiety and Stress Scale (DASS21) DASS21TotalAnxDiagTyp Recommended CDE
5 Depression Anxiety and Stress Scale (DASS 21) - Total stress score  The score related to total stress (multiplied by 2) as part of the Depression, Anxiety and Stress Scale (DASS21) DASS21TotalStressScore Recommended CDE
6 Depression Anxiety and Stress Scale (DASS 21) - Total stress diagnosis type  The type of diagnosis of stress, as a part of the Depression Anxiety and Stress Scale (DASS21) DASS21TotalStressDiagTyp Recommended CDE
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