Anxiety, Depression and Stress Scale  (ADSS-BSPSA)

Anxiety, Depression and Stress Scale (ADSS-BSPSA)



Everyone experiences stress and anxiety at one time or another. The difference between them is that stress is a response to a threat in a situation. Anxiety is a reaction to the stress.

Anxiety is more than the occasional or daily stress. It is one of the most distressing emotions people experience and usually develops when a combination of risk factors occurs and triggers an emotional overload. The most common anxiety is “general anxiety,” and it can often lead to an anxiety disorder. It includes periods of nervousness or fear that can happen during difficult moments. Anxiety becomes a serious problem when it is persistent and interferes with your daily life, affecting your behavior, thoughts, feelings and physical sensations.

Almost everyone feels sad or depressed at times, but clinical depression is stronger and lasts longer. When sadness is accompanied by the inability to cope with everyday life, it may indicate depression. When depressive symptoms are severe over an extended period of time, every aspect of a person’s life can be affected, including physical health, relationships, and work.

There is no single cause of depression, but a combination of factors or situations can increase the risk. Typical contributing causes to depression include unfortunate life events, illness, a chemical imbalance in the brain, genetics, certain medications and drug or alcohol abuse.

Stress has a terrible reputation, but it’s not always bad for you. In fact, it’s essential for survival. Being nervous before an important meeting or having sweaty palms at the top of the ski hill are the kinds of normal human responses created in response to stress, and they can help to motivate and heighten awareness. But exposure to too much stress for too long has a very damaging effect on your heart and overall health.

Learning to manage stressful situations can help you reduce this risk or avoid making your condition worse if you are already living with cardiovascular disease.

Whether in good times or bad, most people say that stress interferes at least moderately with their lives. Chronic stress can affect your health, causing symptoms from headaches, high blood pressure, and chest pain to heart palpitations, skin rashes, and loss of sleep.

Symptoms of Stress

There are a number of emotional and physical disorders linked to stress, including depression, anxiety, heart attacks, strokes, gastrointestinal distress, obesity, and hypertension, to name a few. High levels of stress can wreak havoc on the mind and the body. While stress can manifest in many ways, it helps to know a few common symptoms:

  • Frequent headaches
  • Sleep disturbance
  • Back and/or neck pain
  • Feeling light-headed, faint, or dizzy
  • Sweaty palms or feet
  • Difficulty swallowing
  • Frequent illness
  • Irritability
  • Gastrointestinal problems
  • Excessive worry
  • Rapid heart rate
  • Muscle tension
  • Feeling overwhelmed
  • Having difficulty quieting the mind
  • Poor concentration
  • Forgetfulness
  • Low energy
  • Loss of sexual desire

Symptoms of stress can vary and change over time. Cueing into your own responses to stress can help you increase awareness of how stress manifests for you. Knowing this vital information will help you learn to use stress reduction techniques at the first signs of stress to avoid long-term repercussions.

Coping with Stress

Learning to cope with stress can require some trial and error. What works for your best friend might not work for you. It’s important to build your own stress reduction toolkit so that you have more than one strategy to implement when stress kicks in.

Relaxation breathing: The single best thing you can do when under stress is to engage in deep breathing. Practice this strategy when you’re calm so that you know how to use it when you’re under pressure. Inhale for a count of four, hold for four, and exhale for four. Repeat.

Practice mindfulness: Sure, there’s an app for that, but the best way to practice mindfulness is to disconnect from your digital world and reconnect with your natural world for a specific period of time each day. Take a walk outside and use the opportunity to notice your surroundings using all of your senses.

Get moving: Daily exercise releases feel-good chemicals in your brain. Making exercise a daily habit can buffer you from negative reactions to stressful events.

Keep a journal: Writing down your best and worst of the day helps you sort through the obstacles and focus on what went right. It’s normal to experience ups and downs on any given day.

Get creative: There’s a reason adult coloring books are so popular – they work. Whether you’re drawing, coloring, writing poetry, or throwing paint on a wall, engaging in a creative hobby gives your mind a chance to relax.

Crank up the tunes: Listening to slow, relaxing music decreases your stress response (just as fast-paced music pumps you up for a run.)


To find out the anxiety, depression and stress level of a subject using ADSS

Information of the Subject

Name:-Shankar shah   (Changed)


Sex: Male

Educational background:-Master’s Degree

Occupation: – Private institute

Salary: – 30000

Economic Status: – Middle

Date of Examination: – 2075 Shrawan 20

Time: – 1400 hrs. 

Place: – Subject Classroom

Materials and Equipment

  • Consumable booklet of ADSS Questionnaires
  • Pen/pencil
  • Answer sheet
  • Manual for ADSS
  • paper

Test Description:

The Anxiety, Depression and Stress Scale was developed by Pallavi Bhatnagar and her colleagues and published through National Psychological Corporation, Agra, India. It is the test that measures the anxiety, depression and stress of an individual besides being bilingual, and which is comprehensible for the illiterate and marginalized group. A scale of 63 were developed at first and 48 items out of 63 were retained in the item selection. Standardization of the scale was undertaken in a project by SWASTI Society for Mental Health and Counseling wherein part of the data collection (that of students and psychiatric patients) was also done. The test comprises of a consumable book of ADSS questionnaire which has 48 items, (19 in Anxiety Subscale, 15 in Depression Subscale, and 14 in Stress Subscale) and manual for ADSS. The Manual describes the introduction   of the test and contains description about the development of the scale, item selection, standardization, description of the scale, administration and instructions of the scale, scoring and interpretation of the scoring, tables, reliability and implications

Each item is scored 1 if endorsed “Yes” and 0 if endorsed “No”. Higher score indicates experiencing greater anxiety, depression and stress and vice-versa. The table below shoes that according to the cutoff point, the individual is assigned to the levels of the state ranging from normal to severe.




Below P25 0-3 0-2 0-4 NORMAL
P25- P50 3-5 2-4 4-6 MILD
P50- P75 5-9 4-9 6-9 MODERATE
P75- P100 Above 9 Above 9 Above 9 SEVERE


Method and Procedure


There were two chairs on the position of ‘L” Shape with left hand side to the examiner. The room was bright. A table, pencil, and pen was placed next to the subject for him to use it to write on. Sufficient time was provided. Then the following Instructions were given to the subject:

 “First of all I will request for your kind co-operation. Please let me make you clear that the test result may be useful to you only when you answer statements without hesitation or any reserve. Here are the instructions about how do we complete the test in this test booklet. We all experience anxiety, stress and depression in our lives. I will be asking you few questions regarding everyday stress, anxiety and depression. And if you experience them often then answer ‘yes’ if not answer ‘No’. Yours answer will be kept confidential, so be honest and truthful for reliable information.”

Test Administration:

Before starting administration a good rapport was established with the subject and made him clear about the test. Testing instructions were introduced before the subject before starting the test work. After filling details of the demographic information, one test booklet was given to the subject and another was kept with the test taker. Before answering, administrator read the instructions loudly. After it is ascertained that the subject has understood the process of answering. While answering, subject was inspected if he was doing the work rightly. When the subject asked any questions during the process of answering, the administrator helped the subject checking the responses.

After finishing the test, the subject was asked how he felt about the test. The subject was released after taking his introspective report regarding the test taken.

Introspective report

“It feels like I am without any stress recently. I have not been feeling any of those recently. Anyways I answered it appropriately as far as I think. It feels me good. I had very good time while filling the report.”

Result Analysis

Sub-scale Anxiety Depression Stress
Total Score 15 15 11
Percentile 25 below 25 below 25 below
Category Normal Normal Normal
Percentile 50 below 50 below 50 below
Category Mild Mild Mild
Percentile 75 below 75 below 75 below
Category Moderate Moderate Moderate


The result of the subject is indicated through the means of the total scores of each of the three subscale anxiety, depression and stress.

The subject scores 6 in anxiety sub-scale. It indicates percentile below 75 classifying him in the moderate category. It shows him with moderate level of anxiety.

The subject scores 1 in depression sub-scale. It indicates percentile below 25 classifying him in the normal category. He could be interpreted as a person without depression.

The subject scores 2 in stress sub-scale. It indicates percentile below 25 and makes him fall in the normal category.

Analysis and conclusion:

The subject is classified under moderate category in anxiety sub-scale, under the normal category in depression and stress sub-scales. As he scored 6 in anxiety sub scale, he might have been anxious full situation recently which he needs to adjust it well or it may increase causing anxiety and this can increase the frequency of symptoms such as headaches, dizziness, and depression. But till now he has adjusted it to fall under the mild category of the scale.


The subject has no depression, and stress but a little bit anxiety which is somehow good for competitive world. He is Normal level in Depression and Stress and moderate in Anxiety.


Ahuja, N. (2011). A short Textbook of Psychatry. Journal of Chemical Information and Modeling (Vol. 53)

Pathak Ganga (2012). “An Introduction to psychology”

Manual for ADSS


Lok Raj Pathak
Lok Raj Pathak Administrator

Lok Raj Pathak is a Professional Computer Engineer and Technology enthusiast. He has completed Master in Science in Information Technology (M. Sc. IT) and Master in technology in Computer Science and Engineering (M. Tech. Eng). He usually writes in science and technology, life style and religion.

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