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Article published In: Sign Language & Linguistics
Vol. 28:2 (2025) ► pp.263–298

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Sign language adaptation of the Depression Anxiety Stress Scales — 21 (DASS-21)

ORCiD logo with link | Bar-Ilan UniversityRamat Gan
 | University of Haifa | Gordon CollegeHaifa
 | Achva Academic College | Reichman University
 | Reichman University
 | University of Haifa
 | University of Haifa
Published online: 8 August 2025
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https://doi.org/10.1075/sll.24014.sta
Abstract
Despite the heterogeneity of the deaf population, research shows that deaf individuals experience a high incidence of mental health problems, with high reports of depression and anxiety. This emphasizes the importance of ensuring appropriate mental health therapy. Assessment tools presented in written language or translated spontaneously into sign language could result in misdiagnosis or miscommunication due to linguistic and cultural mismatches. It follows that assessment measures that are systematically translated into sign language are an important step forward in assessing and treating deaf people’s mental health. One reliable diagnostic tool, DASS-21, the 21-item Depression Anxiety Stress Scales, is available in multiple written languages, but, with few exceptions, has typically not been available in a sign language. Our study describes the meticulous process of adaptation we have undertaken to translate DASS-21 from written Hebrew into Israeli Sign Language (ISL). We address the many challenges faced when translating from a written to a visual modality, and we propose resolutions to these challenges. In this way, we hope that the tool whose adaptation we describe here will be useful for any effort to translate a psychological assessment tool into any sign language.
Article outline
  • 1.Introduction
  • 2.Psychological health of the deaf community
    • 2.1The importance of accessible psychological tools
    • 2.2Adaptation of psychological assessment tools into sign language
    • 2.3Depression Anxiety Stress Scales — 21 (DASS-21)
  • 3.Methods: Adaptation procedure
    • 3.1Stage one
    • 3.2Stage two
    • 3.3Stage three
    • 3.4Stage four
  • 4.Discussion
    • 4.1Cultural challenges
    • 4.2Linguistic challenges
      • 4.2.1Body as subject — use of personal pronouns
      • 4.2.2Non-equivalence of emotional terms between Hebrew & ISL: The use of figurative extensions
      • 4.2.3Metonymy
      • 4.2.4Metaphors and their constraints in sign language
    • 4.3Semantic components of emotional expressions conveyed in the questionnaire
      • 4.3.1Gradience of the affective message vs. discreteness of linguistic categories
      • 4.3.2Temporal structure and dynamicity of emotional events
      • 4.3.3Encoding of internal and external motivations of emotional events
  • 5.Conclusions
  • Acknowledgements
  • Notes
  • References
References (110)
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