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

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.