TL;DR: Summary

✅ Available on Bravely Connect

The K10 is a self-report measure used to assess symptoms of non-specific psychological distress associated with severe mental illness. It consists of 10 questions which ask clients about how frequently they have experienced symptoms of distress in the past month. Total scores are calculated via the summation of each item’s score. Potential total scores range from 10 to 50 with higher scores indicating higher levels of psychological distress. Limitations for the K10 include its nonspecificity and questionable cross-cultural applicability in clinical samples. However, the K10’s brevity and simplicity makes it a useful measure for tracking clients’ perceptions of psychological distress—just make sure to do so alongside more thorough clinical interviewing.

Highlights

📏 Lengths: 10 questions (2–3 minutes), but there is a 6 question version

📋 Administration: Self-administered or administered via interview

🎯 Uses: For monitoring non-specific psychological distress, but may be especially useful for anxiety and depression (see “K10 Factor structure”)

⚠️ Important Caveats: Not used for diagnosis

✅ Available in Bravely Connect? Yes

🌏 Culturally Applicable? Possibly, but recommended to be used with clinical interviews

💬 Translations? 19 translations of the K10 available on the Harvard National Comorbidity Survey website

The K10 Question type and length

The client is presented with 10 questions asking how often they have experienced different symptoms of non-specific psychological distress over the past 30 days.

Each question has the same selection of answers:

• None of the time

• A little of the time

• Some of the time

• Most of the time

• All of the time

For the full list of questions check out the measures on Bravely Connect, or follow the following link to the original unautomated version: K10

What does the K10 measure

The K10 was created to measure non-specific psychological distress among respondents during large-scale population surveys with the goal of identifying cases of serious mental illness. It asks clients how often they experience feelings common to cases of serious mental illness such as tiredness, restlessness, depression, and worthlessness. Higher scores indicate higher levels of psychological distress.

K10 Factor structure

The K10 is intended to be a unidimensional measure of non-specific psychological distress with the single dimension representing traits that are common to many cases of serious mental illness. Studies of the K10 in general populations reinforce the unidimensional factor structure. However, research of the K10 in clinical samples with diagnosed mental health conditions have elucidated a potential two-factor structure underlying the scales. In these clinical samples, the K10 appears to target two specific types of psychological stress: depression and anxiety (Sunderland et al., 2012, p. 257).

The history and theory behind the K10

Research suggests that up to one-fifth of the general population has a diagnosable mental health condition at any given point in time (Kessler et al., 2002, p. 960). With limited governmental resources available to provide care for a large number of individuals with mental health concerns, an instrument was needed to identify people with clinically significant psychological distress. The Kessler Psychological Distress Scale was the created by Ronald C. Kessler and Daniel K. Mroczek in collaboration with the US National Center for Health Statistics in effort to identify cases of severe non-specific psychological distress during large-scale population surveys. Since its creation, the K10 has been used in nationwide health surveys in the US, Canada, and Australia. It has also been utilized by the World Health Organization's World Mental Health Initiative.

K10 Scoring Interpretation

K10 scoring is straightfoward via the summation of item scores. The K10 is scored using a 5-point Likert scale ranging from 1 (none of the time) to 5 (all of the time). Potential total scores range from 10 to 50 with higher scores indicating higher levels of psychological distress. Although K10 scores are not applicable for diagnosing specific mental health conditions, they can be used to track a client’s sense of general psychological distress over the course of treatment.

Who developed the measures, licensing and how to obtain the K10

The K10 was developed by Ronald C. Kessler and Daniel K. Mroczek in collaboration with the US National Center for Health Statistics. Items were adapted from preexisting psychometric measures and selected based on clarity and ability to identify individuals with clinically significant psychological distress.

There is no formal licensure or permission required for use of the K10; however, the creators ask that if you use this measure, you use the following citation and include copyright information for the World Health Organization:

Kessler, R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi, E., Howes, M. J, Normand, S-L. T., Manderscheid, R. W., Walters, E. E., Zaslavsky, A. M. (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry, 60(2), 184-189.

Copyright © World Health Organization 2003

The K10 is available on Bravely Connect as part of our automated measures. See the K10 on Bravely Connect →

There are currently 19 translations of the K10. If you find a version you’d like adding to Bravely Connect then just let us know here.

Limitations, biases and when you should/shouldn’t use the K10

The brevity of the K10 measure is both a strength and a limitation. The scale is exceptionally quick and easy to administer with a mere 10 questions and straightforward scoring method. However, because of how short and general the K10 is, it is not to be used for diagnosis. Instead, the K10 should be used in conjunction with disorder-specific measures and clinical interviews for discerning a diagnosis.

In addition, although the K10 has been validated in many of its other languages and shows strong internal consistency in studies from a variety of other countries including Argentina, Canada, France, Japan, Mexico, and South Africa (Silva et al., 2021, p. 92), some research indicates that this consistency may be lacking in clinical samples. Stolk et al. recommend in their 2014 study that practitioners working with culturally diverse communities take high K10 scores seriously, but ultimately recommend also following up to any K10 results with a culturally sensitive clinical interview.

As always, if you’ve found a measure you would like adding to Bravely Connect as an automated measure, just drop us a measure request here.