Assessment of stigma associated with attention-deficit hyperactivity disorder: Psychometric evaluation of the ADHD Stigma Questionnaire

Abstract

This study evaluated the psychometric properties of the ADHD Stigma Questionnaire (ASQ) among a community sample of 301 adolescents ages 11-19 years at high (n = 192) and low risk (n = 109) for attention deficit hyperactivity disorder (ADHD). Study subjects were drawn from a cohort study assessing ADHD detection and service use. The 26-item ASQ demonstrated good internal consistency. Confirmatory factor analysis using random parceling supported a three factor structure with highly correlated subscales of Disclosure Concerns, Negative Self Image, and Concern with Public Attitudes, and a Schmid-Leiman analysis supported an overall stigma factor. Test-retest stability was assessed after two-weeks (n = 45) and found to be adequate for all three subscales. Construct validity was supported by relationships with related constructs, including clinical maladjustment, depression, self-esteem and emotional symptoms and the absence of a relationship with school maladjustment. Findings indicate that the ASQ has acceptable psychometric properties in a large community sample of adolescents, some of whom met DSM-IV criteria for ADHD.

Beliefs About Attention-Deficit/Hyperactivity Disorder and Response to Stereotypes: Youth Postings in Facebook Groups

“…They spent most of their postings commenting on the positive aspects of ADHD, perhaps in an attempt to have readers and their peers see ADHD in a more positive light. These findings support earlier work documenting that adolescents are aware of public stigma regarding ADHD [6], but resist seeing ADHD as a disease that requires treatment [11]. Health practitioners, who can share this positive attitude, will have an easier time supporting teenagers with ADHD.…”

“…More recently, researchers have shown that young people also hold such stigmatizing attitudes toward peers who have been diagnosed with mental illness, including ADHD [4,5]. Indeed, adolescents with a history of ADHD problems show more awareness of potential stigma than those without such a history [6].…”

Willingness to use ADHD treatments: A mixed methods study of perceptions by adolescents, parents, health professionals and teachers

“…One possible explanation for our discrepant quantitative analysis results may be that our question about “embarrassment” was not a fitting proxy for the stigmatizing experiences that have been shown to be associated with ADHD and its treatment (Martin et al, 2007). The concept of stigma has multiple facets and more sophisticated measurement approaches to stigma associated with ADHD have been developed (Kellison et al, 2010; Pescosolido, 2007); however, due to concerns about respondent burden we had selected a simple stigma indicator that may not have been sufficiently sensitive.…”

Stigmatization and self-perception of youth with attention deficit/hyperactivity disorder

“…As part of a longitudinal observational study of help-seeking for ADHD, 45 Bussing et al developed the ASQ by adapting an existing HIV stigma scale 46 and documented acceptable psychometric performance of the ASQ in large community samples. 47,48 Psychometric studies with adolescents established reliability, validated an overall stigma summary score, and demonstrated three subscales: disclosure concerns, negative self-image, and concern with public attitudes. 48 Further study confirmed the ASQ's appropriateness for use with teachers.…”

“…47,48 Psychometric studies with adolescents established reliability, validated an overall stigma summary score, and demonstrated three subscales: disclosure concerns, negative self-image, and concern with public attitudes. 48 Further study confirmed the ASQ's appropriateness for use with teachers. 47 Ferrin et al developed a 33-item questionnaire on attitudes towards treatment for ADHD, and while this instrument does not directly target stigma measurement, parental responses identified a threeitem social stigma subscale in exploratory factor analysis.…”