Children of Parents With a Mental Illness—Stigma Questionnaire: Development and Piloting

Abstract

Children of parents with a mental illness are a particularly vulnerable group as they have a high risk to develop a mental disorder themselves and those are associated with high stigma. Moreover, just like primary recipients of stigma, they are affected by the social taboo surrounding mental illness: they do not receive enough information, are often left alone with their problems, and are thus considered “invisible children”. In previous research, family stigma has only been assessed through general questionnaires for all family members. What has not yet been adequately investigated is how stigma difficulties affect the children of parents with mental illness in particular. To address these limitations, we developed the Children of Parents with Mental Illness-Stigma-Questionnaire (COPMI-SQ), a self-report instrument for young people aged 12–19 years, designed to assess young people's stigma experiences in daily life. Based on a systematic review preceding the questionnaire, we identified relevant stigma dimensions for children of parents with a mental illness that resulted in 93 items that according to theory were assumed to load on four different scales: experienced stigma, anticipated stigma, self-stigma, and structural discrimination. An expert discussion, and a comprehensibility analysis with the target group followed. In this paper, we report on the development process and initial pilot data (N = 32) on the psychometric properties of the COPMI-SQ. Item analyses via an item difficulty index, discriminatory power, as well as internal consistency analysis resulted in a revised instrument reduced to 67 items. We observed very high internal consistencies (between α = 0.868 and α = 0.975) for the subscales. The approach taken to develop the COPMI-SQ followed scientifically accepted principles by ensuring different construction phases and is considered a solid basis for further reliability and validity studies. The study is ongoing and undergoing a further validation investigation; dimensionality and factor structure will also be examined.

Children of parents with a mental illness – stigma questionnaire: validation and revision

“…Children of parents with a mental illness carry an increased risk to experience SBA, one of the assumed mechanisms of the transgenerational transmission of mental disorders ( 25 – 29 ). To our knowledge, the COPMI-SQ is the first questionnaire to have been developed assessing such stigma-specific experiences of adolescents who grow up with a parent with a mental illness ( 30 ). Promising psychometric properties were reported in an initial small pilot study ( 30 ).…”

“…To our knowledge, the COPMI-SQ is the first questionnaire to have been developed assessing such stigma-specific experiences of adolescents who grow up with a parent with a mental illness ( 30 ). Promising psychometric properties were reported in an initial small pilot study ( 30 ). In the current paper, we investigated the factorial structure and psychometric properties of this instrument in a larger sample and present a shortened and revised version—the COPMI-SQ-r.…”

“…Based on a systematic review ( 32 ), the COPMI-SQ ( 30 ) was created as an instrument to assess the stigma experiences of adolescents who grow up with a parent with a mental illness in daily life. According to theory, the items were expected to load on the four different scales “Experienced SBA,” “Anticipated SBA,” “Affiliate SBA,” and “Structural Discrimination”.…”

“…A recent large meta-analysis reported a lifetime risk of 55% among those children and adolescents to develop any mental disorder ( 27 ), whereby subclinical symptoms occur more often and earlier in life ( 29 ). Due to their close and dependent relationship to their parents, these children and adolescents are also considered to be particularly affected by SBA ( 21 , 30 ) and stigmatization has been identified as a potential social mechanism in the transgenerational transmission of mental disorders (TTMD) ( 29 ).…”

“…Structural discrimination refers to the societal and policy structures perpetuating stigmatization ( 34 ). Since—to our knowledge—no adequate scale measuring SBA in adolescents who grow up with a parent with a mental illness exists, we developed the Children of Parents With a Mental Illness-Stigma Questionnaire (COPMI-SQ) ( 30 ) based on the identified stigma dimensions that are specifically relevant for children and adolescents who grow up with a parent with a mental illness ( 32 ). In our first pilot study ( N = 32), we observed the COPMI-SQ’s promising psychometric properties, but as our sample was too small, analysis of the factor structure of the COPMI-SQ was not possible.…”