Development and validation of the Self-Stigma Questionnaire (SSQ) for people with schizophrenia and its relation to social functioning

Ochoa, Susana; Martínez-Zambrano, Francisco; Garcia-Franco, Mar; Vilamala, Sonia; Ribas, Maria José; Arenas, Oti; García-Morales, Esther; Álvarez, Irene; Escartín, Gemma; Villellas, Raúl; Escandell, María José; Martínez-Raves, Mónica; López-Arias, Elisabeth; Cunyat, Christian; Haro, Josep María

doi:10.1016/j.comppsych.2015.06.011

Cited by 16 publications

(14 citation statements)

References 40 publications

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“…In the third factor, hiding the name of the illness from their close circle, environment, and their friends are defined as concealment of the illness. These items were also included in other self-stigma scales as in the same factor [25]. Moreover, in our previous study, we similarly found three factors (social withdrawal, concealment of the illness, and perceived devaluation) that could explain 66.8% of the total variance of the Self-Stigma Inventory for Families (SSI-F) [37].…”

Section: Discussionmentioning

confidence: 80%

“…It was revealed that patients with high level of self-stigma concerning the agreement with the stereotypes of mental illness had poorer medication adherence [24]. In that sense, assessing the self-stigma of the patients with schizophrenia is essential regarding illness prognosis and psychotherapy practices [25].…”

Section: Introductionmentioning

confidence: 99%

“…In this regard, scales assessing the self-stigma focus on one or more of those factors. Some of the most widely used scales are the Internalized Stigma of Mental Illness (ISMI) [26,27], Self-Stigma of Mental Illness Scale (SSMIS) [28], Self-Stigma Questionnaire (SSQ) [25], Perceived Devaluation and Discrimination (PDD) Scale [8], Discrimination and Stigma Scale (DISC) [29], and Consumer Experiences of Stigma Questionnaire (CESQ) [30]. These scales were originated from various countries; thus, every stigma scale includes some cultural statements along with universal concepts.…”

Section: Introductionmentioning

confidence: 99%

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Development of self-stigma inventory for patients with schizophrenia (SSI-P): reliability and validity study

Yıldız

Kiras

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et al. 2018

Psychiatry and Clinical Psychopharmacology

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OBJECTIVES: Internalizing the public stigma in patients with schizophrenia leads to selfstigmatization associated with a number of negative consequences such as depression, low self-esteem, hopelessness, impairment of social adaptation, unemployment, and treatment non-adherence. No instruments have been developed to assess the self-stigmatization for patients with schizophrenia living in Turkey. The purpose of this study was to develop a culturally-sensitive and easy-to-use instrument to measure self-stigma of the patients with schizophrenia and schizoaffective disorder. METHODS: After examining the existing stigma and self-stigma scales for people with mental illnesses, a 19-item self-stigma inventory was formed. Focus group interviews were conducted with patients with schizophrenia and the items were reviewed and rephrased into more comprehensible statements for the patients. The pilot study was conducted with a sample of 15 patients with schizophrenia, and the inventory was given its final form, self-stigma inventory for patients (SSI-P). Outpatients with schizophrenia and schizoaffective disorder were given sociodemographic form, SSI-P, Beck Depression Inventory (BDI), Internalized Stigma of Mental Illness (ISMI), Rosenberg Self-Esteem Scale (RSES), Beck Hopelessness Scale (BHS), Positive and Negative Syndrome Scale (PANSS), Clinical Global Impression-Severity (CGI-S), and Global Assessment of Functioning (GAF). For reliability analyses; internal consistency, item-total correlation, and test-retest reliability were assessed. Validity analyses were conducted with Explanatory Factor Analysis and convergent validity. RESULTS: The sample of the study was 162 patients with schizophrenia and schizoaffective disorder of which 77% were males, 70% were single, mean age was 37, and level of education was 10 years. Cronbach's alpha coefficient of the scale was 0.93 ranging among the subscales between 0.60 and 0.91. Kaiser-Meyer-Olkin value was 0.91, and the Barlett test was significant (p < 0.001) for explanatory factor analysis and three factors were found (perceived devaluation, internalized stereotypes and social withdrawal, concealment of the illness) that can explain 63.5% of the total variance. Two items were removed because of their low factor value, and the final form consisted of 17 items. SSI-P was highly correlated with commonly-used stigma scale ISMI (r = 0.73), and moderately correlated with BDI (r = 0.53), BHS (r = 0.40), and RSES (r = −0.59). It also showed low correlation with PANSS negative score (r = 0.19). The test-retest reliability coefficient of the scale was 0.83. CONCLUSION: SSI-P is a reliable and valid instrument for assessing the self-stigmatization of patients with schizophrenia and schizoaffective disorder. The scale is an easy-to-comprehend, user-friendly, and culturally-sensitive tool with its 17 items. ARTICLE HISTORY

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Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Development of self-stigma inventory for patients with schizophrenia (SSI-P): reliability and validity study

Yıldız

Kiras

İncedere

et al. 2018

Psychiatry and Clinical Psychopharmacology

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“…Literatürde sigara kullanma durumu ile damgalanma arasındaki ilişkiyi inceleyen çalışmaya rastlanmamıştır. Ancak yapılan çalışmalarda şizofrenide sigaraya başlama yaşının düşük olduğu [29] ve sigara kullanımının hastaların dikkat seviyelerini azalttığına yönelik [30] [31] şizofreni hastaları ile yaptıkları çalışmada sosyal işlevsellik düzeyi ile içselleştirilmiş damgalanma arasında ilişki olduğu; içselleştirilmiş damgalanma arttıkça sosyal işlevsellik düzeyinin düştüğü saptanmıştır. Bipolar afektif bozukluğu olan hastalar ile yapılan bir çalışmada hastaların içe kapanma, ev içi ilişkiler, arkadaş ilişkileri, toplumsal etkinliklere katılım, insiyatif alma gibi işlevsellik alanları ile içselleştirilmiş damgalanma puanları arasında ilişki olduğu; bu alanlarda bozulma arttıkça içselleştirilmiş damgalama puanının yükseldiği saptanmıştır.…”

Section: Discussionunclassified

Determination of Internalized Stigmatization and Social Functioning Level in Schizophrenia Patients

Sevinik¹

2020

Psi Hem Derg

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“…Self-stigma scales developed for the patients with mental illnesses [33,34], Internalized Stigma of Mental Illness Scale [30], and the scales developed for the family members or caregivers of the patients such as self-stigma scale [11], internalized stigma [23], and devaluation scale [9] were examined, and 25-item self-stigma scale for the relatives of the patients was formed. A focus group interview was conducted with 18 family members of the patients with schizophrenia, and the items of the scale were reevaluated.…”

Section: Self-stigma Inventory For Families (Ssi-f)mentioning

confidence: 99%

Development of Self-Stigma Inventory for Families of the patients with schizophrenia (SSI-F): validity and reliability study

Yıldız

İncedere

Kiras

et al. 2018

Psychiatry and Clinical Psychopharmacology

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OBJECTIVE: It is known that relatives of the patients with schizophrenia tend to hide the illness from other people, are ashamed of their patients, and feel excluded from society. This situation is referred as self-stigmatization of families, and it may negatively affect the family functioning and therapeutic alliance. Assessing and evaluating the self-stigma of families are essential concerning family therapies and treatment of their patients. The purpose of this study is to develop a culturally sensitive inventory for the assessment of self-stigmatization for families of patients with schizophrenia in Turkey. METHODS: After examining the studies in the related field and conducting a focus group interview with the families of the patients with schizophrenia, a 19-item inventory was formed. One hundred and six relatives of the patients with schizophrenia and schizoaffective disorder were given a sociodemographic form, Self-Stigma Inventory for Families (SSI-F), Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), Rosenberg Self-Esteem Scale (RSES), and Zarit Caregiver Burden Scale (ZCBS). Explanatory factor analysis and convergent validity were assessed as validity analysis, and internal consistency coefficient, item-total correlation, and test-retest reliability were calculated for reliability analysis. RESULTS: The sample consisted of 106 relatives whose 52% were female, 77% were married, mean age was 51 years, and level of education was 9 years. In explanatory factor analysis, three factors (social withdrawal, concealment of the illness, and perceived devaluation) with 14 items were detected, and the factors could explain 66.8% of the total variance. SSI-F was significantly correlated with Beck Depression Inventory (r = 0.48, P < 0.01), Beck Hopelessness Scale (r = 0.27, P < 0.01), Zarit Caregiver Burden Scale (r = 0.54, P < 0.01), and Rosenberg Self-Esteem Scale (r = −0.35, P < 0.01). Cronbach's alpha coefficient for SSI-F total score was calculated as 0.88, and test-retest reliability coefficient of SSI-F was 0.93. CONCLUSIONS: This study shows that the SSI-F is a valid and reliable instrument for assessing self-stigmatization in the families of patients with schizophrenia. It can be considered as a valuable instrument to use for research and therapeutic purposes. ARTICLE HISTORY

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Development and validation of the Self-Stigma Questionnaire (SSQ) for people with schizophrenia and its relation to social functioning

Cited by 16 publications

References 40 publications

Development of self-stigma inventory for patients with schizophrenia (SSI-P): reliability and validity study

Development of self-stigma inventory for patients with schizophrenia (SSI-P): reliability and validity study

Determination of Internalized Stigmatization and Social Functioning Level in Schizophrenia Patients

Development of Self-Stigma Inventory for Families of the patients with schizophrenia (SSI-F): validity and reliability study

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