The Latin American version of the internalized stigma of mental illness scale (LA-ISMI): a multicentric validation study from three Latin American countries

Abstract

BackgroundTo date, no data have been available concerning the psychometric characteristics of the Internalized Stigma of Mental Illness scale (ISMI-29) in Latin American countries. The aim of this study was to validate a Latin American version of the ISMI in people with schizophrenia.MethodsThe study included 253 stabilized outpatients with schizophrenia from 3 Mental Health Services in three Latin American countries: Bolivia (N = 83), Chile (N = 85) and Peru (N = 85). We analyzed the psychometric properties using item response and classical test theories. An item reduction was then performed to improve the psychometric properties of the ISMI-29. The final version of the ISMI was tested for construct validity, reliability, external validity and differential item functioning (DIF).ResultsThe five-factor structure of the ISMI-29 was not confirmed using confirmatory factor analysis (RMSEA = 0.12, CFI = 0.77, and WRMR = 2.20). Seventeen items were discarded to obtain a satisfactory psychometric version. The ISMI-12 evaluates 3 dimensions: social stigma (4 items), stigma experience (4), and self-stigma (3). The factor structure accounted for 68% of the total variance. Internal consistency was satisfactory. The scalability was satisfactory, with INFIT statistics within an acceptable range. In addition, the results confirmed the absence of DIF and supported the invariance of the item calibrations between countries.ConclusionThe ISMI-29 is not valid in our sample and should not be used in Latin American countries. The ISMI-12 is the first internalized stigma questionnaire with satisfactory psychometric properties available in Latin American countries. Its brevity could facilitate its dissemination and use in clinical settings.

Relationship between perceived social support and self stigma in caregivers of patients with schizophrenia

“…In this study the mean scores of social withdrawal was moderate (13.44) level. Previous studies reported the importance of the social withdrawal in the phenomenon of stigmatization (Caqueo-Urízar et al, 2019;Gerlinger et al, 2013). Self-stigmatization of caregivers may lead to unhappiness and despair, perceived devaluation, concealment of the illness, withdrawal from social relations, avoidance of the patient, and lack or delay in seeking treatment (Maiocco et al, 2017;Singh et al, 2016).…”

Predictors of Internalized Stigma in Patients with Schizophrenia in Northern Chile: A Longitudinal Study

“…A higher overall score on the ISMI scale indicates more severe internalized stigmatization. The ISMI has been validated for the Chilean context and its internal consistency and retesting are acceptable for the original version [ 38 ]. The original version of the ISMI scale was translated into Spanish by Bengochea-Seco, et al [ 39 ].…”

A multicomponent intervention to reduce internalized stigma in persons with a diagnosis of severe mental disorder: protocol of a pilot randomized mixed trial

“…It presents adequate validity and internal consistency, with Cronbach's Alphas that vary from 0.77 to 0.88. 42 Rosenberg self-esteem scale (RSES): the original scale was designed to assess the self-esteem of adolescents, but its use has spread to other populations that include people with SMI. 8,9,43 It is a unidimensional self-report instrument composed of 10 items and presented adequate validity and reliability (=0.754).…”