Jennifer E Boyd1, Poorni G Otilingam2, Bruce R Deforge3. 1. Department of Psychiatry, San Francisco VA Medical Center and University of California, San Francisco. 2. Mental Health Service, San Francisco VA Medical Center. 3. School of Social Work, University of Maryland, Baltimore.
Abstract
OBJECTIVE: The internalized stigma of mental illness impedes recovery and is associated with increased depression, reduced self-esteem, reduced recovery orientation, reduced empowerment, and increased perceived devaluation and discrimination. The Internalized Stigma of Mental Illness (ISMI) scale is a 29-item self-report questionnaire developed with consumer input that includes the following subscales: Alienation, Discrimination Experience, Social Withdrawal, Stereotype Endorsement, and Stigma Resistance. Here we present a 10-item version of the ISMI containing the two strongest items from each subscale. METHOD: Participants were all outpatient veterans with serious mental illness. Following the rigorous scale-reduction methods set forth by Stanton and colleagues (2002), we selected the 10 items, tested the psychometrics of the shortened scale in the original validation sample (N = 127), and cross-checked the results in a second dataset (N = 760). RESULTS: As expected, the ISMI-10 retained the essential properties of the ISMI-29, including adequate internal consistency reliability and external validity in relation to depression, self-esteem, recovery orientation, perceived devaluation and discrimination, and empowerment. The ISMI-10 scores are normally distributed and have similar descriptive statistics to the ISMI-29. The reliability and depression findings were replicated in a cross-validation sample. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: We conclude that the ISMI-10 has strong psychometric properties and is a practical, reliable, and valid alternative to the original ISMI-29. Future work should test the ISMI-10 in more diverse samples. This shorter version should reduce respondent burden in program evaluation projects that seek to determine whether participation in psychosocial rehabilitation programming reduces internalized stigma.
OBJECTIVE: The internalized stigma of mental illness impedes recovery and is associated with increased depression, reduced self-esteem, reduced recovery orientation, reduced empowerment, and increased perceived devaluation and discrimination. The Internalized Stigma of Mental Illness (ISMI) scale is a 29-item self-report questionnaire developed with consumer input that includes the following subscales: Alienation, Discrimination Experience, Social Withdrawal, Stereotype Endorsement, and Stigma Resistance. Here we present a 10-item version of the ISMI containing the two strongest items from each subscale. METHOD:Participants were all outpatient veterans with serious mental illness. Following the rigorous scale-reduction methods set forth by Stanton and colleagues (2002), we selected the 10 items, tested the psychometrics of the shortened scale in the original validation sample (N = 127), and cross-checked the results in a second dataset (N = 760). RESULTS: As expected, the ISMI-10 retained the essential properties of the ISMI-29, including adequate internal consistency reliability and external validity in relation to depression, self-esteem, recovery orientation, perceived devaluation and discrimination, and empowerment. The ISMI-10 scores are normally distributed and have similar descriptive statistics to the ISMI-29. The reliability and depression findings were replicated in a cross-validation sample. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: We conclude that the ISMI-10 has strong psychometric properties and is a practical, reliable, and valid alternative to the original ISMI-29. Future work should test the ISMI-10 in more diverse samples. This shorter version should reduce respondent burden in program evaluation projects that seek to determine whether participation in psychosocial rehabilitation programming reduces internalized stigma.
Authors: Mana K Ali; Samantha M Hack; Clayton H Brown; Deborah Medoff; Lijuan Fang; Elizabeth A Klingaman; Stephanie G Park; Lisa B Dixon; Julie A Kreyenbuhl Journal: J Racial Ethn Health Disparities Date: 2017-04-14