Ioannis Bakolis1, Graham Thornicroft2, Silia Vitoratou3, Nicolas Rüsch4, Chiara Bonetto5, Antonio Lasalvia6, Sara Evans-Lacko7. 1. Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. Electronic address: ioannis.bakolis@kcl.ac.uk. 2. Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. 3. Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom. 4. Department of Psychiatry II, University of Ulm and BKH Günzburg, Germany. 5. Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy. 6. Section of Psychiatry, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy; UOC Psichiatria, Azienda Ospedaliera Universitaria Integrata (AOUI) di Verona, Verona, Italy. 7. Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom; Personal Social Services Research Unit, London School of Economics and Political Science, London, United Kingdom.
Abstract
BACKGROUND: The Discrimination and Stigma Scale (DISC-12) was specifically developed to measure experienced and anticipated discrimination reported by people with mental health problems. However, the length of the DISC-12 may represent a disadvantage especially in country settings with limited human capacity and infrastructure. The purpose of the study was to develop a short version of DISC-12 (DISCUS) to address these limitations. METHODS: Data from 1087 participants with major depressive disorder and 732 patients with schizophrenia were collected as part of two research network studies across 35 countries - Anti Stigma Programme European Network (ASPEN) and International Study of Discrimination and Stigma (INDIGO). We used a Meta Exploratory Factor Analysis (meta-EFA) and a Multiple Causes Multiple Indicators (MIMIC) Model to reduce the number of items in the DISC-12 scale. The validity and reliability of the reduced scale (DISCUS) was tested in 202 people with the full spectrum of mental disorders recruited in a cross-sectional study conducted in South London. Psychometric validation for the reduced scale used confirmatory factor analysis and measures of Cronbach's alpha and Pearson's correlation coefficient. RESULTS: meta-EFA reduced twenty-one items to twelve items. An additional item was discarded with the use of the MIMIC model. The 11-item DISCUS demonstrated excellent reliability (Cronbach's alpha >0.85), good fit (Tucker Lewis Index and Comparative Fit Index value>0.9) and weak to moderate construct validity. CONCLUSIONS: The DISCUS scale is a consistent and valid instrument to measure experienced and anticipated discrimination predominantly in personal and social relationships in global settings.
BACKGROUND: The Discrimination and Stigma Scale (DISC-12) was specifically developed to measure experienced and anticipated discrimination reported by people with mental health problems. However, the length of the DISC-12 may represent a disadvantage especially in country settings with limited human capacity and infrastructure. The purpose of the study was to develop a short version of DISC-12 (DISCUS) to address these limitations. METHODS: Data from 1087 participants with major depressive disorder and 732 patients with schizophrenia were collected as part of two research network studies across 35 countries - Anti Stigma Programme European Network (ASPEN) and International Study of Discrimination and Stigma (INDIGO). We used a Meta Exploratory Factor Analysis (meta-EFA) and a Multiple Causes Multiple Indicators (MIMIC) Model to reduce the number of items in the DISC-12 scale. The validity and reliability of the reduced scale (DISCUS) was tested in 202 people with the full spectrum of mental disorders recruited in a cross-sectional study conducted in South London. Psychometric validation for the reduced scale used confirmatory factor analysis and measures of Cronbach's alpha and Pearson's correlation coefficient. RESULTS: meta-EFA reduced twenty-one items to twelve items. An additional item was discarded with the use of the MIMIC model. The 11-item DISCUS demonstrated excellent reliability (Cronbach's alpha >0.85), good fit (Tucker Lewis Index and Comparative Fit Index value>0.9) and weak to moderate construct validity. CONCLUSIONS: The DISCUS scale is a consistent and valid instrument to measure experienced and anticipated discrimination predominantly in personal and social relationships in global settings.
Authors: Caterina Ceccarelli; Ioannis Bakolis; Bethlehem Tekola; Mersha Kinfe; Anton Borissov; Fikirte Girma; Rehana Abdurahman; Tigist Zerihun; Charlotte Hanlon; Rosa A Hoekstra Journal: Glob Ment Health (Camb) Date: 2021-12-13