Chang Chih-Cheng, Wu Tsung-Hsien, Chen Chih-Yin, Wang Jung-Der, Lin Chung-Ying
Department of Psychiatry, Chi Mei Medical Center, Tainan, Taiwan; Health Service and Population Research Department, Institute of Psychiatry, King's College London, London, United Kingdom; Department of Senior Citizen Service Management, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
Department of Psychiatry, Chi Mei Medical Center, Liouying, Tainan, Taiwan.
PLoS One. 2014 Jun 2;9(6):e98767. doi: 10.1371/journal.pone.0098767. eCollection 2014.
The current investigation examined the psychometric properties of the Internalized Stigma of Mental Illness (ISMI) scale in a sample of patients with mental illness. In addition to the internal consistency, test-retest reliability, and concurrent validity that previous studies have tested for the ISMI, we extended the evaluation to its construct validity and measurement invariance using confirmatory factor analysis (CFA).
Three hundred forty-seven participants completed two questionnaires (i.e., the ISMI and the Depression and Somatic Symptoms Scale [DSSS]), and 162 filled out the ISMI again after 50.23±31.18 days.
The results of this study confirmed the frame structure of the ISMI; however, the Stigma Resistance subscale in the ISMI seemed weak. In addition, internal consistency, test-retest reliability, and concurrent validity were all satisfactory for all subscales and the total score of the ISMI, except for Stigma Resistance (α = 0.66; ICC = 0.52, and r = 0.02 to 0.06 with DSSS). Therefore, we hypothesize that Stigma Resistance is a new concept rather than a concept in internalized stigma. The acceptable fit indices supported the measurement invariance of the ISMI across time, and suggested that people with mental illness interpret the ISMI items the same at different times.
The clinical implication of our finding is that clinicians, when they design interventions, may want to use the valid and reliable ISMI without the Stigma Resistance subscale to evaluate the internalized stigma of people with mental illness.
本研究调查了精神疾病内化耻辱感（ISMI）量表在精神疾病患者样本中的心理测量特性。除了先前研究已测试的ISMI的内部一致性、重测信度和同时效度外，我们还使用验证性因子分析（CFA）将评估扩展至其结构效度和测量不变性。
347名参与者完成了两份问卷（即ISMI和抑郁与躯体症状量表 [DSSS]），162人在50.23±31.18天后再次填写了ISMI。
本研究结果证实了ISMI的框架结构；然而，ISMI中的耻辱抵抗子量表似乎较弱。此外，除耻辱抵抗外，所有子量表及ISMI总分的内部一致性、重测信度和同时效度均令人满意（α = 0.66；组内相关系数 [ICC] = 0.52，与DSSS的相关系数r = 0.02至0.06）。因此，我们假设耻辱抵抗是一个新概念，而非内化耻辱感中的一个概念。可接受的拟合指数支持了ISMI随时间的测量不变性，并表明精神疾病患者在不同时间对ISMI项目的理解相同。
我们研究结果的临床意义在于，临床医生在设计干预措施时，可能希望使用不含耻辱抵抗子量表的有效且可靠的ISMI来评估精神疾病患者的内化耻辱感。
