Personal Social Services Research Unit, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
Department of Psychiatry, Universitätsmedizin Greifswald, Ellernholzstr. 2, 17475, Greifswald, Germany.
Soc Psychiatry Psychiatr Epidemiol. 2019 Jan;54(1):59-67. doi: 10.1007/s00127-018-1602-2. Epub 2018 Oct 4.
Self-identification of having a mental illness has been shown to be an important factor underpinning help-seeking behaviour and may mediate the relationship between personal stigma and mental health service use. This study validates a new scale for the self-identification of having a mental illness among a non-clinical, community cohort of young people in the UK.
Following consultation with a group of young person experts with experience of mental health problems, we evaluated the psychometric properties of the self-identification of mental illness scale (SELF-I) among 423 young people aged 13-24 years who are part of an ongoing prospective community cohort. We performed test retest reliability among a subset of 53 participants. Psychometric validation for the scale used measures of Cronbach's alpha and Pearson's correlation coefficient. Item performance was assessed along and in relation with each covariate.
The SELF-I demonstrated robust psychometric properties including high test-retest reliability (0.95) and good internal consistency (0.87 as determined by the Cronbach's alpha). The inter-total correlations for each item, which ranged from 0.62 to 0.74, supported keeping all items in the scale. Reporting greater psychiatric symptomatology via the SDQ (β: 0.82 95% confidence interval 0.40, 1.23), psychotic-like experiences (β: 0.37 95% confidence interval 0.14, 0.59), and use of mental health services (β: 0.92 95% confidence interval 0.71, 1.13) were associated with a greater self-perception as having a mental illness (p < 0.05), providing evidence of convergent validity. As expected, we found that less intended stigmatising behaviour was associated with greater self-perceptions of having a mental illness (B: 0.18, 95% CI 0.07, 0.28).
The SELF-I scale provides a method to gather insight into how young people, who may not identify as service users, perceive their own mental state and potential risk for developing a mental illness. This can be important for understanding perceived need for help and likelihood of using services among those with mental health problems.
自我认同患有精神疾病已被证明是寻求帮助行为的一个重要因素，并且可能在个人污名与精神卫生服务使用之间起中介作用。本研究在英国一个非临床的社区青年队列中验证了一种用于自我识别精神疾病的新量表。
在与一组具有精神健康问题经验的青年专家进行协商后，我们在一个由 423 名 13-24 岁的正在进行的前瞻性社区队列的青年中评估了精神疾病自我识别量表（SELF-I）的心理测量特性。我们对 53 名参与者的亚组进行了测试重测信度。该量表的心理测量验证使用了克朗巴赫α和皮尔逊相关系数的测量。对项目表现进行了评估，并与每个协变量相关联。
SELF-I 表现出可靠的心理测量特性，包括高测试重测信度（0.95）和良好的内部一致性（通过克朗巴赫α确定为 0.87）。每个项目的总项目相关性在 0.62 到 0.74 之间，支持在量表中保留所有项目。通过 SDQ（β：0.82 95%置信区间 0.40，1.23）报告更多的精神病症状，（β：0.37 95%置信区间 0.14，0.59）和使用精神卫生服务（β：0.92 95%置信区间 0.71，1.13）与更高的自我感知患有精神疾病相关（p<0.05），提供了收敛有效性的证据。正如预期的那样，我们发现，意图减少污名化行为与更高的自我感知患有精神疾病相关（B：0.18，95%CI 0.07，0.28）。
SELF-I 量表提供了一种方法，可以深入了解那些可能不认为自己是服务使用者的年轻人如何看待自己的精神状态和患精神疾病的潜在风险。这对于理解那些有精神健康问题的人的感知需求和使用服务的可能性很重要。
