开发和验证 DISCUS 量表：一种可靠的简短测量工具，用于评估全球范围内心理健康问题患者的经历性歧视。

Development and validation of the DISCUS scale: A reliable short measure for assessing experienced discrimination in people with mental health problems on a global level.

机构信息

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.

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.

出版信息

Schizophr Res. 2019 Oct;212:213-220. doi: 10.1016/j.schres.2019.07.018. Epub 2019 Aug 15.

DOI:10.1016/j.schres.2019.07.018

PMID:31421970

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.

摘要

背景

歧视和污名量表（DISC-12）是专门为衡量有心理健康问题的人所经历和预期的歧视而开发的。然而，DISC-12 的长度可能是一个劣势，尤其是在人力资源和基础设施有限的国家环境中。本研究的目的是开发一个 DISC-12 的简短版本（DISCUS），以解决这些限制。

方法

作为跨越 35 个国家的两个研究网络研究的一部分，从 1087 名患有重度抑郁症的参与者和 732 名患有精神分裂症的患者中收集了数据——反污名计划欧洲网络（ASPEN）和国际歧视和污名研究（INDIGO）。我们使用元探索性因素分析（meta-EFA）和多重原因多重指标（MIMIC）模型来减少 DISC-12 量表的项目数量。在横断面研究中，对来自伦敦南部的各种精神障碍患者（共 202 人）测试了简化量表（DISCUS）的有效性和可靠性。使用验证性因素分析和 Cronbach's alpha 及 Pearson 相关系数来评估简化量表的心理测量学验证。

结果

meta-EFA 将 21 个项目简化为 12 个项目。使用 MIMIC 模型后，又剔除了一个项目。11 项的 DISCUS 显示出良好的可靠性（Cronbach's alpha >0.85）、良好的拟合度（Tucker Lewis Index 和比较拟合指数值>0.9）以及较弱到中度的结构有效性。