Centre for Global Mental Health, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Centre for Implementation Science, Health Services and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Psychol Med. 2023 Jul;53(9):3963-3973. doi: 10.1017/S0033291722000630. Epub 2022 Mar 30.
The Discrimination and Stigma Scale (DISC) is a patient-reported outcome measure which assesses experiences of discrimination among persons with a mental illness globally.
This study evaluated whether the psychometric properties of a short-form version, DISC-Ultra Short (DISCUS) (11-item), could be replicated in a sample of people with a wide range of mental disorders from 21 sites in 15 countries/territories, across six global regions. The frequency of experienced discrimination was reported. Scaling assumptions (confirmatory factor analysis, inter-item and item-total correlations), reliability (internal consistency) and validity (convergent validity, known groups method) were investigated in each region, and by diagnosis group.
1195 people participated. The most frequently reported experiences of discrimination were being shunned or avoided at work (48.7%) and discrimination in making or keeping friends (47.2%). Confirmatory factor analysis supported a unidimensional model across all six regions and five diagnosis groups. Convergent validity was confirmed in the total sample and within all regions [ Internalised Stigma of Mental Illness (ISMI-10): 0.28-0.67, stopping self: 0.54-0.72, stigma consciousness: -0.32-0.57], as was internal consistency reliability ( = 0.74-0.84). Known groups validity was established in the global sample with levels of experienced discrimination significantly higher for those experiencing higher depression [Patient Health Questionnaire (PHQ)-2: < 0.001], lower mental wellbeing [Warwick-Edinburgh Well-being Scale (WEMWBS): < 0.001], higher suicidal ideation [Beck Hopelessness Scale (BHS)-4: < 0.001] and higher risk of suicidal behaviour [Suicidal Ideation Attributes Scale (SIDAS): < 0.001].
The DISCUS is a reliable and valid unidimensional measure of experienced discrimination for use in global settings with similar properties to the longer DISC. It offers a brief assessment of experienced discrimination for use in clinical and research settings.
歧视和污名量表（DISC）是一种患者报告的结果衡量标准，用于评估全球范围内患有精神疾病的人群所经历的歧视。
本研究评估了一种简短形式，即歧视和污名量表-超短版（DISCUS）（11 项）的心理测量特性是否可以在来自 15 个国家/地区的 21 个地点的各种精神障碍患者样本中复制，涵盖六大洲。报告了经历歧视的频率。在每个地区和每个诊断组中都研究了量表假设（验证性因子分析、条目间和条目总分相关性）、信度（内部一致性）和效度（聚合效度、已知群体法）。
共有 1195 人参与。最常报告的歧视经历是在工作中被回避或回避（48.7%）和在交友或保持友谊方面受到歧视（47.2%）。验证性因子分析支持所有六个区域和五个诊断组的单维模型。在整个样本中以及所有地区内都确认了聚合效度[内化的精神疾病污名量表（ISMI-10）：0.28-0.67，停止自我：0.54-0.72，污名意识：-0.32-0.57]，以及内部一致性信度（=0.74-0.84）。在全球样本中建立了已知群体的有效性，经历较高抑郁程度的个体的歧视程度显著更高[患者健康问卷（PHQ）-2：<0.001]、心理健康程度较低[华威-爱丁堡幸福感量表（WEMWBS）：<0.001]、自杀意念较高[贝克绝望量表（BHS）-4：<0.001]和自杀行为风险较高[自杀意念属性量表（SIDAS）：<0.001]。
DISCUS 是一种可靠且有效的经历歧视多维衡量标准，可用于具有与较长 DISC 相似特性的全球环境。它提供了一种简短的经历歧视评估，可用于临床和研究环境。
