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Psychometric Evaluation of the Internalized Stigma of Mental Illness Scale for Patients with Mental Illnesses: Measurement Invariance across Time

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  • Chih-Cheng Chang
  • Tsung-Hsien Wu
  • Chih-Yin Chen
  • Jung-Der Wang
  • Chung-Ying Lin

Abstract

Background: 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). Methods: 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. Results: 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. Conclusion: 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.

Suggested Citation

  • Chih-Cheng Chang & Tsung-Hsien Wu & Chih-Yin Chen & Jung-Der Wang & Chung-Ying Lin, 2014. "Psychometric Evaluation of the Internalized Stigma of Mental Illness Scale for Patients with Mental Illnesses: Measurement Invariance across Time," PLOS ONE, Public Library of Science, vol. 9(6), pages 1-8, June.
    • Handle: RePEc:plo:pone00:0098767
    DOI: 10.1371/journal.pone.0098767
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    Cited by:

    1. Ching-Ming Cheng & Chih-Cheng Chang & Jung-Der Wang & Kun-Chia Chang & Shuo-Yen Ting & Chung-Ying Lin, 2019. "Negative Impacts of Self-Stigma on the Quality of Life of Patients in Methadone Maintenance Treatment: The Mediated Roles of Psychological Distress and Social Functioning," IJERPH, MDPI, vol. 16(7), pages 1-16, April.
    2. Prado Silván-Ferrero & Patricia Recio & Fernando Molero & Encarnación Nouvilas-Pallejà, 2020. "Psychological Quality of Life in People with Physical Disability: The Effect of Internalized Stigma, Collective Action and Resilience," IJERPH, MDPI, vol. 17(5), pages 1-15, March.

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