Table 1 Scales assessing stigma experienced by people with personal experience of mental illness
From: Experiences of mental illness stigma, prejudice and discrimination: a review of measures
Scale | Measures Perceived stigma | Measures experienced stigma | Measures self-stigma | Measures Other | N. of studies found in review using measure |
|---|---|---|---|---|---|
1. Perceived Devaluation and Discrimination Scale (PDD) [25] | Perceived discrimination (6 items) Perceived devaluation (6 items) | No | No | No | 35 |
Description | 12 item self complete measure. Each item is rated on a six-point Likert scale anchored at 1 = strongly disagree and 6 = strongly agree. The internal consistency of the scale ranges from α = 0.86 to α = 0.88 [22] | ||||
2. Internalised Stigma of Mental Illness (ISMI) [33] | No | Discrimination experience (5 items) | Alienation (6 items) Stereotype endorsement (7 items) Social withdrawal (6 items) | Stigma resistance (5 items) | 7 |
Description | 29 item self complete measure. Each item is rated on a four-point Likert scale anchored at 1 = strongly disagree and 4 = strongly agree. Internal consistency (α = 0.90), test-retest reliability(r = 0.92) | ||||
3. Self-stigma of Mental Illness Scale (SSMIS) [27] | Stereotype awareness (10 items) | No | Stereotype agreement (10 items) Stereotype self-concurrence (10 items) Self-esteem decrement (10 items) | No | 5 |
Description | 40 item self complete measure. Each item is rated on a 9-point Likert scale anchored at 0 = strongly disagree and 9 = strongly agree). Internal consistency for subscales range α = 0.72 to α = 0.91. Test-retest reliability for subscales ranged from 0.68-0.82. The stereotype awareness items were adapted from the PDD [25] | ||||
4. Consumer Experiences of Stigma Questionnaire (CESQ) [34] | No | Experiences of stigma (9 items) Experiences of discrimination (12 items) | No | No | 3 |
Description | 21 item self complete postal survey. Each item is rated on a five-point Likert scale anchored at 1 = never and 5 = very often. Has also been used as an interview. Psychometric properties not reported | ||||
5. Rejection Experiences Scale (RES) [47] | No | Rejection experiences (11 items) | No | No | 3 |
Description | 11 item self-complete scale, develsoped in Swedish. Each item rated on a 5 point Likert scale anchored 1 = never and at 5 = very often. Internal consistency α = 0.85. The scale was developed based on the 6 items from the SRES [35] and 5 items from the CESQ [34] | ||||
6. Depression Self-stigma Scale (DSSS) [30] | Public stigma (4 items) | Stigmatizing experiences (6 items) | General self-stigma (9 items) Secrecy (9 items) | Treatment stigma (4 items) | 1 [88] |
Description | 32 item self-complete measure. Each item rated on a 7 point Likert scale anchored at 1 = completely agree and 7 = completely disagree. Internal consistency for subscales range α = 0.78- α = 0.95 [88] | ||||
7. Self-reported Experiences of Rejection (SRER) [35] | No | Rejection experiences (12 items) | No | No | 1 [56] |
Description | 12 item self-complete measure. 6 items about experiences related to mental illness and 6 about experiences related to drug use. Each item is scored using a yes/no response. Internal consistency is α = 0.80. A Link and colleagues recommend the use of the CESQ rather than SRER [11] | ||||
8. Stigma Scale (SS) [36] | No | Discrimination (12 items) | Disclosure (11 items) | Positive aspects (5 items) | 0 |
Description | 28 item self complete measure. Each item is rated on a four-point Likert scale anchored at 0 = strongly disagree and 4 = strongly agree. Test-retest reliability (kappa range 0.49-0.71) and internal consistency α = 0.87 | ||||
9. The Inventory of Stigmatising Experiences (ISE) [32] | Perceived stigma 2 items | Experienced stigma 2 items | Social withdrawal 1 item | Impact of stigma (5 item) | 0 |
Description | 10 item interview based measure with qualitative components. Each item is scored on a five point Likert Scale anchored at 1 = never and 5 = always. The scale is intended as a measure of 'the extent and impact of stigma'. Stigma experiences scale KR-20 = 0.83, stigma impact scale α = 0.91 | ||||
10. Self-esteem and Stigma Questionnaire (SESQ) [28] | Feelings of stigmatisation (8 items) | No | No | Self-esteem (6 items) | 0 |
Description | 14 item self complete measure. The feelings of stigmatisation items are adapted from the PDD (Link, 1987). It also contains 5 self-esteem items which address the respondent's confidence in their ability to complete various tasks. A sixth self-esteem item is taken from the Rosenberg self-esteem scale [89]. All items are rated on a six point Likert scale, anchored at 1 = strongly agree and 6 = strongly disagree. Internal consistency α = 0.80. Item-total correlation r = 0.4 or greater for each item. Test retest stigma scale = 0.63, self-esteem scale (0.71). α = 0.79, 0.71 | ||||
Perceived stigma (15 items) | No | No | No | 0 | |
Description | 15 item self-complete measure. Adapted from 18-item measure by Harvey, 2001. Each item is rated on a 5 point Likert Scale anchored at 0 = never and 4 = always. Internal consistency α ≥ 0.80 | ||||
12. MacArthur Foundation Midlife Development in the United States (MIDUS) [37] | No | Major discrimination (11 items) Day to day discrimination (11 items) | No | No | 0 |
Description | 22 item interview based measure. Each item was rated on a 5-point Likert scale anchored at 1 = all of the time and 5 = never. Assess discrimination for any reasons including disability, gender, ethnicity/race, age, religion, physical appearance, SES and other reasons. The disability category was further split into physical and mental disability. Dichotomous response for each question followed by a frequency scale anchored at 1 = often and 4 = never. Internal consistency α = 0.87 | ||||
13. Discrimination and Stigma Scale (DISC) [31] | Anticipated discrimination (4-items) | Experienced discrimination (32 items) | No | No | 0 |
Description | 36 item interview based measure. All items are rated on a 7 point Likert scale anchored at -3 = strong disadvantage and 3 = strong advantage. Psychometric properties not reported | ||||
14. Experiences of Discrimination Scale (EDS) [38] | No | Has discrimination occurred (1 item) Specific settings of discrimination (8 items) | No | Stressfulness of discrimination in specific settings (8 items) | 0 |
Description | Interview based measure which assesses experienced discrimination resulting from mental illness and other stigmatized identities. It asks whether discrimination has occurred, what the basis for this discrimination was, whether discrimination occurred in 8 specific settings and the level of stress associated with discrimination in each setting. Modified version of the Schedule of Racist Events Scale [91] | ||||