The Maristán stigma scale: a standardized international measure of the stigma of schizophrenia and other psychoses
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AuthorSaldivia, Sandra; Runte Geidel, Ariadne; Grandón, Pamela; Torres González, Francisco; Xavier, Miguel; Antonioli, Claudio; Ballester, Dinarte; Melipillán, Roberto; Galende, Emiliano; Vicente, Benjamín; Caldas, José Miguel; Killaspy, Helen; Gibbons, Rachel; King, Michael
StigmaQuestionnairePsychometricsRating scale schizophrenia
Saldivia, S.; et al. The Maristán stigma scale: a standardized international measure of the stigma of schizophrenia and other psychoses. BMC Psychiatry, 14: 182 (2014). [http://hdl.handle.net/10481/34984]
SponsorshipWe are also grateful for support from the Pan-American Health Office (PAHO), Camden and Islington NHS Foundation Trust and University College London (UCL).
Background: People with schizophrenia face prejudice and discrimination from a number of sources including professionals and families. The degree of stigma perceived and experienced varies across cultures and communities. We aimed to develop a cross-cultural measure of the stigma perceived by people with schizophrenia.Method: Items for the scale were developed from qualitative group interviews with people with schizophrenia in six countries. The scale was then applied in face-to-face interviews with 164 participants, 103 of which were repeated after 30 days. Principal Axis Factoring and Promax rotation evaluated the structure of the scale; Horn’s parallel combined with bootstrapping determined the number of factors; and intra-class correlation assessed test-retest reliability.Results: The final scale has 31 items and four factors: informal social networks, socio-institutional, health professionals and self-stigma. Cronbach’s alpha was 0.84 for the Factor 1; 0.81 for Factor 2; 0.74 for Factor 3, and 0.75 for Factor 4. Correlation matrix among factors revealed that most were in the moderate range [0.31-0.49], with the strongest occurring between perception of stigma in the informal network and self-stigma and there was also a weaker correlation between stigma from health professionals and self-stigma. Test-retest reliability was highest for informal networks [ICC 0.76 [0.67 -0.83]] and self-stigma [ICC 0.74 [0.64-0.81]]. There were no significant differences in the scoring due to sex or age. Service users in Argentina had the highest scores in almost all dimensions.Conclusions: The MARISTAN stigma scale is a reliable measure of the stigma of schizophrenia and related psychoses across several cultures. A confirmatory factor analysis is needed to assess the stability of its factor structure.