Development and validation of the Japanese version of the Public Attitudes Toward Epilepsy (PATE-J) Scale

Aim This study aimed to develop and validate a Japanese version of the Public Attitudes Toward Epilepsy (PATE-J) Scale to measure attitudes towards epilepsy among the general Japanese population. Methods The study employed a cross-sectional design using an online survey of 537 participants from the general public in Japan, with follow-up surveys at 2 weeks and 3 months. The PATE Scale was translated following standard guidelines and validated by conducting confirmatory factor analysis (CFA) on the complete data set to assess the original two-factor structure of the PATE Scale. Internal consistency assessment, and convergent validity testing with the Modified Epilepsy Stigma Scale (M-ESS), Perceived Devaluation Discrimination Scale (PDDS), and Epilepsy Knowledge Scale (EKS) were carried out. Results CFA confirmed the two-factor structure of the PATE-J, comprising "Personal Domain" and "General Domain." The model showed acceptable fit indices (chi(2)(76) = 607.974, comparative fit index = 0.849, Tucker-Lewis index = 0.820, root-mean-square error of approximation = 0.114, standardized root-mean-square residual = 0.078) and high reliability (Cronbach's alpha = 0.87 for Personal Domain and 0.75 for General Domain). Strong correlations with the M-ESS (r = 0.713, p < 0.001), and weaker correlations with the PDDS, along with a negative correlation with the EKS (r = -0.306, p < 0.001), highlighted the PATE-J's distinctiveness. No significant associations were found between demographic factors and PATE-J scores. Conclusion The PATE-J demonstrates strong psychometric properties and cultural relevance for measuring public attitudes toward epilepsy in Japan. Its validated two-factor structure supports cross-cultural comparisons and provides a reliable tool for assessing public attitudes, informing interventions, and guiding education campaigns.