Measuring discrimination experienced by people with a mental illness: replication of the short-form DISCUS in six world regions

被引：9

作者：

Brohan, Elaine ^{[1
]}

Thornicroft, Graham ^{[1
,2
]}

Rusch, Nicolas ^{[3
,4
]}

Lasalvia, Antonio ^{[5
]}

Campbell, Megan M. ^{[6
,7
]}

Yalcinkaya-Alkar, Ozden ^{[8
]}

Lanfredi, Mariangela ^{[9
]}

Ochoa, Susana ^{[10
]}

Ucok, Alp ^{[11
]}

Tomas, Catarina ^{[12
,13
,14
]}

Fadipe, Babatunde ^{[15
]}

Sebes, Julia ^{[16
]}

Fiorillo, Andrea ^{[17
]}

Sampogna, Gaia ^{[17
]}

Paula, Cristiane Silvestre ^{[18
]}

Valverde, Leonidas ^{[18
]}

Schomerus, Georg ^{[19
]}

Klemm, Pia ^{[20
]}

Ouali, Uta ^{[21
,22
]}

Castelein, Stynke ^{[23
,24
]}

Alexova, Aneta ^{[25
,26
]}

Oexle, Nathalie ^{[3
,4
]}

Guimaraes, Patricia Neves ^{[27
]}

Sportel, Bouwina Esther ^{[28
]}

Chang, Chih-Cheng ^{[29
,30
]}

Li, Jie ^{[31
]}

Shanthi, Chilasagaram ^{[32
]}

Reneses, Blanca ^{[33
]}

Bakolis, Ioannis ^{[2
,34
]}

Evans-Lacko, Sara ^{[1
,35
]}

机构：

[1] Kings Coll London, Ctr Global Mental Hlth, Inst Psychiat Psychol & Neurosci, Hlth Serv & Populat Res Dept, London, England

[2] Kings Coll London, Ctr Implementat Sci, Inst Psychiat Psychol & Neurosci, Hlth Serv & Populat Res Dept, London, England

[3] Ulm Univ, Dept Psychiat 2, Gunzburg, Germany

[4] BKH Gunzburg, Gunzburg, Germany

[5] Univ Verona, Dept Neurosci Biomed & Movement Sci, Sect Psychiat, Verona, Italy

[6] Univ Cape Town, Fac Hlth Sci, Dept Psychiat & Mental Hlth, Cape Town, South Africa

[7] Rhodes Univ, Dept Psychol, Makhanda, South Africa

[8] Ankara Yadirim Beyazit Univ, Dept Psychol, Ankara, Turkey

[9] IRCCS Ist Ctr San Giovanni di Dio Fatebenefratell, Unit Psychiat, Brescia, Italy

[10] CIBERSAM, Parc Sanitari St Joan de Deu, Barcelona, Spain

[11] Istanbul Fac Med, Dept Psychiat, Istanbul, Turkey

[12] Polytech Inst Leiria, Dept Nursing Sci, Sch Hlth Sci, Leiria, Portugal

[13] Polytech Inst Leiria, Ctr Innovat Care & Hlth Technol ciTechCare, Leiria, Portugal

[14] Univ Porto, Ctr Hlth Technol & Serv Res Innovat & Dev Nursing, Porto, Portugal

[15] Lagos Univ Teaching Hosp, Dept Psychiat, Lagos, Nigeria

[16] Natl Med Rehabil Inst, Psychosomat & Psychotherapy Rehabil Dept, Szanatorium U 19, H-1121 Budapest, Hungary

[17] Univ Campania, Dept Psychiat, Naples, Italy

[18] Univ Prebiteriana Mackenzie, Dev Disorder Program, Sao Paulo, Brazil

[19] Univ Leipzig, Dept Psychiat, Med Ctr, Leipzig, Germany

[20] Greifswald Univ, Med Fac, Dept Psychiat, Greifswald, Germany

[21] Razi Hosp La Manouba, Dept Psychiat A, Manouba, Tunisia

[22] Univ Tunis El Manar, Fac Med Tunis, Tunis, Tunisia

[23] Lentis Psychiat Inst, Lentis Res, Groningen, Netherlands

[24] Univ Groningen, Fac Behav & Social Sci, Groningen, Netherlands

[25] Natl Inst Mental Hlth, Dept Publ Mental Hlth, Klecany, Czech Republic

[26] Charles Univ Prague, Fac Social Sci, Prague, Czech Republic

[27] Univ Estadual Montes Claros, Fac Med, Dept Mental & Publ Hlth, Montes Claros, MG, Brazil

[28] GGZ Drenthe Mental Hlth Inst, Dept Psychot Disorders, Assen, Netherlands

[29] Chi Mei Med Ctr, Dept Psychiat, Tainan, Taiwan

[30] Chang Jung Christian Univ, Dept Hlth Psychol, Tainan, Taiwan

[31] Guangzhou Med Univ, Affiliated Brain Hosp, Guangzhou, Peoples R China

[32] Govt Med Coll, Dept Psychiat, Nizamabad, Telangana, India

[33] Univ Complutense Madrid, San Carlos Univ Hosp, Inst Psychiat & Mental Hlth, Inst Biomed Res IdISSC, Madrid, Spain

[34] Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Biostat & Hlth Informat, London, England

[35] London Sch Econ & Polit Sci, Personal Social Serv Res Unit, London, England

来源：

PSYCHOLOGICAL MEDICINE | 2023年 / 53卷 / 09期

基金：

英国医学研究理事会; 美国国家卫生研究院;

关键词：

Discrimination; DISCUS; Global mental health; Psychometrics; Stigma; MAJOR DEPRESSIVE DISORDER; PSYCHOMETRIC PROPERTIES; INTERNALIZED STIGMA; HEALTH; HOPELESSNESS; SCALE; QUESTIONNAIRE; CRITERIA; ESTEEM;

D O I：

10.1017/S0033291722000630

中图分类号：

B849 [应用心理学];

学科分类号：

040203 ;

摘要：

Background The Discrimination and Stigma Scale (DISC) is a patient-reported outcome measure which assesses experiences of discrimination among persons with a mental illness globally. Methods 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. Results 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 (alpha = 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: p < 0.001], lower mental wellbeing [Warwick-Edinburgh Well-being Scale (WEMWBS): p < 0.001], higher suicidal ideation [Beck Hopelessness Scale (BHS)-4: p < 0.001] and higher risk of suicidal behaviour [Suicidal Ideation Attributes Scale (SIDAS): p < 0.001]. Conclusions 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.

引用

页码：3963 / 3973

页数：11

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