Stigma of Suicide Attempt: The Psychometric Properties of the Persian Version of the Stigma of Suicide Attempt Scale

Abstract

Background: Stigma can undermine social cohesion, increase the risk of social isolation, and marginalize key groups, preventing individuals from seeking urgent health care and discouraging them from engaging in health-promoting behaviors. Assessing stigma is crucial in providing targeted, supportive interventions and measuring changes in public beliefs and attitudes. In Iran, there is no existing scale to measure the stigma surrounding suicide, and the absence of a reliable and valid tool is notable. The Stigma of Suicide Attempt (STOSA) Scale offers a tool for measuring stigma related to suicide attempts in the general population, psychiatric patients, and those who have attempted suicide. Objectives: The aim of this study was to examine the psychometric properties of the Persian version of the STOSA Scale. Methods: The statistical population of this study consisted of all students from Ahvaz University of Medical Sciences during the 2021 - 2022 academic year. From this population, 291 individuals were selected through convenience sampling and completed the STOSA Scale, the Self-Compassion Scale-Short form, the other as Shamer Scale-2, and the Stigma of Suicide Scale (SOSS). Internal consistency was used to assess the reliability of the STOSA scale, while convergent validity, divergent validity, and confirmatory factor analysis (CFA) were employed to measure its validity. Data were analyzed using SPSS version 25 and LISREL 8.80. Results: The CFA results supported the two-factor structure of the STOSA Scale, indicating a good fit. The STOSA Scale showed a positive and significant correlation with the Suicide Stigma Scale and a negative and significant correlation with self-compassion. Additionally, it demonstrated a positive but non-significant correlation with external shame. Cronbach's alpha coefficient for the overall scale and the subscales of caring attitudes, respectful and supportive attitudes, and stigmatizing beliefs and attitudes were 0.81, 0.77, and 0.63, respectively. A significant difference in suicide stigma was found between men and women, with men exhibiting higher levels of stigma than women (P < 0.05). Conclusion: The findings support the construct validity, convergent validity, divergent validity, and reliability of the STOSA Scale. This psychometric study adds to the cross-cultural literature on the STOSA Scale, establishing it as a suitable tool for both research and clinical practice.