Self-Stigma Scale Research Articles

Factors influencing the levels of fear regarding psychotherapy in adolescents with depression

To investigate the factors influencing the levels of fear regarding psychotherapy in adolescents with depression. A prospective study was conducted among 258 adolescents with depression who were treated in the outpatient service and inpatient department of the First Affiliated Hospital of Nanchang University from September 2023 to March 2024. A questionnaire survey was performed. The questionnaires used included General Information Questionnaire, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, Self-Compassion Scale, Self-Concealment Scale, Depression Self-Stigma Scale, and Thoughts About Psychotherapy Survey. The factors influencing the levels of fear regarding psychotherapy were analyzed among the adolescents with depression. The levels of fear regarding psychotherapy in the adolescents with depression were positively associated with the scores on the Patient Health Questionnaire-9, Self-Concealment Scale, and Depression Self-Stigma Scale (P<0.05), and were negatively associated with the score on the Self-Compassion Scale (P<0.05). Concerns about therapist responsiveness were negatively associated with the score on the Self-Compassion Scale (P<0.05), and were positively associated with the scores on the Generalized Anxiety Disorder-7 and Depression Self-Stigma Scale (P<0.05). The adolescents from one-child families had significantly higher levels of concerns about therapist responsiveness than those from non-one-child families (P<0.05). The levels of image concerns were positively associated with the scores on Patient Health Questionnaire-9, Self-Concealment Scale, and Depression Self-Stigma Scale (P<0.05); the levels of coercion concerns were positively associated with the scores of the Patient Health Questionnaire-9 and Self-Concealment Scale (P<0.05) and were negatively associated with the score on the Self-Compassion Scale (P<0.05). Middle school students had a significantly higher risk of coercion concerns than university students (P<0.05). In adolescents with depression, the levels of fear regarding psychotherapy are associated with educational levels, only-child status, depression symptoms, anxiety symptoms, self-compassion, self-concealment, and depression self-stigma.

Towards measuring food insecurity stigma: development and validation of the Food Insecurity Self-stigma Scale and the Food Support Experiences Scale

BackgroundWithin high income countries, individuals experiencing food insecurity have become increasingly reliant on food support to satisfy household food needs. However, experiencing food insecurity and accessing food support are highly stigmatised, negatively impacting psychological and emotional wellbeing. Being able to quantify this stigma may contribute towards reducing these impacts. This study aimed to develop and validate two novel scales enabling the quantification of stigma concepts within the food insecurity and food support context: (1) the Food Insecurity Self-stigma Scale (FISS), which measures the level of self-stigma (and related constructs) that individuals experiencing food insecurity feel regarding their food insecure status; and (2) the Food Support Experiences Scale (FSES), which measures the psycho-social experiences (including the experience of self-stigma) when individuals access a food support service.MethodsEnglish speaking participants who identified as experiencing food insecurity completed the new FISS (N = 211) and FSES (N = 123) measures, alongside other validation measures. Exploratory (EFA) and confirmatory factor analysis (CFA) were carried out for both scales. Regressions using latent variables derived from the CFA were used to test convergent and divergent validity. McDonald’s Omega was used to assess internal reliability and intra-class correlations between initial and retest FISS and FSES scores of a small number of participants (FISS: N = 14; FSES: N = 8) were used to assess test-retest reliability.ResultsEFA indicated three-factor structures best fit both scales. CFA revealed a good fit of the model for the FISS (15 items; 3 factors: righteous anger, non-disclosure, and stereotype endorsement). Meanwhile, an acceptable-to-poor fit of the model was revealed for the FSES (23 items; 3 factors: self-approval and disclosure, dietary and interpersonal satisfaction, and perceived effectiveness and impact). Importantly, convergent validity was only found for the non-disclosure subscale of the FISS and the self-approval and disclosure subscale of the FSES.ConclusionsThe FISS and FSES provide valid tools for quantifying aspects of stigma relating to the experience of food insecurity and accessing food support respectively. Development of these two scales may provide an important first step towards measuring stigma. developing interventions which reduce this psychological burden, and working to promote psychological wellbeing within populations experiencing food insecurity.

Evaluation of self-stigma in patients with epilepsy: Validation of the self-stigma scale to Spanish (ESSS-S).

The Epilepsy Self-Stigma Scale (ESSS) has been developed in Japan for patients with epilepsy (PWE). We aimed to validate the scale in Spanish and examine its validity and reliability. The transcultural adaptation of the ESSS was conducted using translation and back-translation, along with pilot testing and an expert panel review. An online questionnaire was used to assess construct validity, criterion validity, and internal consistency. A total of 260 out of 628 participants completed the questionnaires. We found a two-factor structure that explained 61.3% of the total variance: factor 1 "self-perceived discrimination" with a Cronbach's alpha of 0.80, and factor 2 "social isolation" with a Cronbach's alpha of 0.75. The reliability of overall ESSS-S 8-item scores was high (Cronbach's alpha = 0.74). Convergent validity was tested and demonstrated a significant correlation. P. Self-perceived discrimination scores were associated with higher anxiety and depression scores (r = 0.53/0.54; p < 0.001), lower self-esteem (-0.53; p < 0.001), and lower quality of life (r = -0.66; p < 0.001). Social isolation scores were associated with higher anxiety and depression scores (r = 0.41/0.33; p < 0.001), lower self-esteem (-0.34; p < 0.001), and lower quality of life (r = -0.35; p < 0.001). Temporal reliability was also tested, showing a test-retest ICC of 0.87. The mean self-stigma score in the Spanish population was 17.68 ± 5.45 out of 32 points. Invariance across gender and age groups indicated that there are no systematic response biases by gender or age, so stratified scores could be related to other constructs. The Spanish version of ESSS (ESSS-S) is a valid and reliable tool for the assessment of self-stigma in PWE among Spanish speakers. This study aimed to validate the Epilepsy Self-Stigma Scale (ESSS) for Spanish speakers (ESSS-S). We conducted transcultural adaptation of the scale. ESSS-S showed high reliability and strong validity, correlating with higher anxiety and depression, lower self-esteem, and quality of life. ESSS-S is a reliable and valid tool for assessing self-stigma in Spanish-speaking people with epilepsy.

Adaptation and validation of the Parents’ Self-stigma Scale into Turkish and its association with parenting stress and parental self-efficacy

ObjectivesIn the present era, parents frequently stigmatize themselves for their children’s negative behaviors and inadequate social skills. Parents’ self-stigma (PSS) may lead to a decrease in parental self-efficacy and quality of marital and family life. In light of these reasons, the principal objective of this study to assess the validity and reliability of the Turkish version of the PSS Scale (PSSS) as developed by Eaton et al. (2019) and to investigate the indirect effect that parenting stress has on the relationship between PSS and parental self-efficacy.MethodsWe collected data from a total of 1,118 parents via random sampling, with the first part of the study involving 645 participants (Mage = 32.64 ± 7.28) and the second part of the study involving 473 participants (Mage = 27.43 ± 9.87). In the first part of the study, we employed structural equation modeling for the confirmatory factor analysis and Pearson’s correlation coefficient for the criterion-related validity, average variance extracted, and composite reliability analyses. Moreover, we calculated Cronbach’s alpha, McDonald’s omega, and Guttman split-half coefficients for the reliability analyses. In the second part of the study, we utilized Hayes’ bootstrapping method to assess the indirect effect of parenting stress on the relationship between PSS and parental self-efficacy.ResultsThe first part of the study confirms the PSSS’s 11-item, 3-factor structure, showing the Turkish form to have acceptable goodness-of-fit indices, and found Cronbach’s alpha for the PSSS to be 0.89. Furthermore, the first part of the study demonstrates a significant negative correlation between marital life satisfaction and PSS. Meanwhile, the second part of the study has determined PSS to be positively related to parenting stress and negatively related to parental self-efficacy. The second part of the study also indicates parenting stress to have an indirect effect on the association between PSS and parental self-efficacy.ConclusionsThe study indicates the Turkish version of the PSSS to be a valid and reliable instrument in Turkish culture for measuring parents’ PSS levels regarding their children, with higher scores indicating greater PSS. The scale can be effectively used in both research and clinical settings. The study also suggests parental stress to have a possible impact on the association between PSS and parental self-efficacy. Furthermore, addressing the variables of PSS and parenting stress in family-focused interviews and therapeutic interventions may contribute to increasing parental self-efficacy.

Evaluating Stuttering Self-Stigma and Its Relationship to Adverse Impact in Children and Adolescents With the Child Stuttering Self-Stigma Scale.

Self-stigma occurs when a person internalizes and applies stereotypes, prejudice, and discrimination to themselves. For adults who stutter, self-stigma is linked to negative outcomes and reduced quality of life. The development of self-stigma in people who stutter is not well understood. The aim of this study is to evaluate stuttering self-stigma in school-age children and adolescents and explore potential relationships to stuttering's overall adverse impact. One hundred one children and adolescents who stutter, aged 10-18 years, completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES), a measure of adverse impact related to stuttering, and the Childhood Self-Stigma of Stuttering Scale (Child 4S), our novel adapted version of the Self-Stigma of Stuttering Scale (4S) created for this study. The Child 4S comprises three subscales measuring three stages of self-stigma: Awareness, Agreement, and Application. Each stage was evaluated for relationships with child age and the adverse impact of stuttering. We found a range of self-stigma scores among children and adolescents who stutter. Child age did not correlate with Awareness and Agreement; however, older children and adolescents reported greater Application. All stages of self-stigma strongly predicted adverse impact as measured by the OASES, and latter stages of the model were stronger predictors than earlier stages. Children as young as 10 years old may experience stuttering self-stigma, and the application of self-stigma increases in adolescence, a critical period in the development of personal identity. Importantly, all stages of self-stigma predicted adverse impact related to stuttering, with latter stages being stronger predictors than earlier ones consistent with the progressive model of self-stigma being tested. The findings highlight the need for targeted, early intervention to mitigate downstream effects of stuttering self-stigma. https://doi.org/10.23641/asha.26352556.

S66 - The Substance Abuse Self-Stigma Scale: Reliability Among Veterans With Co-Occurring Chronic Pain and Opioid Use Disorder

S66 - The Substance Abuse Self-Stigma Scale: Reliability Among Veterans With Co-Occurring Chronic Pain and Opioid Use Disorder

Emergency department staff compassion is associated with lower fear of enacted stigma among patients with opioid use disorder.

Fear of enacted stigma (fear of discrimination or being treated unfairly) is associated with decreased health care-seeking behaviors among patients with opioid use disorder (OUD). We sought to describe the prevalence of fear of enacted stigma among patients presenting to the emergency department (ED) with OUD and to test whether experiencing greater compassion from ED staff is associated with lower fear of enacted stigma. We conducted a cross-sectional study in the ED of an academic medical center between February and August 2023. We included adult patients with OUD presenting to the ED and assessed patient experience of compassion from ED staff using a previously validated 5-item compassion measure (score range 5-20). The primary outcome measure was fear of enacted stigma in the ED, measured using the validated 9-item subscale of the Substance Abuse Self-Stigma Scale (score range 9-45). Of the 116 subjects enrolled, 97% (95% confidence interval [CI] 91%-99%) reported some degree of stigma, with a median (interquartile range) score of 23 (16-31). In a multivariable model adjusting for potential confounders, patient experience of greater ED compassion was independently associated with lower fear of enacted stigma, β = -0.66 (95% CI -1.03 to -0.29), suggesting that every 1-point increase in the 5-item compassion measure score is associated with a 0.66-point decrease in the fear of enacted stigma score. Among ED patients with OUD, fear of enacted stigma is common. Patient experience of compassion from ED staff is associated with lower fear of enacted stigma. Future research is warranted to test if interventions aimed at increasing compassion from ED staff reduce patient fear of enacted stigma among patients with OUD.

Paradox of Self-Stigma: Psychometric Validation for the Portuguese Population in Poverty

Stigma is the attribution of labels to individuals to diminish or weaken them in society. The internalized stigma affects self-stigma, which influences their self-concept and confidence. The aim of this study was to translate and validate the PaSS-24 (Paradox of Self-Stigma Scale) for the population living in poverty in Portugal. The scale was translated using the back-translation technique, and the questionnaire was answered online by 357 people living in poverty in Portugal. The results of the exploratory factor analysis show excellent factorial validity, maintaining the factors of the original scale, and the results of the internal consistency, convergent and discriminant validity show excellent psychometric properties.

Factors associated with integration of people recovering from alcohol dependence syndrome with their family: An exploratory study.

Alcohol is the most commonly consumed psycho-active substance in India. People who use substances and are in recovery often face societal discrimination and rejection, such as difficulty in obtaining employment, poor support for treatment, and inter-personal rejection. To find out the factors affecting the integration of people recovering from alcohol dependence syndrome with their families. A cross-sectional observational study was conducted using a purposive sampling technique among 50 pairs of alcohol-dependent people and their family members. Data were collected using self-administered Family Adaptability and Cohesion Evaluation Scale (FACES IV package), Substance Abuse Self-Stigma Scale, Affiliate Stigma scale, and A Social Support Inventory for Successful Transition. Appropriate statistical tests were used to identify correlations. A negative correlation (r = -0.313, P < 0.05) was found between affiliate stigma and integration, and a positive correlation (P < 0.05) was found between social support and integration. Alcohol-dependent people from Alcoholics Anonymous reported higher levels of perceived social support than those from a tertiary hospital (mean = 47.68 vs. 39.84, P < 0.05). Affiliate stigma negatively impacts people with alcohol dependence and contributes to increased opportunities for interventions to address stigma. Social support has a positive impact on family integration of alcohol-dependent people with Alcoholics Anonymous participants reporting higher levels of social support compared to tertiary hospital participants. Therefore, the findings of this study highlight the need to involve families more intensively to reduce affiliate stigma.

The relationship between parenting style and the stigma of mental illness in adolescent athletes: the chain mediating role of self-esteem and mental toughness

The stigma surrounding mental illness is pervasive among athletes competing at the highest levels, and the adolescent athlete’s parenting style, self-esteem, and mental toughness are intimately linked to this stigma. These factors are particularly influential in determining the future career trajectory and athletic pursuits of young athletes. The objective of this study is to examine the correlation between parenting style and the stigma of mental toughness in adolescent athletes, while also confirming the intermediary influence of self-esteem and mental toughness in the relationship between the two variables. A survey was initiated on randomly selected 386 athletes at or above Level I in Guangdong Province through standardized questionnaires based on a parenting assessment scale, self-stigma scale, self-esteem scale, and mental toughness scale. The analysis and experimentation show that parenting style has a significant negative predictive impact on the self-esteem, mental toughness, and mental illness stigma of adolescent athletes. The impact of age and gender on the above factors are also explored. Furthermore, parenting style was also found to indirectly predict mental illness stigma through a chain mediation effect of self-esteem and mental toughness. These results highlight the importance of considering parenting style in improving the self-esteem and mental toughness of adolescent athletes, with the ultimate goal of reducing the stigma of mental illness among this population.

The role of stigma in cannabis use disclosure: an exploratory study

BackgroundAlthough cannabis use incidence, societal acceptance, and legislation all trend positively, cannabis remains federally illegal in the USA. Prior studies have revealed that patients are reluctant to disclose their cannabis use history in the healthcare system, which can negatively impact patient care. This study reports the frequency of cannabis use disclosure with special considerations for stigmatization. To better understand the limitations, providers face in providing collaborative, comprehensive, and informed care, this study evaluated four domains of stigma: perceived, anticipated, enacted, and internalized.MethodsThis study used a descriptive exploratory design. Data collection occurred using an anonymous, online national survey with a convenience sample in the USA. Recruitment relied on electronic media and occurred between July and December 2022. Participants were adults older than 21 years and self-identified as having used cannabis and accessed the healthcare system within the last five years. The survey measured demographic characteristics, cannabis use, and disclosure patterns. Stigma was measured using the Stigma Use Stigma Mechanism Scale (SU-SMS) and Substance Abuse Use Self-Stigma Scale (SASSS) with language modifications for cannabis. Ordinal logistic regression models were performed to evaluate associations between the frequency of cannabis use disclosure patterns and each stigma category. Associations were assessed using Chi-squared or Fisher’s exact tests.ResultsData were available for 249 respondents. Most participants (57.1%) reported initiating a conversation about cannabis with their healthcare provider; 27.8% of the time, cannabis is never discussed, and healthcare providers initiate only 15.1% of related discussions. Anticipated stigma [95% CI 1.045–1.164] and total stigma [95% CI 1.001–1.039] had statistically significant associations with nondisclosure. Annual household income (p = .04), chronicity of cannabis use (p = .03), frequency of cannabis use (p = .02), and a known amount of CBD in products consumed (p = .01) had statistically significant associations with the frequency of cannabis use disclosure.ConclusionsPatients who use cannabis experience stigmatization in the healthcare setting that may limit disclosure of cannabis use history. Future studies would be well served to explore anticipated stigma more deeply. Healthcare providers should be knowledgeable to lead such conversations relating to cannabis while maintaining an unbiased perspective.

Validity and reliability study of the turkish version epilepsy self-stigma scale (ESSS-T)

AimWe translated the Epilepsy Self-stigma Scale (ESSS) into Turkish and aimed to examine the Turkish version ESSS (ESSS-T) validity and reliability. Materials and methodFrom April to August 2023, patients with epilepsy (PWE) were recruited from the neurology outpatient clinic of Ataturk University Hospital in the eastern Turkish city of Erzurum (inclusion criteria: age 18 years or older and adequate reading and speaking ability in Turkish). We conducted our survey using a self-administered questionnaire. The questionnaire consisted of the ESSS-T after appropriate translation by back-translation, and self-esteem (the Rosenberg's Self-Esteem Scale, RSES), depression (the Neurological Disorders Depression Inventory for Epilepsy, NDDI-E), and general stigma (the Stigma Scale for Epilepsy, ESE) for construct validity. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to test factorial validity. Also, Cronbach's alpha coefficient was calculated to verify reliability. ResultsOf the 126 patients, 106 agreed to give informed consent and responded to the questionnaire (84.1 % response rate). The results of EFA suggested the same three-factor structure as in the original version, but CFA showed some limitations in interpreting the three-factor structure and it may be safer to understand it as a unifactorial structure. The alpha coefficients were also validated by the ESSS-T. The alpha coefficients were α = 0.74 for the ESSS-T scale as a whole and α = 0.69–0.74 for each subscale, which were generally acceptable values. ConclusionThe Turkish version of the ESSS proved valid and reliable. It is a measurement tool with a three-dimensional structure. It can be used to assess the self-stigmatization of patients with epilepsy in Turkey.

Intention of Psychological Counseling, Attitude Toward Seeking Psychological Help, and Shame Among Vocational College Students: A Cross-Sectional Survey.

The aim of this study was to explore the psychological counseling intention of college students, the attitude of seeking psychological help, and the related factors of shame so as to promote the psychological health of college students. In 4 comprehensive colleges with sound psychological counseling centers, students of different grades were selected and divided into an active help-seeking group (n = 216) and a help-refusal group (n = 270). Students' shame behaviors were evaluated using the Self-Stigma of Seeking Help (SSOSH) scale and Self-Stigma Scale (SSS). The intention of psychological counseling was measured by the General Help-Seeking Questionnaire. The Inventory of Attitudes Toward Seeking Mental Health Services was used to evaluate the psychological status. Data from the above scales were compared through the t-test. Additionally, multiple linear regression analysis was performed to explore the impact of shame on the intention of psychological counseling. The study found that the active help-seeking group scored lower on SSOSH scale compared to those in the help-refusal group (total score: 41.2 ± 9.1 vs. 37.9 ± 8.7, P = .0017). Meanwhile, the help-refusal group had higher scores on the shame dimension of the SSS (16.2 ± 3.9 vs. 5.3 ± 1.1, P = .00085). After adjusting for age, gender, and other variables, multiple linear regression analysis indicated a negative correlation between shame and intention of psychological help and counseling, revealing a significant impact of shame on professional psychological counseling (P < .05). Our study findings suggest that shame has a negative impact on the intention of seeking psychological help and counseling among college students, highlighting the importance of addressing shame-related factors to promote psychological health and encourage the utilization of professional psychological counseling services.

An online survey on differences in knowledge and stigma about epilepsy among the Tokyo metropolitan area and non-urban areas in Japan, a post-hoc study

PurposeExtant research elucidating the domains of knowledge and bias on epilepsy has consistently underscored a deficiency in cognizance and an inclination toward bias within non-urban areas. Investigations into geographical disparities concerning epilepsy awareness and prejudice within the Japanese context remain conspicuously absent. To address this lacuna in the literature, we undertook a post-hoc analysis to elucidate the discernible regional differentials in epilepsy awareness and the associated stigma. MethodsFrom July to August 2021, we conducted an internet questionnaire survey for 310 people with epilepsy (PWE) and 213 ordinary people without epilepsy who registered on the database of the Japanese Research Company. We inquired PWE to answer the Epilepsy Self-Stigma Scale (ESSS), the Rosenberg Self-Esteem Scale (RSES), and the Epilepsy Knowledge Scale (EKS). We inquired to answer ordinary people without epilepsy EKS. We analyzed residential addresses separately for Greater Tokyo and non-urban areas by comparing the degree of knowledge of people with epilepsy and people without epilepsy. ResultsThe average knowledge of people with and without epilepsy in the Greater Tokyo area was 39.60 and 28.43 points, although in non-urban areas (nine regions from all over Japan except for the Greater Tokyo, Tokai region, and Kinki region), the knowledge averages were 38.44 and 28.66 points of 100. In addition, self-stigma was highest in the Greater Tokyo area: 22.99 and in non-urban areas: 22.77. An two-way ANOVA with knowledge as the dependent variable and epilepsy diagnosis status and region (Greater Tokyo area/non-urban areas) as the independent variables revealed no interaction between diagnosis and region (F(1,346) = 1.48, η2 = 0.003). Knowledge was significantly higher in PWE than in people without epilepsy, but we could not identify any significant difference between ESSS (t = 0.24, d = 0.03) and RSES (t = 1.16, d = 0.16) in the Greater Tokyo/non-urban areas. ConclusionsWe obtained specific information about regional differences in the level of knowledge and stigma about epilepsy in Japan. Because Japan underwent educational reforms after World War II and more than 90% of the population received equally advanced education, the results found no regional differences in knowledge and stigma about epilepsy. We believe collecting information about the respondents' birth and upbringing environment and conducting a thorough investigation is necessary in the future.

Stigma and self-esteem in patients of bronchial asthma.

Asthma is a debilitating chronic disease that renders individuals physically as well as mentally sick. The perception of stigmatization further leads to inappropriate control of asthma resulting in a bidirectional relationship. A prospective, cross-sectional study was conducted in a tertiary care centre of semi urban area of north India during 2021-2022. Three hundred cases of bronchial asthma and 50 healthy controls were enrolled. The asthma control test (ACT) was used to evaluate the control of asthma. Stigma and self-esteem were measured with the use of 28 item self-stigma scale, Rosenberg self-esteem scale, and stigma-related social problem scale (SPSS). The impact of sociodemographic and clinical profiles on stigma and self-esteem was evaluated. Correlation of different scales with each other was done along with. The mean age of asthmatic patients was 47.41±15.507 years with 56% being females; 49.3% of patients were well controlled and 36.3% were partly controlled. Positive subscales of 28 item self-stigma scale, Rosenberg self-esteem scale and SSPS showed statistically significant differences between cases and controls (p<0.001). ACT significantly correlated with 28 item self-stigma scale, Rosenberg self-esteem scale and SSPS, and all three stigma and self-esteem scales correlated significantly with each other.

Validation of the Chinese version stage of recovery instrument-30 (STORI-30) for adults with severe mental illness

BackgroundStage of Recovery Instrument-30 (STORI-30) is grounded in a five-stage model of psychological recovery, and serves as measuring recovery stage of people with mental illness.AimsTo develop and validate the Chinese version STORI-30 on adults with severe mental illness.MethodsSTORI-30 was translated to traditional Chinese through forward-backward method. An expert panel and potential users evaluated face validity and content validity. The Chinese version STORI-30 plus other convergent and divergent scales were then administered to 113 participants for field test.ResultsFace and content validity were confirmed with acceptable Content Validity Index and high inter-rater agreement. Exploratory factor analysis revealed a three-factor structure. An ordinal sequence was presented among the five subscales, similar to the original version. Construct validity was supported by positive correlations with recovery and mental well-being scales, and negative correlation with self-stigma scale. Good internal consistency (Cronbach’s α = 0.78–0.86) and high level of test-retest reliability (Intraclass correlation coefficient = 0.96) were obtained.ConclusionsChinese STORI-30 presents satisfactory psychometric properties in internal consistency, construct convergent and divergent validity, and test-retest reliability. The three-factor structure revealed does not echo the original five-stage recovery model. Further studies exploring the underlying structure are warranted.

Assessment of self-stigma in epilepsy: Validation of the German version Epilepsy Self-Stigma Scale (ESSS-G).

Self-stigma is the internalization of unfavorable public perceptions, which people with epilepsy (PWE) frequently experience. PWE with strong self-stigma have low self-esteem and are less likely to engage in treatment behavior. The Epilepsy Self-Stigma Scale (ESSS) has been developed and validated in Japan. We translated the ESSS into German for this study to examine its reliability and validity. We created the German version of ESSS (ESSS-G) based on the original Japanese version. From May to October 2022, we recruited out- and inpatients from Bethel Epilepsy Centre, University Hospital for Epileptology, for psychometric evaluation. Inclusion criteria were an age of ≥18 years, sufficient reading and speaking skills in German, and the ability to comprehend the German questionnaires. Participants also completed the Rosenberg Self-Esteem Scale (RSES), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), Generalized Anxiety Disorder 7 (GAD-7), Epilepsy Knowledge Scale, and items on "overall quality of life (QOL)" and "overall health" (items from QOLIE-31). One hundred twenty-eight of 146 patients asked to participate granted informed consent and completed the study questionnaire (87.7% response rate). 115 cases were analyzed since 13 did not match the inclusion criteria. The analysis revealed a single factor explaining 49.2% of the total variance. All factor loadings were >0.40, and the reliability was high (Cronbach's α = 0.80). Higher ESSS total scores were associated with higher anxiety (GAD-7, r = 0.54, P < 0.001) and depression (NDDI-E, r = 0.45, P < 0.001), lower self-esteem (RSES, r = -0.41, P < 0.001), overall QOL (r = -0.40, P < 0.001), and overall health (r = -0.35, P < 0.001), but not with knowledge about epilepsy (r = 0.03, P = 0.770). In Germany, females, younger individuals, patients with earlier seizure onset, and those with generalized epilepsy had significantly higher self-stigma. The German version of the ESSS proved reliable and valid. It allows to evaluate the efficacy of treatment strategies in lowering self-stigma and conducting intercultural comparisons of epilepsy self-stigma.

Health-related quality of life and stigma in opioid dependence: Comparison between buprenorphine users and non-users.

Opioid dependence leads to reduced quality of life (QOL) and stigma. There is scarcity of literature on impact of buprenorphine on QOL of patients with opioid dependence from India. This study reports QOL and stigma in patients taking buprenorphine and compare it with those who were not on any treatment. A cross-sectional, descriptive, comparative study was conducted among three groups (n = 100 each). Group 3 comprised patients who were already taking buprenorphine for at least 3 months from a government outpatient opioid-assisted treatment center. Group 2 comprised patients who were not on any treatment but had come to enrol in buprenorphine treatment and Group 1 comprised patients who had come to get some other treatment and were not willing for buprenorphine. After fulfilling inclusion and exclusion criteria, sociodemographic pro forma, Hindi self-stigma scale, and World Health Organization QOL-BREF Hindi were applied. Appropriate statistical analyses were done. Patients already taking buprenorphine had significantly better QOL and it improved as the duration of treatment increased. Patients on buprenorphine treatment had significantly lesser stigma than patients not already on treatment. Stigma negatively impacted QOL in the three groups. QOL and factors affecting it should be an integral part of management of opioid dependence. Efforts should be made to enrol maximum number of patients in treatment to enhance their quality of life and reduce stigma.

Development and Psychometric Evaluation of the IPV Internalized Stigma Scale.

Self-stigma is the internalization of widespread and negative attitudes around a devalued attribute. Being a victim of intimate partner violence (IPV) is a stigmatized identity, with IPV self-stigma is a potential barrier to help seeking. The lack of an IPV self-stigma scale limits current measurement of this latent trait; this study sought to fill this gap. We developed the IPV Internalized Self-stigma Scale (IPVIS) by revising existing self-stigma and devaluation/discrimination measures and adding new items to fill perceived gaps. Using an online survey, a diverse sample (N = 455, M = 39.51, SD = 12.03) with various relationship types (e.g., heterosexual, same-sex), IPV circumstances (e.g., male or female perpetrators/victims) and different gender and sexual identities was recruited. Participants first completed the item pool (44-items), followed by measures of IPV, anxiety, depression, social health, and self-efficacy with data analyzed using a multi-model approach (e.g., factor analysis, item response theory [IRT]). Factor analyses revealed one dominant factor; IRT analyses further refined the unidimensional item set. The final 11 items had high internal consistency, ω = .90, 95% CI [0.89, 0.91], and were highly informative with moderate to high discrimination levels. The IPVIS demonstrated measurement invariance by demographics, showing no differential item functioning by age groups, sex, residence (urban/suburban/rural), ethnicity (European/Caucasian vs. others), or relationship status (partnered/unpartnered). Initial validity examination revealed significant correlations between the IPVIS and related measures (e.g., depression, anxiety, social health). The IPVIS is suitable for research and has widespread clinical applicability. To the best of our knowledge, the IPVIS is the first scale developed that assesses IPV self-stigma inclusive of a diverse range of clients/participants, relationship types, and IPV circumstances.

Investigation of the relationship between weight self-stigma, emotional eating, and diet satisfaction in obese individuals

Objectives: Obese people are often stigmatized and discriminated against as unmotivated, incompatible, sloppy, undisciplined, and lazy because of their excess weight. The stigma associated with weight has serious adverse effects on mental health, social functioning, and physical health. It has been suggested that weight stigma can be internalized and lead to the development and maintenance of self-stigma. Methods: Personal Information Form, Turkish Emotional Eating Scale (EES), Weight Self-Stigma Scale (WSSQ), and Diet Satisfaction Scale (DSS) were used. Results: One hundred forty-five volunteer obese individuals who applied to the Diet Clinic and whose informed consent was obtained were included in the study. When the differences between the scale scores of the individuals according to demographic, health, and nutrition findings are examined, it is seen that the TEES scores according to the gender and income status of the obese individuals, the WSSQ scores according to the gender and employment status of the obese individuals, and the DSS scores according to the income status of the obese individuals, the psychological diagnosis status made by the physician, It was found that there was a significant difference according to the chronic disease states and the number of daily snacks (p &amp;lt; 0.05 and p &amp;lt; 0.001, respectively). Conclusions: When the relationship between the scales was examined, a significant correlation was found between the WSSQ scores of obese individuals and their EES scores. It was found that there was a statistically significant effect of WSSQ scores on EES scores. It is thought that the findings of this study will contribute significantly to the relevant literature.