Assessing the dimensionality and construct validity of the military stigma scale across current service members.

US service members are at elevated risk for distress and suicidal behavior, compared to the general US population. However, despite the availability of evidence-based treatments, only 40% of Service members in need of mental health care seek help. One potential reason for the lower use of services is that service members experience stigma or concerns that the act of seeking mental health care from a mental health provider carries a mark of disgrace. The Military Stigma Scale (MSS) was designed to assess two theoretical dimensions of help-seeking stigma (public and self), specifically among service members. The goal of the current study was to further examine the validity of the MSS among 347 active duty service members. Examination of unidimensional, two-factor, and bifactor models revealed that a bifactor model, with a general (overall stigma), two specific factors (public and self-stigma), and one method factor (accounting for negatively worded items) provided the best fit to the data. Ancillary reliability analyses also supported the MSS measuring a broad stigma factor associated with seeking mental health care in the military. Subsequent model analyses showed that the MSS was associated with other stigma-related constructs. Overall, findings suggest that the MSS is a reliable and validated scale that can be used to assess military help-seeking stigma and to evaluate results of programs designed to reduce stigma.

Measurement invariance of suicide screening measures across military branch.

Military suicide rates are near all-time highs. To help clinicians and researchers study suicide risk factors in military samples, the Military Suicide Research Consortium (MSRC) developed a set of brief suicide-risk screening measures. While previous research has examined the reliability of these screening measures, it remains unclear if measurement differences exist across different military branches. This is an important omission given that establishing measurement equivalence or invariance (ME/I) across groups is a prerequisite for making group comparisons, which are necessary for accurately identifying and effectively intervening with groups at heightened risk. This study examined the ME/I of four MSRC screening measures (e.g., Depressive Symptom Index - Suicidality Subscale; Interpersonal Needs Questionnaire; Suicidal Behaviors Questionnaire - Revised; Suicide Intent Scale) using a sample of 4,487 participants across military branches (Army; National Guard; Navy; Marine; Air Force) using a series of multiple-group confirmatory factor analyses (MGCFA). We assessed configural, threshold, and loading invariance, with results indicating that the brief screening measures are fully invariant between individuals from different military branches and that these suicide screeners can be used to examine differences across branches in future research. Research and applied implications are discussed.

Measurement Invariance of the Self-Stigma of Mental Illness Scale: A Cross-Cultural Study.

The current study assessed the measurement invariance of the Self-stigma of Mental Illness scale (SSOMI) across Chinese and US samples and assessed whether the SSOMI differentially relates to distress levels across Chinese and US participants. We included 487 participants in China and 550 in the US (mean age was 19.52 in China and 19.29 in the US). The results indicated that partial measurement invariance of the SSOMI scale across China and the United States participants was established. Furthermore, we observed validity evidence for the SSOMI scale through its correlations with a well-established self-stigma measure and measures of depression, anxiety, and stress. Finally, we found that the SSOMI scale is more strongly linked to symptoms of depression, anxiety, and stress in China than it is in the United States, supporting previous research. These findings enable researchers to utilize the scale cross-culturally (i.e., with participants of Chinese and US origin), and to develop and implement interventions targeting mental illness stigma in both China and the United States.