Development and validation of the Self-Stigma Questionnaire (SSQ) for people with schizophrenia and its relation to social functioning.

Self-stigma specifically in people with schizophrenia has been little studied. The aims of the present study were to validate a new instrument for the assessment of self-stigma (SSQ) and to assess the relationship between self-stigma and social functioning in people with schizophrenia. A sample of 76 people with schizophrenia was assessed at two moments in time with the SSQ, the PDD (stigma), two scales of social functioning (LSP, SFS), and a scale of general functioning (GAF). The results indicated that SSQ presented good psychometric properties, with Cronbach's alpha ranging between 0.75 and 0.901. The stability of the instrument was between 0.836 and 0.402. Three factors were found in the factor analysis (social discrimination, perceived capabilities, concealment of the disease), explaining 62.66% of the total variance. A relationship was found between self-stigma and social functioning in people with schizophrenia, especially in relation to social contact. In conclusion, the SSQ seems to be a valid and reliable questionnaire for the assessment of self-stigma in people with schizophrenia, and interventions should be designed to cope with self-stigma in order to improve the social functioning of people who suffer schizophrenia.

The RECAPACITA project: Description of the clinical, neuropsychological and functional profile of a sample of people with severe mental disorder and legal capacity modification in Spain.

Severe mental disorder (SMD) includes people with long-term mental disorders, disability and social dysfunction. The mental capacity evaluation of the people has been a key aspect in legislative systems around the world and different proposals have been made. In countries like Spain, until 2021, the mental capacity of individuals was assessed by means of legal proceedings. In the last years, there has been a notable increase in the number of claims for legal incapacity, but no data are available on the total number of persons with CM, neither on the specific pathologies, or clinical and cognitive profiles. In view of the total absence of data on the profile of people with SMD and modification of capacity, the RECAPACITA study was born. This study includes patients with SMD and CM, as well as those without CM, with the aim to describe exhaustively their clinical, neuropsychological and functional profile of people with SMD and CM, as well as obtaining a basic description of the social environment. OBJECTIVES: To describe CM in SMD, to identify clinical diagnoses, clinical severity and neuropsychological deterioration. METHODS: Cross-sectional descriptive study. 77 adult patients with SMD and CM, inpatients from the mental health sector of the Parc Sanitari Sant Joan de Déu (Spain), outpatients linked to the community rehabilitation services (CRS), and penitentiary inmates. CM, sociodemographic, clinical, functional and neuropsychological data are collected. RESULTS: In the sample, 59.5% present total CM. 74.7% are men (mean: 52.5 years). 87,0% have a diagnosis of schizophrenia. The estimated premorbid IQ is 91.4. The Global Assessment of Functioning (GAF) had a mean of 50.5, the "Clinical Global Impression Scale" (CGI) was 4.6 and Scale Unawareness of Mental Disorders (SUMD) was 9.28. The cognitive results shows a profile with slow proceeding speed (mean scale score: 6.6), good working memory (mean SC: 8.3) and adequate verbal comprehension (mean SC: 7.3). In memory, coding is altered (Pz: -1.9), and long-term spontaneous recall (Pz: -2.3). In abstract reasoning, a slight alteration is obtained (Mean SC: 6), as well as in semantic fluency (Mean SC: 6.3), phonological (Mean SC: 5.9), and inhibitory capacity (Mean SC: 5.7). CONCLUSIONS: Most of the sample are men with schizophrenia, with a total MC assumed by a tutelary foundation. They show a moderate alteration in global functioning and clinical global impression, with partial awareness of the disease. They present dysexecutive mild cognitive impairment, with poor memory coding and free retrieval capacity, and a normal IQ, adequate verbal comprehension and working memory. This study is the first to present objective data on the psychiatric, functional and cognitive status of a group of patients with CM. Such research could be a good starting point to address a topic of great interest from the health, social and legal point of view of the CM processes of people with SMD.

Effectiveness of an intervention for reducing social stigma towards mental illness in adolescents.

AIM: To evaluate the effectiveness of an intervention for reducing social stigma towards mental illness in adolescents. The effect of gender and knowledge of someone with mental illness was measured. METHODS: Two hundred and eighty secondary school students were evaluated using the Community Attitudes towards Mental Illness (CAMI) questionnaire. The schools were randomized and some received the intervention and others acted as the control group. The programme consisted of providing information via a documentary film and of contact with healthcare staff in order to reduce the social stigma within the school environment. RESULTS: The intervention was effective in reducing the CAMI authoritarianism and social restrictiveness subscales. The intervention showed significant changes in girls in terms of authoritarianism and social restrictiveness, while boys only showed significant changes in authoritarianism. Following the intervention, a significant reduction was found in authoritarianism and social restrictiveness in those who knew someone with mental illness, and only in authoritarianism in those who did not know anyone with mental illness. CONCLUSION: The intervention was effective to reduce social stigma towards people with mental illness, especially in the area of authoritarianism. Some differences were found depending on gender and whether or not the subjects knew someone with mental illness.

Spanish version of the Link's Perceived Devaluation and Discrimination scale.

BACKGROUND: The aim of this study is to translate, adapt and validate the “Perceived Devaluation and Discrimination Scale” (PDD) in Spanish in a sample of people with schizophrenia. METHOD: A total of 130 people between 18 and 65 years and with a diagnosis of schizophrenia according to DSM-IV-R criteria from Barcelona and Vitoria were included. The patients were assessed with the translated version of the PDD, the Social Functioning Scale (SFS), the Global Assessment of Functioning (GAF), the Clinical Global Impression Scale (CGI-S) and the Self-perception of Stigma Questionnaire for people with schizophrenia (SSQ). RESULTS: The questionnaire scored a Cronbach’s a of .868 regarding its internal consistency reliability. Two components were found in the factorial analysis explaining 40% of the variance of the instrument (component 1 associated with individual self-perception and component 2 refers more to social stigma). The stability of the instrument   measured using the intraclass correlation coefficient on both occasions oscillated between .415 and .806. Significant correlations were found with SSQ and SFS. CONCLUSIONS: The Spanish version of the PDD seems a good instrument for the assessment of self stigma.

Spanish validation of the social stigma scale: Community Attitudes towards Mental Illness. / Validación al castellano de la escala de estigma social: Community Attitudes towards Mental Illness en población adolescente.

INTRODUCTION: The stigma against people with mental illness is very high. In Spain there are currently no tools to assess this construct. The aim of this study was to validate the Spanish version of the Community Attitudes towards Mental Illness questionnaire in an adolescent population, and determining its internal consistency and temporal stability. Another analysis by gender will be also performed. MATERIAL AND METHODS: A translation and back-translation of the Community Attitudes towards Mental Illness was performed. A total of 150 students of between 14 and 18 years-old were evaluated with this tool in two stages. Internal consistency was tested using Cronbach α; and intraclass correlation coefficient was used for test-retest reliability. Gender-stratified analyses were also performed. RESULTS: The Cronbach α was 0.861 for the first evaluation and 0.909 for the second evaluation. The values of the intraclass correlation coefficient ranged from 0.775 to 0.339 in the item by item analysis, and between 0.88 and 0.81 in the subscales. In the segmentation by gender, it was found that girls scored between 0.797 and 0.863 in the intraclass correlation coefficient, and boys scored between 0.889 and 0.774. CONCLUSIONS: In conclusion, the Community Attitudes towards Mental Illness is a reliable tool for the assessment of social stigma. Although reliable results have been found for boys and girls, our results found some gender differences in the analysis.

Intervention for reducing stigma: Assessing the influence of gender and knowledge.

AIM: To evaluate the effectiveness in reducing social stigma of an intervention and to assess the influence of gender and knowledge. METHODS: The program consisted in providing information and contact with users of mental health in order to reduce social stigma in the school environment. A total of 62 secondary school students (age 14-16 years) were evaluated with the Opinions on Mental Illness (OMI) questionnaire before and after the intervention. The subscales of the OMI were: authoritarianism, interpersonal etiology, benevolence, restrictiveness and negativism. The analysis was performed over the total sample, separating by gender and knowledge of someone with a mental disorder. t-test for repeated measures was used in the statistical analysis. RESULTS: All the OMI subscales showed a significant change after the intervention (P < 0.001), except for benevolence. Women presented significant changes in the subscales of authoritarianism and restrictiveness, while men presented changes in negativism and interpersonal etiology rather than restrictiveness (P < 0.001-0.003). Students that knew someone with a mental disorder presented significant changes in authoritarianism, interpersonal etiology, and negativism (P < 0.001-0.003) and students that do not know anyone with a mental disorder improved in restrictiveness and authoritarianism (P < 0.001-0.001). In all the subscales of the instrument the students improved their perception of mental disorders, reducing their levels of stigma. CONCLUSION: The intervention designed to reduce social stigma was effective, especially in the area of authoritarianism. The whole sample showed improved attitudes towards mental illness, although the areas were different depending on gender and knowledge.

Validación al castellano de la escala de estigma social: community Attitudes towards Mental Illness en población adolescente / Spanish validation of the social stigma scale: Community Attitudes towards Mental Illness

Introducción. El estigma hacia las personas con una enfermedad mental es muy elevado. En España no existen instrumentos actuales para evaluar este constructo. El objetivo del presente estudio es validar la versión española del cuestionario Community Attitudes towards Mental Illness en una población de adolescentes, estudiando la consistencia interna del instrumento, así como la estabilidad temporal. Este último análisis se realizará también por género. Material y métodos. Se llevó a cabo una traducción y retrotraducción del Community Attitudes towards Mental Illness. Se evaluaron con este instrumento un total de 150 alumnos de Enseñanza Secundaria Obligatoria, de entre 14 y 18 años, en 2 momentos. Se analizó la consistencia interna del instrumento mediante el α de Cronbach, y la fiabilidad test-retest con el coeficiente de correlación intraclase. Se realizaron análisis estratificados por género. Resultados. El α de Cronbach fue de 0,861 para la primera evaluación y de 0,909 para la segunda evaluación. Los valores del coeficiente de correlación intraclase oscilan entre 0,775-0,339 en el análisis de ítem por ítem, y entre 0,88-0,81 en las subescalas. En la segmentación por género encontramos que las puntuaciones en el coeficiente de correlación intraclase en el grupo de chicas está entre 0,797-0,863 y en los chicos entre 0,889-0,774. Conclusiones. En conclusión podemos afirmar que el Community Attitudes towards Mental Illness es un instrumento fiable para la evaluación del estigma social. A pesar de resultar fiable de la misma manera para chicos y para chicas, se han encontrado algunas diferencias en el análisis por género (AU)

Introduction. The stigma against people with mental illness is very high. In Spain there are currently no tools to assess this construct. The aim of this study was to validate the Spanish version of the Community Attitudes towards Mental Illness questionnaire in an adolescent population, and determining its internal consistency and temporal stability. Another analysis by gender will be also performed. Material and methods. A translation and back-translation of the Community Attitudes towards Mental Illness was performed. A total of 150 students of between 14 and 18 years-old were evaluated with this tool in two stages. Internal consistency was tested using Cronbach α; and intraclass correlation coefficient was used for test-retest reliability. Gender-stratified analyses were also performed. Results. The Cronbach α was 0.861 for the first evaluation and 0.909 for the second evaluation. The values of the intraclass correlation coefficient ranged from 0.775 to 0.339 in the item by item analysis, and between 0.88 and 0.81 in the subscales. In the segmentation by gender, it was found that girls scored between 0.797 and 0.863 in the intraclass correlation coefficient, and boys scored between 0.889 and 0.774. Conclusions. In conclusion, the Community Attitudes towards Mental Illness is a reliable tool for the assessment of social stigma. Although reliable results have been found for boys and girls, our results found some gender differences in the analysis (AU)

Spanish version of the link´s perceived devaluaton and discrimination scale / Versión española de la escala Perceived Devaluation and Discrimination de Link

BACKGROUND: The aim of this study is to translate, adapt and validate the «Perceived Devaluation and Discrimination Scale» (PDD) in Spanish in a sample of people with schizophrenia. METHOD: A total of 130 people between 18 and 65 years and with a diagnosis of schizophrenia according to DSM-IV-R criteria from Barcelona and Vitoria were included. The patients were assessed with the translated version of the PDD, the Social Functioning Scale (SFS), the Global Assessment of Functioning (GAF), the Clinical Global Impression Scale (CGI-S) and the Self-perception of Stigma Questionnaire for people with schizophrenia (SSQ). RESULTS: The questionnaire scored a Cronbach's a of .868 regarding its internal consistency reliability. Two components were found in the factorial analysis explaining 40% of the variance of the instrument (component 1 associated with individual self-perception and component 2 refers more to social stigma). The stability of the instrument measured using the intraclass correlation coefficient on both occasions oscillated between .415 and .806. Significant correlations were found with SSQ and SFS. CONCLUSIONS: The Spanish version of the PDD seems a good instrument for the assessment of self stigma

ANTECEDENTES: el objetivo de este estudio es traducir, adaptar y validar la «Perceived Devaluation and Discrimination Scale» (PDD) en español en una muestra de personas con esquizofrenia. MÉTODO: se incluyeron un total de 130 personas de entre 18 y 65 años con un diagnóstico de esquizofrenia según los criterios del DSM-IV-R de Barcelona y Vitoria. Los pacientes fueron evaluados con la versión traducida de la PDD, la Escala de Funcionamiento Social (SFS), la Evaluación Global de Funcionamiento (GAF), la escala Clinical Global Impresión (CGI-S) y la autopercepción de Estigma Cuestionario para las personas con esquizofrenia (SSQ). RESULTADOS: la consistencia interna del cuestionario, evaluada utilizando a de Cronbach, fue .868. Dos componentes fueron encontrados en el análisis factorial explicando el 40% de la varianza del instrumento (componente 1 asociado a la auto-percepción y el componente 2 individual se refiere más al estigma social). Los valores de estabilidad temporal medidos utilizando el coeficiente de correlación intraclase en ambas ocasiones oscilan entre .415 y .806. Se encontraron correlaciones significativas con SSQ y SFS. CONCLUSIONES: la versión española de PDD parece un buen instrumento para la evaluación del auto-estigma