Measurement invariance of the Self-Stigma of Mental Illness Scale (Short Form) across Scottish and Australian adults living with severe and enduring mental illness

Hunter, Simon and Groot, Chris and Rehm, Imogen and Findlay, Jo and Knifton, Lee (2024) Measurement invariance of the Self-Stigma of Mental Illness Scale (Short Form) across Scottish and Australian adults living with severe and enduring mental illness. Stigma and Health. ISSN 2376-6972 (In Press)

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Abstract

People living with severe and enduring mental illnesses experience stigma and discrimination from multiple sources in society. Internalisation of negative cultural messages about one’s experience of mental illness can lead to negative outcomes such as reduced self-esteem and help-seeking behaviors. Understanding whether these experiences differ across countries is important as efforts to tackle stigma are taking place internationally. This study estimates the measurement invariance of an adapted short form of a commonly used measure of internalised stigma, namely the Self-Stigma of Mental Illness Scale – Short Form (SSMIF-SF; Corrigan et al., 2012), across Scotland and Australia. Data were collected, using two cross-sectional surveys, from adults living with severe, complex, and/or enduring mental health issue(s) in Scotland (N=346; Meanage = 39.80, S.D.age = 13.74) and Australia (N=1912; Meanage = 39.21, S.D.age = 12.82). Confirmatory factor analyses led to the Harm to Self-esteem factor being removed from the SSMIF-SF. However, the resulting three-factor scale did not demonstrate measurement invariance across Scotland and Australia, raising questions about its use as a tool with which to conduct international comparisons. Clinical Impact Statement: People living with severe and enduring mental illnesses experience stigma and discrimination. Understanding whether these experiences differ across countries is important as efforts to tackle stigma are taking place internationally. This study reports on whether a commonly used measure of self-stigma produces scores that can be directly compared across Scotland and Australia. Using survey data, we show that the “Harm to Self-esteem” factor should not be considered a component of the most commonly used measure of self-stigma. Furthermore, we find that the resulting three-factor scale does not evidence comparable scores across samples from Scotland and Australia, raising questions about its use as a tool to conduct international comparisons.

ORCID iDs

Hunter, Simon, Groot, Chris, Rehm, Imogen, Findlay, Jo and Knifton, Lee ORCID logoORCID: https://orcid.org/0000-0002-2227-7305;
CORE (COnnecting REpositories)