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Measuring stigma in children receiving mental health treatment: Validation of the Paediatric Self-Stigmatization Scale (PaedS)

Published online by Cambridge University Press:  23 March 2020

A. Kaushik ,
E. Papachristou ,
D. Dima ,
S. Fewings ,
E. Kostaki ,
G.B. Ploubidis  and
M. Kyriakopoulos
A. Kaushik
Affiliation:
National and Specialist Acorn Lodge Inpatient Children Unit, South London and Maudsley NHS Foundation Trust, London, UK
E. Papachristou
Affiliation:
Department of Primary Care & Population Health, University College London, London, UK
D. Dima
Affiliation:
Department of Psychology, School of Arts and Social Sciences, City University London, London, UK Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
S. Fewings
Affiliation:
National and Specialist Acorn Lodge Inpatient Children Unit, South London and Maudsley NHS Foundation Trust, London, UK
E. Kostaki
Affiliation:
National and Specialist Acorn Lodge Inpatient Children Unit, South London and Maudsley NHS Foundation Trust, London, UK
G.B. Ploubidis
Affiliation:
Centre for Longitudinal Studies, Department of Social Science, University College London, London, UK
M. Kyriakopoulos*
Affiliation:
National and Specialist Acorn Lodge Inpatient Children Unit, South London and Maudsley NHS Foundation Trust, London, UK Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
*
*Corresponding author. Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience (PO66), King’s College London, De Crespigny Park, SE5 8AF London, UK. Tel.: +44 2032 284 521. E-mail address:marinos.kyriakopoulos@kcl.ac.uk (M. Kyriakopoulos).
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Abstract

Background:

Research on the impact of stigma associated with mental illness in children is scarce. Considering the known negative effects of stigma associated with mental illness in adults, it is crucial to explore the stigma experienced by children who access mental health treatment. However, no scale measuring self-stigmatization in younger children is available to date. This study aimed to develop and validate such a scale, the Paediatric Self-Stigmatization Scale (PaedS).

Methods:

A total of 156 children (119 receiving outpatient and 37 receiving inpatient treatment), aged 8–12 years, completed the PaedS, the Self-Perception Profile for Children and the Pediatric Quality of Life Inventory (PedsQL – Child Report, ages 8–12). In addition, parents completed the PedsQL (Parent Report for Children, ages 8–12), the Strengths and Difficulties Questionnaire (SDQ) and a modified subscale of the PaedS measuring the children's rejection by others due to their mental health difficulties.

Results:

A confirmatory factor analysis showed that a four-factor structure, comprising Societal Devaluation, Personal Rejection, Self-Stigma and Secrecy scales, had excellent fit to the data (CFI = 0.95; TLI = 0.95; RMSEA = 0.05). Child-reported PaedS scores were positively correlated with parental-reported PaedS scores and negatively with PedsQL, the SDQ, and 5 out of 6 subscales of the Self-Perception Profile for Children, suggesting adequate convergent validity (all P-values < 0.05).

Conclusions:

The PaedS is a valid instrument, which is hoped to advance the understanding of self-stigmatization in children with mental health difficulties and contribute to its prevention.

Keywords

ChildrenSelf-stigmatizationStigmaMental illnessScale
Type
Original article
Information
European Psychiatry , Volume 43 , June 2017 , pp. 1 - 8
Copyright
Copyright © European Psychiatric Association 2017

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References

Global Burden of Disease Study 2013 Collaborators Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study. Lancet 2015;386(9995):743–800.CrossRefGoogle Scholar
Ford, THamilton, HGoodman, RMeltzer, HService contacts among the children participating in the British child and adolescent mental health surveys. Child Adolesc Ment Health 2005;10(1):2–9.CrossRefGoogle Scholar
Whiteford, HADegenhardt, LRehm, JBaxter, AJFerrari, AJErskine, HEet al.Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet 2013;382(9904):1575–1586.CrossRefGoogle ScholarPubMed
Department of Health (UK) Achieving better access to mental health services by 2020. Department of Health; 2014 https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/361648/mental-health-access.pdf [accessed 16 July 2016].Google Scholar
Rüsch, NAngermeyer, MCCorrigan, PWMental illness stigma: concepts, consequences, and initiatives to reduce stigma. Eur Psychiatry 2005;20(8):529–539.CrossRefGoogle ScholarPubMed
Stengård, EAppelqvist-Schmidlechner, KMental health promotion in young people – an investment for the future Europe: World Health Organisation; 2010 http://www.euro.who.int/__data/assets/pdf_file/0013/121135/E94270.pdf [accessed 16 July 2016].Google Scholar
Goffman, EStigma: notes on the management of spoiled identity London: Penguin; 1963.Google Scholar
Kaushik, AKostaki, EKyriakopoulos, MThe stigma of mental illness in children & adolescents: a systematic review. Psychiatry Res 2016;243: 469–494.CrossRefGoogle ScholarPubMed
Rose, DThornicroft, GPinfold, VKassam, A250 labels used to stigmatise people with mental illness. BMC Health Serv Res 2007;7:97.CrossRefGoogle ScholarPubMed
Moses, TStigma and self-concept among adolescents receiving mental health treatment. Am J Orthopsychiatry 2009;79(2):261–274.CrossRefGoogle ScholarPubMed
Harter, SThe perceived competence scale for children. Child Dev 1982;53: 87–97.CrossRefGoogle Scholar
Harter, SManual of the Self-Perception Profile for Children Denver: University of Denver; 1985.Google Scholar
Varni, JWSeid, MKurtin, PSPedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care 2001;39(8):800–812.CrossRefGoogle ScholarPubMed
Shaffer, DGould, MSBrasic, JAmbrosini, PFisher, PBird, Het al.A children's global assessment scale (CGAS). Arch Gen Psychiatry 1983;40(11):1228–1231.CrossRefGoogle Scholar
Goodman, RThe Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry 1997;38(5):581–586.CrossRefGoogle ScholarPubMed
Muthen, BLatent variable structural equation modeling with categorical data. J Econometrics 1983;22(1):43–65.CrossRefGoogle Scholar
Muthén, BA general structural equation model with dichotomous, ordered categorical, and continuous latent variable indicators. Psychometrika 1984;49(1):115–132.CrossRefGoogle Scholar
Hu, LBentler, PMCutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struct Equation Model 1999;6(1):1–55.CrossRefGoogle Scholar
Brown, TAConfirmatory factor analysis for applied research. Guilford Publications; 2006.Google Scholar
Bollen, KAStructural equations with latent variables New York: John Wiley & Sons; 1989.CrossRefGoogle Scholar
Efron, BTibshirani, RJAn introduction to the bootstrap New York: Chapman & Hall; 1993.CrossRefGoogle Scholar
Mokkink, LBTerwee, CBPatrick, DLAlonso, JStratford, PWKnol, DLet al.The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res 2010;19(4):539–549.CrossRefGoogle Scholar
Muthén, LKMuthén, BOMplus User's Guide, Sixth Edition, Los Angeles, CA: Muthén & Muthén; 1998–2011.Google Scholar
StataCorp, Stata statistical software: Release 14 College Station, TX: StataCorp LP; 2015.Google Scholar
Mundfrom, DJShaw, DGKe, TLMinimum sample size recommendations for conducting factor analyses. Int J Testing 2005;5(2):159–168.CrossRefGoogle Scholar
Cheung, GWLau, RSTesting mediation and suppression effects of latent variables: bootstraping with structural equation models. Organ Research Methods 2008;11(2):296–325.CrossRefGoogle Scholar
Gleser, LJComment on “Bootstrapping confidence intervals” by T.J. DiCiccio and B. Efron. Stat Sci 1996;11(3):219–221.Google Scholar
MacKinnon, DPLockwood, CMWilliams, JConfidence limits for the indirect effect: distribution of the product and resampling methods. Multivariate Behav Res 2004;39(1):99–128.CrossRefGoogle ScholarPubMed
O’Driscoll, CHeary, CHennessy, EMcKeague, LAdolescents’ beliefs about the fairness of exclusion of peers with mental health problems. J Adolesc 2015;42: 59–67.CrossRefGoogle ScholarPubMed
O’Driscoll, CHeary, CHennessy, EMcKeague, LExplicit and implicit stigma towards peers with mental health problems in childhood and adolescence. J Child Psychol Psychiatry 2012;53(10):1054–1062.CrossRefGoogle ScholarPubMed
Swords, LHeary, CHennessy, EFactors associated with acceptance of peers with mental health problems in childhood and adolescence. J Child Psychol Psychiatry 2011;52(9):933–941.CrossRefGoogle ScholarPubMed
Martin, JKPescosolido, BAOlafsdottir, SMcLeod, JDThe construction of fear: Americans’ preferences for social distance from children and adolescents with mental health problems. J Health Soc Behav 2007;48(1):50–67.CrossRefGoogle ScholarPubMed
Mukolo, AHeflinger, CAFactors associated with attributions about child health conditions and social distance preference. Community Ment Health J 2011;47(3):286–299.CrossRefGoogle ScholarPubMed
McKeague, LHennessy, EO’Driscoll, CHeary, CPeer Mental Health Stigmatization Scale: psychometric properties of a questionnaire for children and adolescents. Child Adolesc Ment Health 2015;20(3):163–170.CrossRefGoogle Scholar
Livingston, JDBoyd, JECorrelates and consequences of internalized stigma for people living with mental illness: a systematic review and meta-analysis. Soc Sci Med 2010;71(12):2150–2161.CrossRefGoogle ScholarPubMed
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