Stigma Scale Adaptation and Validation for Measuring COVID-19 Stigma

Background: The current coronavirus disease 2019 (COVID-19) pandemic has been found to be associated with increased psychosocial problems such as depression, anxiety, stress, and stigma. Many health-related stigma instruments that have been developed are condition-specific; these should be adapted and validated for generic use, across different health conditions. This study was conducted to measure stigma, stress, anxiety, and depression using the COVID-19 Stigma Scale-Modified (CSS-M), a modified version of the HIV Stigma Scale, among the Indian population. Methods: A weblink-based online survey was conducted using the adapted CSS-M, along with the Depression, Anxiety, and Stress Scale-21. Collected data were analyzed with correlation analysis, reliability analysis, exploratory factor analysis, and convergent and divergent validity. Results: With a sample size of 375, the modified scale for COVID-19 stigma showed internal consistency and a good inter-item correlation (Cronbach’s alpha 0.821). Principal axis factoring with varimax rotation along with alternative parallel analysis established the two factorial structure and had valid composite reliability, discriminate validity, and partial convergent validity. Conclusion: We found that COVID-19 Stigma Scale-Modified is a valid measure to assess COVID-19-related stigma. The scale was found to be internally consistent with a good inter-item correlation, composite reliability, valid discriminate validity, and partial convergent validity. Specific COVID-related validated scales for stigma should be developed in the future.

[1]  V. Nong,et al.  COVID‐19‐related stigma and its association with mental health of health‐care workers after quarantine in Vietnam , 2020, Psychiatry and clinical neurosciences.

[2]  D. Banerjee,et al.  The “Untold” Side of COVID-19: Social Stigma and Its Consequences in India , 2020, Indian journal of psychological medicine.

[3]  Carmen Moreno,et al.  Impact of coronavirus syndromes on physical and mental health of health care workers: Systematic review and meta-analysis , 2020, Journal of Affective Disorders.

[4]  Suzannah Stuijfzand,et al.  Psychological impact of an epidemic/pandemic on the mental health of healthcare professionals: a rapid review , 2020, BMC Public Health.

[5]  R. Ursano,et al.  Public responses to the novel 2019 coronavirus (2019‐nCoV) in Japan: Mental health consequences and target populations , 2020, Psychiatry and clinical neurosciences.

[6]  T. Moore,et al.  Validation of a modified Berger HIV stigma scale for use among patients with hepatitis C virus (HCV) infection , 2020, PloS one.

[7]  D. Westreich,et al.  Stigma and Ebola survivorship in Liberia: Results from a longitudinal cohort study , 2018, PloS one.

[8]  C. Portillo,et al.  Shortened and Culturally Appropriate HIV Stigma Scale for Asians Living with HIV in the United States: Psychometric Analysis , 2018, The Journal of the Association of Nurses in AIDS Care : JANAC.

[9]  L. Wettergren,et al.  Development of a 12-item short version of the HIV stigma scale , 2017, Health and Quality of Life Outcomes.

[10]  Irwanto,et al.  Cultural validation of a new instrument to measure leprosy-related stigma: the SARI Stigma Scale. , 2017, Leprosy review.

[11]  N. Rüsch,et al.  What is the impact of self-stigma? Loss of self-respect and the “why try” effect , 2016, Journal of mental health.

[12]  F. Molero,et al.  Adaptation of the HIV Stigma Scale in Spaniards with HIV , 2015, The Spanish Journal of Psychology.

[13]  Jill A. Kuhlberg,et al.  Mental illness, poverty and stigma in India: a case–control study , 2015, BMJ Open.

[14]  L. Wettergren,et al.  Psychometric Evaluation of the HIV Stigma Scale in a Swedish Context , 2014, PloS one.

[15]  L. Wettergren,et al.  Psychometric properties of a short version of the HIV stigma scale, adapted for children with HIV infection , 2013, Health and Quality of Life Outcomes.

[16]  G. Eysenbach.  Correction: Improving the Quality of Web Surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES) , 2012, Journal of Medical Internet Research.

[17]  S. Bharat.  A systematic review of HIV/AIDS-related stigma and discrimination in India: Current understanding and future needs , 2011, SAHARA J : journal of Social Aspects of HIV/AIDS Research Alliance.

[18]  Carol T. Miller,et al.  Measurement of stigma in people with HIV: a reexamination of the HIV Stigma Scale. , 2007, AIDS education and prevention : official publication of the International Society for AIDS Education.

[19]  Wim H Van Brakel,et al.  Measuring health-related stigma—A literature review , 2006, Psychology, health & medicine.

[20]  W. Mak,et al.  Comparative stigma of HIV/AIDS, SARS, and Tuberculosis in Hong Kong , 2006, Social Science & Medicine.

[21]  K B Keeling,et al.  A Regression Equation for Determining the Dimensionality of Data , 2000, Multivariate behavioral research.

[22]  P. Lovibond,et al.  The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. , 1995, Behaviour research and therapy.

[23]  H. Kaiser.  A second generation little jiffy , 1970 .

[24]  R. Cattell.  The Scree Test For The Number Of Factors. , 1966, Multivariate behavioral research.

[25]  J. Horn.  A rationale and test for the number of factors in factor analysis , 1965, Psychometrika.

[26]  D. Rao,et al.  Assessing HIV/AIDS Stigma in South India: Validation and Abridgement of the Berger HIV Stigma Scale , 2011, AIDS and Behavior.

[27]  Robert Goodman,et al.  Advantages and limitations of web-based surveys: evidence from a child mental health survey , 2009, Social Psychiatry and Psychiatric Epidemiology.

[28]  T. Templin,et al.  Stigma scale revised: reliability and validity of a brief measure of stigma for HIV+ youth. , 2007, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.