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Őri D, Vass E, Vajsz K, Vincze K, Sztancsik V, Szemán-Nagy A, Simon L. Psychometric validation of the Reported and Intended Behaviour Scale (RIBS) in Hungary with a particular focus on 'Don't know' responses and further scoring recommendations. BMC Public Health 2023; 23:1773. [PMID: 37700224 PMCID: PMC10496190 DOI: 10.1186/s12889-023-16707-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 09/05/2023] [Indexed: 09/14/2023] Open
Abstract
AIMS Reported and Intended Behaviour Scale (RIBS) was designed to measure mental health stigma-related behaviors in the general public. We aimed to examine its psychometric properties and validate the scale in a Hungarian non-clinical community sample. The secondary aim of this study was to assess the appropriateness of the current scoring recommendations of 'Don't know' responses being coded as neutral, which had never been investigated before. In addition, we provide an overview of the results of already existing studies on the scale. METHODS Hungarian participants completed the RIBS within this cross-sectional online survey study and were considered non-clinical individuals based on a cut-off point of the Global Severity Index T score of 63 on the Symptom Checklist-90-Revised. Confirmatory factor analysis, reliability measures, and comparative analyses were performed. RESULTS Of the n = 5,701, n = 5,141 participants were included in the analysis. The mean age was 27.8 ± 11.1 years, and 89.2% (n = 4,587) of the sample were female. The unidimensional structure was supported by good model fit indices (RMSEA = 0.031, CFI = 0.999, TLI = 0.996, and WRMR = 0.006). Internal consistency of the RIBS and its test-retest reliability with a 5-month follow-up period were found to be good (Cronbach's alpha = 0.88 and ICC = 0.838). We found statistically significant differences between the total scores when the 'Don't know' responders were excluded from the sample or when they were coded as neutral as recommended by the scale authors (16 (IQR:13-18) vs. 15 (IQR:13-18) p < 0.0001). There were also statistically significant differences between 'Neither agree nor disagree' and 'Don't know' participants in several aspects of lived experiences of mental health problems. CONCLUSIONS The RIBS demonstrated good psychometric properties and can be transferred to the Hungarian context. It will be a valuable tool in assessing stigmatizing behavior and testing the efficacy of antistigma programs. Our results suggest that 'Neither agree nor disagree' and 'Don't know' responses bear different meanings, and coding should account for this.
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Affiliation(s)
- D Őri
- Institute of Behavioural Sciences, Semmelweis University, Nagyvárad Tér 4., 1089, Budapest, Hungary.
- Department of Mental Health, Heim Pál National Pediatric Institute, Budapest, Hungary.
- Department of Psychology, Illinois Institute of Technology, Chicago, USA.
| | - E Vass
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - K Vajsz
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
- Department of Clinical Psychology, Semmelweis University, Budapest, Hungary
| | - K Vincze
- Institute of Environmental Medicine, Karolinska Institute, Solna, Sweden
| | - V Sztancsik
- Department of Psychiatry, Clinical Center of the University of Debrecen, Debrecen, Hungary
| | - A Szemán-Nagy
- Department of Personality and Clinical Psychology, University of Debrecen, Debrecen, Hungary
| | - L Simon
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
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de la Higuera-Romero J, Candelas-Muñoz A, Jiménez-González A, Castañeda-Jiménez C, Fuica-Pereg P, Zurita-Carrasco M, Martínez-Fernandez-Repeto E, Senín-Calderón C. Spanish adaptation and validation of the Peer Mental Health Stigmatization Scale (PMHSS-24). REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2022; 15:176-184. [PMID: 36167643 DOI: 10.1016/j.rpsmen.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 06/15/2020] [Indexed: 06/16/2023]
Abstract
INTRODUCTION There is currently a growing interest in interventions aimed at the reduction of stigma towards people with emotional difficulties in adolescents. Unfortunately, the number of scales available in Spanish to assess stigma at these ages is limited. This paper aims to adapt and validate the scale of stigmatizing attitudes towards mental health among peers (Peer Mental Health Stigmatization Scale PMHSS-24). MATERIAL AND METHODS A total of 443 adolescents (46.6% female and 53.7% male) between 13 and 17 years of age participated (Mage = 14.64; SD = 0.83) in the 3rd and 4th grades of Obligatory Secondary Education. The internal consistency of the test was calculated, an exploratory factorial analysis (EFA) was performed with half of the sample and a confirmatory one (CFA) with the other half, and the invariance of measurement of the scale through sex was found. RESULTS The EFA showed a two-factor structure for the negative scale (53% of the variance explained) and another 2 for the positive scale (62% of the variance explained). The CFA corroborated the factor structure with appropriate goodness-of-fit indicators (CFI > 0.95; NNFI > 0.95, SRMR < 0.08, RMSEA < 0.08). Factor loads ranged from 0.49 to 0.89, with α factor correlation between r = 0.53 and 0.45. Both subscales exhibited optimal alpha values (negative 0.94 and positive 0.81). The scale was invariant between the sexes. CONCLUSIONS The data suggest that PMHSS-24 may be a useful scale for the initial screening of the stereotypes exhibited by adolescents toward people with mental illness.
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Affiliation(s)
| | - Andrea Candelas-Muñoz
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario de Puerto Real, Cádiz, Spain
| | - Andrea Jiménez-González
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario de Puerto Real, Cádiz, Spain
| | | | - Paula Fuica-Pereg
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario de Puerto Real, Cádiz, Spain
| | - María Zurita-Carrasco
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario de Puerto Real, Cádiz, Spain
| | | | - Cristina Senín-Calderón
- Departamento de Psicología, Facultad de CC de la Educación, Universidad de Cádiz, Cádiz, Spain
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Freţian AM, Graf P, Kirchhoff S, Glinphratum G, Bollweg TM, Sauzet O, Bauer U. The Long-Term Effectiveness of Interventions Addressing Mental Health Literacy and Stigma of Mental Illness in Children and Adolescents: Systematic Review and Meta-Analysis. Int J Public Health 2022; 66:1604072. [PMID: 34975363 PMCID: PMC8714636 DOI: 10.3389/ijph.2021.1604072] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 11/01/2021] [Indexed: 11/17/2022] Open
Abstract
Objectives: This study aims to provide a systematic review and meta-analysis of the literature on the long-term effects of interventions addressing children’s and adolescents’ mental health literacy and/or stigmatizing attitudes. Methods: Articles in English or German published between January 1997 and May 2020 were retrieved from five databases, leading to a total of 4,375 original articles identified. Results: 25 studies were included after applying exclusion criteria, 13 of which were eligible for meta-analysis. The overall average of the follow-up period was about 5 months. Long-term improvements were sustained for mental health literacy, d = 0.48, 95% CI = (0.34, 0.62), as well as for stigmatizing attitudes, d = 0.30, 95% CI = (0.24, 0.36), and social distance, d = 0.16, 95% CI = (0.03, 0.29). The combination of educational and contact components within interventions led to worse results for mental health literacy, but not stigmatizing attitudes or social distance. Conclusion: Interventions targeting children and adolescents generally have a brief follow-up period of an average of 5 months. They show a stable improvement in mental health literacy, but are to a lesser degree able to destigmatize mental illness or improve social distance.
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Affiliation(s)
- Alexandra Maria Freţian
- Faculty of Educational Science, Bielefeld University, Bielefeld, Germany.,School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Patricia Graf
- Faculty of Educational Science, Bielefeld University, Bielefeld, Germany
| | - Sandra Kirchhoff
- Faculty of Educational Science, Bielefeld University, Bielefeld, Germany
| | - Gloria Glinphratum
- Faculty of Educational Science, Bielefeld University, Bielefeld, Germany
| | - Torsten M Bollweg
- Faculty of Educational Science, Bielefeld University, Bielefeld, Germany
| | - Odile Sauzet
- School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Ullrich Bauer
- Faculty of Educational Science, Bielefeld University, Bielefeld, Germany
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de la Higuera-Romero J, Candelas-Muñoz A, Jiménez-González A, Castañeda-Jiménez C, Fuica-Pereg P, Zurita-Carrasco M, Martínez-Fernandez-Repeto E, Senín-Calderón C. Spanish adaptation and validation of the Peer Mental Health Stigmatization Scale (PMHSS-24). REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2020; 15:S1888-9891(20)30073-2. [PMID: 32709572 DOI: 10.1016/j.rpsm.2020.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 06/09/2020] [Accepted: 06/15/2020] [Indexed: 11/22/2022]
Abstract
INTRODUCTION There is currently a growing interest in interventions aimed at the reduction of stigma towards people with emotional difficulties in adolescents. Unfortunately, the number of scales available in Spanish to assess stigma at these ages is limited. This paper aims to adapt and validate the scale of stigmatizing attitudes towards mental health among peers (Peer Mental Health Stigmatization Scale PMHSS-24). MATERIAL AND METHODS A total of 443 adolescents (46.6% female and 53.7% male) between 13 and 17 years of age participated (Mage=14.64; SD=.83) in the 3rd and 4th grades of Obligatory Secondary Education. The internal consistency of the test was calculated, an exploratory factorial analysis (EFA) was performed with half of the sample and a confirmatory one (CFA) with the other half, and the invariance of measurement of the scale through sex was found. RESULTS The EFA showed a two-factor structure for the negative scale (53% of the variance explained) and another 2for the positive scale (62% of the variance explained). The CFA corroborated the factor structure with appropriate goodness-of-fit indicators (CFI>.95; NNFI>.95, SRMR<.08, RMSEA<.08). Factor loads ranged from .49 to .89, with α factor correlation between r=.53 and .45. Both subscales exhibited optimal alpha values (negative .94 and positive .81). The scale was invariant between the sexes. CONCLUSIONS The data suggest that PMHSS-24 may be a useful scale for the initial screening of the stereotypes exhibited by adolescents toward people with mental illness.
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Affiliation(s)
| | - Andrea Candelas-Muñoz
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario de Puerto Real, Cádiz, España
| | - Andrea Jiménez-González
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario de Puerto Real, Cádiz, España
| | | | - Paula Fuica-Pereg
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario de Puerto Real, Cádiz, España
| | - María Zurita-Carrasco
- Unidad de Gestión Clínica de Salud Mental, Hospital Universitario de Puerto Real, Cádiz, España
| | | | - Cristina Senín-Calderón
- Departamento de Psicología, Facultad de CC de la Educación, Universidad de Cádiz, Cádiz, España
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Subramaniam M, Shahwan S, Abdin E, Goh CMJ, Ong WJ, Tan GTH, Baig N, Samari E, Kwok KW, Chong SA. Advancing Research to Eliminate Mental Illness Stigma: The Design and Evaluation of a Single-Arm Intervention Among University Students in Singapore. Front Psychol 2020; 11:1151. [PMID: 32581957 PMCID: PMC7283943 DOI: 10.3389/fpsyg.2020.01151] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 05/05/2020] [Indexed: 11/13/2022] Open
Abstract
Background Anti-stigma interventions for school and college students have been studied in several countries, but to the best of our knowledge, this has not been addressed in Singapore. The current study was designed to address this lacuna and aimed to evaluate the effectiveness of an anti-stigma intervention focusing on depression among university students in Singapore. Methods A one-off intervention comprising education and personal contact with a person with lived experience of depression was carried out in nine consecutive sessions over 6 months (October 2018 to April 2019) among 390 university students. Knowledge of depression and extent of stigma toward mental illness were assessed pre- and post-intervention as well as at 3-month follow-up. Results The intervention was effective in improving depression knowledge (d = 1.09; p < 0.001), as well as reducing social distancing (d = 0.54; p < 0.001) and personal stigma (dangerous/undesirable: d = 0.60; p < 0.001 and weak not sick: d = 0.10; p < 0.033) pre- to post-intervention as well as pre- intervention to 3-month follow-up (p < 0.005). Limitations While 3-month follow-up data indicates favorable medium-term impact on knowledge and stigma; the study lacks long-term follow-up to examine the impact of anti-stigma interventions across time. The data were collected through self-report measures; however, social desirability bias is possible despite the assurances of confidentiality. Conclusion Given the impact of the intervention, there is a need to consider the feasibility, challenges, and enablers of implementation of such interventions into the curriculum of university students to ensure a broader and sustained outreach and stigma reduction.
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Affiliation(s)
- Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Singapore.,Lee Kong Chian School of Medicine, Singapore, Singapore
| | - Shazana Shahwan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Edimansyah Abdin
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Wei Jie Ong
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Nawira Baig
- Nursing Department, Institute of Mental Health, Singapore, Singapore
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Kian Woon Kwok
- School of Social Sciences, Nanyang Technological University, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
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Gallego J, Cangas AJ, Aguilar JM, Trigueros R, Navarro N, Galván B, Smyshnov K, Gregg M. Education Students' Stigma Toward Mental Health Problems: A Cross-Cultural Comparison. Front Psychiatry 2020; 11:587321. [PMID: 33250795 PMCID: PMC7676434 DOI: 10.3389/fpsyt.2020.587321] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 09/30/2020] [Indexed: 12/18/2022] Open
Abstract
One of the main obstacles to integrating individuals with severe mental disorders into society today is the stigma directed at them. Although breakthroughs in treatment have been made in recent years, many professionals continue to admit that they do not possess enough training to combat this problem. Considering this situation, the present study analyzes the existing stigma among University Education students in three countries with different education systems and cultures, namely Spain, Russia, and Canada. A total of 1,542 students from these three countries participated in the study. ANOVA, MANOVA, and Multigroup Confirmatory Factor Analysis were applied in the data analysis. The results showed that the highest rates of stigma were in Spain and the lowest were in Canada, while Russia displayed intermediate values. This work addresses the relevance of these results, the influence that cultural difference may have on education policies, and the need to implement anti-stigma programs in countries like Spain, which has a relatively high level of social stigma and where these programs are practically not applied at all.
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Affiliation(s)
- José Gallego
- Department of Education, Health Research Centre, University of Almería, Almería, Spain
| | - Adolfo J Cangas
- Department of Psychology, Health Research Centre, University of Almería, Almería, Spain
| | - José M Aguilar
- Department of Psychology, Health Research Centre, University of Almería, Almería, Spain
| | - Rubén Trigueros
- Department of Psychology, Health Research Centre, University of Almería, Almería, Spain
| | - Noelia Navarro
- Department of Psychology, Health Research Centre, University of Almería, Almería, Spain
| | - Blanca Galván
- Department of Psychology, Health Research Centre, University of Almería, Almería, Spain
| | - Konstantin Smyshnov
- Faculty of Physical Culture, North-Caucasian Federal University, Stavropol, Russia
| | - Melanie Gregg
- Department of Kinesiology and Applied Health, University of Winnipeg, Winnipeg, MB, Canada
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