[Internalized Stigma of Schizophrenia: Validation of the German Version of the Internalized Stigma of Mental Illness-Scale (ISMI)].
OBJECTIVE
Schizophrenia is particularly associated with stigma. Especially internalized stigma, the inner subjective experience of stigma and its psychological effects resulting from applying negative stereotypes and stigmatising attitudes to oneself, is a barrier to recovery. The Internalized Stigma of Mental Illness-scale (ISMI) developed by Jennifer Boyd Ritsher and colleagues is a valid instrument for self-rated assessment of the subjective experience of stigma. The aim of the study was to examine the psychometric properties of the German Version of the ISMI among people with schizophrenia spectrum disorder.


METHODS
The ISMI was translated into German. Reliability and validity of the instrument were tested and predictors of internalized stigma were explored. Data of 157 people were collected on the ISMI and demographic and clinical variables. Construct validity was tested by comparing results with already established constructs such as perceived devaluation and discrimination, depression, self-esteem, empowerment, control convictions and quality of life.


RESULTS
The German Version of the ISMI showed good psychometric properties with high internal consistency, good test-retest reliability and good construct validity among people with schizophrenia spectrum disorder. About one third had a mean above the midpoint of the scale indicating a high level of internalized stigma. Internalized stigma was predicted by insufficient social network, level of education less than high school and inpatient or day clinic treatment compared to outpatient treatment.


CONCLUSIONS
Results suggest that the German version of the ISMI is comparable to its original version. With the German version of the ISMI internalized stigma can be measured reliably and validly among people with schizophrenia spectrum disorder. Future studies may use the ISMI to record changes in internalized stigma pertinent to the achievement of therapeutic goals.
Medizinische Universität Wien, Universitätsklinik für Psychiatrie und Psychotherapie, KlinischeAbteilung für SozialpsychiatrieWähringer Gürtel 18–201090 Wien, Austria. ingrid.sibitz@meduniwien.ac.at
Ingrid
I
Sibitz
Michaela Elena
ME
Friedrich
Annemarie
A
Unger
Anatol
A
Bachmann
Thomas
T
Benesch
Michaela
M
Amering
D000293:Adolescent; D000328:Adult; D001317:Austria; D003431:Cross-Cultural Comparison; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D012647:Self-Assessment; D057545:Social Stigma; D011795:Surveys and Questionnaires; D014175:Translating; D055815:Young Adult