title: A theoretical and empirical framework for constructing culture-specific stigma instruments for Chile.
abstract: Different cultural contexts contribute to substantial variation in the stigma faced by people with psychosis globally. We propose a new formulation of how culture affects stigma to create psychometrically-validated tools to assess stigma's culture-specific effects. We propose to construct culture-specific stigma measures for the Chilean context via: 1) open-ended administration of 'universal' stigma scales to a sample of individuals with psychosis, relatives, and community respondents; 2) qualitative analyses to identify how culture shapes stigma and to derive initial 'culture-specific' stigma items; 3) construction and pilot-testing of final 'culture-specific' stigma measures; 4) initial psychometric validation among a sample of individuals with psychosis. We identify initial hypotheses for how stigma might threaten the capacities to participate in fundamental activities that 'matter most' in the Chilean context. These include mental illness stigma threatening the man's ability to protect the honor of the family, and the woman's ability to be a 'holy and pure' mother. Mental illness stigma may further endanger the ability of the family to uphold reciprocal obligations within their social network. Developing such measures promises to aid efforts to address culture-specific forms of stigma, and to facilitate implementation of community mental health services, in Chile and other Latin American contexts.
authors.affiliation: Assistant Professor at Department of Epidemiology, Columbia University - New York, NY, USA.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Yang
authors.forename: Elie
authors.initials: E
authors.lastname: Valencia
authors.forename: Ruben
authors.initials: R
authors.lastname: Alvarado
authors.forename: Bruce
authors.initials: B
authors.lastname: Link
authors.forename: Nina
authors.initials: N
authors.lastname: Huynh
authors.forename: Kristy
authors.initials: K
authors.lastname: Nguyen
authors.forename: Kara
authors.initials: K
authors.lastname: Morita
authors.forename: Mariella
authors.initials: M
authors.lastname: Saavedra
authors.forename: Chak
authors.initials: C
authors.lastname: Wong
authors.forename: Sandro
authors.initials: S
authors.lastname: Galea
authors.forename: Ezra
authors.initials: E
authors.lastname: Susser
keywords: Latin America; culture; mental health; social stigma