title: Brief version of the Internalized Stigma of Mental Illness (ISMI) scale: psychometric properties and relationship to depression, self esteem, recovery orientation, empowerment, and perceived devaluation and discrimination.
abstract: OBJECTIVE
  The internalized stigma of mental illness impedes recovery and is associated with increased depression, reduced self-esteem, reduced recovery orientation, reduced empowerment, and increased perceived devaluation and discrimination. The Internalized Stigma of Mental Illness (ISMI) scale is a 29-item self-report questionnaire developed with consumer input that includes the following subscales: Alienation, Discrimination Experience, Social Withdrawal, Stereotype Endorsement, and Stigma Resistance. Here we present a 10-item version of the ISMI containing the two strongest items from each subscale.
  
  
  METHODS
  Participants were all outpatient veterans with serious mental illness. Following the rigorous scale-reduction methods set forth by Stanton and colleagues (2002), we selected the 10 items, tested the psychometrics of the shortened scale in the original validation sample (N = 127), and cross-checked the results in a second dataset (N = 760).
  
  
  RESULTS
  As expected, the ISMI-10 retained the essential properties of the ISMI-29, including adequate internal consistency reliability and external validity in relation to depression, self-esteem, recovery orientation, perceived devaluation and discrimination, and empowerment. The ISMI-10 scores are normally distributed and have similar descriptive statistics to the ISMI-29. The reliability and depression findings were replicated in a cross-validation sample.
  
  
  CONCLUSIONS
  We conclude that the ISMI-10 has strong psychometric properties and is a practical, reliable, and valid alternative to the original ISMI-29. Future work should test the ISMI-10 in more diverse samples. This shorter version should reduce respondent burden in program evaluation projects that seek to determine whether participation in psychosocial rehabilitation programming reduces internalized stigma.
authors.affiliation: Department of Psychiatry, San Francisco VA Medical Center and University of California, San Francisco.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Boyd
authors.affiliation: Mental Health Service, San Francisco VA Medical Center.
authors.forename: Poorni G
authors.initials: PG
authors.lastname: Otilingam
authors.affiliation: School of Social Work, University of Maryland, Baltimore.
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Deforge
mesh_terms: D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology*; D008875:Middle Aged; D011209:Power, Psychological; D011594:Psychometrics / Q000379:methods*; D015203:Reproducibility of Results; D012649:Self Concept; D057566:Self Report; D063508:Social Discrimination / Q000523:psychology; D057545:Social Stigma; D013240:Stereotyping; D014728:Veterans / Q000523:psychology