title: Measuring the Stigma Surrounding Type 2 Diabetes: Development and Validation of the Type 2 Diabetes Stigma Assessment Scale (DSAS-2).
abstract: To develop and validate a self-report measure of perceived and experienced stigma for use with adults with type 2 diabetes: the Type 2 Diabetes Stigma Assessment Scale (DSAS-2).
  
  
  
  An item pool was drafted based on qualitative data from 25 adults with type 2 diabetes and content from other health-related stigma questionnaires. Thirteen adults with type 2 diabetes completed 57 draft diabetes stigma items and participated in cognitive debriefing interviews. Based on participant feedback, the pool was reduced to 48 items with a 5-point Likert scale (strongly disagree to strongly agree). A total of 1,064 adults with type 2 diabetes completed a survey including these 48 items and other validated measures. Data were subject to principal components analysis and Spearman ρ correlations.
  
  
  
  The scale was reduced to 19 items, with an unforced three-factor solution indicative of three subscales: Treated Differently (6 items, α = 0.88), Blame and Judgment (7 items, α = 0.90), and Self-stigma (6 items, α = 0.90). A forced one-factor solution supported the calculation of a total score (α = 0.95). Satisfactory concurrent, convergent, and discriminant validity were demonstrated.
  
  
  
  The 19-item DSAS-2 is a reliable and valid measure of type 2 diabetes stigma. A rigorous design and validation process has resulted in a relatively brief measure of perceived and experienced stigma in type 2 diabetes. The novel scale has satisfactory psychometric properties and is now available to facilitate much-needed research in this field.
authors: School of Psychology, Deakin University, Geelong, Australia jbrowne@acbrd.org.au.|The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia.
authors: Jessica L
authors: JL
authors: Browne
authors: School of Psychology, Deakin University, Geelong, Australia.|The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia.
authors: Adriana D
authors: AD
authors: Ventura
authors: The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia.|School of Psychology, Australian Catholic University, Sydney, Australia.
authors: Kylie
authors: K
authors: Mosely
authors: School of Psychology, Deakin University, Geelong, Australia.|The Australian Centre for Behavioural Research in Diabetes, Diabetes Victoria, Melbourne, Australia.|AHP Research, Hornchurch, U.K.
authors: Jane
authors: J
authors: Speight
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology* / Q000628:therapy; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D011594:Psychometrics; D015203:Reproducibility of Results; D057566:Self Report; D057545:Social Stigma; D011795:Surveys and Questionnaires