Measuring discrimination experienced by people with a mental illness: replication of the short-form DISCUS in six world regions

Brohan, Elaine, Thornicroft, Graham, Rüsch, Nicolas, Lasalvia, Antonio, Campbell, Megan M, Yalçınkaya-Alkar, Özden, Lanfredi, Mariangela, Ochoa, Susana, Ucok, Alp, Tomás, Catarina, Fadipe, Babatunde, Sebes, Julia, Fiorillo, Andrea, Sampogna, Gaia, Silvestre de Paula, Christiane, Valverde, Leonidas, Schomerus, Georg, Klemm, Pia, Ouali, Uta, Castelein, Stynke, Alexová, Aneta, Oexle, Nathalie, Neves Guimarães, Patrícia, Sportel, Bouwina Esther, Chang, Chih-Cheng, Lie, Ji, Shanthi, Chilasagaram, Reneses, Blanca, Bakolis, Ioannis and Evans-Lacko, Sara ORCID: 0000-0003-4691-2630 (2023) Measuring discrimination experienced by people with a mental illness: replication of the short-form DISCUS in six world regions. Psychological Medicine, 53 (9). 3963 - 3973. ISSN 0033-2917

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Abstract

BACKGROUND: The Discrimination and Stigma Scale (DISC) is a patient-reported outcome measure which assesses experiences of discrimination among persons with a mental illness globally. METHODS: This study evaluated whether the psychometric properties of a short-form version, DISC-Ultra Short (DISCUS) (11-item), could be replicated in a sample of people with a wide range of mental disorders from 21 sites in 15 countries/territories, across six global regions. The frequency of experienced discrimination was reported. Scaling assumptions (confirmatory factor analysis, inter-item and item-total correlations), reliability (internal consistency) and validity (convergent validity, known groups method) were investigated in each region, and by diagnosis group. RESULTS: 1195 people participated. The most frequently reported experiences of discrimination were being shunned or avoided at work (48.7%) and discrimination in making or keeping friends (47.2%). Confirmatory factor analysis supported a unidimensional model across all six regions and five diagnosis groups. Convergent validity was confirmed in the total sample and within all regions [ Internalised Stigma of Mental Illness (ISMI-10): 0.28-0.67, stopping self: 0.54-0.72, stigma consciousness: -0.32-0.57], as was internal consistency reliability ( α = 0.74-0.84). Known groups validity was established in the global sample with levels of experienced discrimination significantly higher for those experiencing higher depression [Patient Health Questionnaire (PHQ)-2: p < 0.001], lower mental wellbeing [Warwick-Edinburgh Well-being Scale (WEMWBS): p < 0.001], higher suicidal ideation [Beck Hopelessness Scale (BHS)-4: p < 0.001] and higher risk of suicidal behaviour [Suicidal Ideation Attributes Scale (SIDAS): p < 0.001]. CONCLUSIONS: The DISCUS is a reliable and valid unidimensional measure of experienced discrimination for use in global settings with similar properties to the longer DISC. It offers a brief assessment of experienced discrimination for use in clinical and research settings.

Item Type:	Article
Official URL:	https://www.cambridge.org/core/journals/psychologi...
Additional Information:	© 2022 The Authors
Divisions:	Care Policy and Evaluation Centre
Subjects:	H Social Sciences > HV Social pathology. Social and public welfare. Criminology R Medicine > RA Public aspects of medicine B Philosophy. Psychology. Religion > BF Psychology
Date Deposited:	17 Feb 2022 16:03
Last Modified:	12 Dec 2024 02:52
URI:	http://eprints.lse.ac.uk/id/eprint/113773

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