Measuring Self-Stigma of Mental Illness in China and Its Implications for Recovery

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hunghom.
International Journal of Social Psychiatry (Impact Factor: 1.15). 10/2007; 53(5):408-18. DOI: 10.1177/0020764007078342
Source: PubMed


This study translated and validated the Chinese Version of the Self-stigma of Mental Illness Scale (CSSMIS), which may be used to measure self-stigma of mental health consumers in China. We also examined its correlation with self-esteem, self-efficacy and psychosocial treatment compliance. A cross-sectional observational study was implemented. Some 51 males and 57 females who suffered from severe mental illness were recruited from psychiatric settings in Hong Kong. They were required to complete the Chinese Version of the Self-stigma of Mental Illness Scale, the Rosenberg Self-esteem Scale and the Self-efficacy Scale. Their level of compliance during psychosocial treatment and their demographic information were recorded by their case managers. Exploratory factor analysis revealed two homologous factors for the four subscales of the CSSMIS. Factor 1 was related to the negative beliefs and consequences of having mental disorders, whereas Factor 2 was related to positive beliefs. The perceived stigma subscale and the three self-stigma subscales were strongly inter-correlated. Significant correlations were also found between almost all subscales of the CSSMIS and the remaining scales. The psychometric properties of the CSSMIS are statistically acceptable. The results also suggest that stigma played a detrimental role in undermining self-esteem, self-efficacy and psychosocial treatment compliance. Implications for recovery of mental health consumers are discussed.

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    • "Chinese parents of children with disabilities tend to experience higher levels of social discrimination, and may view their child's disability as a source of shame and failure based on cultural expectations (Sun et al., 2013). Previous studies have found that Chinese parents of children with disabilities are more likely to self-stigmatize because they focus more on their social identity and value (Fung et al., 2007). Once they are stigmatized by society, they internalize stigma more easily. "
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    ABSTRACT: Abstract Purpose The current study examined self-esteem, social support, and life satisfaction in Chinese parents of children with autism spectrum disorder (ASD), and observed the mediation effects of social support on the relationship between self-esteem and life satisfaction. Methods We compared 118 Chinese parents of children with ASD to 122 demographic-matched parents of typically developing children on measures of self-esteem, social support, and life satisfaction using the Rosenberg Self-Esteem Scale (SES), Multidimensional Scale of Perceived Social Support (MSPSS), and Satisfaction with Life Scale (SWLS), respectively. Results Parents of children with ASD scored significantly lower on self-esteem, social support, and life satisfaction than the controls (ps < 0.01), and social support partly mediated the relationship between self-esteem and life satisfaction in both groups. Hierarchical regressions indicated that after controlling for demographic variables, social support and self-esteem were significant predictors of life satisfaction in both groups but explained more variance in life satisfaction for the parents of children with ASD. Conclusions Social support and self-esteem play a more important role in life satisfaction for parents of children with ASD than those of typically developing children. Life satisfaction is positively related to higher household income, higher self-esteem, and stronger social support for parents. Self-esteem is likely to be associated with greater life satisfaction by means of greater social support. Future research and interventions should focus on fostering a more positive climate of social support for ASD families in China.
    Research in Autism Spectrum Disorders 09/2015; 17. DOI:10.1016/j.rasd.2015.05.003 · 2.96 Impact Factor
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    • "For example, Fung and colleagues studied the relationship between mental illness stigma, selfesteem , and self-effi cacy in participants diagnosed primarily with schizophrenia or aff ective disorders . Th eir fi ndings concur with earlier research such that increased stigma was found to contribute to decreased self-esteem and lower self-effi cacy (Fung et al., 2007). Recent work suggests that the impact of MHS on self-esteem/self-effi cacy can be remediated (Ilic et al., 2012; Sorsdahl, Kakuma, Wilson, & Stein, 2012), as has been also demonstrated in other health areas (e.g., HIV, eating disorders, renal disease treatment; Berger, Ferrans, & Lashley, 2001; Jansen, Rijken, Heijmans, & Boeschoten, 2010; Mond, Hay, Rodgers, & Owen, 2008). "
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    ABSTRACT: Mental illness remains a pervasive social issue that aff ects the well-being of millions of individuals globally. Despite the overall prevalence of mental illness, increasing numbers of individuals needing mental health treatment do not receive it. Mental Health Stigma (MHS) has been proposed as a signifi cant barrier to seeking/obtaining mental health treatment. Mounting evidence suggests that MHS is experienced in virtually all life domains and that it may signifi cantly influence multiple health outcomes, including treatment seeking behavior. The current review paper uniquely contributes to the literature on MHS in at least four ways. First, this paper provides a recent overview of the prevalence and social costs of mental illness in society. Second, this paper presents a current literature review of MHS and helps to elucidate the impact of MHS on a range of individual outcomes, including psychological and physical health. Third, this paper specifically reviews existing literature on understanding the relationship between MHS and treatment seeking behavior. This is the fi rst known review paper to focus specifi cally on the MHS-treatment seeking relationship. Finally, the paper presents implications for future research on MHS and treatment seeking which may lead to the development of theory-based interventions to address MHS in clinical practice.
    Advances in Mental Health 12/2014; 12(3):202-215. DOI:10.1080/18374905.2014.11081898
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    • "It consists of four subscales: (1) stereotype awareness, which represents perceived discrimination due to social stigma; (2) stereotype agreement, which represents the degree to which respondents agree with stigmatizing views; (3) self-concurrence, which represents the degree to which respondents apply stigmatizing views to themselves and other PLMI; and (4) self-esteem decrement, which represents the degree of harm to ones' self-esteem as a result of self-stigma. Composed of 40 items rated on a 9-point Likert scale with higher scores indicating higher levels of self-stigma, the CSSMIS has shown strong reliability and various forms of validity [22]. It was included in this study to examine the concurrent validity of the CSS. "
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    ABSTRACT: Background Stigma of mental illness is a global public health concern, but there lacks a standardized and cross-culturally validated instrument for assessing the complex experience of stigma among people living with mental illness (PLMI) in the Chinese context. Aim This study examines the psychometric properties of a Chinese version of the Stigma Scale (CSS), and explores the relationships between stigma, self-esteem and depression. Methods A cross-sectional survey was conducted with a community sample of 114 Chinese PLMI in Hong Kong. Participants completed the CSS, the Chinese Self-Stigma of Mental Illness Scale, the Chinese Rosenberg Self-Esteem Scale, and the Chinese Patient Health Questionnaire-9. An exploratory factor analysis was conducted to identify the underlying factors of the CSS; concurrent validity assessment was performed via correlation analysis. Results The original 28-item three-factor structure of the Stigma Scale was found to be a poor fit to the data, whereas a revised 14-item three-factor model provided a good fit with all 14 items loaded significantly onto the original factors: discrimination, disclosure and positive aspects of mental illness. The revised model also displayed moderate to good internal consistency and good construct validity. Further findings revealed that the total stigma scale score and all three of its subscale scores correlated negatively with self-esteem; but only total stigma, discrimination and disclosure correlated positively with depression. Conclusion The CSS is a short and user-friendly self-administrated questionnaire that proves valuable for understanding the multifaceted stigma experiences among PLMI as well as their impact on psychiatric recovery and community integration in Chinese communities.
    Comprehensive Psychiatry 09/2014; 56. DOI:10.1016/j.comppsych.2014.09.016 · 2.25 Impact Factor
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