Translating and Testing the Validation of the Arabic Peer Mental Health Stigmatization Scale
-
Omar Al Omari
,
Yousef Abu Shindi
,
Sulaiman Al Sabei
,
Mohammad Al Qadire
,
Iman Al Hashmi
,
Atika Khalaf
Abstract
Objective: Attitudes toward mental difficulties are influenced by culture, and different cultural backgrounds have different effects on people's behavior. This study aimed to prepare the Arabic version of the Peer Mental Health Stigmatization Scale (PMHSS) and validate it among Omani adolescents.
Method: The study was conducted from October 2020 to the end of February 2021. The 24-items PMHSS was translated into Arabic and tested in a sample of 369 adolescents from different governmental schools in Oman. Both exploratory factor analysis (a principal component analysis (PCA) technique with Varimax rotation) and confirmatory factor analysis were performed to examine the construct validity of the PMHSS.
Results: Confirmatory factor analysis was performed to examine the construct validity of the PMHSS. Cronbach’s α was 0.86 for the total scale and 0.84 and 0.81 for awareness and agreement, respectively. Therefore, the goodness-of fit-indicators support the two-correlated factor 16-item model to measure stigma (χ2 / df = 2.64 (p > 0.001), GFI = 0.92, AGFI = 0.89, CFI = 0.90, IFI = 0.90, RMSEA = 0.067).
Conclusion: The Arabic version of the Peer Mental Health Stigmatization Scale (PMHSS) could assess adolescents’ stigmatizing attitudes toward various types of mental health problems within the Arabic context, and it can be utilized by researchers in Arab countries to screen for stigmatizing attitudes and to suggest suitable, effective, and outcome-focused interventions based on its results.
1. Bor W, Dean AJ, Najman J, Hayatbakhsh R. Are child and adolescent mental health problems increasing in the 21st century? A systematic review. Aust N Z J Psychiatry. 2014;48(7):606-16.
2. Merikangas KR, He JP, Burstein M, Swendsen J, Avenevoli S, Case B, et al. Service utilization for lifetime mental disorders in U.S. adolescents: results of the National Comorbidity Survey-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2011;50(1):32-45.
3. Olfson M, Druss BG, Marcus SC. Trends in Mental Health Care among Children and Adolescents. N Engl J Med. 2015;373(11):1079.
4. Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56(3):345-65.
5. Schnyder N, Panczak R, Groth N, Schultze-Lutter F. Association between mental health-related stigma and active help-seeking: systematic review and meta-analysis. BJPsych. 2017;210(4):261-8.
6. Al Omari O, Khalaf A, Al Sabei S, Al Hashmi I, Al Qadire M, Joseph M, et al. Facilitators and barriers of mental health help-seeking behaviours among adolescents in Oman: a cross-sectional study. Nord J Psychiatry. 2022:1-11.
7. Pang S, Liu J, Mahesh M, Chua BY, Shahwan S, Lee SP, et al. Stigma among Singaporean youth: a cross-sectional study on adolescent attitudes towards serious mental illness and social tolerance in a multiethnic population. BMJ Open. 2017;7(10):e016432.
8. Kudva KG, El Hayek S, Gupta AK, Kurokawa S, Bangshan L, Armas-Villavicencio MVC, et al. Stigma in mental illness: Perspective from eight Asian nations. Asia Pac Psychiatry. 2020;12(2):e12380.
9. Livingston JD, Boyd JE. Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Soc Sci Med. 2010;71(12):2150-61.
10. DuPont-Reyes MJ, Villatoro AP, Phelan JC, Painter K, Link BG. Adolescent views of mental illness stigma: An intersectional lens. Am J Orthopsychiatry. 2020;90(2):201-11.
11. Mulfinger N, Rüsch N, Bayha P, Müller S, Böge I, Sakar V, et al. Secrecy versus disclosure of mental illness among adolescents: I. The perspective of adolescents with mental illness. J Ment Health. 2019;28(3):296-303.
12. Seeman N, Tang S, Brown AD, Ing A. World survey of mental illness stigma. J Affect Disord. 2016;190:115-21.
13. Corrigan PW, Bink AB, Schmidt A, Jones N, Rüsch N. What is the impact of self-stigma? Loss of self-respect and the "why try" effect. J Ment Health. 2016;25(1):10-5.
14. Elkington KS, Hackler D, McKinnon K, Borges C, Wright ER, Wainberg ML. Perceived Mental Illness Stigma Among Youth in Psychiatric Outpatient Treatment. J Adolesc Res. 2012;27(2):290-317.
15. Griffiths KM, Christensen H, Jorm AF, Evans K, Groves C. Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: randomised controlled trial. Br J Psychiatry. 2004;185:342-9.
16. Calear AL, Griffiths KM, Christensen H. Personal and perceived depression stigma in Australian adolescents: magnitude and predictors. J Affect Disord. 2011;129(1-3):104-8.
17. Pescosolido BA. The public stigma of mental illness: what do we think; what do we know; what can we prove? J Health Soc Behav. 2013;54(1):1-21.
18. Al Omari O, Wynaden D, Alkhawaldeh A, Al-Delaimy W, Heslop K, Al Dameery K, et al. Knowledge and Attitudes of Young People toward Mental Illness: A Cross Sectional Study. Compr Child Adolesc Nurs. 2020;43(4):301-13.
19. Calear AL, Griffiths KM, Christensen H. Personal and perceived depression stigma in Australian adolescents: magnitude and predictors. J Affect Disord. 2011;129(1-3):104-8.
20. Jorm AF, Wright A. Influences on young people's stigmatising attitudes towards peers with mental disorders: national survey of young Australians and their parents. Br J Psychiatry. 2008;192(2):144-9.
21. McKeague L, Hennessy E, O'Driscoll C, Heary C. Peer Mental Health Stigmatization Scale: psychometric properties of a questionnaire for children and adolescents. Child Adolesc Ment Health. 2015;20(3):163-70.
22. de la Higuera-Romero J, Candelas-Muñoz A, Jiménez-González A, Castañeda-Jiménez C, Fuica-Pereg P, Zurita-Carrasco M, et al. Spanish adaptation and validation of the Peer Mental Health Stigmatization Scale (PMHSS-24). Rev Psiquiatr Salud Ment (Engl Ed). 2022;15(3):176-84.
23. Nunnally JC. Psychometric theory 3E: Tata McGraw-hill education; 1994.
24. World Health Organization [WHO]. Process of translation and adaptation of instruments 2021 [Available from: https://www.coursehero.com/file/30372721/WHO-Process-of-translation-and-adaptation-of-instrumentspdf/.
25. Nearchou F, O'Driscoll C, McKeague L, Heary C, Hennessy E. Psychometric properties of the Peer Mental Health Stigmatization Scale-Revised in adolescents and young adults. Early Interv Psychiatry. 2021;15(1):201-5.
26. Plichta SB, Kelvin EA, Munro BH. Munro's statistical methods for health care research. 6th ed ed. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2013.
27. Lawshe CH. A quantitative approach to content validity. Pers. Psychol. 1975;28(4):563-75.
28. Fornell C, Larcker DF. Evaluating structural equation models with unobservable variables and measurement error. J. Mark. 1981;18(1):39-50.
29. Lam LW. Impact of competitiveness on salespeople's commitment and performance. J. Bus. Res. 2012;65(9):1328-34.
30. Chin WW. The partial least squares approach to structural equation modeling. Bus. Res. 1998;295(2):295-336.
31. Kaiser HF. An index of factorial simplicity. psychometrika. 1974;39(1):31-6.
32. Tabachnick BG, Fidell LS, Ullman JB. Using multivariate statistics: pearson Boston, MA; 2007.
33. Al Omari O, Khalaf A, Al Sabei S, Wynaden D, Ballad CA, Al Dameery K, et al. Associated factors of stigma toward people with mental illness among university and school students. Perspect Psychiatr Care. 2022;58(4):1736-43.
34. Schweizer K. On the changing role of Cronbach’s α in the evaluation of the quality of a measure. Eur J Psychol Assess. 2011.
35. Furnham A, Swami V. Mental health literacy: A review of what it is and why it matters. Int. Perspect. Psychol.: Res. Pract. Consult. 2018;7(4):240.
36. Kermode M, Bowen K, Arole S, Pathare S, Jorm AF. Attitudes to people with mental disorders: a mental health literacy survey in a rural area of Maharashtra, India. Soc Psychiatry Psychiatr Epidemiol. 2009;44(12):1087-96.
37. Costello AB, Osborne J. Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Pract. Assess. Res. Eval. 2005;10(1):7.
38. Baglin J. Improving your exploratory factor analysis for ordinal data: A demonstration using FACTOR. Pract. Assess. Res. Eval. 2014;19(1):5.
39. Carlson KD, Herdman AO. Understanding the impact of convergent validity on research results. Organ. Res. Methods. 2012;15(1):17-32.
40. Wei Y, McGrath P, Hayden J, Kutcher S. The quality of mental health literacy measurement tools evaluating the stigma of mental illness: a systematic review. Epidemiol Psychiatr Sci. 2018;27(5):433-62.
2. Merikangas KR, He JP, Burstein M, Swendsen J, Avenevoli S, Case B, et al. Service utilization for lifetime mental disorders in U.S. adolescents: results of the National Comorbidity Survey-Adolescent Supplement (NCS-A). J Am Acad Child Adolesc Psychiatry. 2011;50(1):32-45.
3. Olfson M, Druss BG, Marcus SC. Trends in Mental Health Care among Children and Adolescents. N Engl J Med. 2015;373(11):1079.
4. Polanczyk GV, Salum GA, Sugaya LS, Caye A, Rohde LA. Annual research review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents. J Child Psychol Psychiatry. 2015;56(3):345-65.
5. Schnyder N, Panczak R, Groth N, Schultze-Lutter F. Association between mental health-related stigma and active help-seeking: systematic review and meta-analysis. BJPsych. 2017;210(4):261-8.
6. Al Omari O, Khalaf A, Al Sabei S, Al Hashmi I, Al Qadire M, Joseph M, et al. Facilitators and barriers of mental health help-seeking behaviours among adolescents in Oman: a cross-sectional study. Nord J Psychiatry. 2022:1-11.
7. Pang S, Liu J, Mahesh M, Chua BY, Shahwan S, Lee SP, et al. Stigma among Singaporean youth: a cross-sectional study on adolescent attitudes towards serious mental illness and social tolerance in a multiethnic population. BMJ Open. 2017;7(10):e016432.
8. Kudva KG, El Hayek S, Gupta AK, Kurokawa S, Bangshan L, Armas-Villavicencio MVC, et al. Stigma in mental illness: Perspective from eight Asian nations. Asia Pac Psychiatry. 2020;12(2):e12380.
9. Livingston JD, Boyd JE. Correlates and consequences of internalized stigma for people living with mental illness: A systematic review and meta-analysis. Soc Sci Med. 2010;71(12):2150-61.
10. DuPont-Reyes MJ, Villatoro AP, Phelan JC, Painter K, Link BG. Adolescent views of mental illness stigma: An intersectional lens. Am J Orthopsychiatry. 2020;90(2):201-11.
11. Mulfinger N, Rüsch N, Bayha P, Müller S, Böge I, Sakar V, et al. Secrecy versus disclosure of mental illness among adolescents: I. The perspective of adolescents with mental illness. J Ment Health. 2019;28(3):296-303.
12. Seeman N, Tang S, Brown AD, Ing A. World survey of mental illness stigma. J Affect Disord. 2016;190:115-21.
13. Corrigan PW, Bink AB, Schmidt A, Jones N, Rüsch N. What is the impact of self-stigma? Loss of self-respect and the "why try" effect. J Ment Health. 2016;25(1):10-5.
14. Elkington KS, Hackler D, McKinnon K, Borges C, Wright ER, Wainberg ML. Perceived Mental Illness Stigma Among Youth in Psychiatric Outpatient Treatment. J Adolesc Res. 2012;27(2):290-317.
15. Griffiths KM, Christensen H, Jorm AF, Evans K, Groves C. Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: randomised controlled trial. Br J Psychiatry. 2004;185:342-9.
16. Calear AL, Griffiths KM, Christensen H. Personal and perceived depression stigma in Australian adolescents: magnitude and predictors. J Affect Disord. 2011;129(1-3):104-8.
17. Pescosolido BA. The public stigma of mental illness: what do we think; what do we know; what can we prove? J Health Soc Behav. 2013;54(1):1-21.
18. Al Omari O, Wynaden D, Alkhawaldeh A, Al-Delaimy W, Heslop K, Al Dameery K, et al. Knowledge and Attitudes of Young People toward Mental Illness: A Cross Sectional Study. Compr Child Adolesc Nurs. 2020;43(4):301-13.
19. Calear AL, Griffiths KM, Christensen H. Personal and perceived depression stigma in Australian adolescents: magnitude and predictors. J Affect Disord. 2011;129(1-3):104-8.
20. Jorm AF, Wright A. Influences on young people's stigmatising attitudes towards peers with mental disorders: national survey of young Australians and their parents. Br J Psychiatry. 2008;192(2):144-9.
21. McKeague L, Hennessy E, O'Driscoll C, Heary C. Peer Mental Health Stigmatization Scale: psychometric properties of a questionnaire for children and adolescents. Child Adolesc Ment Health. 2015;20(3):163-70.
22. de la Higuera-Romero J, Candelas-Muñoz A, Jiménez-González A, Castañeda-Jiménez C, Fuica-Pereg P, Zurita-Carrasco M, et al. Spanish adaptation and validation of the Peer Mental Health Stigmatization Scale (PMHSS-24). Rev Psiquiatr Salud Ment (Engl Ed). 2022;15(3):176-84.
23. Nunnally JC. Psychometric theory 3E: Tata McGraw-hill education; 1994.
24. World Health Organization [WHO]. Process of translation and adaptation of instruments 2021 [Available from: https://www.coursehero.com/file/30372721/WHO-Process-of-translation-and-adaptation-of-instrumentspdf/.
25. Nearchou F, O'Driscoll C, McKeague L, Heary C, Hennessy E. Psychometric properties of the Peer Mental Health Stigmatization Scale-Revised in adolescents and young adults. Early Interv Psychiatry. 2021;15(1):201-5.
26. Plichta SB, Kelvin EA, Munro BH. Munro's statistical methods for health care research. 6th ed ed. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2013.
27. Lawshe CH. A quantitative approach to content validity. Pers. Psychol. 1975;28(4):563-75.
28. Fornell C, Larcker DF. Evaluating structural equation models with unobservable variables and measurement error. J. Mark. 1981;18(1):39-50.
29. Lam LW. Impact of competitiveness on salespeople's commitment and performance. J. Bus. Res. 2012;65(9):1328-34.
30. Chin WW. The partial least squares approach to structural equation modeling. Bus. Res. 1998;295(2):295-336.
31. Kaiser HF. An index of factorial simplicity. psychometrika. 1974;39(1):31-6.
32. Tabachnick BG, Fidell LS, Ullman JB. Using multivariate statistics: pearson Boston, MA; 2007.
33. Al Omari O, Khalaf A, Al Sabei S, Wynaden D, Ballad CA, Al Dameery K, et al. Associated factors of stigma toward people with mental illness among university and school students. Perspect Psychiatr Care. 2022;58(4):1736-43.
34. Schweizer K. On the changing role of Cronbach’s α in the evaluation of the quality of a measure. Eur J Psychol Assess. 2011.
35. Furnham A, Swami V. Mental health literacy: A review of what it is and why it matters. Int. Perspect. Psychol.: Res. Pract. Consult. 2018;7(4):240.
36. Kermode M, Bowen K, Arole S, Pathare S, Jorm AF. Attitudes to people with mental disorders: a mental health literacy survey in a rural area of Maharashtra, India. Soc Psychiatry Psychiatr Epidemiol. 2009;44(12):1087-96.
37. Costello AB, Osborne J. Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Pract. Assess. Res. Eval. 2005;10(1):7.
38. Baglin J. Improving your exploratory factor analysis for ordinal data: A demonstration using FACTOR. Pract. Assess. Res. Eval. 2014;19(1):5.
39. Carlson KD, Herdman AO. Understanding the impact of convergent validity on research results. Organ. Res. Methods. 2012;15(1):17-32.
40. Wei Y, McGrath P, Hayden J, Kutcher S. The quality of mental health literacy measurement tools evaluating the stigma of mental illness: a systematic review. Epidemiol Psychiatr Sci. 2018;27(5):433-62.
| Files | ||
| Issue | Vol 18 No 3 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v18i3.13007 | |
| Keywords | ||
| Adolescents Mental Health Oman Social Stigma | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Al Omari O, Abu Shindi Y, Al Sabei S, Al Qadire M, Al Hashmi I, Khalaf A. Translating and Testing the Validation of the Arabic Peer Mental Health Stigmatization Scale. Iran J Psychiatry. 2023;18(3):311-318.
