Measuring Self-Stigma Among Romanian Psychiatric Patients: Cultural Adaptation of the Self-Stigma of Mental Illness Scale and the Paradox of Self-Stigma Scale

In the present study, we aimed to validate two instruments designed to assess self-stigmatization: the Self-Stigma of Mental Illness Scale and the Paradox of Self-Stigma Scale. Responses from 326 psychiatric patients (58% women) diagnosed with internalizing and externalizing disorders were collected to evaluate the instruments' structural validity, measurement invariance, reliability, convergent, and criterion validity. Confirmatory factor analyses offered support for the intended structure of both instruments and the pattern of associations with the other investigated variables further sustained their validity. Reliability was optimal, as revealed by excellent internal consistency estimates. Additionally, by means of network analysis, we captured the complementarity of the two scales together with a third one – the Internalized Stigma of Mental Illness Scale, in relation to quality of life and mental health complaints. Our results suggest that both instruments can be confidently used by Romanian specialists, providing an effective toolkit for measuring self-stigmatization related to mental health.