Estudo das propriedades psicométricas da “Escala de Estigma Internalizado para Transtorno Mental – ISMI-BR”

Abstract

The study of stigma among the population with mental illness have shown significant advances in the international literature, representing an indication of need and relevance of studies in the area. However, most studies have focused on the perspective of stigmatizer and little is known about the phenomenon from the perspective of the stigmatized, called internalized stigma or self-stigma. Internalized stigma is considered the most significant negative effect of social stigma and can result in loss of status, low self-esteem, hopelessness, lack of adherence to treatment, among other damages. It is necessary to develop studies in the area, including the development of assessment tools, which is important tool for advances in knowledge and for improving interventions. In this context, the present study was divided into two studies: 1) To do the translation and cultural adaptation of Internalized Stigma of Mental Illness scale - ISMI for the Brazilian context, 2) To assess the psychometric properties of the ISMI for Brazil scale. In the first studie, the ISMI was translated into Portuguese and translated back into English. All comments were accepted by the committee of experts to consolidate the final version, which was submitted to the pre-test. There was no change needed and the version was evaluated on its psychometric properties. In the second studie 308 patients of mental health services were interviewed in the city of Juiz de Fora, MG. The questionnaire was composed of the instruments: the Escala de Estigma Internalizado para Transtorno Mental – ISMI-BR; the Rosenberg Self-Esteem Scale (EAER), the Herth Hope Scale (EEH), Center for Epidemiologic Studies (CES-D) and demographic questionnaire . Regarding the type of treatment to which patients were linked, 25% (n=76) attended the service daily and 75% (n=232) attending the service for periodic cappointments. With regard to diagnosis, the highest incidence was Mood disorders (affective), with 47.7 %, followed by Neurotic, stress-related and somatoform

disorders (27.3%) and Schizophrenia, schizotypal and delusional disorders (25%). The mean age was 46 years ranging from 19 to 72 years old. Regarding the duration of treatment, 35% (n=108) reported being in treatment fo more than 11 years. The reliability of the instrument was considered high, since the Cronbach's alpha coefficient was 0.90, the Spearman-Brown coefficient (split-half) was 0.86 and test-retest correlation was 0.80. The evidence for the construct valididy by the hypothesis Analysis was consistent with the literature. Correlation coefficients were satisfactory, being: ISMI and EE=-0.62; ISMI and EAER=-0.67 and ISMI and CES- D=0.59. The Internalized Stigma of Mental Illness Scale - ISMI - BR presented good psychometric properties and demonstrated to be useful for the Brazilian population. The scale can contribute to research, knowledge and advances in the treatment of internalized stigma among individuals with mental illness.