The stigma scale : adaptação transcultural para o português brasileiro e primeiras evidências de validade

Abstract

Studies suggest that the mental illness stigma (MIS) is an aggravating factor for mental disorders. Social stigma inhibits the search and reduces the rate of adherence to psychotherapeutic and pharmacological treatments. However, measuring MIS is a complex task, since there are multiple forms of stigma and divergent opinions about what type of stigma an instrument can measure in a particular population. This task is even more challenging in Brazil, because as far as we know, there is no instrument capable of evaluating the perceptions and experiences of MIS lived by people with mental disorders. Thus, an instrument capable of measuring MIS can contribute to the planning of interventions capable of reducing MIS and increasing the search and adherence to treatments, supporting the mental health of the Brazilian population. Thus, the present dissertation had as objective the transcultural adaptation of the Stigma Scale of Mental Illness (SSMI) to Brazilian Portuguese and to obtain its first evidences of validity. In the first study, a systematic review was conducted following the steps suggested by PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses), aiming to investigate which psychometric instruments are most utilized in the measurement of perceived and experienced stigma and to verify the main intervenient variables involved in the MIS studies. In the second study, the transcultural adaptation of SSMI was performed and its first psychometric validity evidences were obtained. The methodological steps followed were: 1) obtaining permission to adapt; 2) translation of the instrument; 3) synthesis and evaluation by specialists; 4) back-translation and specialists’ evaluation; 5) pilot study. The reliability index among the specialists (n = 3) was measured using the Light's Kappa index. The pilot study sample consisted in 23 adults (18-61 years). The internal consistency of the SSMI was estimated by means of polycory correlation matrices of the items and the ordinal Cronbach Alpha coefficient. The findings suggest that the SSMI show good evidence of content validity (k = 0.81) and internal consistency (α = 0.87). However, it is noteworthy that, although promising, these psychometric data are still preliminary. Therefore, new surveys with the SSMI that take into account other cultural contexts at national level are needed in order to confirm and expand the conclusions of this dissertation.