The questionnaire was developed following analysis of a number of stigma measures for use with adults: the Self-Stigma of Mental Illness Scale (SSMIS; Corrigan et al., 2006), a stigma questionnaire developed by Moses (2009), the Revised Attribution Questionnaire (Corrigan et al., 2002); the Perceived Devaluation/ Discrimination Scale (PDDS; Link, Struening, Rahav, Phelan, & Nuttbrock, 1997), the attitude questions in a measure developed by Pinfold et al. (2003); and a measure of depression stigma developed by Griffiths et al. (2004).
Based on analysis of these scales, the items chosen for inclusion measured stereotypes (dangerousness, blameworthiness, poor self-care, academic ability), prejudice (fear, not trustworthy, behaviour in class), discrimination (‘hang out with’, refusing employment) and low social status (‘look down on’). These items were chosen because they are consistent with Corrigan and Shapiro’s (2010) conceptualisation of the components of stigmatising responses and are developmentally appropriate i.e. they can be applied to the lives of young people in school settings.
Sixteen of the items described young people negatively (e.g. are dangerous) and eight described them positively (e.g. are just as intelligent as others). The decision to include the positive statements was based on Hinshaw’s (2005) exhortation that printed statements about young people with mental health problems should include messages of strength, courage and resilience. These positive items are not included in the scale or the sub-scales.
The conceptual structure of the scale distinguishes between awareness of societal stigma towards young people with mental health problems and personal beliefs. Each statement in the scale regarding perception of societal stigma has a corresponding item relating to personal endorsement of that statement (following Corrigan et al., 2006). This produced a total of 24 items, 12 items relating to societal stigma and 12 relating to personal stigma.
Many adult scales measuring stigma refer to ‘mental illness’ which is not appropriate for the context of adolescent and young adults. Following Moses (2009) we used the phrase ‘emotional and behavioural problems’ in place of the term ‘mental illness’ for all items in the PMHSS.
References
Corrigan, P. W., & Shapiro, J. R. (2010). Measuring the impact of programs that challenge the public stigma of mental illness. Clinical psychology review, 30(8), 907-922.
Corrigan, P. W., Watson, A. C., & Barr, L. (2006). The self–stigma of mental illness: Implications for self–esteem and self–efficacy. Journal of social and clinical psychology, 25(8), 875-884.
Corrigan, P.W., Rowan, D., Green, A., Lundin, R., River, P., Up- hoff-Wasowski, K., ... & Kubiak, M.A. (2002). Challenging two mental illness stigmas: Personal responsibility and dangerousness. Schizophrenia Bulletin, 28, 293–309.
Griffiths, K.M., Christensen, H., Jorm, A.F., Evans, K., & Groves, C. (2004). Effect of web-based depression literacy and cognitive behavioural therapy interventions on stigmatising attitudes to depression. British Journal of Psychiatry, 185, 342–349.
Hinshaw, S. P. (2005). The stigmatization of mental illness in children and parents: developmental issues, family concerns, and research needs. Journal of child Psychology and Psychiatry, 46(7), 714–734.
Link, B.G., Struening, E.L., Rahav, M., Phelan, J.C., & Nutt- brock, L. (1997). On stigma and its consequences: Evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. Journal of Health and Social Behavior, 38, 177–190.
Moses, T. (2009). Stigma and self‐concept among adolescents receiving mental health treatment. American Journal of Orthopsychiatry, 79(2), 261-274.