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Table 2 Instruments used to measure anticipated/perceived, internalized or experienced stigma

From: Out of the silos: identifying cross-cutting features of health-related stigma to advance measurement and intervention

Author Country Condition Target group N Evidence of validity Comments
Berger stigma scale
Berger et al. [24] USA HIV People with HIV 318 Alpha 0.96; alpha sub-scales 0.90–0.93, correlation coefficient reliability 0.92. Construct validity supported by correlation with Rosenberg Self-esteem scale and Center for Epidemiological Studies-Depression scale  
Dadun et al. [98] Indonesia Leprosy Persons affected by leprosy 392 Alpha 0.88; sub-scale alphas 0.79–0.84, SDCa 1.37, ICC 0.75 (95% CI 0.64–0.83); no floor or ceiling effects; construct validity supported by correlation with the P-scale and WHOQOL-BREF Renamed ‘SARI Stigma Scale’ because of substantial changes to structure
Rump et al. [53] Netherlands MRSA MRSA carriers 57 Validity was supported by correlation with the RAND mental health inquiry An adapted version was used
Boyd Ritsher et al. [44] USA Mental health conditions Mental health outpatients 127 Alpha 0.90 (sub-scales 0.58–0.80); test-retest reliability r = 0.92 (n = 16) (sub-scales 0.68–0.94); good construct validity 29 items
Brohan et al. [134] 13 European countries Bipolar disorder and depression Mental health patients 1182 Alpha 0.94; construct validity supported by strong correlations with an empowerment scale and a devaluation and discrimination scale 24-item ISMI was used, excluding the Resilience sub-scale
Singh et al. [135] India Mental health Persons with severe mental disorders 161 Alpha 0.86; ICC test-retest reliability (n = 31) sub-scales range 0.84–0.96; 5-component structure supported by factor analysis; good correlation with EMIC  
Luoma et al. [99] USA Substance abuse Adults with a substance use disorder 88 Alpha 0.82 and 0.92 at pre- and post-assessment  
Stevelink et al. [101] India HIV
Patients/persons affected 95 HIV
95 leprosy
Alpha 0.87
Alpha 0.91
Rensen et al. [96] India Leprosy Affected persons 806 Alpha 0.96; sub-scale alphas 0.79–0.96; weighted kappa 0.62 (n = 49); no floor or ceiling effects 18-item ISMI
Taft et al. [100] USA Inflammatory bowel disease Irritable bowel disease patients 191 No validation was reported  
Arachchi et al. [136] Sri Lanka Leprosy Affected persons 132 No validation was reported  
EMIC affected persons
Weiss et al. [45] India Leprosy, mental health Patients 56 + 31 controls Item-wise kappa values 0.62–0.93 (n = 16–18); association with established mental health instruments (SCID and HDARS)bsupported construct validity 8-item EMIC
Raguram et al. [102, 103] India Depression, schizophrenia Patients
Family, caretakers
Alpha 0.71
Alpha 0.81
10-item EMIC
13-item EMIC
Brieger et al. [105] Nigeria Onchocerciasis Patients 500 No validation was reported 13-item EMIC was used
Vlassoff et al. [93] Nigeria
Cameroon Ghana
Onchocerciasis Patients 469 Alpha 0.80 13-item EMIC was used
Chowdhury et al. [49] India Mental health conditions Patients 25 Kappa 0.89 (inter-rater) 20-25 items, depending on version
Stienstra et al. [94] Ghana Buruli ulcer Patients 33 Alpha 0.65 (of 11 items asked of both patients and controls) 15-item EMIC
Weiss et al. [106] Bangladesh
India Malawi
Tuberculosis Patients 102
Alpha 0.77
Alpha 0.85
Alpha 0.63
Alpha 0.65
18-item EMIC
Stevelink et al. [101] India HIV
Patients/persons affected 95 HIV
95 leprosy
Alpha 0.76
Alpha 0.83
Rensen et al. [96] India Leprosy Patients 806 Alpha 0.88; weighted kappa 0.70; no floor or ceiling effects 17-item EMIC
Grover et al. [104] India Bi-polar disorder Patients 185 Alpha 0.94; good correlation with ISMI and Participation scale scores 15-item EMIC
Arachchi et al. [136] Sri Lanka Leprosy Patients 132 No validation was reported Not reported
  1. aSDCgroup Smallest detectable change in the group (based on standard error of measurement (SEM), using the formula 1.96 × √2 × SEM divided √n) ICC intraclass correlation coefficient, ISMI Internalized Stigma of Mental Illness, MRSA Meticillin-resistant Staphylococcus aureus, P-scale Participation Scale, WHOQOL-BREF WHO Quality of Life scale – Brief
  2. bSCID Structured Clinical Interview for DSM-III-R; HDARS Hamilton Depression and Anxiety Rating Scale,