Measuring the paradox of self-stigma : Psychometric properties of a brief scale

Annals of General Psychiatry, 20(1), 5

Background: Exposure to public stigma can lead to stereotype endorsement and resignation, which are constructs
related to self-stigma. This latter phenomenon has well-documented deleterious consequences for people living with
mental illness. Paradoxically, it can also lead to the empowering reactions of righteous anger and coming out proud.
Aim: The aim of this study was to develop and validate a brief tool to measure stereotype endorsement, righteous
anger, and non-disclosure across diferent groups of stigmatized persons. This process was conducted in collaboration
with users.
Method: Using focus groups with mental health professionals and people living with mental illness, 72 items were
developed to measure various aspects of self-stigma. The Paradox of Self-Stigma scale (PaSS-24) containing 24 items
and three subscores (stereotype endorsement, non-disclosure, and righteous anger) resulted from a calibration phase
using factor analysis. This structure was cross-validated on an independent sample. Internal consistency, test–retest
reliability, and convergent validity were also evaluated.
Results: 202 patients were assessed. The PaSS-24 demonstrated good internal validity. Internal consistency, test–
retest reliability, and convergent validity estimates were also good.
Conclusions: The PaSS-24 is a short but psychometrically rigorous tool designed to measure self-stigma and related
constructs in French language, developed in collaboration with users. The development and validation of the PaSS-24
represent a frst step towards implementing and evaluating programs aimed at reducing negative consequences of

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