Validating measures of stigma against those with mental illness among a community sample in Kilifi Kenya

[摘要] Background. Stigma against persons with mental illness is a universal phenomenon, but culture influences the understanding of etiology of mental illness and utilization of healthservices.Methods. We validated Kiswahili versions of three measures of stigma which were originallydeveloped in the United Kingdom: Community Attitudes Toward the Mentally Ill Scale(CAMI), Reported and Intended Behaviors Scale (RIBS) and Mental Health AwarenessKnowledge Schedule (MAKS) and evaluated their psychometric properties using a communitysample (N = 616) in Kilifi, Kenya.Results. Confirmatory factor analysis confirmed the one-factor solution for RIBS [root meansquared error of approximation (RMSEA) < 0.01, comparative fit index (CFI) = 1.00, Tucker–Lewis index (TLI) = 1.01] and two-factor solution for MAKS (RMSEA = 0.04, CFI = 0.96,TLI = 0.95). A 23-item, three-factor model provided the best indices of goodness of fit forCAMI (RMSEA = 0.04, CFI = 0.90, TLI = 0.89). MAKS converged with both CAMI andRIBS. Internal consistency was good for the RIBS and acceptable for CAMI and MAKS.Test–retest reliabilities were excellent for RIBS and poor for CAMI and MAKS, but kappascores for inter-rater agreement were relatively low for these scales. Results support validityof the original MAKS and RIBS scale and a modified CAMI scale and suggest that stigmais not an enduring trait in this population. The low kappa scores are consistent with firstkappa paradox which is due to adjustment for agreements by chance in case of marginalprevalence values.Conclusions. Kiswahili versions of the MAKS, RIBS and a modified version of the CAMI arevalid for use in the study population. Stigma against people with mental illness may not be anenduring trait in this population.

[学科分类] 化石学

[关键词] CAMI III;Kenya;Kilifi;Kiswahili;MAKS;mental disorders;psychometrics;RIBS;stigma