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[Contribution to the Italian validation of the Chronic Illness Anticipated Stigma Scale (CIASS)]

Contributo alla validazione italiana del Chronic Illness Anticipated Stigma Scale (CIASS)

Authors

Published
26 February 2025
Section
Original Articles
DOI
10.4081/gimle.604
Pages
49-55

Abstract

Background. Interpersonal relationships contribute to the psychological adjustments to chronic disease, directly affecting health and, more generally, life satisfaction of patients. Those factors are often threatened by the fear of becoming target of prejudices and discrimination from those who share their daily life with. Thus, this study proposes a contribution to the Italian adaptation and validation of the Chronic Illness Anticipated Stigma Scale (CIASS), a brief questionnaire (12 items) that aims to assess perceived stigma of chronic illness patients in family, work and health care contexts.
Method. 279 chronic illness patients have completed the questionnaire, comparing the scores with those obtained in depression (BDI-Il), anxiety (STAI), and internalized stigma scales.
Results. Confirmatory factor analysis (CFA) on the Italian sample has shown the same structure of the original questionnaire, composed by three dimensions of anticipated stigma, experienced with family and friends, work colleagues and health care providers. Correlation analyses confirm the relation between scores of anticipated stigma and other mental health indicators as anxiety and depression.
Conclusion. Italian version of CIASS demonstrates to be a valid and reliable instrument, considering it both as an indicator of person's state of health and a promising marker of the specific kind of perceived discrimination in family, care and working contexts.

References

  1. 1) Istituto nazionale di statistica (ISTAT). Indagine multiscopo "Aspetti della vita quotidiana" 2014. Disponibile online su: http://www.istat.it/ it/archivio/4630.
  2. 2) McGonagle AK, Barnes-Farrell JL. Chronic illness in the workplace: stigma, identity threat and strain. Stress Health 2014; 30(4): 310-321. DOI: https://doi.org/10.1002/smi.2518
  3. 3) Quinn DM, Chaudoir SR. Living with a concealable stigmatized identity: The impact of anticipated stigma, centrality, salience, and cultural stigma on psychological distress and health. J Pers Soc Psychol 2009; 97(4): 634-651. DOI: https://doi.org/10.1037/a0015815
  4. 4) Holzemer WL, Human S, Arudo J, et al. (2009) Exploring HIV stigma and quality of life for persons living with HIV infection. Journal of the Association of Nurses in AIDS Care 20(3): 161-168. 5) Stutterheim SE, Pryor JB, Bos AE, Hoogendijk R, Muris P, Schaalma HP. HIV-related stigma and psychological distress: the harmful effects of specific stigma manifestations in various social settings. AIDS 2009; 23(17): 2353-2357. DOI: https://doi.org/10.1097/QAD.0b013e3283320dce
  5. 6) Corrigan P. How Stigma Interferes With Mental Health Care. Am Psychol 2004; 59(7): 614-625. DOI: https://doi.org/10.1037/0003-066X.59.7.614
  6. 7) Pascoe EA, Smart Richman L. Perceived discrimination and health: a meta-analytic review. Psychol Bull 2009; 135(4): 531-554. DOI: https://doi.org/10.1037/a0016059
  7. 8) Rose JH. Social support and cancer: Adult patients' desire for support from family, friends, and health professionals. Am J Community Psychol 1990; 18(3): 439-464. DOI: https://doi.org/10.1007/BF00938117
  8. 9) Major B, O'Brien LT. The social psychology of stigma. Annu Rev Psychol 2005; 56: 393-421. DOI: https://doi.org/10.1146/annurev.psych.56.091103.070137
  9. 10) Corrigan PW, Watson AC, Barr L. The Self-Stigma of Mental IIIness: Implications for Self-Esteem and Self-Efficacy. J Soc Clin Psychol 2006; 25(8): 875-884. DOI: https://doi.org/10.1521/jscp.2006.25.8.875
  10. 11) Earnshaw VA, Quinn DM. The impact of stigma in healthcare on people living with chronic illnesses. J Health Psychol 2012; 17: 157-168. DOI: https://doi.org/10.1177/1359105311414952
  11. 12) Overstreet NM, Quinn DM. The intimate partner violence stigmatization model and barriers to help seeking. Basic Appl Soc Psych 2013; 35: 109-122. DOI: https://doi.org/10.1080/01973533.2012.746599
  12. 13) Ponzio M, Brichetto G, Zaratin P, Battaglia MA. Workers with disability: the case of multiple sclerosis. Neurol Sci 2015; 36(10): 1835-1841. DOI: https://doi.org/10.1007/s10072-015-2265-3
  13. 14) Anagnostouli M, S Katsavos S, Artemiadis A et al. Determinants of stigma experienced by patients suffering from multiple sclerosis. A Hellenic population study. Mult Scler J 2014; 20: (S1): 67-284.
  14. 15) Harden CL, Kossoy A, Vera S, Nikolov B. Reaction to Epilepsy in the Workplace. Epilepsia 2004; 45(9): 1134-1140. DOI: https://doi.org/10.1111/j.0013-9580.2004.67003.x
  15. 16) McTernan WP, Dollard MF, LaMontagne AD. Depression in the workplace: An economic cost analysis of depression-related productivity loss attributable to job strain and bullying. Work Stress 2013; 27(4): 321-338. DOI: https://doi.org/10.1080/02678373.2013.846948
  16. 17) Pollack KM. Chronic diseases and individual risk for workplace injury. Occup Environ Med 2014; 71(3): 155-156. DOI: https://doi.org/10.1136/oemed-2013-101875
  17. 18) Earnshaw, VA.; Quinn, DM. Development and evaluation of the chronic illness anticipated stigma scale. The Annual Convention of the Association for Psychological Science; Boston, MA 2010.
  18. 19) Earnshaw VA, Quinn DM, Kalichman SC, Park CL. Development and psychometric evaluation of the Chronic Illness Anticipated Stigma Scale. J Behav Med 2013; 36(3): 270-282. DOI: https://doi.org/10.1007/s10865-012-9422-4
  19. 20) Hampel P, Rudolph H, Stachow R, Laß-Lentzsch A, Petermann F. Coping among children and adolescents with chronic illness. Anxiety, Stress Coping 2005; 18(2): 145-155. DOI: https://doi.org/10.1080/10615800500134639
  20. 21) Chan F, McMahon BT, Cheing G, Rosenthal DA, Bezyak J. Drivers of workplace discrimination against people with disabilities: the utility of Attribution Theory. Work 2005; 25(1): 77-88. DOI: https://doi.org/10.3233/WOR-2005-00484
  21. 22) Beatty JE, Joffe R. An Overlooked Dimension Of Diversity: The Career Effects of Chronic Illness. Organ Dyn 2006; 35(2): 182-195. 23) Stanton AL, Revenson TA, Tennen H. Health Psychology: Psychological Adjustment to Chronic Disease. Annu Rev Psychol 2007; 58(1): 565-592. DOI: https://doi.org/10.1146/annurev.psych.58.110405.085615
  22. 24) Van Brakel WH. Measuring health-related stigma—A literature review. Psychol Health Med 2006; 11(3): 307-334. DOI: https://doi.org/10.1080/13548500600595160
  23. 25) Beck AT, Steer RA, Brown GK. Manual for the Beck Depression Inventory-Il. San Antonio, TX: Psychological Corporation; 1996. 26) Spielberger CD, Gorsuch RI, Lushene RE. The STAI manual for the State-Trait Anxiety Inventory. Palo Alto, Calif.: Consulting Psychologists Press, 1970.
  24. 27) R Development Core Team (2008). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. ISBN 3-900051-07-0, URL http://www.R-project.org 28) Forero CG, Maydeu-Olivares A, Gallardo-Pujol D. Factor Analysis with Ordinal Indicators: A Monte Carlo Study Comparing DWLS and ULS Estimation. Struct Equ Model A Multidiscip J 2009; 16(4): 625-641. 29) Flora DB, Curran PJ. An Empirical Evaluation of Alternative Methods of Estimation for Confirmatory Factor Analysis With Ordinal Data. Psychol Methods 2004; 9(4): 466-491. DOI: https://doi.org/10.1080/10705510903203573
  25. 30) Furr RM, Bacharach VR. Psychometrics: an introduction. Thousand Oaks, CA: Sage Publishers, 2008.
  26. 31) Hu L, Bentler PM. Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Struct Equ Model A Multidiscip J 1999; 6(1): 1-55. DOI: https://doi.org/10.1080/10705519909540118
  27. 32) Schermelleh-Engel K, Moosbrugger H, Müller H. Evaluating the Fit of Structural Equation Models: Tests of Significance and Descriptive Goodness-of-Fit Measures. Method Psychol Res 2003; 8(2): 23-74.
  28. 33) Mickelson KD. Perceived Stigma, Social Support, and Depression. Personal Soc Psychol Bull 2001; 27(8): 1046-1056. DOI: https://doi.org/10.1177/0146167201278011
  29. 34) Cataldo JK, Brodsky JL. Lung cancer stigma, anxiety, depression and symptom severity. Oncology 2013; 85(1): 33-40. DOI: https://doi.org/10.1159/000350834
  30. 35) Quinn DM, Williams MK, Quintana F, et al. Examining effects of anticipated stigma, centrality, salience, internalization, and outness on psychological distress for people with concealable stigmatized identities. PLoS One 2014; 9(5): e96977. DOI: https://doi.org/10.1371/journal.pone.0096977
  31. 36) Grov C, Golub SA, Parsons JT, Brennan M, Karpiak SE. Loneliness and HIV-related stigma explain depression among older HIV-positive adults. AIDS Care 2010. DOI: https://doi.org/10.1080/09540120903280901
  32. 37) Chaudoir SR, Quinn DM. Evidence that anticipated stigma predicts poorer depressive symptom trajectories among emerging adults living with concealable stigmatized identities. Self Identity 2015: 1-13. DOI: https://doi.org/10.1080/15298868.2015.1091378
  33. 38) Rehse B, Pukrop R: Effects of psychosocial interventions on quality of life in adult cancer patients: Meta analysis of 37 published controlled outcome studies. Patient Education and Counseling 2003, 50: 179-186. DOI: https://doi.org/10.1016/S0738-3991(02)00149-0
  34. 39) Greaves-Otte JGW, Greaves J, Kruyt PM, et al. Problems at social re-integration of long-term cancer survivors. Eur J Cancer 1991; 27: 178-81. DOI: https://doi.org/10.1016/0277-5379(91)90482-S
  35. 40) Schag CA, Ganz PA, Wing DS, et al. Quality of life in adult survivors of lung, colon and prostate cancer. Qual Life Res 1994; 3: 127-141. DOI: https://doi.org/10.1007/BF00435256

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