Measuring discrimination experienced by people with a mental illness
- Brohan, Elaine, Thornicroft, Graham, Rüsch, Nicolas, Lasalvia, Antonio, Campbell, Megan M, Yalçınkaya-Alkar, Özden, Lanfredi, Mariangela, Ochoa, Susana, Üçok, Alp, Tomás, Catarina, Fadipe, Babatunde, Sebes, Julia, Fiorillo, Andrea, Sampogna, Gaia, Paula, Cristiane Silvestre, Valverde, Leonadis, Schomerus, Georg, Klemm, Pia, Ouali, Uta, Castelein, Stynke, Alexová, Aneta, Oexle, Nathalie, Guimarães, Patrícia Neves, Sportel, Bouwina Esther, Chang, Chih-Cheng, Li, Jie, Shanthi, Chilasagaram, Reneses, Blanca, Bakolis, Ioannis, Evans-Lacko, Sarah
- Authors: Brohan, Elaine , Thornicroft, Graham , Rüsch, Nicolas , Lasalvia, Antonio , Campbell, Megan M , Yalçınkaya-Alkar, Özden , Lanfredi, Mariangela , Ochoa, Susana , Üçok, Alp , Tomás, Catarina , Fadipe, Babatunde , Sebes, Julia , Fiorillo, Andrea , Sampogna, Gaia , Paula, Cristiane Silvestre , Valverde, Leonadis , Schomerus, Georg , Klemm, Pia , Ouali, Uta , Castelein, Stynke , Alexová, Aneta , Oexle, Nathalie , Guimarães, Patrícia Neves , Sportel, Bouwina Esther , Chang, Chih-Cheng , Li, Jie , Shanthi, Chilasagaram , Reneses, Blanca , Bakolis, Ioannis , Evans-Lacko, Sarah
- Date: 2022
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/302498 , vital:58202 , xlink:href="https://doi.org/10.1017/S0033291722000630"
- Description: Background: The Discrimination and Stigma Scale (DISC) is a patient-reported outcome measure which assesses experiences of discrimination among persons with a mental illness globally. Methods: This study evaluated whether the psychometric properties of a short-form version, DISC-Ultra Short (DISCUS) (11-item), could be replicated in a sample of people with a wide range of mental disorders from 21 sites in 15 countries/territories, across six global regions. The frequency of experienced discrimination was reported. Scaling assumptions (confirmatory factor analysis, inter-item and item-total correlations), reliability (internal consistency) and validity (convergent validity, known groups method) were investigated in each region, and by diagnosis group. Results: 1195 people participated. The most frequently reported experiences of discrimination were being shunned or avoided at work (48.7%) and discrimination in making or keeping friends (47.2%). Confirmatory factor analysis supported a unidimensional model across all six regions and five diagnosis groups. Convergent validity was confirmed in the total sample and within all regions [ Internalised Stigma of Mental Illness (ISMI-10): 0.28–0.67, stopping self: 0.54–0.72, stigma consciousness: −0.32–0.57], as was internal consistency reliability (α = 0.74–0.84). Known groups validity was established in the global sample with levels of experienced discrimination significantly higher for those experiencing higher depression [Patient Health Questionnaire (PHQ)-2: p more than 0.001], lower mental wellbeing [Warwick-Edinburgh Well-being Scale (WEMWBS): p is less than 0.001], higher suicidal ideation [Beck Hopelessness Scale (BHS)-4: p is less than 0.001] and higher risk of suicidal behaviour [Suicidal Ideation Attributes Scale (SIDAS): p is less than 0.001]. Conclusions: The DISCUS is a reliable and valid unidimensional measure of experienced discrimination for use in global settings with similar properties to the longer DISC. It offers a brief assessment of experienced discrimination for use in clinical and research settings.
- Full Text:
- Date Issued: 2022
- Authors: Brohan, Elaine , Thornicroft, Graham , Rüsch, Nicolas , Lasalvia, Antonio , Campbell, Megan M , Yalçınkaya-Alkar, Özden , Lanfredi, Mariangela , Ochoa, Susana , Üçok, Alp , Tomás, Catarina , Fadipe, Babatunde , Sebes, Julia , Fiorillo, Andrea , Sampogna, Gaia , Paula, Cristiane Silvestre , Valverde, Leonadis , Schomerus, Georg , Klemm, Pia , Ouali, Uta , Castelein, Stynke , Alexová, Aneta , Oexle, Nathalie , Guimarães, Patrícia Neves , Sportel, Bouwina Esther , Chang, Chih-Cheng , Li, Jie , Shanthi, Chilasagaram , Reneses, Blanca , Bakolis, Ioannis , Evans-Lacko, Sarah
- Date: 2022
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/302498 , vital:58202 , xlink:href="https://doi.org/10.1017/S0033291722000630"
- Description: Background: The Discrimination and Stigma Scale (DISC) is a patient-reported outcome measure which assesses experiences of discrimination among persons with a mental illness globally. Methods: This study evaluated whether the psychometric properties of a short-form version, DISC-Ultra Short (DISCUS) (11-item), could be replicated in a sample of people with a wide range of mental disorders from 21 sites in 15 countries/territories, across six global regions. The frequency of experienced discrimination was reported. Scaling assumptions (confirmatory factor analysis, inter-item and item-total correlations), reliability (internal consistency) and validity (convergent validity, known groups method) were investigated in each region, and by diagnosis group. Results: 1195 people participated. The most frequently reported experiences of discrimination were being shunned or avoided at work (48.7%) and discrimination in making or keeping friends (47.2%). Confirmatory factor analysis supported a unidimensional model across all six regions and five diagnosis groups. Convergent validity was confirmed in the total sample and within all regions [ Internalised Stigma of Mental Illness (ISMI-10): 0.28–0.67, stopping self: 0.54–0.72, stigma consciousness: −0.32–0.57], as was internal consistency reliability (α = 0.74–0.84). Known groups validity was established in the global sample with levels of experienced discrimination significantly higher for those experiencing higher depression [Patient Health Questionnaire (PHQ)-2: p more than 0.001], lower mental wellbeing [Warwick-Edinburgh Well-being Scale (WEMWBS): p is less than 0.001], higher suicidal ideation [Beck Hopelessness Scale (BHS)-4: p is less than 0.001] and higher risk of suicidal behaviour [Suicidal Ideation Attributes Scale (SIDAS): p is less than 0.001]. Conclusions: The DISCUS is a reliable and valid unidimensional measure of experienced discrimination for use in global settings with similar properties to the longer DISC. It offers a brief assessment of experienced discrimination for use in clinical and research settings.
- Full Text:
- Date Issued: 2022
Validity of categories related to gender identity in ICD-11 and DSM-5 among transgender individuals who seek gender-affirming medical procedures
- Robles, Rebeca, Keeley, Jared W, Vega-Ramírez, H, Cruz-Islas, Jeremy, Rodríguez-Pérez, Victor, Sharan, Pratap, Purnima, Shivani, Rao, Ravindra, Rodrigues-Lobato, María I, Soll, Bianca, Askevis-Leherpeux, Françoise, Roelandt, Jean-Luc, Campbell, Megan M, Grobler, Gerhard, Stein, Dan H, Khoury, Brigitte, El Khoury, Joseph, Fresán, Ana, Medina-Mora, María, Reed, Geoffrey M
- Authors: Robles, Rebeca , Keeley, Jared W , Vega-Ramírez, H , Cruz-Islas, Jeremy , Rodríguez-Pérez, Victor , Sharan, Pratap , Purnima, Shivani , Rao, Ravindra , Rodrigues-Lobato, María I , Soll, Bianca , Askevis-Leherpeux, Françoise , Roelandt, Jean-Luc , Campbell, Megan M , Grobler, Gerhard , Stein, Dan H , Khoury, Brigitte , El Khoury, Joseph , Fresán, Ana , Medina-Mora, María , Reed, Geoffrey M
- Date: 2022
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/302589 , vital:58210 , xlink:href="https://doi.org/10.1016/j.ijchp.2021.100281"
- Description: Background/Objective: The most recent versions of the two main mental disorders classifications—the World Health Organization's ICD-11 and the American Psychiatric Association's DSM–5—differ substantially in their diagnostic categories related to transgender identity. ICD-11 gender incongruence (GI), in contrast to DSM-5 gender dysphoria (GD), is explicitly not a mental disorder; neither distress nor dysfunction is a required feature. The objective was compared ICD-11 and DSM-5 diagnostic requirements in terms of their sensitivity, specificity, discriminability and ability to predict the use of gender-affirming medical procedures. Method: A total of 649 of transgender adults in six countries completed a retrospective structured interview. Results: Using ROC analysis, sensitivity of the diagnostic requirements was equivalent for both systems, but ICD-11 showed greater specificity than DSM-5. Regression analyses indicated that history of hormones and/or surgery was predicted by variables that are an intrinsic aspect of GI/GD more than by distress and dysfunction. IRT analyses showed that the ICD-11 diagnostic formulation was more parsimonious and contained more information about caseness than the DSM-5 model. Conclusions: This study supports the ICD-11 position that GI/GD is not a mental disorder; additional diagnostic requirements of distress and/or dysfunction in DSM-5 reduce the predictive power of the diagnostic model.
- Full Text:
- Date Issued: 2022
- Authors: Robles, Rebeca , Keeley, Jared W , Vega-Ramírez, H , Cruz-Islas, Jeremy , Rodríguez-Pérez, Victor , Sharan, Pratap , Purnima, Shivani , Rao, Ravindra , Rodrigues-Lobato, María I , Soll, Bianca , Askevis-Leherpeux, Françoise , Roelandt, Jean-Luc , Campbell, Megan M , Grobler, Gerhard , Stein, Dan H , Khoury, Brigitte , El Khoury, Joseph , Fresán, Ana , Medina-Mora, María , Reed, Geoffrey M
- Date: 2022
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/302589 , vital:58210 , xlink:href="https://doi.org/10.1016/j.ijchp.2021.100281"
- Description: Background/Objective: The most recent versions of the two main mental disorders classifications—the World Health Organization's ICD-11 and the American Psychiatric Association's DSM–5—differ substantially in their diagnostic categories related to transgender identity. ICD-11 gender incongruence (GI), in contrast to DSM-5 gender dysphoria (GD), is explicitly not a mental disorder; neither distress nor dysfunction is a required feature. The objective was compared ICD-11 and DSM-5 diagnostic requirements in terms of their sensitivity, specificity, discriminability and ability to predict the use of gender-affirming medical procedures. Method: A total of 649 of transgender adults in six countries completed a retrospective structured interview. Results: Using ROC analysis, sensitivity of the diagnostic requirements was equivalent for both systems, but ICD-11 showed greater specificity than DSM-5. Regression analyses indicated that history of hormones and/or surgery was predicted by variables that are an intrinsic aspect of GI/GD more than by distress and dysfunction. IRT analyses showed that the ICD-11 diagnostic formulation was more parsimonious and contained more information about caseness than the DSM-5 model. Conclusions: This study supports the ICD-11 position that GI/GD is not a mental disorder; additional diagnostic requirements of distress and/or dysfunction in DSM-5 reduce the predictive power of the diagnostic model.
- Full Text:
- Date Issued: 2022
Prioritising African perspectives in psychiatric genomics research
- Kamaara, Eunice, Kong, Camillia, Campbell, Megan M
- Authors: Kamaara, Eunice , Kong, Camillia , Campbell, Megan M
- Date: 2020
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/302520 , vital:58204 , xlink:href="https://doi.org/10.1111/dewb.12248"
- Description: Psychiatric genomics research with African populations comes with a range of practical challenges around translation of psychiatric genomics research concepts, procedures, and nosology. These challenges raise deep ethical issues particularly around legitimacy of informed consent, a core foundation of research ethics. Through aconsideration of the constitutive function of language, the paper problematises like‐for‐like, designative translations which often involve the ‘indigenization’ of English terms or use of metaphors which misrepresent the risks and benefits of research. This paper argues that effective translation of psychiatric genomics research terminology in African contexts demands substantive engagement with African conceptual schemas and values. In developing attenuated forms of translational thinking, researchers may recognise the deeper motivational reasons behind participation in research, highlighting the possibility that such reasons may depart from the original meaning implied within informed consent forms. These translational issues might be ameliorated with a critical re-examination of how researchers develop and present protocols to institutional ethics review boards.
- Full Text:
- Date Issued: 2020
- Authors: Kamaara, Eunice , Kong, Camillia , Campbell, Megan M
- Date: 2020
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/302520 , vital:58204 , xlink:href="https://doi.org/10.1111/dewb.12248"
- Description: Psychiatric genomics research with African populations comes with a range of practical challenges around translation of psychiatric genomics research concepts, procedures, and nosology. These challenges raise deep ethical issues particularly around legitimacy of informed consent, a core foundation of research ethics. Through aconsideration of the constitutive function of language, the paper problematises like‐for‐like, designative translations which often involve the ‘indigenization’ of English terms or use of metaphors which misrepresent the risks and benefits of research. This paper argues that effective translation of psychiatric genomics research terminology in African contexts demands substantive engagement with African conceptual schemas and values. In developing attenuated forms of translational thinking, researchers may recognise the deeper motivational reasons behind participation in research, highlighting the possibility that such reasons may depart from the original meaning implied within informed consent forms. These translational issues might be ameliorated with a critical re-examination of how researchers develop and present protocols to institutional ethics review boards.
- Full Text:
- Date Issued: 2020
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