Advertisement

Stigma and discrimination toward mental illness: translation and validation of the Italian version of the attribution questionnaire-27 (AQ-27-I)

  • Luca Pingani
  • Matilde Forghieri
  • Silvia Ferrari
  • Dror Ben-Zeev
  • Paolo Artoni
  • Fausto Mazzi
  • Gaspare Palmieri
  • Marco Rigatelli
  • Patrick W. Corrigan
Original Paper

Abstract

Purpose

The aim of this study was to translate the Attribution Questionnaire-27 (AQ-27) to the Italian language (AQ-27-I), and to examine the reliability and validity of this new Italian version.

Methods

The questionnaire was translated using the standard translation/back-translation method. Cronbach’s alpha and intraclass coefficients were used to estimate instrument reliability. Confirmatory factor analysis was conducted to corroborate the original English version factor structure in the new measure, and to establish validity. Path analyses were meant to validate relationships found in the English version among Italian-speaking participants.

Results

The AQ-27-I demonstrated acceptable internal consistency, with a Cronbach’s alpha of 0.82 for the total scale and ranging between 0.52 and 0.91 for the subscales. The test–retest reliability was also satisfactory, with intraclass correlation coefficients of 0.72 for the total scale and ranging between 0.51 and 0.89 for the subscales. Fit indices of the model supported the factor structure and paths.

Conclusions

The AQ-27-I is a reliable measure to assess stigmatizing attitudes in Italian.

Keywords

Psychometrics Reliability and validity Stereotyping Questionnaires Factor analysis 

Notes

Conflict of interest

All authors declare that there are no financing arrangements or payments that might be considered a conflict of interests related to the present paper.

References

  1. 1.
    Marwaha S, Johnson S (2005) Views and experiences of employment among people with psychosis: a qualitative descriptive study. Int J Soc Psychiatry 51:302–316PubMedCrossRefGoogle Scholar
  2. 2.
    Baumann A (2007) Stigmatization, social distance and exclusion because of mental illness: the individual with mental illness as a ‘stranger’. Int Rev Psychiatry 19:131–135PubMedCrossRefGoogle Scholar
  3. 3.
    El-Badri S, Mellsop G (2007) Stigma and quality of life as experienced by people with mental illness. Australas Psychiatry 15:195–200PubMedCrossRefGoogle Scholar
  4. 4.
    Halter M (2008) Perceived characteristics of psychiatric nurses: stigma by association. Arch Psychiatr Nurs 22:20–26PubMedCrossRefGoogle Scholar
  5. 5.
    Vauth R, Kleim B, Wirtz M, Corrigan P (2007) Self-efficacy and empowerment as outcomes of self-stigmatizing and coping in schizophrenia. Psychiatry Res 150:71–80PubMedCrossRefGoogle Scholar
  6. 6.
    Yap MB, Wright A, Jorm AF (2010) The influence of stigma on young people’s help-seeking intentions and beliefs about the helpfulness of various sources of help. Soc Psychiatry Psychiatr Epidemiol. doi: 10.1007/s00127-010-0300-5
  7. 7.
    Mojtabai R (2010) Mental illness stigma and willingness to seek mental health care in the European Union. Soc Psychiatry Psychiatr Epidemiol 45(7):705–712PubMedCrossRefGoogle Scholar
  8. 8.
    Norman RM, Sorrentino RM, Gawronski B, Szeto AC, Ye Y, Windell D (2010) Attitudes and physical distance to an individual with schizophrenia: the moderating effect of self-transcendent values. Soc Psychiatry Psychiatr Epidemiol 45(7):751–758PubMedCrossRefGoogle Scholar
  9. 9.
    Corrigan P, Thompson V, Lambert D, Sangster Y, Noel Jm Campbell J (2003) Perceptions of discrimination among persons with serious mental illness. Psychiatr Serv 54:1105–1110PubMedCrossRefGoogle Scholar
  10. 10.
    Link B, Phelan J (2001) Conceptualizing stigma. Ann Rev Sociol 27:363–385CrossRefGoogle Scholar
  11. 11.
    Corrigan PW, Watson AC (2002) Understanding the impact of stigma on people with mental illness. World Psychiatry 1(1):16–20PubMedGoogle Scholar
  12. 12.
    Weiner B (1995) Judgment of responsibility: a foundation for a theory of social conduct. Guilford press, New YorkGoogle Scholar
  13. 13.
    Edwards JM, Endler NS (1989) Appraisal of stressful situations. Personal Individ Differ 10(1):7–10CrossRefGoogle Scholar
  14. 14.
    Paterson RJ, Neufeld RW (1987) Clear danger: situational determinants of the appraisal of threat. Psychol Bull 101:404–416PubMedCrossRefGoogle Scholar
  15. 15.
    Fung KM, Tsang HW, Chan F (2010) Self-stigma, stages of change and psychosocial treatment adherence among Chinese people with schizophrenia: a path analysis. Soc Psychiatry Psychiatr Epidemiol 45(5):561–568PubMedCrossRefGoogle Scholar
  16. 16.
    Corrigan P, Green A, Lundin R, Kubiak M, Penn D (2001) Familiarity with and social distance from people who have serious mental illness. Psychiatr Serv 52:953–958PubMedCrossRefGoogle Scholar
  17. 17.
    Angermeyer MC, Matschinger H (2004) The stereotype of schizophrenia and its impact on discrimination against people with schizophrenia: results from a representative survey in Germany. Schizophr Bull 30(4):1049–1061PubMedCrossRefGoogle Scholar
  18. 18.
    Crisp A (2000) Changing minds: every family in the land. An update on the College’s campaign. Psychiatric Bull 24:267–268CrossRefGoogle Scholar
  19. 19.
    Handikappombudsmannen (2000) The Psyke Campaign—a concluding evaluation by the Swedish Disability. Ombudsman, StockholmGoogle Scholar
  20. 20.
    Hocking B (2003) Reducing mental illness stigma and discrimination—everybody’s business. Med J Aust 178:S47–S48PubMedGoogle Scholar
  21. 21.
    Association WorldPsychiatric (1998) Open the doors: WPA global program to reduce stigma and discrimination because of schizophrenia. World Psychiatric Association, GenevaGoogle Scholar
  22. 22.
    Sartorius N, Schulze H (2005) Reducing the stigma of mental illness. A report from a Global program of the World Psychiatric Association. Cambridge University Press, CambridgeGoogle Scholar
  23. 23.
    World Health Organization (2005) Stigma and discrimination against the mentally ill in Europe. Briefing for the WHO Ministerial Conference on Mental Health. World Health Organization, GenevaGoogle Scholar
  24. 24.
    Schulze B (2007) Stigma and mental health professionals: a review of the evidence on an intricate relationship. Int Rev Psychiatry 19:137–155PubMedCrossRefGoogle Scholar
  25. 25.
    Jorm AF, Griffiths KM (2008) The public’s stigmatizing attitudes towards people with mental disorders: how important are biomedical conceptualizations? Acta Psychiatr Scand 118(4):315–321PubMedCrossRefGoogle Scholar
  26. 26.
    Lincoln TM, Arens E, Berger C, Rief W (2008) Can antistigma campaigns be improved? A test of the impact of biogenetic vs psychosocial causal explanations on implicit and explicit attitudes to schizophrenia. Schizophr Bull 34(5):984–994PubMedCrossRefGoogle Scholar
  27. 27.
    Buizza C, Schulze B, Bertocchi E, Rossi G, Ghilardi A, Pioli R (2007) The stigma of schizophrenia from patients’ and relatives’ view: a pilot study in an Italian rehabilitation residential care unit. Clin Pract Epidemiol Ment Health 3:23PubMedCrossRefGoogle Scholar
  28. 28.
    Magliano L, Fiorillo A, De Rosa C, Malangone C, Maj M (2004) Beliefs about schizophrenia in Italy: a comparative nationwide survey of the general public, mental health professionals, and patients’ relatives. Can J Psychiatry 49:322–330PubMedGoogle Scholar
  29. 29.
    Magliano L, De Rosa C, Fiorillo A, Malangone C, Guarneri M, Marasco C, Maj M (2004) Beliefs of psychiatric nurses about schizophrenia: a comparison with patients’ relatives and psychiatrists. Int J Soc Psychiatry 50:319–330PubMedCrossRefGoogle Scholar
  30. 30.
    Buizza C, Pioli R, Ponteri M, Vittorielli M, Corradi A, Minicuci N, Rossi G (2005) Community attitudes towards mental illness and socio-demographic characteristics: an Italian study. Epidemiol Psichiatr Soc 14(3):154–162PubMedCrossRefGoogle Scholar
  31. 31.
    Magliano L, Marasco C, Guarneri M, Malangone C, Lacrimini G, Zanus P, Maj M (1999) A new questionnaire assessing the opinions of the relatives of patients with schizophrenia on the causes and social consequences of the disorder: reliability and validity. Eur Psychiatry 14(2):71–75PubMedCrossRefGoogle Scholar
  32. 32.
    Bhugra D (1989) Attitudes towards mental illness. A review of the literature. Acta Psychiatr Scand 80:1–12PubMedCrossRefGoogle Scholar
  33. 33.
    Link B, Mirotznik J, Cullen F (1991) The effectiveness of stigma coping orientations: can negative consequences of mental illness labelling be avoided? J Health Soc Behav 32:302–320PubMedCrossRefGoogle Scholar
  34. 34.
    Wolff G, Pathare S, Craig T, Leff J (1996) Public education for community care. A new approach. Br J Psychiatry 168:441–447PubMedCrossRefGoogle Scholar
  35. 35.
    Byrne P (1997) Psychiatric stigma: past, passing and to come. J R Soc Med 90:618–621PubMedGoogle Scholar
  36. 36.
    Corrigan P, Markowitz F, Watson A, Rowan D, Kubiak M (2003) An attribution model of public discrimination towards persons with mental illness. J Health Soc Behav 44:162–179PubMedCrossRefGoogle Scholar
  37. 37.
    Weiner B (1988) Attribution theory and attributional therapy: some theoretical observations and suggestions. Br J Clin Psychol 27:99–104PubMedCrossRefGoogle Scholar
  38. 38.
    Link B, Cullen F (1986) Contact with the mentally ill and perceptions of how dangerous they are. J Health Soc Behav 27:289–302PubMedCrossRefGoogle Scholar
  39. 39.
    Martin JK, Pescosolido BA, Tuch S (2000) Of Fear and loathing: the role of disturbing behaviour, labels, and casual attributions in shaping public attitudes toward people with mental illness. J Health Soc Behav 41:208–223CrossRefGoogle Scholar
  40. 40.
    Corrigan P, Rowan D, Green A, Lundin R, River P, Uphoff-Wasowsky K, White K, Kubiak M (2002) Challenging two mental illness stigmas: personal responsibility and dangerousness. Schizophr Bull 28:293–309PubMedCrossRefGoogle Scholar
  41. 41.
    Corrigan P, Watson A, Warpinski A, Gracia G (2004) Stigmatizing attitudes about mental illness and allocation of resources to mental health services. Community Ment Health J 40:297–307PubMedCrossRefGoogle Scholar
  42. 42.
    Corrigan P, Lurie B, Goldman H, Slopen N, Medasani K, Phelan S (2005) How adolescents perceive the stigma of mental illness and alcohol abuse. Psychiatr Serv 56:544–550PubMedCrossRefGoogle Scholar
  43. 43.
    Istituto Nazionale di Statistica (2008) Indicatori socio-demografici. http://dati.istat.it/
  44. 44.
    Magliano L, Fadden G, Madianos M, De Almeida J, Held T, Guarneri M, Marasco C, Tosini P, Maj M (1998) Burden on the families of patients with schizophrenia: results of the BIOMED I study. Soc Psychiatry Psychiatr Epidemiol 33:405–412PubMedCrossRefGoogle Scholar
  45. 45.
    Piccinelli M, Politi P, Barale F (2002) Focus on psychiatry in Italy. Br J Psychiatry 181:538–544PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Luca Pingani
    • 1
  • Matilde Forghieri
    • 2
  • Silvia Ferrari
    • 2
  • Dror Ben-Zeev
    • 3
    • 4
  • Paolo Artoni
    • 2
  • Fausto Mazzi
    • 2
  • Gaspare Palmieri
    • 5
  • Marco Rigatelli
    • 2
  • Patrick W. Corrigan
    • 6
  1. 1.Department of Psychiatry, International Doctorate School in Clinical and Experimental MedicineUniversity of Modena and Reggio EmiliaModenaItaly
  2. 2.Department of PsychiatryUniversity of Modena and Reggio EmiliaModenaItaly
  3. 3.Dartmouth Psychiatric Research Center, Dartmouth Medical SchoolLebanonUSA
  4. 4.Thresholds Research InstituteChicagoUSA
  5. 5.Villa Igea HospitalModenaItaly
  6. 6.Institute of Psychology, Illinois Institute of TechnologyChicagoUSA

Personalised recommendations