The Self‐Stigma of Depression Scale (SSDS): development and psychometric evaluation of a new instrument

Abstract

Self-stigma may feature strongly and be detrimental for people with depression, but the understanding of its nature and prevalence is limited by the lack of psychometrically-validated measures. This study aimed to develop and validate a measure of self-stigma about depression. Items assessing self-stigma were developed from focus group discussions, and were tested and refined over three studies using surveys of 408 university students, 330 members of a depression Internet network, and 1312 members of the general Australian public. Evaluation involved item-level and bivariate analyses, and factor analytic procedures. Items performed consistently across the three surveys. The resulting Self-Stigma of Depression Scale (SSDS) comprised 16 items representing subscales of Shame, Self-Blame, Social Inadequacy, and Help-Seeking Inhibition. Construct validity, internal consistency and test-retest reliability were satisfactory. The SSDS distinguishes self-stigma from perceptions of stigma by others, yields in-depth information about self-stigma of depression, and possesses good psychometric properties. It is a promising tool for the measurement of self-stigma and is likely to be useful in further understanding self-stigma and evaluating stigma interventions.

A Self-Paced, Web-Based, Positive Emotion Skills Intervention for Reducing Symptoms of Depression: Protocol for Development and Pilot Testing of MARIGOLD (Preprint)

“…      Depression Self Stigma Scale (DSSS) [133] 32 items measuring self-stigma related to depression.      Self Stigma Depression Scale (SSDS) [134] 16 items assessing levels of measures shame, selfblame, help-seeking inhibition and social      inadequacy regarding depressive symptoms.…”

Depression explanatory models of primary care patients and doctors: Relationship with self-stigma, communication effectiveness, and recovery

“…Two scales have been specifically developed for selfstigma in people with depression -the Depression Self-Stigma Scale (DSSS) by Kanter, Rusch, and Brondino (2008) and the Self-Stigma of Depression Scale (SSDS) by Barney, Griffiths, Christensen, and Jorm (2010 as mentioned earlier, has shown that personal self-stigma has more impact on a person with depression than anticipated stigma from others. Stevelink et al (2012) .…”

“…While the SSDS's limited reliability is admittedly a constraint, I chose to use it for the reasons detailed in the previous paragraph and also because it was developed in an Australian context (Barney et al, 2010). To counter the limitations of the SSDS, I combined items from it with the ISMI (modified to be relevant to depression).…”

“…The availability of psychometrically sound self-stigma scales enables researchers to determine the nature and degree of depression self-stigma (an important component of my thesis), to appropriately design interventions to target aspects of self-stigma, and to evaluate whether such programmes are effective (Barney et al, 2010). Rüsch, Angermeyer, and Corrigan (2005) However, Schnittker (2008) argued that the rise of genetic frameworks for mental illness fosters an essentialist perspective of mental conditions as stable and unyielding, even with treatment.…”

“…The problem could have been avoided by using either the Depression Self-Stigma Scale (DSSS: Kanter et al, 2008) or the Self-Stigma of Depression Scale (SSDS: Barney et al, 2010) instead of combining items from the SSDS with the ISMI (Ritsher et al, 2003). The rationale was to retain the content validity of the SSDS because it had been developed in Australia from people with direct or indirect experience of depression while incorporating the psychometrically superior ISMI (Stevelink et al, 2012).…”