■精神障碍在社会中经常受到污名化。精神疾病的污名会影响患有精神疾病的人本身及其家庭成员-这种现象称为协会污名(SBA)。患有精神疾病(COPMI)的父母的孩子是SBA的特殊弱势群体。在我们的系统审查中,经验丰富的SBA,预期的SBA,附属SBA,结构性歧视被确定为患有精神疾病的父母子女的相关污名化维度。评估与患有精神疾病的父母一起长大的青少年的SBA,开发了COPMI-SQ。
■N=930名青少年完成了这项研究。其中,N=380名青少年(样本1;72.6%为女性,平均年龄17.12(SD=2.01)岁)报告与至少一位患有精神疾病的父母一起长大。使用验证性因素分析(CFA)和探索性因素分析(EFA)以及标准项目和可靠性分析,我们对第一个样本的COPMI-SQ进行了分析和修正。为了验证修订后的COPMI-SQ的阶乘结构,CFA也在其他N=550青少年的独立样本中进行(样本2;80.0%女性,平均年龄16.36(SD=1.98)岁),报告没有与患有精神疾病的父母一起长大。要测试四个测量不变性,在报告父母有或无精神疾病成长的青少年的合并样本中进行了多组CFA(样本1和样本2).
■样本1中的CFA导致理论上假定的四因素结构的模型拟合不充分(CFI=.687;RMSEA=.064(90%CI=.062-.066);SRMR=.092;AIC=229155.63)。在对样本1进行EFA和项目和可靠性分析后,COPMI-SQ降低到四个量表(“有经验的SBA,\“\”附属公司SBA,\"\"羞耻,\"和\"预期SBA\")和两个额外的筛查量表(\"医疗保健\"和\"社会支持\")。为了方便问卷的使用,每个量表只保留了三个最好的项目,将项目总数减少到12个,外加5个额外的筛选项目。样本2中的CFA也导致理论上假定的四因素结构的模型拟合不充分(CFI=.667;RMSEA=.065(90%CI=.063-.066);SRMR=.101;AIC=335651.99)。相比之下,最终版本的COPMI-SQ-r显示出最佳的模型拟合(CFI=.945;RMSEA=.062(90%CI=.052-.072);SRMR=.049;AIC=60008.05)。在多组CFA(样本1和样本2)中,建立了度量不变性(χ2(208)=481.58,p<.001;CFI=.939;RMSEA=.053(90%CI=.047-.059);SRMR=.056)。在样本2中,发现内部一致性对于总量表(α=.84)是好的,对于子量表(α=.64至.78)几乎可以接受。
■COPMI-SQ(COPMI-SQ-r)的修订版是一种可靠且经济的问卷,用于评估与患有精神疾病的父母一起长大的青少年的SBA。COPMI-SQ-r可用于帮助开发和评估受影响青少年的反污名和一般干预措施。
UNASSIGNED: Mental disorders are often stigmatized in society. The stigma of mental illness affects people with a mental illness themselves as well as their family members-a phenomenon called stigma by association (SBA). Children of parents with a mental illness (COPMI) are a particular vulnerable group for SBA. In our systematic review, experienced SBA, anticipated SBA, affiliate SBA, and structural discrimination were identified as relevant stigma dimensions for children of parents with a mental illness. To assess SBA in adolescents who grow up with a parent with a mental illness, the COPMI-SQ was developed.
UNASSIGNED: N = 930 adolescents completed the study. Of those, N = 380 adolescents (sample 1; 72.6% female, mean age 17.12 (SD = 2.01) years) reported growing up with at least one parent with a mental illness. Using confirmatory (CFA) and exploratory factor analyses (EFA) as well as standard item and reliability analyses, we analyzed and revised the COPMI-SQ in the first sample. To validate the factorial structure of the revised COPMI-SQ, CFA was also conducted in the independent sample of the other N = 550 adolescents (sample 2; 80.0% female, mean age 16.36 (SD = 1.98) years) who reported not growing up with a parent with a mental illness. To test four measurement invariance, a multiple-group CFA was conducted in the combined sample of adolescents who reported growing up with and without a parent with a mental illness (sample 1 and sample 2).
UNASSIGNED: CFA in sample 1 resulted in an inadequate model fit for the theoretically assumed four-factor structure (CFI = .687; RMSEA = .064 (90% CI = .062-.066); SRMR = .092; AIC = 229 155.63). Following EFA and item and reliability analyses in sample 1, the COPMI-SQ was reduced to four scales (\"Experienced SBA,\" \"Affiliate SBA,\" \"Shame,\" and \"Anticipated SBA\") and two additional screening scales (\"Healthcare\" and \"Social support\"). To facilitate questionnaire use, only the three best items were retained in each scale, reducing the total item number to 12 plus five additional screener items. CFA in sample 2 also resulted in an inadequate model fit for the theoretically assumed four factor structure (CFI = .667; RMSEA = .065 (90% CI = .063-.066); SRMR = .101; AIC = 335 651.99). In comparison, the final version of the COPMI-SQ-r showed the best model fit (CFI = .945; RMSEA = .062 (90% CI = .052-.072); SRMR = .049; AIC = 60 008.05). In the multiple-group CFA (sample 1 and sample 2), metric invariance was established (χ2 (208) = 481.58, p < .001; CFI = .939; RMSEA = .053 (90% CI = .047-.059); SRMR = .056). In sample 2, internal consistency was found to be good for the total scale (α = .84) and almost acceptable to almost good for the subscales (α = .64 to.78).
UNASSIGNED: The revised version of the COPMI-SQ (COPMI-SQ-r) is a reliable and economic questionnaire to assess SBA in adolescents who grow up with a parent with a mental illness. The COPMI-SQ-r can be used to help develop and evaluate anti-stigma and general interventions for affected adolescents.