Psychometric properties of the Malay and Chinese Epilepsy Self-Stigma Scale (ESSS)

Document Type

Article

Publication Date

2-1-2025

Abstract

Objective: Self-stigma means internalizing negative beliefs and attitudes associated with stigmatized identity. This study aimed to translate and validate the Malay and Chinese versions of the Epilepsy Self-Stigma Scale (ESSS). Methods: The Epilepsy Self-Stigma Scale was translated into the Malay (ESSS-M) and Chinese versions (ESSS-C) according to standard principles and were tested in 100 Malay and 100 Chinese-speaking people with epilepsy (PWE) respectively. Psychometric evaluations were done based on equal item variance, convergent and discriminant validity, construct validity and reliability. Correlation analyses were carried out between the ESSS and the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) and Generalized Anxiety Disorder-7 (GAD-7). Results: For the ESSS-M, 100 Malay-speaking PWE with a mean age of 42.25 years (+15.18) were recruited. Exploratory factor analysis identified eight items loaded on three factors: ``Internalization of stigma'', ``Societal incomprehension'', and ``Confidentiality''. However, item 1 was loaded under a different component from the initial paper, conceptualized as confidentiality. For the ESSS-C, 100 Chinese-speaking participants with a mean age of 41.07 years (+15.57). Exploratory factor analysis identified three loading factors similar to the original scale: ``Internalization of stigma'', ``Societal incomprehension'', and ``Confidentiality''. Both ESSS-M and ESSS-C scales showed significant correlations with NDDI-E and GAD-7 scores, showcasing substantial construct validity. The Cronbach's alpha values were alpha = 0.822 for the ESSS-M and alpha = 0.831 for the ESSS-C. Conclusion: Both the ESSS-M and ESSS-C were reliable and valid for measuring epilepsy self-stigma among the Malay- and Chinese-speaking PWE in Malaysia.

Keywords

Self-stigma, Discrimination, Translation, Validation, Reliability, Factor analysis

Divisions

medicinedept,pharmacy

Funders

Department of Medicine Research Support Fund (DOM-RSF) Award, Cycle 3/2022 (DOMRSF-2022-05)

Publication Title

Epilepsy & Behavior

Volume

163

Publisher

Elsevier

Publisher Location

525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA

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