The Stigma subscale of the Consumer Experiences of Stigma Questionnaire (CESQ): A psychometric evaluation in Polish psychiatric patients Piotr Świtaj a, ⁎ , Paweł Grygiel b , Jacek Wciórka a , Grzegorz Humenny c , Marta Anczewska a a I Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland b Institute of Sociology, University of Rzeszów, Rzeszów, Poland c Educational Research Institute, Warsaw, Poland Abstract Objective: There is a scarcity of well validated measures of the subjective experience of the stigma of mental illness. The aim of this paper was to evaluate the psychometric properties of the Stigma subscale of the Consumer Experiences of Stigma Questionnaire (CESQ). Methods: A secondary analysis of the data from two cross-sectional studies using the CESQ was conducted in order to assess the factor structure, internal consistency and concurrent validity of the Stigma subscale. Sample 1 included 373 diagnostically heterogeneous patients (65% had psychotic disorders) and Sample 2 included 136 patients with schizophrenia. Results: Since none of the factor models of the original 9-item scale was satisfactory, it was shortened by removing two psychometrically weakest items. The abbreviated 7-item scale proved to be a one-dimensional instrument, with good estimates of internal consistency. Its concurrent validity was partly confirmed by demonstrating negative correlation with quality of life and positive correlations with self-rated psychopathological symptoms. However, contrary to theoretical expectations, the stigma score was not associated with global functioning and clinician-rated symptoms. Conclusions: The psychometric properties of the Stigma subscale of the CESQ may be improved by shortening the instrument. Although the reliability and validity of the abbreviated version were partly established, further research is needed to explore in particular its test–retest reliability and concurrent validity. © 2013 Elsevier Inc. All rights reserved. 1. Introduction The psychiatric stigma is common and severe and constitutes a harsh burden for people with mental disorders. It may dramatically restrict their life chances and lead to diminished self-esteem and self-efficacy, compromised quality of life and poor adherence to treatment [1,2]. It has been even suggested that stigma may significantly contribute to the risk of suicide [3]. After decades of concentration on stigmatizing societal attitudes, in recent years increasing attention has been paid to the issue of the subjective experiences of the recipients of mental illness stigma. It is argued that no other method can replace the first-hand reports obtained from people with mental health problems who face stigma in their everyday lives and hence know best what stigma is and how it affects them [4]. However, a major limitation of this kind of research is the paucity of well- validated stigma measures. Researchers distinguish three main areas of the personal stigma of mental illness [5]: 1) perceived stigma, i.e. an individual’s beliefs about to what extent society stigmatizes the group to which he/she belongs and him/her personally as a member of the stigmatized group; 2) self-stigma, i.e. the process of internalization of stigmatizing public attitudes, resulting in feelings of shame, decrement in self-esteem and loss of hope; and, finally, 3) experienced stigma, i.e. experience of actual rejection or discrimination. It seems that the lack of instruments with established psychometric properties is particularly noticeable in the field of experi- enced stigma. In their review of stigma measurement methods, Link et al. [6] recommended the Consumer Experiences of Stigma Questionnaire (CESQ) [4] as the Available online at www.sciencedirect.com Comprehensive Psychiatry 54 (2013) 713 – 719 www.elsevier.com/locate/comppsych ⁎ Corresponding author. Tel.: +48 22 8424034; fax: +48 22 4582818. E-mail address: switaj@ipin.edu.pl (P. Świtaj). 0010-440X/$ – see front matter © 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.comppsych.2013.03.001