caa a22 4500 606178228 CHVBK 20210128100755.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s11136-014-0868-4 doi (NATIONALLICENCE)springer-10.1007/s11136-014-0868-4 Reexamining epilepsy-associated stigma: validation of the Stigma Scale of Epilepsy in Zambia [Elektronische Daten] [Melissa Elafros, Ryan Bowles, Masharip Atadzhanov, Edward Mbewe, Alan Haworth, Elwyn Chomba, Gretchen Birbeck] Purpose: Epilepsy-associated stigma is an important patient-centered outcome, yet quantification remains challenging. Jacoby's 3-item Stigma Scale is commonly used to assess felt stigma among people with epilepsy (PWE) yet has ceiling effects. The Stigma Scale of Epilepsy (SSE) is a 24-item instrument that measures felt stigma among PWE and stigmatizing attitudes among others. If cross-culturally valid, the SSE may elucidate stigma determinants and provide an outcome measure for interventions. Methods: We assessed the properties of the SSE in 102 Zambian PWE using exploratory and confirmatory item response theories and compared the latent traits assessed by the SSE to those assessed by Jacoby's Stigma Scale. Differential item functioning based on forced disclosure of epilepsy was examined. Results: The SSE yielded two latent traits—the first reflected difficulties faced by PWE; the second reflected emotions associated with epilepsy. Jacoby's Stigma Scale was associated only with the first latent trait. Forced disclosure was associated with "worry” and "pity” that were associated with the second latent trait. Conclusions: In Zambian PWE, the SSE captured two latent traits. One trait represents feelings associated with epilepsy, which is theorized as a substantial yet unmeasured part of stigma. The SSE performs well across cultures and may more comprehensively assess felt stigma than other instruments. Further validation is required to determine whether the SSE adequately assesses stigmatizing attitudes among people without epilepsy. Springer International Publishing Switzerland, 2014 Felt stigma nationallicence Enacted stigma nationallicence Stigmatizing attitudes nationallicence Sub-Saharan Africa nationallicence Patient-centered outcome nationallicence Forced disclosure nationallicence Elafros Melissa International Neurologic and Psychiatric Epidemiology Program (INPEP), Michigan State University, 909 Fee Road, Room 324, West Fee Hall, 48824, East Lansing, MI, USA aut Bowles Ryan Department of Human Development and Family Studies, College of Social Science, Michigan State University, East Lansing, MI, USA aut Atadzhanov Masharip Department of Medicine, University of Zambia, Lusaka, Zambia aut Mbewe Edward Chainama College of Health Sciences, Lusaka, Zambia aut Haworth Alan Department of Psychiatry, University of Zambia School of Medicine, Lusaka, Zambia aut Chomba Elwyn Zambia Ministry of Community Development, Mother and Child Health, Lusaka, Zambia aut Birbeck Gretchen Epilepsy Division, Departments of Neurology and Public Health, University of Rochester, Rochester, NY, USA aut Quality of Life Research Springer International Publishing 24/6(2015-06-01), 1483-1489 0962-9343 24:6<1483 2015 24 11136 https://doi.org/10.1007/s11136-014-0868-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 brief-communication jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s11136-014-0868-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Elafros Melissa International Neurologic and Psychiatric Epidemiology Program (INPEP), Michigan State University, 909 Fee Road, Room 324, West Fee Hall, 48824, East Lansing, MI, USA aut NATIONALLICENCE 700 1- Bowles Ryan Department of Human Development and Family Studies, College of Social Science, Michigan State University, East Lansing, MI, USA aut NATIONALLICENCE 700 1- Atadzhanov Masharip Department of Medicine, University of Zambia, Lusaka, Zambia aut NATIONALLICENCE 700 1- Mbewe Edward Chainama College of Health Sciences, Lusaka, Zambia aut NATIONALLICENCE 700 1- Haworth Alan Department of Psychiatry, University of Zambia School of Medicine, Lusaka, Zambia aut NATIONALLICENCE 700 1- Chomba Elwyn Zambia Ministry of Community Development, Mother and Child Health, Lusaka, Zambia aut NATIONALLICENCE 700 1- Birbeck Gretchen Epilepsy Division, Departments of Neurology and Public Health, University of Rochester, Rochester, NY, USA aut NATIONALLICENCE 773 0- Quality of Life Research Springer International Publishing 24/6(2015-06-01), 1483-1489 0962-9343 24:6<1483 2015 24 11136