Validity and reliability of the internalized stigma of smoking inventory: An exploration of shame, isolation, and discrimination in smokers with mental health diagnoses
Validity and reliability of the internalized stigma of smoking inventory: An exploration of shame, isolation, and discrimination in smokers with mental health diagnoses
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DOI：
10.1111/ajad.12215
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发表时间：
2015-08-01
影响因子：
3.7
通讯作者：
Prochaska, Judith J.
中科院分区：
文献类型：
--
作者：
Brown-Johnson, Cati G.;Cataldo, Janine K.;Prochaska, Judith J.
背景和目的作为一项公共卫生战略，吸烟的非正常化可能会使无法戒烟的弱势群体感到羞耻和孤立。为了研究吸烟耻辱感的性质和影响，我们开发了内化吸烟耻辱感量表（ISSI），测试了其效度和信度，并探讨了可能导致吸烟耻辱感的因素。结果减少了ISSI的8个项目，3个分量表：吸烟自我耻辱相关的羞耻，感到耻辱相关的社会孤立，歧视的经验。在这三个分量表中，歧视是最普遍认可的。多变量广义线性模型预测吸烟污名分量表的方差为21-30%。自我耻辱是最大的那些打算戒烟;觉得耻辱是最高的那些经历耻辱在其他领域，即种族和精神疾病为基础的;和吸烟相关的歧视是最高的妇女，高加索人，和那些有更多的Education.Discussion和ConclusionSmoking耻辱可能复合耻辱的经验在其他领域。吸烟耻辱的耻辱，隔离和歧视的领域方面有关的建模耻辱的反应，特别是准备戒烟和烟瘾，并被发现是更突出的烟草使用最不普遍的群体。(Am J Addict 2015;24：410 - 418）
Background and ObjectivesDe-normalization of smoking as a public health strategy may create shame and isolation in vulnerable groups unable to quit. To examine the nature and impact of smoking stigma, we developed the Internalized Stigma of Smoking Inventory (ISSI), tested its validity and reliability, and explored factors that may contribute to smoking stigma.MethodsWe evaluated the ISSI in a sample of smokers with mental health diagnoses (N=956), using exploratory and confirmatory factor analysis, and assessed construct validity.ResultsResults reduced the ISSI to eight items with three subscales: smoking self-stigma related to shame, felt stigma related to social isolation, and discrimination experiences. Discrimination was the most commonly endorsed of the three subscales. A multivariate generalized linear model predicted 21-30% of the variance in the smoking stigma subscales. Self-stigma was greatest among those intending to quit; felt stigma was highest among those experiencing stigma in other domains, namely ethnicity and mental illness-based; and smoking-related discrimination was highest among women, Caucasians, and those with more education.Discussion and ConclusionSmoking stigma may compound stigma experiences in other areas. Aspects of smoking stigma in the domains of shame, isolation, and discrimination were related to modeled stigma responses, particularly readiness to quit and cigarette addiction, and were found to be more salient for groups where tobacco use is least prevalent.Scientific SignificanceThe ISSI measure is useful for quantifying smoking-related stigma in multiple domains. (Am J Addict 2015;24:410 -418)