Internalized Stigma and Stigma Resistance Among Patients with Mental Illness in Han Chinese Population

Yin Ju Lien, Yu Chen Kao, Yia Ping Liu, Hsin An Chang, Nian Sheng Tzeng, Chien Wen Lu, Ching Hui Loh

Research output: Contribution to journalArticle

21 Citations (Scopus)


Research suggests that accurate measurement is essential in evaluating internalized stigma and abilities to combat with stigma for treatment compliances and outcomes in individuals with mental illness. The purpose of this study was to assess the reliability and validity of the Chinese version of the Internalized Stigma of Mental Illness Scale (ISMIS-C), which is one of the few tools available to measure internalized stigma and stigma resistance (SR) simultaneously. A total of 160 outpatients with (n = 103) and without (n = 57) psychotic disorders were administrated with the ISMIS-C, and measures of self-esteem, self-efficacy, depression, and hopelessness. Overall, the 29-item ISMIS-C was presented to be internal reliable (Cronbach’s alpha = 0.90), and reliable over time (intraclass correlation coefficients = 0.36–0.73). The construct validity of the ISMIS-C derived from the factor analysis was nearly identical to the original version. ISMIS-C dimension scores were well correlated with each other and measures of self-esteem, self-efficacy, depression, and hopelessness. Our data also demonstrated that psychotic patients experienced higher internalized stigma scores than those without psychotic diagnoses, but endorsed indifferently on SR scores. This scale can be used as an informative device when investigating “internalized stigma” and “SR” among individuals with or without psychotic disorders.

Original languageEnglish
Pages (from-to)181-197
Number of pages17
JournalPsychiatric Quarterly
Issue number2
Publication statusPublished - 2015 Jun 1



  • Internalized stigma
  • Internalized stigma of mental illness scale
  • Stigma resistance

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this