Validation of the Greek version of the Affiliate Stigma Scale among mothers of children with autism spectrum disorder

BJPsych Open. 2022 Jan 20;8(1):e30. doi: 10.1192/bjo.2021.1083.

Abstract

Background: Caregivers of children with autism spectrum disorder (ASD) are sensitive to the internalisation of the stigma, known as affiliate stigma, resulting in reduced self-esteem, isolation and poor psychological well-being.

Aims: This study aims to validate the Greek version of the Affiliate Stigma Scale (ASS) among mothers of children with ASD.

Method: The translated version of ASS in Greek was administered to 53 mothers of children newly diagnosed with ASD in two time periods: 1-6 months from diagnosis (time point 1) and 12 months from the initial assessment (time point 2). The control group consisted of 62 mothers of typically developing children.

Results: The ASS total mean score revealed a moderate level of stigma to the ASD group in both assessments. The reliability measures by item showed a satisfactory composite reliability (affective 0.828, cognitive 0.833, behaviour 0.857). Cronbach's alpha revealed that the estimated internal consistency was excellent (α = 0.888), and it found a high positive item-total correlation. Receiver operating characteristic analysis results indicated a statistically significant positive discrimination (area under the curve 0.849, P = 0.000) between the groups. The cut-off point was 31.00, with a sensitivity of 0.849 and a 1 - sensitivity of 0.258.

Conclusions: The proposed version of the ASS has good psychometric properties and is valid and reliable for measuring affiliate stigma among caregivers of children with ASD in Greece. Health professionals can use it to assess and understand the stigma experienced by caregivers of children with ASD, and design appropriate interventions to reduce their affiliate stigma.

Keywords: Affiliate stigma; Greek version; autism spectrum disorders; family caregivers; validation.