Depression Stigma Scale (DSS)

Lead developer: 
Kathy Griffiths
Usage: 
Permission required

Contact

 Kathy Griffiths

The Depression Stigma Scale is designed to measure stigma associated with depression. It has two subscales which measure two different types of stigma: personal and perceived. The Personal Stigma Subscale measures stigma in the respondents own attitudes towards depression by asking them to indicate how strongly they personally agree with nine statements about depression. The Perceived Stigma Subscale measures the respondent’s perception about the attitudes of others towards depression by asking them to indicate what they think most other people believe about the same nine statements. Responses to each item are measured on a five-point scale (ranging from zero ‘strongly disagree’ to four ‘strongly agree’). Higher scores indicate higher levels of depression stigma.

Personal Stigma items

Perceived Stigma items

  • People with depression could snap out of it if they wanted.
  • Depression is a sign of personal weakness.
  • Depression is not a real medical illness.
  • People with depression are dangerous.
  • It is best to avoid people with depression so you don’t become depressed yourself.
  • People with depression are unpredictable.
  • If I had depression I would not tell anyone.
  • I would not employ someone if I knew they had been depressed.
  • I would not vote for a politician if I knew they had been depressed.
  • Most people believe that people with depression could snap out of it if they wanted.
  • Most people believe that depression is a sign of personal weakness.
  • Most people believe that depression is not a medical illness.
  • Most people believe that people with depression are dangerous.
  • Most people believe that it is best to avoid people with depression so that you don’t become depressed yourself.
  • Most people believe that people with depression are unpredictable.
  • If they had depression, most people would not tell anyone.
  • Most people would not employ someone they knew had been depressed.
  • Most people would not vote for a politician they knew had been depressed.

Test-retest reliability

DSS- Personal Stigma Subscale: r = 0.71 (n=435)***

DSS- Perceived Stigma Subscale: r = 0.67 (n =434)***

Internal consistency:

DSS- Personal Stigma Subscale: α = 0.77*, 0.82** and 0.75***

DSS- Perceived Stigma Subscale: α = 0.82*, 0.77** and 0.75***

Total Depression Stigma Scale: α = 0.78* and 0.78***

Convergent validity:

Correlation between DSS-Personal Stigma Subscale and Social Distance Scale: r (998) = 0.53, p < 0.0001*

Discriminant validity:

Correlation between DSS-Personal Stigma Subscale and DSS-Perceived Stigma Subscale: r = 0.12* and r = 0.12**

Correlation between DSS-Perceived Stigma Subscale and Social Distance Scale: r = 0.08*, r = 0.08**

Samples

*Sample 1: 1001 Australian adults aged over 18 years who were randomly sampled from 250 census districts across the whole of Australia during 2003-04.

**Sample 2: 5,572 adults under the age of 50 selected randomly from the Canberra Region electoral roll.

***Sample 3: 487 people who were a subset of sample 2 and who satisfied the eligibility criteria for entry into a randomised controlled trial.

Norms

Percentage endorsing agree or strongly agree on each Depression Stigma Scale item. Based on a community sample of 3998 Australian adults aged over 18 years and a community sample of 2000 Japanese adults aged between 20-60 years.

Personal Stigma Subscale

Item

%

People with depression could snap out of it if they wanted.

Australia: 24.7

Japan: 47.2

Depression is a sign of personal weakness

Australia: 13.4

Japan: 45.4

Depression is not a real medical illness

Australia: 14.6

Japan: 40.2

People with depression are dangerous.

Australia: 11.9

Japan: 14.6

It is best to avoid people with depression so you don’t become depressed yourself

Australia: 6.9

Japan: 7.8

People with depression are unpredictable

Australia: 42.2

Japan: 18.6

If I had depression I would not tell anyone

Australia: 17.0

Japan: 26.8

I would not employ someone if I knew they had been depressed

Australia: 21.6

Japan: 38.6

I would not vote for a politician if I knew they had been depressed.

Australia: 30.1

Japan: 58.0

Perceived Stigma Subscale

Item

%

Most people believe that people with depression could snap out of it if they wanted

Australia: 58.9

Japan: 45.4

Most people believe that depression is a sign of personal weakness.

Australia: 52.6

Japan: 58.2

Most people believe that depression is not a medical illness.

Australia: 52.4

Japan: 45.0

Most people believe that people with depression are dangerous.

Australia: 37.8

Japan: 32.6

Most people believe that it is best to avoid people with depression so that you don’t become depressed yourself.

Australia: 35.6

Japan: 32.2

Most people believe that people with depression are unpredictable.

Australia: 65.6

Japan: 35.8

If they had depression, most people would not tell anyone.

Australia: 63.1

Japan: 37.8

Most people would not employ someone they knew had been depressed.

Australia: 69.1

Japan: 65.6

Most people would not vote for a politician they knew had been depressed.

Australia: 69.0

Japan: 73.6

Key references: 

Griffiths, K.M., Christensen, H., Jorm, A.F., Evans, K., & Groves, C. Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression: Randomised controlled trial. The British Journal of Psychiatry 2004; 185: 342-349.

Griffiths, K.M., Nakane, Y., Christensen, H., Yoshioka, K., Jorm A.F., & Nakane, H. Stigma in response to mental disorders: a comparison of Australia and Japan. BMC Psychiatry 2006; 6:21.

Griffiths, K.M., Christensen, H., & Jorm, A.F. Predictors of depression stigma. BMC Psychiatry 2008; 8:25.

Personal Stigma items

Perceived Stigma items

  • Mensen met een depressie kunnen hier uit raken als ze dat zouden willen.
  • Depressie is een teken van persoonlijke zwakte.
  • Depressie is geen echte medische ziekte.
  • Mensen met een depressie zijn gevaarlijk.
  • Het is het beste om mensen met een depressie te mijden zodat je zelf niet depressief wordt.
  • Mensen met een depressie zijn onvoorspelbaar.
  • Als ik een depressie zou hebben, zou ik het aan niemand vertellen.
  • Ik zou iemand niet aannemen als ik wist dat hij/zij depressief is geweest.
  • Ik zou niet op een politicus stemmen als ik wist dat hij/zij depressief is geweest.
  • De meeste mensen geloven dat mensen met een depressie hier uit raken als ze dat zouden willen.
  • De meeste mensen geloven dat depressie een teken van persoonlijke zwakte is.
  • De meeste mensen geloven dat depressie geen echte, medische ziekte is.
  • De meeste mensen geloven dat mensen met een depressie gevaarlijk zijn.
  • De meeste mensen geloven dat je mensen met een depressie het beste kunt mijden zodat je zelf niet depressief wordt.
  • De meeste mensen geloven dat mensen met een depressie onvoorspelbaar zijn.
  • Als ze een depressie hadden, zullen de meeste mensen dat aan niemand vertellen.
  • De meeste mensen zouden iemand van wie ze weten dat hij/zij depressief geweest is niet aannemen.
  • De meeste mensen zouden niet stemmen op een politicus van wie ze weten dat hij/zij depressief geweest is.

Internal consistency:

DSS- Personal Stigma Subscale: α = 0.78

DSS- Perceived Stigma Subscale: α = 0.82

Based on a sample of both diagnosed and subclinical participants (n = 352) in the Netherlands recruited through municipal health services and mental health institutions.

Updated:  01 May 2017/Responsible Officer:  Director, CMHR/Page Contact:  Web Admin, CMHR