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BMC Public Health
Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Research

Reliability and validity evaluation of the stigma of loneliness scale in Chinese college students

Authors: Zhiguang Fan, Xiaoli Shi, Shuhan Yang, Yueliang Sun, Ri Chen

Published in: BMC Public Health | Issue 1/2024

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Abstract

Background

The stigma of loneliness exacerbates the negative effect of loneliness, reduces the willingness to seek help, damages interpersonal relationships, and threatens health status. However, there is currently no valid scale for measuring the stigma of loneliness in China. The study aims to translate the Stigma of Loneliness Scale (SLS) and evaluate the reliability and validity of the Chinese version.

Methods

The investigation was conducted in two phases. In the first phase, the SLS was used to conduct a questionnaire survey on 657 college students aged 17 to 24; in the second phase, the SLS, the UCLA Loneliness Scale (ULS-8), the Distress Disclosure Index (DDI), the Revised Cheek and Buss Shyness Scale (RCBS), the Self-Concealment Scale (SCS), the Social Interaction Anxiety Scale (SIAS), the Social Phobia Scale (SPS), the Kessler Psychological Distress Scale (K10), and the Rosenberg Self-Esteem Scale (RSES) were used to conduct the questionnaire survey on 801 college and graduates students aged 18 to 39.

Results

Two dimensions of Self-stigma of Loneliness and Public Stigma of Loneliness were extracted with a cumulative factor interpretation rate of 74.60% when conducting exploratory factor analysis on the first-stage data. The factor loading of each item ranged from 0.585 to 0.890, and the commonality ranged from 0.609 to 0.735. The confirmatory factor analysis and reliability and validity test were carried out on the data gathered in the second phase, indicating that the two-factor model fits well. In addition, the scores of SLS and all dimensions were significantly positively correlated with the total scores of ULS-8, RCBS, SCS, SIAS, SPS, and K10, and negatively correlated with those of DDI and RSES. The Cronbach’s alpha coefficients for SLS and SSL and PSL dimensions were 0.957, 0.941, and 0.955. The cross-group invariance test found that the SLS was equivalent for males and females. Meanwhile, males scored significantly higher than females on both the total scores of SLS score and each dimension.

Conclusions

The Chinese version of SLS displayed satisfactory psychometric properties and can be a valid tool to assess the stigma of loneliness among Chinese young people.
Literature
1.
Paquet C, Whitehead J, Shah R, Adams AM, Dooley D, Spreng RN, et al. Social prescription interventions addressing social isolation and loneliness in older adults: meta-review integrating on-the-ground resources. J Med Internet Res. 2023;25:e40213.PubMedPubMedCentralCrossRef
2.
Trucharte A, Calderón L, Cerezo E, Contreras A, Peinado V, Valiente C. Three-item loneliness scale: psychometric properties and normative data of the Spanish version. Curr Psychol. 2023;42:7466–74.PubMedCrossRef
3.
Ernst M, Niederer D, Werner AM, Czaja SJ, Mikton C, Ong AD, et al. Loneliness before and during the COVID-19 pandemic: a systematic review with meta-analysis. Am Psychol. 2022;77:660–77.PubMedPubMedCentralCrossRef
4.
Farrell AH, Vitoroulis I, Eriksson M, Vaillancourt T. Loneliness and well-being in children and adolescents during the COVID-19 pandemic: a systematic review. Child (Basel). 2023;10:279.
5.
Antunes JT, Machado ÍE, Malta DC. Loneliness and associated factors among Brazilian adolescents: results of national adolescent school-based health survey 2015. J Pediatr (Rio J). 2022;98:92–8.PubMedCrossRef
6.
7.
Susanty S, Chung M-H, Chiu H-Y, Chi M-J, Hu SH, Kuo C-L, et al. Prevalence of loneliness and associated factors among community-dwelling older adults in Indonesia: a cross-sectional study. Int J Environ Res Public Health. 2022;19:4911.PubMedPubMedCentralCrossRef
8.
Murayama H, Suda T, Nakamoto I, Shinozaki T, Tabuchi T. Changes in social isolation and loneliness prevalence during the COVID-19 pandemic in Japan: the JACSIS 2020–2021 study. Front Public Health. 2023;11:1094340.PubMedPubMedCentralCrossRef
9.
Benke C, Autenrieth LK, Asselmann E, Pané-Farré CA. One year after the COVID-19 outbreak in Germany: long-term changes in depression, anxiety, loneliness, distress and life satisfaction. Eur Arch Psychiatry Clin Neurosci. 2023;273:289–99.PubMedCrossRef
10.
11.
Espinoza G, Hernandez HL. Adolescent loneliness, stress and depressive symptoms during the COVID-19 pandemic: the protective role of friends. Infant Child Dev. 2022;31:e2305.PubMedPubMedCentralCrossRef
12.
Lewis KC, Roche MJ, Brown F, Tillman JG. Attachment, loneliness, and social connection as prospective predictors of suicidal ideation during the COVID-19 pandemic: a relational diathesis-stress experience sampling study. Suicide Life Threat Behav. 2023;53:64–74.PubMedCrossRef
13.
Rodriguez M, Osborn TL, Gan JY, Weisz JR, Bellet BW. Loneliness in Kenyan adolescents: socio-cultural factors and network association with depression and anxiety symptoms. Transcult Psychiatry. 2022;59:797–809.PubMedCrossRef
14.
Rönkä AR, Taanila A, Koiranen M, Sunnari V, Rautio A. Associations of deliberate self-harm with loneliness, self-rated health and life satisfaction in adolescence: northern Finland birth cohort 1986 study. Int J Circumpolar Health. 2013;72.
15.
Kupcewicz E, Rachubińska K, Gaworska-Krzemińska A, Andruszkiewicz A, Kuźmicz I, Kozieł D, et al. Loneliness and optimism among Polish nursing students during the COVID-19 pandemic: the mediatory role of self-efficacy. Healthc (Basel). 2022;10:971.
16.
Phillips DM, Finkel D, Petkus AJ, Muñoz E, Pahlen S, Johnson W, et al. Longitudinal analyses indicate bidirectional associations between loneliness and health. Aging Ment Health. 2023;27:1217–25.PubMedCrossRef
17.
18.
Perez LG, Siconolfi D, Troxel WM, Tucker JS, Seelam R, Rodriguez A, et al. Loneliness and multiple health domains: associations among emerging adults. J Behav Med. 2022;45:260–71.PubMedPubMedCentralCrossRef
19.
Stickley A, Koyanagi A, Koposov R, Schwab-Stone M, Ruchkin V. Loneliness and health risk behaviours among Russian and U.S. adolescents: a cross-sectional study. BMC Public Health. 2014;14:366.PubMedPubMedCentralCrossRef
20.
Hanna JR, McConnell T, Harrison C, Patynowska KA, Finucane AM, Hudson B, et al. There’s something about admitting that you are lonely - prevalence, impact and solutions to loneliness in terminal illness: an explanatory sequential multi-methods study. Palliat Med. 2022;36:1483–92.PubMedPubMedCentralCrossRef
21.
22.
Mehta N, Clement S, Marcus E, Stona A-C, Bezborodovs N, Evans-Lacko S, et al. Evidence for effective interventions to reduce mental health-related stigma and discrimination in the medium and long term: systematic review. Br J Psychiatry. 2015;207:377–84.PubMedPubMedCentralCrossRef
23.
Kvaale EP, Gottdiener WH, Haslam N. Biogenetic explanations and stigma: a meta-analytic review of associations among laypeople. Soc Sci Med. 2013;96:95–103.PubMedCrossRef
24.
Kerr NA, Stanley TB. Revisiting the social stigma of loneliness. Pers Indiv Differ. 2021;171:110482.CrossRef
25.
Barreto M, van Breen J, Victor C, Hammond C, Eccles A, Richins MT, et al. Exploring the nature and variation of the stigma associated with loneliness. J Soc Pers Relat. 2022;39:2658–79.PubMedPubMedCentralCrossRef
26.
Tsai F-F, Reis HT. Perceptions by and of lonely people in social networks. Personal Relationships. 2009;16:221–38.CrossRef
27.
Rotenberg KJ, Bartley JL, Toivonen D. Children’s stigmatization of chronic loneliness. J Social Behav Personality. 1997;12:577.
28.
Ko SY, Wei M, Rivas J, Tucker JR. Reliability and validity of scores on a measure of stigma of loneliness. Couns Psychol. 2022;50:96–122.CrossRef
29.
Lau S, Gruen GE. The social stigma of loneliness: effect of target person’s and perceiver’s sex. Pers Soc Psychol Bull. 1992;18:182–9.CrossRef
30.
Barbosa Neves B, Sanders A, Kokanović R. It’s the worst bloody feeling in the world: experiences of loneliness and social isolation among older people living in care homes. J Aging Stud. 2019;49:74–84.PubMedCrossRef
31.
Yang K, Armstrong N, Diamond C, Lane AR, Dunne S. The meaning of loneliness to stroke survivors: a qualitative study in Northeast England. J Health Psychol. 2022;27:2539–48.PubMedCrossRef
32.
Wang W, Zhou K, Yu Z, Li J. The cost of impression management to life satisfaction: sense of control and loneliness as mediators. Psychol Res Behav Manag. 2020;13:407–17.PubMedPubMedCentralCrossRef
33.
Franssen T, Stijnen M, Hamers F, Schneider F. Age differences in demographic, social and health-related factors associated with loneliness across the adult life span (19–65 years): a cross-sectional study in the Netherlands. BMC Public Health. 2020;20:1118.PubMedPubMedCentralCrossRef
34.
Hosseinabadi R, Foroughan M, Harouni GG, Lotfi M-S, Pournia Y. Psychometric properties of the Persian version of the 11-Item de Jong Gierveld loneliness scale in Iranian older adults. Eval Health Prof. 2021;44:378–84.PubMedCrossRef
35.
Xiang B, Ren L, Zhou Y, Liu J. Psychometric properties of Cheek and Buss shyness scale in Chinese college students. Chin J Clin Psychol. 2018;26:4.
36.
Beaton DE, Bombardier C, Guillemin F, Ferraz MB. Guidelines for the process of cross-cultural adaptation of self-report measures. Spine (Phila Pa 1976). 2000;25:3186–91.PubMedCrossRef
37.
Carpenter S. Ten steps in scale development and reporting: a guide for researchers. Commun Methods Meas. 2018;12:25–44.CrossRef
38.
Simms LJ. Classical and modern methods of psychological scale construction. Soc Pers Psychol Compass. 2008;2:414–33.CrossRef
39.
Worthington RL, Whittaker TA. Scale development research: a content analysis and recommendations for best practices. Couns Psychol. 2006;34:806–38.CrossRef
40.
Bialobrzeska O. Niceness scale: development and validation of self-reported behavioral niceness measure. Pers Indiv Differ. 2024;218:112480.CrossRef
41.
Ho MY, Liang S, Hook JN. Development and validation of the Forbearance scale. J Pers Assess. 2023;105:779–88.PubMedCrossRef
42.
Byrne GJ, Pachana NA. Development and validation of a short form of the geriatric anxiety inventory–the GAI-SF. Int Psychogeriatr. 2011;23:125–31.PubMedCrossRef
43.
Rossi AA, Panzeri A, Mannarini S. The Italian version of the difficulties in emotion regulation scale– short form (IT-DERS-SF): a two-step validation study. J Psychopathol Behav Assess. 2023;45:572–90.CrossRef
44.
45.
Lin C-Y, Tsai C-S, Fan C-W, Griffiths MD, Chang C-C, Yen C-F, et al. Psychometric evaluation of three versions of the UCLA loneliness scale (full, eight-item, and three-item versions) among sexual minority men in Taiwan. Int J Environ Res Public Health. 2022;19:8095.PubMedPubMedCentralCrossRef
46.
Lin C-Y, Tsai C-S, Jian C-R, Chao S-R, Wang P-W, Lin H-C, et al. Comparing the psychometric properties among three versions of the UCLA loneliness scale in individuals with schizophrenia or schizoaffective disorder. Int J Environ Res Public Health. 2022;19:8443.PubMedPubMedCentralCrossRef
47.
Kahn JH, Hessling RM. Measuring the tendency to conceal versus disclose psychological distress. J Soc Clin Psychol. 2001;20:41–65.CrossRef
48.
Li L, Zhong H-Y, Xiao T, Xiao R-H, Yang J, Li Y-L, et al. Association between self-disclosure and benefit finding of Chinese cancer patients caregivers: the mediation effect of coping styles. Support Care Cancer. 2023;31:684.PubMedCrossRef
49.
Wu X, Zhang M, Zhao J, Mai Y, Fang Y, Zhao J. A two-year follow-up study of psychological symptoms in medical students. Chin Mental Health J. 2020;34:6.
50.
Hopko DR, Stowell J, Jones WH, Armento MEA, Cheek JM. Psychometric properties of the revised Cheek and Buss shyness scale. J Pers Assess. 2005;84:185–92.PubMedCrossRef
51.
Larson D, Chastain R, Self-Concealment. Conceptualization, measurement, and health implications. J Soc Clin Psychol. 1990;9:439–55.CrossRef
52.
Wang C. The factor structure of the Chinese adaptation of self concealment scale in middle school students. Chin J Appl Psychol. 2002;:15–7.
53.
Fergus TA, Valentiner DP, McGrath PB, Gier-Lonsway SL, Kim H-S. Short forms of the social interaction anxiety scale and the social phobia scale. J Pers Assess. 2012;94:310–20.PubMedCrossRef
54.
Zhong J, Liu J, Xu G, Zheng H, Bowker J, Coplan RJ. Measurement invariance of two different short forms of social interaction anxiety scale (SIAS) and social phobia scale (SPS) in Chinese and US samples. Eur J Psychol Assess. 2023;39:14–20.CrossRef
55.
Bougie E, Arim RG, Kohen DE, Findlay LC. Validation of the 10-item Kessler psychological distress scale (K10) in the 2012 Aboriginal peoples Survey. Health Rep. 2016;27:3–10.PubMed
56.
Ren Q, Li Y, Chen D-G. Measurement invariance of the Kessler psychological distress scale (K10) among children of Chinese rural-to-urban migrant workers. Brain Behav. 2021;11:e2417.PubMedPubMedCentralCrossRef
57.
Wu Y, Zuo B, Wen F, Yan L. Rosenberg self-esteem scale: method effects, factorial structure and scale invariance across migrant child and urban child populations in China. J Pers Assess. 2017;99:83–93.PubMedCrossRef
58.
Song H, Cai H, Brown JD, Grimm KJ. Differential item functioning of the Rosenberg self-esteem scale in the US and China: measurement bias matters. Asian J Soc Psychol. 2011;14:176–88.CrossRef
59.
Gehlbach H, Brinkworth ME. Measure twice, cut down error: a process for enhancing the validity of survey scales. Rev Gen Psychol. 2011;15:380–7.CrossRef
60.
Fabrigar LR, Wegener DT, MacCallum RC, Strahan EJ. Evaluating the use of exploratory factor analysis in psychological research. Psychol Methods. 1999;4:272–99.CrossRef
61.
Bentler PM, Bonett DG. Significance tests and goodness of fit in the analysis of covariance structures. Psychol Bull. 1980;88:588–606.CrossRef
62.
Viladrich C, Angulo-Brunet A, doval E. A journey around alpha and omega to estimate internal consistency reliability. Anales De Psicologia. 2017;33:755–82.CrossRef
63.
Dimitrov DM. Testing for factorial invariance in the context of construct validation. Meas Evaluation Couns Dev. 2010;43:121–49.CrossRef
64.
Cheung GW, Rensvold RB. Evaluating goodness-of-fit indexes for testing measurement invariance. Struct Equ Model. 2002;9:233–55.CrossRef
65.
Kaushik A, Kostaki E, Kyriakopoulos M. The stigma of mental illness in children and adolescents: a systematic review. Psychiatry Res. 2016;243:469–94.PubMedCrossRef
66.
Evans-Lacko S, Brohan E, Mojtabai R, Thornicroft G. Association between public views of mental illness and self-stigma among individuals with mental illness in 14 European countries. Psychol Med. 2012;42:1741–52.PubMedCrossRef
67.
Efstathiou G, Kouvaraki E, Ploubidis G, Kalantzi-Azizi A, Self-Stigma. Public-stigma and attitudes towards professional psychological help: psychometric properties of the Greek version of three relevant questionnaires. Int J Adv Counselling. 2019;41:175–86.CrossRef
68.
Qiu L, Feng Y, Luo J, Zhang Y, Yang Q. Predictors of personal depression stigma in medical students in China: differences in male and female groups. Med Educ Online. 2022;27:2093427.PubMedPubMedCentralCrossRef
69.
Schmitt N, Kuljanin G. Measurement invariance: review of practice and implications. Hum Resource Manage Rev. 2008;18:210–22.CrossRef
70.
Byrne BM, Stewart SM, TEACHER’S CORNER. The MACS approach to testing for multigroup invariance of a second-order structure: a walk through the process. Struct Equation Modeling: Multidisciplinary J. 2006;13:287–321.CrossRef
71.
Kim S, Anstey KJ, Mortby ME. Who displays dementia-related stigma and what does the general public know about dementia? Findings from a nationally representative survey. Aging Ment Health. 2022:No Pagination Specified-No Pagination Specified.
72.
Potts LC, Bakolis I, Deb T, Lempp H, Vince T, Benbow Y, et al. Anti-stigma training and positive changes in mental illness stigma outcomes in medical students in ten countries: a mediation analysis on pathways via empathy development and anxiety reduction. Soc Psychiatry Psychiatr Epidemiol. 2022;57:1861–73.PubMedPubMedCentralCrossRef
73.
Pfeiffer S, In-Albon T. Gender specificity of self-stigma, public stigma, and help-seeking sources of mental disorders in youths. Stigma Health. 2023;8:124–32.CrossRef
74.
75.
Markus HR, Kitayama S. Cultures and selves: a cycle of mutual constitution. Perspect Psychol Sci. 2010;5:420–30.PubMedCrossRef
76.
Markus HR, Kitayama S. Culture and the self: implications for cognition, emotion, and motivation. Psychol Rev. 1991;98:224–53.CrossRef
77.
Corrigan PW, Rao D. On the self-stigma of mental illness: stages, disclosure, and strategies for change. Can J Psychiatry. 2012;57:464–9.PubMedCrossRef
78.
Cai W, Guinote A, Wu S. Revisiting the powerful-not-lonely effect across cultures: the mediating role of self-construal and social support. Curr Psychol. 2023;42:8824–32.CrossRef
79.
Zhang X, Dong S. The relationships between social support and loneliness: a meta-analysis and review. Acta Psychol (Amst). 2022;227:103616.PubMedCrossRef
80.
Chen X, He Y, De Oliveira AM, Coco AL, Zappulla C, Kaspar V, et al. Loneliness and social adaptation in Brazilian, Canadian, Chinese and Italian children: a multi-national comparative study. J Child Psychol Psychiatry. 2004;45:1373–84.PubMed
Metadata
Title
Reliability and validity evaluation of the stigma of loneliness scale in Chinese college students
Authors
Zhiguang Fan
Xiaoli Shi
Shuhan Yang
Yueliang Sun
Ri Chen
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-17738-0

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