Preliminary psychometric testing of a newly developed scale to assess perceived social stigma of Thai adolescents with type 1 diabetes

Abstract

Adolescents with type 1 diabetes (T1D) are vulnerable to social stigma because their visible disease management may draw unwanted attention, misunderstanding, or judgment. These social pressures can cause emotional distress and hinder self-management, affecting both psychological well-being and diabetes control. Reliable tools to assess perceived social stigma remain limited, especially in Thailand. To address the gap, the Perceived Social Stigma in Diabetes Questionnaire (PSSDQ) was developed for Thai adolescents with T1D. The study examined the preliminary psychometric properties, including content validity and internal consistency reliability. Participants consisted of 90 adolescents (10–19 years) with T1D recruited from pediatric diabetes clinics at two Bangkok university hospitals. Recruitment followed a convenience sampling approach, targeting those treated with multiple daily injections of basal-bolus insulin. Data were collected between June and December 2024. Content validity index (CVI), Cronbach’s alpha, average inter-item correlations, and corrected item-total correlations were computed to evaluate the psychometric properties of the 20-item PSSDQ. Results showed strong content validity with item-level CVIs ranging from 0.80 to 1.00. The total scale demonstrated acceptable internal consistency (Cronbach’s alpha=0.86). Average inter-item correlations of the total scale and subscales ranged from 0.23 to 0.32, indicating that the items measured a coherent construct. However, four items had low corrected item-total correlations (< 0.30) because their wording did not reflect negative social perceptions or experiences of unwanted attention. Also, item mean scores were skewed toward the lower end with small standard deviations, indicating a potential ceiling or floor effect. Thereupon, future testing within a more heterogeneous sample may be necessary to elicit broader response variability. Such advancements will enhance its utility in both research and clinical practice, allowing for a deeper understanding of the social stigma experienced by adolescents with T1D.