Stigma of Suicide Attempt (STOSA) scale and Stigma of Suicide and Suicide Survivor (STOSASS) scale: Two new assessment tools
Abstract
This study aimed at validating two new assessment tools, the Stigma of Suicide Attempt (STOSA) scale and the Stigma of Suicide and Suicide Survivor (STOSASS) scale. The Devaluation-Discrimination scale of Link et al. was translated into Italian and adapted to measure stigma towards suicidal behavior. Both scales were administered to a mixed sample including members of the general population (n=282), patients with a mental disorder (n=113), suicide attempters (n=57) and people who had lost a significant other to suicide (n=75). Reliability of the scales was good in terms of both internal coherence and test-retest stability. Factor analysis produced an acceptable solution for the STOSA-scale. Items were distributed into two factors, one grouping items to measure supportive, respectful and caring attitudes, the other factor grouping items oriented towards stigmatizing attitudes and beliefs. The clinical populations were more inclined towards stigmatization of suicide than were people from the general population, who might be less aware of the stigma attached to suicide. The two scales may be helpful to quantify stigma at individual level in order to provide targeted supportive interventions, and at population level to measure changes in the beliefs and attitudes of the general population.
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Seven studies examined associations of stigma with grief difficulties and sociodemographic variables.
“Seven studies examined the associations of stigma with grief difficulties and sociodemographic variables [1,15,35–37,43,44].”
From The Stigma of Suicide Survivorship and Related Consequences—A Systematic Review (2016) · cites this paper as [1]
Female participants were at a higher risk of experiencing stigma.
“Female participants were at a higher risk of experiencing stigma [1,35,37].”
From The Stigma of Suicide Survivorship and Related Consequences—A Systematic Review (2016) · cites this paper as [1]
In Scocco et al., stigma scores did not differ between the general population, psychiatric patients, and suicide survivors.
“Analysis of responses revealed that stigma scores did not differ between the groups, with participants generally expressing moderately negative attitudes towards suicide survivors.”
From The Stigma of Suicide Survivorship and Related Consequences—A Systematic Review (2016) · cites this paper as [1]
In Scocco et al., participants generally expressed moderately negative attitudes towards suicide survivors.
“Analysis of responses revealed that stigma scores did not differ between the groups, with participants generally expressing moderately negative attitudes towards suicide survivors.”
From The Stigma of Suicide Survivorship and Related Consequences—A Systematic Review (2016) · cites this paper as [1]
Only one study met inclusion criteria with results indicating that stigmatizing attitudes are indeed common among the general population.
“Only one study met inclusion criteria with results indicating that stigmatizing attitudes are indeed common among the general population.”
From The Stigma of Suicide Survivorship and Related Consequences—A Systematic Review (2016) · cites this paper as [1]
Cites
Stigma; Notes On The Management Of Spoiled Identity
Defleur, M., & Goffman, E. (1964) · Social Forces · doi:10.2307/2575995 · Cited by 23,025 · see citing works
Stigma: Notes on the Management of Spoiled Identity
(1969) · Postgraduate Medical Journal · doi:10.1136/pgmj.45.527.642 · Cited by 14,251 · see citing works
Link, B. G., & Phelan, J. C. (2001) · Annual Review of Sociology · doi:10.1146/annurev.soc.27.1.363 · Cited by 8,848 · see citing works
Statistics notes: Cronbach's alpha: Table 1
Bland, J. M., & Altman, D. G. (1997) · BMJ · doi:10.1136/bmj.314.7080.572 · Cited by 5,300 · see citing works
How stigma interferes with mental health care.
Corrigan, P. (2004) · American Psychologist · doi:10.1037/0003-066x.59.7.614 · Cited by 3,648 · see citing works
On the use, the misuse, and the very limited usefulness of Cronbach’s alpha
Sijtsma, K. (2009) · Psychometrika · doi:10.1007/s11336-008-9101-0 · Cited by 2,814 · see citing works
A Modified Labeling Theory Approach to Mental Disorders: An Empirical Assessment
Link, B. G., Cullen, F. T., Struening, E., Shrout, P. E., & Dohrenwend, B. P. (1989) · American Sociological Review · doi:10.2307/2095613 · Cited by 1,935 · see citing works
Understanding the impact of stigma on people with mental illness.
(2002) · Europe PMC (PubMed Central) · Cited by 1,786 · see citing works
Internalized stigma of mental illness: psychometric properties of a new measure
Ritsher, J. B., Otilingam, P. G., & Grajales, M. (2003) · Psychiatry Research · doi:10.1016/j.psychres.2003.08.008 · Cited by 1,641 · see citing works
FACTOR: A computer program to fit the exploratory factor analysis model
Lorenzo‐Seva, U., & Ferrando, P. J. (2006) · Behavior Research Methods · doi:10.3758/bf03192753 · Cited by 1,325 · see citing works
A Basis for Analyzing Test-Retest Reliability
Guttman, L. (1945) · Psychometrika · doi:10.1007/bf02288892 · Cited by 1,123 · see citing works
Statistical methods for assessing observer variability in clinical measures.
Brennan, P., & Silman, A. J. (1992) · BMJ · doi:10.1136/bmj.304.6840.1491 · Cited by 984 · see citing works
Dictionary of Statistics and Methodology: A Nontechnical Guide for the Social Sciences
Vaidyanathan, R., & Vogt, W. P. (1994) · Journal of Marketing Research · doi:10.2307/3152235 · Cited by 880 · see citing works
Stigma: ignorance, prejudice or discrimination?
Thornicroft, G., Rose, D., Kassam, A., & Sartorius, N. (2007) · British Journal of Psychiatry · doi:10.1192/bjp.bp.106.025791 · Cited by 826 · see citing works
Grief Counseling and Grief Therapy: A Handbook for the Mental Health Practitioner
Worden, J. W. (1982) · Medical Entomology and Zoology · Cited by 802 · see citing works
Griffiths, K. M., Christensen, H., Jorm, A. F., Evans, K., & Groves, C. (2004) · British Journal of Psychiatry · doi:10.1192/bjp.185.4.342 · Cited by 789 · cited 3× · see citing works
“The scales measure perceived stigma, which was shown to differ in some correlates and predictors from personal stigma (Griffiths et al., 2004; 2008).”
Angermeyer, M. C., & Matschinger, H. (2003) · Acta Psychiatrica Scandinavica · doi:10.1034/j.1600-0447.2003.00150.x · Cited by 608 · see citing works
BILOG 3 : item analysis and test scoring with binary logistic models
Mislevy, R. J., & Bock, R. D. (1990) · Medical Entomology and Zoology · Cited by 541 · see citing works
The impact of stigma on severe mental illness
Corrigan, P. W. (1998) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(98)80006-0 · Cited by 523 · see citing works
Shame and guilt in interpersonal relationships.
Tangney, J. P. (1995) · Cited by 503 · see citing works
Predictors of depression stigma
Griffiths, K. M., Christensen, H., & Jorm, A. F. (2008) · BMC Psychiatry · doi:10.1186/1471-244x-8-25 · Cited by 454 · cited 3× · see citing works
“The scales measure perceived stigma, which was shown to differ in some correlates and predictors from personal stigma (Griffiths et al., 2004; 2008).”
Dictionary of statistics and methodology: a nontechnical guide for the social sciences
(1993) · Choice Reviews Online · doi:10.5860/choice.31-1310 · Cited by 438 · see citing works
Is Suicide Bereavement Different? A Reassessment of the Literature
Jordan, J. R. (2001) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.31.1.91.21310 · Cited by 433 · see citing works
Stigma and discrimination limit access to mental health care
Thornicroft, G. (2008) · Epidemiologia e Psichiatria Sociale · doi:10.1017/s1121189x00002621 · Cited by 432 · cited 1× · see citing works
“People often refrain from accessing the support and care they need for fear of being negatively labeled by relatives or friends on account of their mental health status (Angermeyer and Matschinger, 2003; Thornicroft, 2008).”
Angermeyer, M. C., Holzinger, A., Carta, M. G., & Schomerus, G. (2011) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.110.085563 · Cited by 377 · see citing works
Do Suicide Survivors Suffer Social Stigma: A Review of the Literature
Cvinar, J. G. (2005) · Perspectives In Psychiatric Care · doi:10.1111/j.0031-5990.2005.00004.x · Cited by 298 · see citing works
Zeigler‐Hill, V., & Shackelford, T. K. (2020) · Springer eBooks · doi:10.1007/978-3-319-24612-3_302355 · Cited by 210 · see citing works
Suicide and Stigma: A Review of the Literature and Personal Reflections
Sudak, H., Maxim, K., & Carpenter, M. (2008) · Academic Psychiatry · doi:10.1176/appi.ap.32.2.136 · Cited by 202 · see citing works
Grief counseling and grief therapy: A handbook for the mental health practitioner
Lynch, P. D. (1983) · Patient Education and Counseling · doi:10.1016/0738-3991(83)90021-6 · Cited by 197 · see citing works
Stigmatization and Suicide Bereavement
Feigelman, W., Gorman, B. S., & Jordan, J. R. (2009) · Death Studies · doi:10.1080/07481180902979973 · Cited by 183 · see citing works
Estimation On the Basis of Snowball Samples: How To Weight?
Snijders, T. A. B. (1992) · Bulletin of Sociological Methodology/Bulletin de Méthodologie Sociologique · doi:10.1177/075910639203600104 · Cited by 176 · see citing works
Factor Simplicity Index and Transformations
Bentler, P. M. (1977) · Psychometrika · doi:10.1007/bf02294054 · Cited by 147 · see citing works
Development of the Grief Experience Questionnaire
Barrett, T. W., & Scott, T. B. (1989) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.1989.tb01033.x · Cited by 146 · see citing works
Walker, R. L., Lester, D., & Joe, S. (2006) · Journal of Black Psychology · doi:10.1177/0095798406290467 · Cited by 136 · see citing works
Personal and perceived depression stigma in Australian adolescents: Magnitude and predictors
Calear, A. L., Griffiths, K. M., & Christensen, H. M. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.08.019 · Cited by 130 · see citing works
Suicide and its aftermath : understanding and counseling the survivors
Dunne, E., McIntosh, J. L., & Dunne-Maxim, K. (1987) · Norton eBooks · Cited by 118 · see citing works
Shame reactions after suicide attempt.
Wiklander, M., Samuelsson, M., & Åsberg, M. (2003) · Scandinavian Journal of Caring Sciences · doi:10.1046/j.1471-6712.2003.00227.x · Cited by 115 · see citing works
Harwood, D., Hawton, K., Hope, T., & Jacoby, R. (2002) · Journal of Affective Disorders · doi:10.1016/s0165-0327(01)00462-1 · Cited by 113 · see citing works
The Association of Shame and Guilt with Suicidality
Lester, D. S. (1998) · The Journal of Social Psychology · doi:10.1080/00224549809600407 · Cited by 93 · see citing works
Control group studies of suicide survivors: A review and critique
McIntosh, J. L. (1993) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.1993.tb00379.x · Cited by 87 · see citing works
The Impact of Suicide in Television Movies: Replication and Commentary
Gould, M. S., Shaffer, D., & Kleinman, M. (1988) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.1988.tb00144.x · Cited by 80 · see citing works
The intensive care unit and the suicide attempt patient
Wolk‐Wasserman, D. (1985) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1985.tb02552.x · Cited by 52 · see citing works
The Stigma for Attempting Suicide and the Loss to Suicide Prevention Efforts
Lester, D., & Walker, R. L. (2006) · Crisis · doi:10.1027/0227-5910.27.3.147 · Cited by 45 · see citing works
Kalish, R. A. (1966) · Community Mental Health Journal · doi:10.1007/bf01420690 · Cited by 42 · see citing works
Lester, D. (1993) · OMEGA - Journal of Death and Dying · doi:10.2190/pb36-aug6-1r77-lpmg · Cited by 30 · see citing works
The Attitudes of Preclinical and Clinical Turkish Medical Students Toward Suicide Attempters
Emül, M., Uzunoglu, Z., Sevi̇nç, H. F., et al. (2011) · Crisis · doi:10.1027/0227-5910/a000065 · Cited by 26 · see citing works
Knight, M. T. D., Furnham, A. F., & Lester, D. (2000) · Personality and Individual Differences · doi:10.1016/s0191-8869(99)00205-6 · Cited by 19 · see citing works
Scocco, P., Frasson, A., Costacurta, A., & Pavan, L. J. (2006) · Crisis · doi:10.1027/0227-5910.27.1.39 · Cited by 17 · see citing works
Self-citationLay Theories of Suicide in Turkish and American Students
Vatan, S., Gençöz, F., Walker, R. L., et al. (2010) · OpenMETU (Middle East Technical University) · Cited by 6 · see citing works
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The Reciprocal Relationship between Suicidality and Stigma
Carpiniello, B., & Pinna, F. (2017) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2017.00035 · Cited by 252 · see citing works
The Stigma of Suicide Survivorship and Related Consequences—A Systematic Review
Hanschmidt, F., Lehnig, F., Riedel-Heller, S. G., & Kersting, A. (2016) · PLOS ONE · doi:10.1371/journal.pone.0162688 · Cited by 184 · see citing works
Stakeholder perspectives on the stigma of suicide attempt survivors
Sheehan, L. L., Corrigan, P. W., Al-Khouja, M. A., & the Stigma of Suicide Research Team (2017) · Crisis · doi:10.1027/0227-5910/a000413 · Cited by 121 · see citing works
The ripple effect: a digital intervention to reduce suicide stigma among farming men
Kennedy, A. J., Brumby, S. A., Versace, V. L., & Brumby-Rendell, T. (2020) · BMC Public Health · doi:10.1186/s12889-020-08954-5 · Cited by 51 · see citing works
Scocco, P., Zerbinati, L., Preti, A., Ferrari, A., & Totaro, S. (2019) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1111/papt.12175 · Cited by 26 · see citing works
Self-citationFulginiti, A., He, A. S., & Negriff, S. (2018) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2018.10.010 · Cited by 17 · see citing works
Bottomley, J. S., Campbell, K. W., Feigelman, W., Schamber, E. L., & Rheingold, A. A. (2025) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.02.102 · Cited by 7 · see citing works
- Authors
- Scocco, P., Castriotta, C., Toffol, E., & Preti, A.
- Affiliations
- University of Padua (IT)
- University of Helsinki (FI)
- University of Cagliari (IT)
- Corresponding author
- Scocco, Paolo
- Venue
- Psychiatry Research
- Publisher
- Elsevier BV
- Published
- 2012-12
- Volume
- 200
- Issue
- 2-3
- Pages
- 872-878
- ISSN
- 0165-1781 (ISSN-L)
- OpenAlex
- W2117773283
- Cited by
- 96
- References
- 49
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 4 · 2023: 8 · 2022: 8 · 2021: 8 · 2020: 7 · 2019: 6 · 2018: 9 · 2017: 9 · 2016: 7 · 2015: 8 · 2014: 5 · 2013: 4
- FWCI
- 6.16
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatry Research (publishedVersion)
- PubMed (publishedVersion)
- UNICA IRIS Institutional Research Information System (University of Cagliari) (submittedVersion)
- Institutional Research Information System University of Turin (University of Turin) (submittedVersion)
- STM:n Hallinnonalan avoin julkaisuarkisto (Julkari) (submittedVersion)
- WOS
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Grief, Bereavement, and Mental Health
- Keywords
- suicide stigma, suicide survivors, stigma measurement, scale validation, Italian translation, mental illness, attitudes toward suicide, test-retest reliability, factor structure
- MeSH terms
- Adult, Aged, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Psychometrics, Surveys and Questionnaires, Stereotyping, Suicide, Attempted, Reproducibility of Results, Survivors, Social Stigma
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