Measuring intimate relationship self-stigma in serious mental illness: scale development and validation

Individuals living with serious mental illness (SMI) face pervasive stigma, with damaging effects on their intimate lives. Although evidence suggests individuals might endorse stereotypes about their romantic relationships, no tool has addressed self-stigma in this domain.

This study aimed to develop and validate the Intimate Relationship Self-Stigma Scale (IRSS), specifically, to determine its structural and construct validity, as well as the internal consistency and test-retest reliability.

This instrument was co-constructed with peer support workers living with SMI. Using a bipolar semantic differential format, the IRSS captures both self-stigmatizing beliefs and positive self-perceptions. Items were generated through focus groups and literature review. Participants with SMI (N = 150) completed the IRSS online, along with measures of internalized stigma, self-esteem, and romantic functioning.

Exploratory factor analyses supported a four-factor structure-Disclosure Effects, Self-Attractiveness, Stability, and Intimacy Needs-explaining 48.6% of the variance. Subscales demonstrated satisfactory internal consistency (ω = .69-.87), test-retest reliability (ICC = .79-.93), and expected correlations with related constructs.

The IRSS fills a critical gap in recovery-oriented mental health care by providing a comprehensive assessment of internalized stigma in romantic contexts while simultaneously capturing positive self-perceptions. Further validation, including confirmatory factor analyses and cross-cultural validity, is warranted.