Validity and reliability evaluation of the Chinese version of the attention-deficit/hyperactivity disorder stigma...

Psychological problems among children and adolescents are increasing, and people with attention-deficit/hyperactivity disorder (ADHD) face varying degrees of stigma as they grow up. Such perceptions of stigma can prevent them from seeking psychological help and adhering to treatment. However, a standardized instrument for assessing ADHD-related stigma in Chinese populations is lacking. This study assessed the validity and reliability of a Chinese version of the Attention-Deficit/Hyperactivity Disorder Stigma Questionnaire (ASQ).

A total of 508 adolescents with ADHD, mostly aged 11-13 years (mean age = 13.68 ± 2.12 years), participated in this study. Among them, 51.8% were junior high school students, and the distribution of male and female participants was relatively balanced. Data were collected from two Chinese hospitals between September 2023 and September 2024. The ASQ was translated and culturally adapted into Simplified Chinese. Psychometric evaluation included exploratory and confirmatory factor analyses, assessment of internal consistency, test-retest reliability, and examination of content and construct validity.

Confirmatory factor analysis supported a three-factor structure for the study, demonstrating good model fit ( ${\chi }^2$ /df = 1.325; goodness-of-fit index (GFI) = 0.900; comparative fit index (CFI) = 0.977; root mean square error of approximation (RMSEA) = 0.036). Convergent validity was supported by average variance extracted values above 0.50 and composite reliability values above 0.70. The scale showed excellent internal consistency (Cronbach's α = 0.951) and strong test-retest reliability (r = 0.958).

The Chinese version of the ASQ is a valid and reliable measurement tool that can be used for assessing ADHD-related stigma in Chinese adolescents. This survey tool can assist healthcare professionals in this field in identifying and addressing stigma more effectively, thereby improving treatment adherence.