Presentation Information
[P-15-06]Cross-Cultural Assessment of Self-Stigma in Epilepsy: A Multinational Comparative Study Using the Epilepsy Self-Stigma Scale (ESSS)
*Izumi Kuramochi1, Go Taniguchi1, Esra Yildiz4, Estefanía Conde-Blanco3, Anne Hagemann2, Kheng-Seang Lim5, Eiji Nakagawa1 (1.National Center of Neurology and Psychiatry(Japan), 2.Society for Epilepsy Research, Bielefeld(Germany), 3.Epilepsy Program, Neurology Department, Hospital Clinic Barcelona(Spain), 4.Faculty of Nursing, Atatürk University, Erzurum(Turkey), 5.Division of Neurology, Department of Medicine, Faculty of Medicine, Universiti Malaya(Malaysia))
Keywords:
Cross-cultural validation,Mental health,Psychometric analysis,Self-esteem,Quality of life
Background: Self-stigma, the internalization of negative societal attitudes, adversely affects the quality of life, treatment engagement, and mental health of people with epilepsy (PWE). While the Epilepsy Self-Stigma Scale (ESSS) was originally developed in Japan, cross-cultural validations have now been conducted in Germany, Spain, Turkey, and Malaysia.
Objective: To synthesize findings from international validation studies of the ESSS and explore cultural and psychological factors associated with self-stigma in PWE.
Methods: We reviewed psychometric validation studies of the ESSS across five cultural contexts (Japan, Germany, Spain, Turkey, Malaysia—Malay and Chinese groups). Each version underwent factor analysis, reliability testing, and evaluation of construct validity with established psychological scales (e.g., NDDI-E, GAD-7, RSES). This presentation is based on previously published studies. No new data collection involving human participants was conducted by the authors for this synthesis.
Results: The ESSS demonstrated good internal consistency in all versions (Cronbach’s α = 0.74–0.83). Factor structures varied: Japan and Turkey supported a three-factor model; Spain revealed two factors; Germany showed a unidimensional structure. ESSS scores consistently correlated with depression, anxiety, and lower self-esteem. Japanese and Turkish cohorts exhibited higher self-stigma than Spanish and Malaysian groups. Cultural differences in stigma expression were partly mediated by psychological distress (depression/anxiety), as shown in ANCOVA models.
Conclusion: This cross-cultural synthesis highlights the importance of integrating mental health support into anti-stigma efforts. The ESSS enables standardized evaluation of self-stigma in epilepsy across cultures and provides a foundation for developing culturally tailored interventions.
Objective: To synthesize findings from international validation studies of the ESSS and explore cultural and psychological factors associated with self-stigma in PWE.
Methods: We reviewed psychometric validation studies of the ESSS across five cultural contexts (Japan, Germany, Spain, Turkey, Malaysia—Malay and Chinese groups). Each version underwent factor analysis, reliability testing, and evaluation of construct validity with established psychological scales (e.g., NDDI-E, GAD-7, RSES). This presentation is based on previously published studies. No new data collection involving human participants was conducted by the authors for this synthesis.
Results: The ESSS demonstrated good internal consistency in all versions (Cronbach’s α = 0.74–0.83). Factor structures varied: Japan and Turkey supported a three-factor model; Spain revealed two factors; Germany showed a unidimensional structure. ESSS scores consistently correlated with depression, anxiety, and lower self-esteem. Japanese and Turkish cohorts exhibited higher self-stigma than Spanish and Malaysian groups. Cultural differences in stigma expression were partly mediated by psychological distress (depression/anxiety), as shown in ANCOVA models.
Conclusion: This cross-cultural synthesis highlights the importance of integrating mental health support into anti-stigma efforts. The ESSS enables standardized evaluation of self-stigma in epilepsy across cultures and provides a foundation for developing culturally tailored interventions.