Background n=128) or non-ALD (n=83).The LDSS assessed internalized, anticipated (family and healthcare), and experienced (family and healthcare) stigma.Psychometric evaluation included exploratory factor analysis (EFA), internal consistency (Cronbach's alpha), and convergent validity with the Substance Use Stigma Mechanisms Scale (SU-SMS) and mental health symptoms.Known-groups validity was assessed using t-tests and adjusted linear regression.Results: EFA supported a five-factor structure accounting for 73.7% of variance.Subscale reliability was excellent ( = 0.90-0.97).LDSS subscales showed strong convergent validity with corresponding SU-SMS subscales (r = 0.43-0.80)and moderate correlations with mental health (r = 0.18-0.60).Known-groups validity was demonstrated by higher stigma scores among participants with ALD, particularly for internalized stigma (2.34 vs 1.50, p < 0.001, d = 0.85) and family-experienced stigma (1.80 vs 1.18, p < 0.001, d = 0.77).After adjustment, differences in internalized and family-experienced stigma remained significant. J o u r n a l P r e -p r o o fConclusions: The LDSS demonstrated a stable five-factor structure, strong reliability, and good convergent validity, supporting its use as a psychometrically sound measure of liver disease-specific stigma.Patients with ALD showed higher stigma levels, underscoring the scale's clinical relevance and the need for further research on stigma and outcomes in liver disease.Findings require validation in larger, more diverse, and independent samples.
Zhang et al. (Fri,) studied this question.