Psychometric assessment of the brief version of the Internalized stigma of mental illness in Arabic-speaking patients with schizophrenia

Background Although the Internalized Stigma of Mental Illness (ISMI-10) is one of the most commonly used measures to assess IS, its originally proposed conceptualization and factor structure remain unclear, inconsistent across samples, and not empirically justified. This study proposes to validate – for the first time – the ISMI-10 for use among Arabic-speaking patients diagnosed with schizophrenia.Methods A cross-sectional study was conducted over a period of 6 months (January–June 2025) among 302 Tunisian patients diagnosed with schizophrenia.Results Four items out of 10 were identified as problematic as they did not show substantial loadings (<0.40), and were discarded for further analysis. The reliability analysis yielded a Cronbach’s alpha coefficient in the total sample of 0.75 for the version with 6 items, indicating an adequate level of internal consistency. Concurrent validity was supported by the significant correlations between IS and scores of psychotic symptoms, depression, suicidal ideation, and recovery. Measurement invariance was established across both sexes.Discussion The new ISMI-6 scale is a short, validated measure of internalized stigma that is tailored for use in Arabic-speaking patients diagnosed with schizophrenia. More research is needed to ensure the generalizability of these findings.