Developing the Label Avoidance Measure of Stigma: A preliminary psychometric review

Stigma acts as a barrier to treatment for mental health concerns. Label avoidance, one of several different aspects that compose the overarching concept of stigma, captures the stigma involved when individuals avoid social institutions that might confer a psychiatric diagnostic label and would mark them as an individual with a mental health problem. Label avoidance has been described as a key stigma construct in the literature but has been sparsely studied. Answering a call in the field for new, psychometrically sound stigma measures, we created a new measure of label avoidance and acquired initial validity and reliability evidence supporting its use among an adult population. Preliminary item development for the Label Avoidance Measure (LAM) was performed using a rational scale construction approach, allowing us to generate items based on our conceptual understanding of label avoidance and stigma theory. A sample (n = 41) of undergraduate students provided input during the item development phase. Data were then collected over two time periods utilizing participants from the crowdsourcing technique, Amazon Mechanical Turk (MTurk) (Time 1: n = 232; Time 2: n = 95). An exploratory components factor analysis of the LAM indicated a one-factor solution, rather than suggesting the LAM should comprise multiple subscales. Three items were eliminated because they did not meaningfully load onto the factor (criterion level \u3c .4). Internal consistency analysis indicated that the items on the LAM are strongly related (α = .976). Additionally, preliminary convergent and discriminant validity evidence was gathered to compare the LAM to existing measures. The LAM was significantly and strongly correlated with the Self-Stigma of Seeking Help Scale (r = .744, pr = .619, pr = -.243, pr = -.309, pr = .810,