Search results

Despite the fact that shame is recognized as a significant factor in clinical encounters, it is under-recognized, under-researched and under-theorized in health prevention, assessment and cross-cultural contexts. Thus, this study aims to investigate the psychometric properties of the most widely used scale, the “Other as Shamer Scale” (OAS), to assess the risk and proclivities of external shame in adults. As in health care, there is a barrier between what is known through research in one culture and what is acceptable in practice in another culture.

The Urdu version was prepared using the standard back-translation method, and the study was conducted from June 2021 to January 2022. The translation and adaptation were completed in four steps: forward translation, adaptation and translation, back translation, committee approach and cross-language validation. The sample, selected through the purposive sampling method, is comprised of 200 adults (men = 100 and women = 100), with an age range of 18–60 years (M = 28, SD = 5.5), spanning all stages of life. The Cronbach's alpha reliability and factorial validity of the OAS were assessed through confirmatory factor analysis and Pearson correlation analyses. Internal consistency and test–retest reliability (at a two-week interval) were used to evaluate the reliability. Statistical analyses were performed using Statistical Package for Social Sciences (version 22) software.

Preliminary analysis revealed that the overall instrument had good internal consistency (Urdu OAS a = 0.91; English OAS a = 0.92) as well as test–retest correlation coefficients for 15 days (r = 0.88). The factor loading of all items ranged from 0.69 to 0.9, which explained the significant level and indicated the model's overall goodness of fit.

Findings suggest that this scale has significant psychometric properties and the potential to be used as a valid, reliable and cost-effective clinical and research instrument. This study contributes to scientific knowledge and helps to develop and test indigenous cross-cultural instruments that can be used to examine external shame in Pakistani people.

Stigma is a major impediment to human rights in health care that causes discrimination, isolation and the exclusion of individuals from essential health-care services. It fosters fear, leading to negative stereotyping of individuals based on their social, cultural or health status and undermines their dignity and respect, consequently violating their right to health. Therefore, the purpose of this study is to evaluate the moderating role of psychological flexibility in the relationship between stigma (enacted, anticipated and internalized), mental health and the quality of life of substance users.

This study was based on a cross-sectional design and included 200 male patients with an age range of 18–65 years from 23 rehabilitation centers in four cities in Pakistan. The purposive sampling technique was used, and the sample size ranged from 4 to 23 participants for each site. Four scales were used to measure stigma, general mental health, quality of life and psychological flexibility in substance users.

The data were analyzed using SPSS and Smart PLS, which showed that stigma (enacted, anticipated and internalized) had a detrimental effect on substance users’ mental health and quality of life. Additionally, psychological flexibility acts as an efficient moderator between them.

This research unveils the moderating role of psychological flexibility in mitigating stigma’s adverse effects on individuals with substance use disorders. Future investigations should prioritize interventions aimed at enhancing psychological flexibility to ameliorate the repercussions of stigma, ultimately enhancing the well-being and quality of life of substance users.