Perceived Devaluation and Discrimination toward mental illness Scale (PDDs): Its association with sociodemographic variables and interpersonal contact in a Mexican sample

Jazmín Mora-Ríos, Miriam Ortega-Ortega



Introduction. Research about stigma on mental illness in different sociocultural contexts is crucial to guide international efforts to reduce discrimination.

Objective. Analyze the psychometric properties of the Perceived Devaluation and Discrimination (PDD) scale adapted for the Mexican population and its relationship with sociodemographic variables and interpersonal contact.

Method. The study was based on a psychometric and cross-sectional design. The PDD scale was applied to a sample of 295 participants recruited through community programs in the south of Mexico City. Data were analyzed using confirmatory factor analysis to identify the subscales of PDDs. These subscales were compared by age, gender, and education using a univariate analysis. One-way analysis of variance (ANOVA) was then performed to determine whether there were differences in educational level between three PDDM-subscales.

Results. The PDD scale obtained an adequate global internal consistency (α = .78). Three PDDs factors were identified: myths and stereotypes, favorable attitudes, and social exclusion, which explain 57.8% of the total variance. The results shows an Χ2SB = 140.88 (df = 143, p = .05, CFI = 1, RMSEA = .000, CI [.000, .029]). Other findings showed significant differences in favorable attitudes toward mental illness subscale by gender and age. The ANOVA results for the social perception of the devaluation subscale reveal that those with a higher educational level could be more aware about devaluation in society toward people with mental illness than other groups with lower education (F = 4.88, p = .005).

Discussion and conclusion. The PDD-M scale adapted in Mexico is a culturally valid and reliable measure that could be useful for evaluating the variations and commonalities of public stigma in comparative studies between Latino populations and other international research contexts.


Confirmatory factor analysis; Perceived Devaluation and Discrimination (PDD-M) Scale adapted in Mexico; mental illness; public stigma

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Ahn, J.-H., Kim, W.-H., Choi, H.-J., Jeon, J.-Y., Song, I.-G. & Bae, J.-N. (2015). Stigma of mental illness as perceived by North Korean defectors living in South Korea. Psychiatry Investigation, 12(1), 9-15. doi: 10.4306/pi.2015.12.1.9

Angermeyer, M. C., Matschinger, H., Carta M. G., & Shomerus, G. (2014). Changes in the perception of mental illness stigma in Germany over the last two decades. European Psychiatry, 29(6), 390-395. doi: 10.1016/j.eurpsy.2013.10.004

Bentler, P. M. (2006). EQS Structural Equation Model Program. Encino, CA: Multivariate Software Inc. Available from

Björkman, T., Svensson, B., & Lundberg, B. (2007). Experiences of stigma among people with severe mental illness. Reliability, acceptability and construct validity of the Swedish versions of two stigma scales measuring devaluation/discrimination and rejection experiences. Nordic Journal Psychiatry, 61(5), 332-338. doi: 10.1080/08039480701642961

Brohan, E., Slade, M., Clement, S., & Thornicroft, G. (2010). Experiences of mental illness stigma, prejudice and discrimination: a review of measures. BMC Health Services Research, 10(1), 80. doi: 10.1186/1472-6963-10-80

Cabassa, L. J., Gomes, A., Meyreles, Q., Capitelli, L., Younge, R., Dragatsi, D., … Lewis-Fernández, R. (2014). Primary health care experiences of Hispanics with serious mental illness: A mixed methods study. Administration and Policy in Mental Health, 41(6), 724-736. doi: 10.1007/s10488-013-0524-2

Corrigan, P. W. (1998). The impact of stigma on severe mental illness. Cognitive and Behavioral Practice, 5(2), 201-222. doi: 10.1016/S1077-7229(98)80006-0

Corrigan, P. W., & Miller, F. E. (2004). Shame, blame, and contamination: A review of the impact of mental illness stigma on family members. Journal of Mental Health, 13(6), 537-548. doi: 10.1080/09638230400017004

Corrigan, P. W., & Watson, A. C. (2007). The stigma of psychiatric disorders and the gender, ethnicity and education of the perceiver. Community Mental Health Journal, 43(5), 439-458. doi: 10.1007/s10597-007-9084-9

Corrigan, P. W., Morris, S. B., Michaels, P. J., Rafacz, J. D., & Rüsch, N. (2012). Challenging public stigma of mental illness: a meta-analyses of outcome studies. Psychiatric Services, 63(10), 963-973. doi: 10.1176/

Couture, S., & Penn, D. (2003). Interpersonal contact and the stigma of mental illness: A review of the literature. Journal of Mental Health, 12(3), 291-305. doi: 10.1080/09638231000118276

Evans-Lacko, S., Henderson, C., & Thornicroft, G. (2013). Public knowledge, attitudes and behaviour regarding people with mental illness in England 2009–2012. The British Journal of Psychiatry, 202(s55), s51-s57. doi: 10.1192/bjp.bp.112.11297

Fresán, A., Robles-García, R., Martínez-López, N., Tovilla-Zárate, C., & Madrigal, E. (2018). Stigma and perceived aggression towards schizophrenia in female students of medicine and psychology. Salud Mental, 41(5), 207-212. doi: 10.17711/SM.0185-3325.2018.031

IBM Corporation. (2012). IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp.

Interian, A., Ang, A., Gara, M. A., Link, B. G., Rodriguez, M. A., & Vega, W. A. (2010). Stigma and depression treatment utilization among Latinos: utility of four stigma measures. Psychiatric Services, 61(4), 373-379. doi: 10.1176/

Lee, K. H. (2001). A study on the stigma about persons with mental disability. Seoul: Ewha Womans University.

Link, B. G. (1987). Understanding labeling effects in the area of mental disorders: An assessment of the effects of expectations of rejection. American Sociological Review, 52(1), 96-112. doi: 10.2307/2095395

Link, B. G., Yang, L. H., Phelan, J. C., & Collins, P. Y. (2004). Measuring mental illness stigma. Schizophrenia Bulletin, 30(3), 511-541. doi: 10.1093/oxfordjournals.schbul.a007098

Martínez-Zambrano, F., Pizzimenti, M., Barbeito, S., Vila-Badia, R., Comellas, G., Escandell, M. J., … Ochoa, S. (2016). Spanish version of the Link´s Perceived Devaluation and Discrimination Scale. Psicothema, 28(2), 201-206. doi: 10.7334/psicothema2015.89

Mascayano, F., Tapia, T., Shilling, S., Alvarado, R., Tapia, E., Lips, W., & Yang, L. (2016). Stigma toward mental illness in Latin America and the Caribbean. A systematic review. Brazilian Journal of Psychiatry, 38(1), 73-85. doi: 10.1590/1516-4446-2015-1652

Matschinger, H., Angermeyer, M. C., & Link, B. C. (1991). Variation of response structures in relation to degree of personal involvement -a methodological study using exemplified by the Discrimination Devaluation Scale. Psychotherapie Psychosomatik Medizinische Psychologie, 41(7), 278-283.

Mora-Ríos, J., Bautista-Aguilar, N., Natera, G., & Pedersen, D. (2013a). Adaptación semántica de instrumentos de medidas sobre estigma y enfermedad mental en la Ciudad de México. Salud Mental, 36(1), 9-18. doi: 10.17711/SM.0185-3325.2013.002

Mora-Ríos, J., Natera-Rey, G., Bautista-Aguilar, N., & Ortega-Ortega, M. (2013b). Estigma público y enfermedad mental. Una aproximación desde la teoría de las representaciones sociales. In Flores-Palacios F, (Coordinator). Representaciones sociales y contexto de investigación con perspectiva de género (pp. 45-80). México: Centro Regional de Investigaciones Multidisciplinarias, UNAM.

Parcesepe, A. M., & Cabassa, L. J. (2013). Public stigma of mental illness in the United States: a systematic literature review. Administration and Policy in Mental Health, 40(5), 384-399. doi: 10.1007/s10488-012-0430-z

Pedersen, D. (2009). Estigma y exclusión social en las enfermedades mentales: apuntes para el análisis y diseños de intervenciones. Acta Psiquiátrica y Psicológica de América Latina, 55(1), 39-50.

Pescosolido, B. A. (2013). The public stigma of mental illness: what do we think; what do we know; what can we prove? Journal of Health and Social Behavior, 54(1), 1-21. doi: 10.1177/0022146512471197

Pescosolido, B. A., Medina, T. R., Martin, J. K., & Long, J. S. (2013). The “backbone” of stigma: identifying the global core of prejudice associated with mental illness. American Journal of Public Health, 103(5), 853-860. doi: 10.2105/AJPH.2012.301147

Pettigrew, T. F., & Tropp, L. R. (2006). A meta-analytic test of intergroup contact theory. Journal of Personality and Social Psychology, 90(5), 751-783. doi: 10.1037/0022-3514.90.5.751

Razali, S. M., & Ismail, Z. (2014). Public stigma towards patients with schizophrenia of ethnic Malay: a comparison between the general public and patients' relatives. Journal of Mental Health, 23(4), 176-180. doi: 10.3109/09638237.2014.910644

Rüsch, N., Evans-Lacko, S., & Thornicroft, G. (2012). What is a mental illness? Public views and their effects on attitudes and disclosure. Australian and New Zealand Journal of Psychiatry, 46(7), 641-650. doi: 10.1177/0004867412438873

Schomerus, G., Schwahn, C., Holzinger, A., Corrigan, P. W., Grabe, H. J., Carta, M. G., & Angermeyer, M. C. (2012). Evolution of public attitudes about mental illness: a systematic review and meta-analysis. Acta Psychiatrica Scandinavica, 125(6), 440-452. doi: 10.1111/j.1600-0447.2012.01826.x

Thornicroft, G., Mehta, N., Clement, S., Evans-Lacko, S., Doherty, M., Rose, D., … Henderson, C. (2016). Evidence for effective interventions to reduce mental-health-related stigma and discrimination. Lancet, 387(10023), P1123-1132. doi: 10.1016/S0140-6736(15)00298-6

Vicario Cañas, A., & Moral-Jiménez, M. V. (2016). Actitudes hacia los trastornos mentales y su asociación percibida con delito: Estigma social. Salud & Sociedad, 7(3), 254-269. doi: 10.22199/S07187475.2016.0003.00002

Yang, L. H., & Link, B. G. (2016). Measurement of attitudes, beliefs and behaviors of mental health and mental illness. National Academy of Science.

Yang, L. H., Thornicroft, G., Alvarado, R., Vega, E., & Link, B. G. (2014). Recent advances in cross-cultural measurement in psychiatric epidemiology: utilizing ‘what matters most’ to identify culture-specific aspects of stigma. International Journal of Epidemiology, 43(2), 494-510. doi: 10.1093/ije/dyu039

Zieger, A., Mungee, A., Schomerus, G., Ta, T. T., Dettling, M., Angermeyer, M. C., & Hahn, E. (2016). Perceived stigma of mental illness: A comparison between two metropolitan cities in India. Indian Journal of Psychiatry, 58(4), 432-437. doi: 10.4103/0019-5545.196706