The images of psychiatry scale: development, factor structure, and reliability

Heather Stuart, Norman Sartorius, Tiina Liinamaa, Images Study Group

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)
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This analysis is based on a survey questionnaire designed to describe medical educators’
views of psychiatry and psychiatrists. Our goals in this paper were to assess the psychometric
properties of the survey questions by (a) using exploratory factor analysis to identify the basic
factor structure underlying 37 survey items; (b) testing the resulting factor structure using
confirmatory factor analysis; and (c) assessing the internal reliability of each identified factor.
To our knowledge, this is the first attempt to use these techniques to psychometrically assess
a scale measuring the strength of stigma that medical educators attached to psychiatry.
Survey data were collected from a random sample of 1,059 teaching faculty in 23 academic
teaching sites in 15 countries. We conducted exploratory and confirmatory factor analysis to
identify the scale structure and Cronbach’s alpha to assess internal consistency of the
resulting scales.
Results showed that a two-factor solution was the best fit for the data. Following exploratory
factor analysis, we conducted confirmatory factor analysis on a split half of the sample.
Results highlighted several items with low loadings. Excluding factors with low correlations
and allowing for several correlated variances resulted in a good fitting model explaining 95%
of the variance in the data.
We identified two unidimensional scales. The Images Scale contained 11 items measuring
stereotypic content concerning psychiatry and psychiatrists. The Efficacy of Psychiatry Scale
contained 5 items addressing perceptions of the challenges and effectiveness of psychiatry as
a discipline.
Original languageEnglish
Article number337
JournalBMC Psychiatry
Publication statusPublished - 11 Dec 2014


  • stigma
  • medical educators
  • images of psychiatry scale


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