Construct Validity and Reliability of the Beliefs Toward Mental Illness Scale for American, Japanese, and Korean Women

Purpose: The aim of this study was to evaluate the psychometric properties of the Beliefs Toward Mental Illness Scale (BMI) across women from the United States, Japan, and South Korea. Methods: A cross-sectional study design was employed. The sample was 564 women aged 21-64 years old who were recruited in the United States and Korea (American = 127, Japanese immigrants in the United States = 204, and Korean = 233). We carried out item analysis, construct validity by confirmatory factor analysis (CFA), and internal consistency using SPSS Version 22 and AMOS Version 22. Results: An acceptable model fit for a 20-item BMI (Beliefs Toward Mental Illness Scale-Revised [BMI-R]) with 3 factors was confirmed using CFA. Construct validity of the BMI-R showed to be all acceptable; convergent validity (average variance extracted [AVE] >= 0.5, construct reliability [CR] >= 0.7) and discriminant validity (r = .65-.89, AVE>.79). The Cronbach's alpha of the BMI-R was .92. Conclusion: These results showed that the BMI was a reliable tool to study beliefs about mental illness across cultures. Our findings also suggested that continued efforts to reduce stigma in culturally specific contexts within and between countries are necessary to promote help-seeking for those suffering from psychological distress.