Cross-cultural validity of the self-stigma of seeking help (SSOSH) scale: Examination across six nations

David L. Vogel, Patrick Ian Armstrong, Pei Chun Tsai, Nathaniel G. Wade, Joseph H. Hammer, Georgios Efstathiou, Elizabeth Holtham, Elli Kouvaraki, Hsin Ya Liao, Zipora Shechtman, Nursel Topkaya

Research output: Contribution to journalArticlepeer-review


Researchers have found that the stigma associated with seeking therapyparticularly self-stigma can inhibit the use of psychological services. Yet, most of the research on self-stigma has been conducted in the United States. This is a considerable limitation, as the role of self-stigma in the help-seeking process may vary across cultural groups. However, to examine cross-cultural variations, researchers must first develop culturally valid scales. Therefore, this study examined scale validity and reliability of the widely used Self-Stigma of Seeking Help scale (SSOSH; Vogel, Wade, & Haake, 2006) across samples from 6 different countries (England, Greece, Israel, Taiwan, Turkey, and the United States). Specifically, we used a confirmatory factor analysis framework to conduct measurement invariance analysis and latent mean comparisons of the SSOSH across the 6 sampled countries. Overall, the results suggested that the SSOSH has a similar univariate structure across countries and is sufficiently invariant across countries to be used to explore cultural differences in the way that self-stigma relates to help-seeking behavior.

Original languageEnglish
Pages (from-to)303-310
Number of pages8
JournalJournal of Counseling Psychology
Issue number2
StatePublished - Apr 2013


  • Cross-cultural
  • Help seeking
  • Self-stigma
  • Stigma
  • Validity

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology
  • Social Psychology


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