Translation, Cultural Adaptation, and Psychometric Validation of the Urdu Perceived Stigmatization Questionnaire Among Acid Attack Survivors in Pakistan

Abstract

No culturally adapted and psychometrically validated Urdu instrument is currently available to assess perceived stigmatization among individuals with visible disfigurements in Pakistan. Therefore, this study aimed to translate, culturally adapt, and evaluate the psychometric properties of the PSQ in Urdu (PSQ-Urdu). Following standard forward–backward translation and cultural adaptation procedures, a cross-sectional study was conducted on a sample of 133 acid attack survivors recruited using purposive sampling from different burn care centers and rehabilitation organizations in Pakistan. Participants completed the PSQ-Urdu and RSES Urdu version. Furthermore, visibility of burn scars was included as a clinical characteristic to examine its association with perceived stigmatization. The PSQ-Urdu version showed excellent internal consistency reliability, i.e., α = .91, ω =.93, with high reliability across its subscales: α = 0.90, ω=.91 for absence of friendly behavior, α =.93, ω=.95 for staring behavior, and α =.90, ω=.96 for hostile behavior. Furthermore, a strong negative correlation (r = -.85**) between perceived stigmatization and self-esteem provides evidence for good construct validity. Additionally, a moderate positive association between PSQ-U and visibility of burn scars provided evidence of validity based on associations with a relevant clinical characteristic. Exploratory factor analysis using principal axis factoring with Promax rotation supported a three-factor structure consistent with the original PSQ (KMO = .94; Bartlett’s test of sphericity, χ² (210) = 4166.24, p < .001), explaining 85.34% of the total variance. The findings provide evidence for the PSQ-Urdu as a reliable and valid instrument to assess perceived stigmatization among the Urdu-speaking population with visible disfigurements.