The mediating role of internalized stigma in the relationship between social exclusion and quality of life in individuals with special needs

This study aims to examine the relationship between the perceptions of social exclusion and quality of life among individuals with special needs, as well as to investigate the mediating role of internalized stigma in this relationship. The research was conducted in two phases. In the first phase, a culturally adapted, valid, and reliable scale titled "Internalized Stigma Scale for Individuals with Special Needs (ISSS)" was developed to assess the level of internalized stigma among individuals with special needs. The scale consists of three sub-dimensions: "Stigma Endorsement," "Stigma Approval," and "Stigma Internalization." In the second phase, data were collected using the Social Exclusion Scale for Individuals with Disabilities, the Internalized Stigma Scale for Individuals with Special Needs, and the World Health Organization Quality of Life Scale – Disability Module to test whether internalized stigma plays a mediating role between social exclusion and quality of life. The analysis, conducted using the PROCESS Macro based on the bootstrap method, revealed that the indirect effect of social exclusion on quality of life was statistically significant, confirming that internalized stigma mediates the relationship between social exclusion and quality of life in individuals with special needs.