Clinical Psychology

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The relationship between mode and locus of exposure and the impact of interpersonal violence in a sample of South African adolescents.
(2014) Jameson, Deborah Anne.; Collings, Steven John.
Children living in South Africa are exposed to chronic adversity on a daily basis, placing them at increased risk for psychological distress and high levels of fear. In particular, the impact of interpersonal violence on children has been noted with concern and has been well researched. Whilst numerous studies have focused separately on either mode of exposure (direct versus indirect or vicariously experienced) or locus of exposure (the specific domain such as the home, school or community) to interpersonal violence and the wide array of detrimental outcomes on childhood development, there remain inconsistencies in findings. The aim of this study was therefore to systematically investigate the constructs of mode and locus of exposure, simultaneously and comprehensively, in order to provide more clarity into the relative impact of different forms of interpersonal violence on South African children. The study expanded on an existing research project that was conducted over three loci of exposure: the home, the school, and community, in order to explore the nature of South African adolescent fears, using existing data. Ecological systems theory was the guiding framework to gain an integrative perspective. This was a quantitative study that employed a cross-sectional survey research design. Stratified random sampling in terms of the quintile system was utilized. A self-administered questionnaire consisting of a free response format and a 5-point Likert scale, was administered to a sample of 312 adolescent school children in the North West province (South Africa) in 2013. Systematic Content Analysis was utilized to derive content categories and coding was informed by Hobfoll’s Conservation of Resources theory. Data were analysed using a 2 (mode) x 2 (locus) Analysis of Variance (ANOVA). The results showed that the risk of exposure to interpersonal violence was high, with 56.1% of respondents reporting that they had been exposed to some form of interpersonal violence in the past 12 months. A significant main effect of mode of exposure indicated that vicarious forms of traumatic exposure were significantly more distressing for participants than were direct forms of traumatic exposure. However, the impact of exposure to interpersonal violence was found to be unrelated to locus of exposure. Respondent’s age, gender, and race were not found to be related to the impact of exposure to interpersonal violence. These findings suggest that the impact of interpersonal violence on children is mediated by mode of exposure but not by locus of exposure. Our results took into consideration children’s chronic exposure to interpersonal violence within the South African context. These findings are discussed with reference to their implications for practice and future research.
A qualitative study of psychotherapists' approaches to cross-cultural assessment, diagnosis and treatment of posttraumatic stress disorder and major depressive disorder in KwaZulu-Natal, South Africa.
Slabbert, Meggan.; Mayaba, Phindile Lungile.
Psychiatric illnesses are a reason for major concern for the health and welfare of people internationally and within the South Africa context (Slone et al., 2006; Stein et al). The rates of specific disorders such as Major Depressive Disorder (MDD) and Posttraumatic Stress Disorder (PTSD) are high within the South African context. This may be attributed to past human rights abuses, and current high rates of poverty, violence and trauma (Edwards, 2005). In South Africa, the process of psychological assessment, diagnosis and interventions can be challenging for psychologists specifically (Knight, 2004), due to the multicultural and multi-lingual contextual nature of the country. In this study, the relevant approaches used by psychotherapists, when assessing, diagnosing and intervening with clients from different ethno-cultural orientations were investigated from an interpretive paradigm in which a qualitative approach was used. Specific reference was given to the assessment, diagnosis and treatment of Major Depressive Disorder (MDD) and Posttraumatic Stress Disorder (PTSD) across cultures. Psychotherapists whom assess, diagnose and treat within private practice from various areas were selected to represent the broader KwaZulu-Natal area. Contextual factors are influential in determining multicultural assessment processes and the cultural competency of a clinician. Clinicians maintain that there is a need for different approaches to assessing, diagnosing and treating clients from different ethno-cultural orientations but also highlight that this is not sufficient in determining the approaches that may suit the needs of clients. The findings of this study highlight that the assessment, diagnosis and treatment of MDD and PTSD across cultures within the South African context is dependent on the clinician‟s perception and awareness of the relationship between culture and pathology. This will ultimately inform the clinician‟s understanding of the client‟s problems; the practical work done in relation to these problems; as well as how clients may respond to interventions used. The transition from the use of standard assessment and perception of cultural sensitivity to the use of multicultural assessment and development of cultural competency was prominent in this study. The need for attention to be given to the notion of clinician bias in developing and maintaining cultural competency in assessing, diagnosing and treating client‟s from multiple ethno-cultural orientations was highlighted in this study.
Identity, PTSD, and psychotherapy with policemen during the transition from apartheid to post-apartheid South Africa.
(2013) Auld, Sharon.; Hayes, Grahame.
Abstract available in PDF file.
How treatment is possible in the absence of a concept of mental disorder.
(2015) Pitchford, Michael Thomas.; Lindegger, Graham Charles.
Commonly it is accepted that one of the advantages of the concept of mental disorder is its necessity when it comes to practical treatment issues. It is for this and other practical reasons that the concept of mental disorder is so ubiquitous. However since the adoption of mental disorder by psychiatry there have been sceptics. In recent years there has been a push to abandon the concept of mental disorder citing problems with validity and reliability of any concept that proposes a clear boundary between the normal and the abnormal. There are many potential arguments that a proponent of mental disorder could raise in objection to such a position. One of these arguments is that the concept of mental disorder is necessary for practitioners to provide the most effective treatment, thereby emphasising the necessity of the concept. One response available to these arguments is to argue that treatment issues are not necessarily a matter resolved by diagnosis. The aim in this dissertation is to set out an argument to that effect.
Understanding the experiences of people recovering from drug use at the ARCA Rehabilitation Centre in Durban.
(2015) Hunsley, Row-Anne Marcia-Lee.; Petersen, Inge.
Background: Recently there has been a significant increase in treatment demand in South Africa for heroin (an opioid), a dangerous and extremely addictive drug that remains popular among different segments of the population, including Kwa-Zulu Natal. ARCA Durban is said to be one of the few rehabilitation centres that provide the drug naltrexone, which is an effective evidence-based treatment for heroin addiction. Aim: This study aimed to understand the experiences of people recovering from drug use at ARCA Durban so as to add to literature on drug addiction and effective treatments for opioid/heroin addiction, especially in the South African context. The information generated by this study can be potentially useful for informing programmes in government run hospitals and rehabilitation centres. Method: This study followed a qualitative research design and used a multiple case study approach. Qualitative data was obtained using semi-structured interviews using a small sample of participants (n=10). The research participants were chosen using convenience sampling and were suitable for this study as they were recovering from opioid/heroin addiction, were certified by ARCA as being clean of any substances and had completed or were at the end of ARCA’s rehabilitation programme (i.e. six months +). This study was understood using the Transtheoretical Model of Stages of Change as a framework, which informed the interview questions asked in this qualitative evaluation of the ARCA programme. Thematic analysis was used to analyse the data. Results: It could be suggested that ARCA Durban successfully assisted/guided all the participants in this study through the following stages of change: contemplation, preparation, action and maintenance. The participant’s positive experience of ARCA and the anti-craving medication naltrexone were supported by previous and current literature. The underlying factor to their successful recovery was their personal choice to change, or as literature describes as their readiness to change. Conclusion: ARCA Durban’s approach in the treatment of opioid/heroin addiction is effective and relevant in the South African context, as all participants were of all races from the most popular areas where heroin is distributed, and these participants were able to reach the stage of Maintenance without any relapses at the end of the study.
Exploring how PLWHA with co-morbid depression perceive depression and mental health services.
(2015) Madlala, Nkanyiso Lionel.; Petersen, Inge.
Background: South Africa, like many low and middle income countries (LMICs) continue to bear the excessive burden of HIV/AIDS. This problem has been further compounded by the growing prevalence of common mental disorders such as depression, which are often comorbid with HIV/AIDS. There is growing recognition of the seriousness of the co-morbidity of common mental disorders, primarily depression with HIV/AIDS. Literature suggests that co-morbidity between depression and HIV leads to reduced adherence to Anti- Retro-Viral Therapy (ART) and Accelerate the progression of HIV. In the context of a scarcity of mental health services, this is of particular concern. Aim: The aim of this study is to explore how PLWHA with co-morbid depression perceive depression and mental health services. The secondary aim of the study is to learn about their perceptions of acceptable interventions. Method: This study used a qualitative design. Qualitative data was obtained from 15 participants attending a large primary health facility through semi-structured interviews. The participants were recruited through a two stepped process with initial inclusion criteria being that participants were HIV-positive and had to meet the diagnostic criteria for major depressive disorder (MDD) using the Structured Clinical Interview for DSMIV Diagnosis (SCID). Thematic analysis, specifically the Framework approach was used to analyze the collected data. Results: Findings from the study attest to the lack of mental health services for PLWHA who suffer from depression. It emerged from the findings that all the participants had no knowledge of any mental health services that might be available. A factor that stood out was that of low levels of mental health literacy as a strong barrier to seeking or even inquiring about mental health services. With regard to appropriate interventions, participants expressed a strong preference for support groups as compared to being helped as individuals. Conclusion: The scarcity of mental health services for people suffering from mental illness continues to be a pressing challenge in South Africa. Depression co-morbid with HIV poses numerous challenges that continue to threaten the wellbeing of PLWHA with co-morbid depression. Further, some determinants of depression such as poverty also pose a great threat to the ART programme by interfering with ART medication adherence. In attempts to address the problem of the shortage of specialized mental health personnel, many writers and researchers have advocated and called for task shifting as a possible relief to the scarcity of these vital services. However more studies are needed that demonstrate the effectiveness and feasibility of task shifting.
An investigation of the relationship between self-esteem and risk-taking behaviour among adolescent students studying at the University of KwaZulu-Natal, Pietermaritzburg campus.
(2015) Manzini, Themba Trust.; Kometsi, Molelekoa Johannes.
This study sought to investigate the relationship between self-esteem and risk-taking behaviour among adolescent students studying at the University of KwaZulu-Natal, Pietermaritzburg Campus. A total of 188 adolescent students within the age range of 18 and 22 from different race, academic level and genders were sampled from the student population. The study was conducted using a quantitative method, using correlational statistics. Self-esteem and risk-taking behaviour were the main variables studied. Research shows that adolescents’ engagement in risk-taking behaviour is prevalent and on the rise both locally and internationally. Negotiating adolescence involves many challenges and adjustment problems. Those who experience difficulties may resort to risktaking behaviour. Only a few studies have linked low self-esteem to risk-taking behaviour. A self-administered questionnaire was used to collect data and it comprised of items from two separate questionnaires: (1) the Rosenberg Self-esteem Scale (RSS); and (2) a Risk-Taking Behaviour Assessment Scale. Data were computed and analyzed using the Statistical Package for Social Sciences (SPSS). This study found that self-esteem and risk-taking behaviour did not correlate significantly. Thus the null-hypothesis was proved to be true, indicating that self-esteem did not correlate with risk-taking behaviour, possibly because adolescent risk-taking behaviour is a complex phenomenon with multiple determinants or etiological factors. Detailed findings also revealed different patterns and levels of risk-engagement, and how they related to demographics. For example, alcohol use was found to be the most common form of risk behaviour amongst the participants. Risk-taking behaviour was higher amongst males than females. The findings of the present study provide information and possible understanding of the nature of the relationship between self-esteem and risk-taking behaviour among adolescent students. This has possible implications for further research, prevention and treatment strategies for counselling centre staff at local universities.
Sexual socialisation and gender identities : the impact on risky sexual behaviour in Ematyholweni.
(2014) Tuluma, Vuyolwethu.; Van der Riet, Mary Boudine.
In South Africa, there is a high rate of HIV/AIDS infection and 12.2 percent of the population is HIV positive (UNAIDS, 2012). This can be traced in the dynamics that exist between gender and identity. To understand these dynamics, this study explored the gender and power dimensions of sexual relationships and how this influenced HIV risk. The purpose of this study was to find out how the youth are sexually socialized about sex, relationships and gender roles. It also explored how learning about sex, relationships and gender roles influences the construction of masculine and feminine identities. The study investigated how this creates risk for HIV among the youth of Ematyholweni, a rural area in the Eastern Cape province of South Africa. A qualitative research design was adopted in this study. This study sampled data from a broader data set originating in an NRF study on sexual activity and risk behaviour. Seven focus groups and 12 individual interviews with female and male participants aged between 15-30 years were sampled for this study. The total sample size for this study was 58. Thematic analysis and a discursive framework guided the analysis of the data. The analysis found that the youth are sexually socialized in and through different sites and processes such as schools, traditional isiXhosa games, clinics, the mass media, as well as through peers and parents. In this process youth learn about gender roles. For example young women learn the importance of being in a committed relationship, and young men learn the importance of sexual intercourse in a relationship. This study found that barriers to safe sex are influenced by dominant discourses and how young people learn about sex, relationships and gender roles. These ways of learning and the participants’ investments in these discourses rationalized risky sexual behaviours.
Help-seeking attitudes : a study of University of KwaZulu-Natal students.
(2015) Motau, Bathabile Audrey.; Nwoye, Augustine.
The study examined the help-seeking attitudes and behaviour of students of the University of KwaZulu-Natal. The aim was to explore the frequently encountered problems that students face, their preferred sources of help for those problems and their attitudes towards psychological help. One-hundred-and-fifty undergraduate and post-graduate students from the University of KwaZulu-Natal, Pietermaritzburg campus, participated in the study. The sample was selected by means of non-probability convenient sampling due to the ease of this technique. The instruments for the study consisted of an adapted questionnaire that consisted of three sections. The data collected was quantitative in nature. Data was then captured in the Statistical Package for Social Sciences (SPSS) and presented in frequency tables. The findings revealed nine significant problems frequently encountered by the students. At the top of the list participants reported that financial problems were the most widespread problem encountered by them. The study also revealed, as expected, that close friends were the preferred sources of help solicited by the students. The study further discovered that students had an intermediate attitude towards professional psychological help. This finding depicts a slight shift from previous studies which reported a trend of negative attitudes among students, which means some students are starting to understand the role and value of professional psychological services. The implications of these findings were drawn and some recommendations for clinical practice and further studies were presented.
The religious characteristics that influence risk behaviour in Christian youth.
(2014) Oduntan, Rachel Oluwayemisi.; Lindegger, Graham Charles.
The purpose of this study was to investigate if the belief and practice of Christianity is associated with alcohol use/abuse behaviour as well as risky sexual behaviour among Christian youth. The religious characteristics of focus were social support from church leaders/elders, social support from church peers, God control beliefs and reported religiosity. The sample selected were Christian youth between the ages of 18 and 21 years from churches in Durban, KwaZulu-Natal. The need for this research was motivated by the limited amount of research on religion and risk behaviour among young people as well as what religious factors influence these said risk behaviours. Furthermore, available research on religion and risk behaviour have mostly focused on indirect religious influences such as church attendance and involvement in church activities. However, God control beliefs argued to be a more direct religious influence have been less studied. This study sheds light on these direct and indirect characteristics of religion as factors that influence risk behaviour. A questionnaire comprising demographic information, a measure of reported religiosity, the AGLOC-A scale, the SexGLOC-A scale, the Social Support from Church Peers scale and the Social Support from Church Leaders/elders scale was used to collect the data. The results found God control beliefs to be the most predictive of alcohol use/abuse behaviour. With risky sexual behaviour, significant negative relationships were found with social support from church peers, social support from church leaders/elders and God control beliefs, however the most significant predictor of risky sexual behaviour was social support from church leaders/elders.
An interpretive evaluation of a positive rights based sexual health programme for Grade 11 learners in a secondary school in Durban, KwaZulu-Natal.
(2014) Mncwabe, Joachim Sduduzo.; Frizelle, Kerry Lyn.
Advances in the prevention and treatment of HIV/AIDS in the past 15 years have led to a reputable decline in the rate of new infections and a reduction of HIV related deaths. However, the prevalence rate in the Sub-Saharan region reveals that HIV/AIDS still meets general epidemic criteria. South Africa is the country with the highest number of people living with HIV. While there is a number of sexual health programmes aimed at South African youth their effectiveness is not the same for all programmes. Thus, there is a continued need to evaluate implemented interventions to assess for effectiveness. This study was initiated as a response to the need for an evaluation of an annual youth sexuality and sexual health programme offered by service learning university students. Objective: In this study, a process evaluation of a sexuality and sexual health programme designed and implemented by HIV/AIDS Service learning module students was evaluated. The learners’ subjective experience of the programme was explored. The learners’ evaluation of the programme in comparison to other programmes, the experience of being taught by University students, and areas of interests related to youth sexuality were explored. Methods: Four focus group interviews were conducted with a sample of 18 learners who had participated in the programme. Interpretive data analysis was used to analyse the data. Findings: The participants were appreciatively receptive to a youth sexuality programme facilitated by service learning university students. Furthermore, the positive rights based approach was recognized by the learners as one that nurtures a comfortable environment for learning about youth sexuality and sexual health. Comparisons with previous sources of information highlighted the perceived relevance of the programme evaluated in this study. Gender inequality, sexual diversity, positive aspects of sexuality and safe sex practices emerged as key areas of interest for learners.
An exploration of stigmatisation relating to the terms used to refer to HIV and AIDS amongst women in a rural area in the Eastern Cape.
(2016) Sutherland, Julie.; Van der Riet, Mary Boudine.
This thesis explores the terms used by women in a rural area of the Eastern Cape Province to reference HIV/AIDS. Exploring whether these terms are stigmatising and investigating and describing how they are stigmatising is at the heart of this study. Stigma is a barrier to HIV/AIDS related public health interventions. In order to understand HIV/AIDS stigma, this study considers the complex social and psychological processes that underpin the construction of HIV/AIDS stigma through an examination of the terms used to refer to HIV/AIDS. This project employs a qualitative research design and draws on an existing NRF Thuthuka project on sexual health, sexual risk behaviours and HIV. A purposive sampling technique was used to sample a total of 36 transcripts collected from interviews and focus groups. Thematic analysis was used to code and analyse the data. The findings of this study suggest that HIV/AIDS related fear propels an ‘othering’ response, a necessary psychological coping mechanism in the face of the overwhelming threat HIV/AIDS represents. This is fundamental to the generation and perpetuation of stigma. Cognisance of these processes is essential in rendering HIV/AIDS interventions increasingly effective.
Traditional healing in KwaZulu-Natal Province : a study of University students’ assessment, perceptions and attitudes.
(2016) Ndlovu, Sithabile Siphosenkosi Progaria.; Maruping, Kealeboga Portia.; Nyowe, Augustine.
Traditional healing practices are widely used by Black South Africans from different socio-economic backgrounds. These practices are highly esteemed by most, while frowned upon by others. Scholars have engaged in various debates about the efficacy of traditional healing practices and some have advocated for their inclusion in mainstream health care. It is argued that merging Western forms of healing with African traditional healing practices could provide optimal health care for African people as theAfrican cosmology of health and illness strongly influences help-seeking patterns among South Africans. This study examined University of KwaZulu-Natal students’assessment of, and perceptions and attitudes towards, traditional healing practices in the province.It aimed to determine whether they would partake in these practices on their own or in combination with other forms of healing. Ten students on the University’s Pietermaritzburg campus participated in the study and were engaged in individual interviews and a focus group discussion.They were selected using non-probability convenience sampling as university students were easy to access and willing to participate in the study.Black studentswere considered relevant to respond to the research questionsas they have experience of and opinions on traditional healing practices in KwaZulu-Natal province. The results showed that university students were discontent with certain aspects of African traditional healing practices, although they appear willing tocontinue to resort to such practices when the need arises. Key aspects of traditional healing practices that caused student discontent includedthe on-goingstigma attached to such practices,the alleged incompetence of some practitioners,and the overall inefficacy of the practice.Given that some of the participants describedtraditional healing practices in a pejorative manner, this suggests that students have an unfavourable view of such practices.It was found thatthese negative attitudes were influenced by education, urban living and adherence to Western religious convictions. The study further revealed that the mainconcerns raised by university students related to concerns aboutsafety and the inefficacy of some traditional healing practices. Constructions of traditional healing practices and the discourses shared among university students served to position traditional healing as inferior to alternative healing practices and further maintain negative views of such practices. However, since the sample for this study was small and the study design was qualitative, no conclusive negative generalization against African traditional healing practices is suggested. Further research is required to corroborate the negative outlook portrayed by the study participants.
A psychobiography of Vuyiswa Mckonie.
(2015) Baatjies, Vunyiwe Princess.; Hayes, Grahame.
This is a psychobiographical study of Vuyiswa Mackonie’s life, with the use of psychological theory to better understand and uncover her life. The choice was based on the extraordinary qualities that Vuyiswa Mackonie possesses. A purposive sampling was used in selecting the subject of the study. Vuyiswa Mackonie meets the requirements of a psychobiography study because of her extraordinary life and accomplishments. Vuyiswa Mackonie’s life story was explored using qualitative, single case, interpretive research approach. The study was guided by Levinson’s life structure theory (1996). The data for this study was collected from different sources; the researcher interviewed the subject and the community members to collect the data. According to Levinson (1996) an individual goes through a unique life structure which is characterized by sequential periods, eras, developmental periods and tasks that influence their lives at various stages. The study suggests that while the first two eras of Vuyiswa Mackonie (pre-adulthood era and early adulthood) are similar to that proposed by Levinson (1996), some aspects of the midlife and late adulthood transition are far different to those proposed by Levinson.
"A qualitative investigation into the perceived benefits and barriers in accessing psychological services amongst first year university students".
(2015) Matabane, Pebetse Rahab Garlie.; Valjee, Sachet Rabindranath.
Aim: This study aimed at investigating the perceived benefits and perceived barriers in accessing psychological services amongst 1st year humanities‟ students from University of KwaZulu-Natal (Howard College). Methodology: Purposive sampling was employed to select the 16 participants in this study. Semi-structured interviews were conducted. The sample was stratified according to race and thematic analysis was used to analyse data. Results: The findings from this study suggest that the participants do not have sufficient knowledge regarding the purpose of psychological services and the psychologists‟ scope of practice. Gender roles, cultural belief and language were identified as barriers in accessing psychological services. Furthermore, participants indicated that denial, stigma and shame were perceived as indirect threats regarding their decisions to access psychological services and this was most likely the case when their illness had physical symptoms and appeared severe. The majority of the participants preferred other forms of interventions such as traditional healing, ancestral offerings and prayer. However these were dependent upon the participant‟s socio-cultural context. Conclusion: The results from this study suggest that even though the participants are aware of some of the benefits of utilising psychological services they often prefer sources of help that they are familiar with while the perceived barriers served as justification for not utilising these services even when they could easily access them within the university setting.
"A qualitative investigation into the perceived benefits and barriers in accessing psychological services amongst first year university students".
(2015) Matabane, Pebetse Rahab Garlie.; Valjee, Sachet Rabindranath.
Aim: This study aimed at investigating the perceived benefits and perceived barriers in accessing psychological services amongst 1st year humanities‟ students from University of KwaZulu-Natal (Howard College). Methodology: Purposive sampling was employed to select the 16 participants in this study. Semi-structured interviews were conducted. The sample was stratified according to race and thematic analysis was used to analyse data. Results: The findings from this study suggest that the participants do not have sufficient knowledge regarding the purpose of psychological services and the psychologists‟ scope of practice. Gender roles, cultural belief and language were identified as barriers in accessing psychological services. Furthermore, participants indicated that denial, stigma and shame were perceived as indirect threats regarding their decisions to access psychological services and this was most likely the case when their illness had physical symptoms and appeared severe. The majority of the participants preferred other forms of interventions such as traditional healing, ancestral offerings and prayer. However these were dependent upon the participant‟s socio-cultural context. Conclusion: The results from this study suggest that even though the participants are aware of some of the benefits of utilising psychological services they often prefer sources of help that they are familiar with while the perceived barriers served as justification for not utilising these services even when they could easily access them within the university setting.
An exploration of the relationships amongst the constructs of the interpersonal-psychological theory of suicidal behaviour in an outpatient clinical population sample in KwaZulu-Natal, South Africa.
(2016) Van Wyk, Nicole.; Naidoo, Sarojini.
Suicidal behaviour presents a significant global concern. Despite several global studies on suicide; there remains a lack of a comprehensive theory of suicidal behaviour. Several theories have been proposed over the years in an effort to conceptualize suicidal behaviour; however to date, no theory has been able to accurately account for the various factors involved in suicidal behaviour. Joiner (2005) proposed a theory of suicidal behaviour – the interpersonal-psychological theory of suicidal behaviour – where he builds upon the strengths of previous theories, as well as the literature on suicide risk factors, to provide, arguably, the most accurate theoretical account of suicidal behaviour to date. According to Joiner’s (2005) interpersonal-psychological theory of suicide, an individual will die by suicide because: i) they can, and ii) they want to. The current study explored the relationships amongst the constructs of Joiner’s (2005) interpersonal-psychological theory in an outpatient clinical population, with the aim of adding to the body of knowledge on suicide in South Africa, particularly with regards to theoretical understanding. The study enrolled 239 participants receiving psychological services at state hospitals, an outpatient clinic, or private facility. The findings of the current study indicated that the most significant predictors of suicide desire were: symptoms of depression, marital status, and the simultaneous presence of thwarted belongingness and perceived burdensomeness. This finding was expected given the theory’s claim that a sense of interpersonal distress is likely to result in suicidal desire, as well as the literature on suicide indicating, that the presence of psychopathology, particularly depression, is a risk factor for suicide. In the current study, acquired capability for suicide was not found to be a significant predictor of suicide risk, which was expected. The constructs of Joiner’s (2005) interpersonal-psychological theory have yielded interesting findings in studies conducted abroad thus far. Further research using Joiner’s (2005) interpersonal-psychological theory in South Africa would be beneficial, particularly amongst a sample with current / a history of suicide desire.
"Vicarious traumatization in therapists working with trauma : do defences make a difference?"
(2017) Dubock, Urishka Sharee.; Cartwright, Duncan James.
Vicarious traumatization presents a significant concern for therapists around the globe. In South Africa, research around therapist wellbeing appears lacking. Despite various international studies on vicarious trauma, there remains a lack of conceptual clarity and comprehensive theory on vicarious trauma in therapists. Several studies have attempted to find factors associated with the development of vicarious trauma, with varying outcomes. Factors such as history of personal trauma, trauma caseload and supervision have been found to be associated with vicarious trauma. However, few studies have focused on the possibility that defence style could play a significant role. Recent research by Adams and Riggs (2008) found trauma symptoms in trainee therapists to be significantly associated with defence style. The current study explored the relationship between vicarious trauma and defence style (image-distorting, affect-regulating and adaptive defence styles). In addition, demographic factors were analyzed to discover whether they may be better determinants of vicarious trauma. The study used 127 participants (independent practitioners) from across South Africa. Participants were requested to complete three questionnaires: a demographic questionnaire, the DSQ 60 and the ProQol 5. Data were analyzed using a quantitative, positivist method. Correlations were used to identify significant relationships among the variables and a series of multiple regressions were conducted to explore predictive factors of the defence styles. Multiple regressions were also used to explore the predictive ability of the demographic variables and professional quality of life. The findings indicated a strong positive relationship between image distorting defence style and vicarious trauma. Of the demographic factors analyzed, therapeutic modality was found to be a significant predictor of vicarious trauma. A significant negative correlation was also found between help seeking for personal trauma and compassion satisfaction. This study provides evidence for the relationship between defence style and vicarious trauma. Further, it is indicative that most demographic factors had no effect on professional quality of life and ultimately, vicarious trauma. The current study suggests that further research needs to be done to further investigate the impact of defence style on vicarious traumatization. Implications, limitations and future directions of these findings are discussed further.
Community caregivers: a thematic analysis of the perceived psychological impact that community caregiving has on the caregivers.
(2016) Mncube, Zamalotshwa.; Buthelezi, Nontobeko Precious Angela.
This study focused on the impact of community caregiving work on caregivers. The HIV/AIDS pandemic and other health crises have led to an increased number of orphans and vulnerable children in South Africa. There is hence a growing need for community care workers to assist vulnerable families and children. While it is acknowledged that community caregivers face difficult and ambiguous situations in their work environment, there is a paucity of research on the impact of their work on CCGs. This study adopted a qualitative approach to explore the work experiences of CCGs and the impact of these experiences on their well-being. Motivational theory and the effort reward model were adopted to provide a framework to examine this question. Twenty eight community caregivers participated in focus group discussions in Pietermaritzburg, KwaMashu, and Osizweni in KwaZulu-Natal. The findings indicate that community caregivers’ psychological well-being is negatively affected by the challenges they encounter in their work. These leave them feeling exploited, undermined, and vulnerable to harm. The study concludes that poorly functioning referral systems, undermining of caregivers’ roles, a lack of adequate support to deal with work-related stress, and inadequate rewards are some of the challenges that lead to distress among community caregivers. The caregivers felt that increased recognition, adequate rewards, psychological support, and ensuring their safety would have a positive impact on their well-being. While the findings are generalizable, future studies could sample caregivers from various non-governmental organisations and across sectors to strengthen generalizability.
Mental health literacy : conceptions and attitudes toward mental disorders and beliefs about treatment among African residents of Sisonke district in KwaZulu-Natal.
(2016) Kometsi, Molelekoa Johannes.; Mkhize, Nhlanhla Jerome.
Nearly 1 in 10 people have a mental disorder worldwide, and there are many people with chronic or severe mental disorders who are unaware that they have a diagnosable disorder or that effective treatment is available. This may lead to delays in appropriate help-seeking and negative attitudes toward patients with mental illness. It is plausible that this is largely because of the public’s non-alignment of biomedical understanding of mental illness which may imply lack of mental health literacy. Such assumptions, however, do not take into consideration the fact that various societies draw their knowledge from different worldviews, which in turn informs their conceptualisation of mental illness. This study investigated conceptions and attitudes toward three mental disorders, namely, depression, schizophrenia, and alcohol dependency, and beliefs about their treatment among African residents of Sisonke District in KwaZulu-Natal. The sample was drawn from two municipalities of Sisonke District (Kokstad and Kwa Sani) using a survey. In total, 787 African participants of both genders were randomly recruited, and they completed a self-administered questionnaire. Data was analysed using Statistical Package for Social Sciences for Windows, Version 24.0. The results show an endorsement of multiple explanatory models of illness, thus suggesting an embracement of both Western and indigenous influences in conceptualisation of mental illness. This study found that participants did not use standard psychological nomenclature to describe mental illness, but instead used very broad, over-encompassing terms which may be indicative of their worldview. Of the three disorders investigated, depression was mainly conceptualised using psychological and medical terms, and schizophrenia and alcohol dependency were conceptualised in psychological and social terms. In addition, only schizophrenia, among the three disorders investigated was conceptualised using supernatural descriptions such as bewitchment and ukuthwasa. The results also show that conceptualisation of mental illness is not haphazard; but is viewed as holistic and as encompassing social, psychological and physical factors. The results of the current study also revealed that participants’ conceptions of mental illness are significantly related to their aetiological beliefs. The results of this study highlighted the strong preference among the respondents for professional help-seeking, particularly from social workers and medical practitioners, for the treatment of depression and alcohol dependency. However, traditional healing was seen as more helpful for treating schizophrenia. Furthermore, the results indicate that vitamins, minerals and tonics, pain relievers, antibiotics as well as tranquilisers were considered more helpful for the treatment of depression. Regarding attitudes towards mental illness, the key findings in this study indicate that negative attitudes towards people with mental illness are widely maintained. Of the three disorders investigated in this study, most of the participants attributed stigmatising attitudes more toward alcohol dependency. Furthermore, the results suggest a general willingness to have a closer social distance with mentally ill individuals, especially when the relationship is perceived as less intimate. However, this finding was converse when the relationship was perceived to be more intimate. The results of this study highlight the importance of awareness campaigns that take into consideration and respect the cultural differences of the people, collaboration between traditional and medical practitioners. Suggestions for future research, emphasising the use of discourse analysis to further explore indigenous communities’ constructions of mental illness and their beliefs about its causes and treatment are recommended.

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