Suicide is a prevalent and international problem which has substantive economic and psychological consequences. This has led to governments placing prevention of suicide as a priority on healthcare agendas. Recognition has been given to vulnerable groups in society that have been identified as being at particularly high risk of self-harm and suicide. This includes those in contact with mental health and forensic services. There is a great deal of literature that has considered the risk factors, processes and mechanisms associated with suicide. Comparatively only a small amount of literature has looked at the concept of suicidality within restricted samples such as psychiatric inpatients and prisoners. This may be as a consequence of extensive ethical and procedural processes that are involved in conducting research in such settings. This results in it being necessary to continually make generalisations from community based literature, meaning that factors relating specifically to such settings may be overlooked or underestimated. In the first paper, the initial sections consider existing risk assessments and models of suicidality. Predominantly being structured around static risk factors, means they are often criticised for lacking predictive utility and specificity. Literature examining dynamic psychosocial factors of suicidality in restricted samples was reviewed and 20 articles were identified. A wide range of dynamic correlates are presented. These form a theoretical model of suicidality specific to restricted samples. The clinical and theoretical implications are discussed in terms of risk assessment procedures and adapting and shaping interventions in accordance with the findings. Developing risk assessments around more dynamic factors will allow for greater sensitivity and prediction of those at greatest risk of imminent harm. The second, empirical paper supports the promotion of recovery focused practice and explores the relationship between suicidality and perceived personal agency in patients in secure mental health settings; Personal agency having previously been suggested as conferring resilience to suicidality. Psychometric measures and experience sampling methodology were utilised to examine the relationship. Perceptions of personal agency were found to confer resilience against suicidality. Change in perceptions of personal agency was not associated with suicidality but the overall level of personal agency was. Implications for service delivery are discussed with emphasis given to fostering perceptions of agency, control and self-efficacy and promoting inclusion, empowerment and person centred care. The final paper provides a personal and a critical reflection on the research process. It highlights and discusses clinical and theoretical strengths and limitations of the two papers and considers the methodological processes of both papers in more detail. Further reflections on how practice could be adapted in line with the findings are given. Future directions for research within secure settings are considered, in the hope of maintaining the drive for research with this vulnerable and often overlooked population.

Correctional Officers are responsible for responding to emergency/crisis situations in correctional settings. Research shows that their work is characterized by numerous psychological stressors that vary by degree and intensity, which can lead to compromised job performance and, ultimately, job burnout. Despite the increased attention directed to the problem of occupational stress in first responders among other professions over the past several years, virtually no investigations have focused on correctional officer resilience. The purpose of this study was to: (a) identify whether select positive personal variables (i.e., hope, optimism, social support) are associated with increased resilience, (b) determine the extent to which individual resilience acts as a protective factor against job burnout, (c) ascertain whether resilience serves as a significant mediator between hope, optimism and social support and reduced burnout, and (d) utilize the findings to make suggestions for future interventions and research in this area. By identifying specific individual characteristics that increase resilience and protect correctional officers against job burnout, it is expected that more efficacious approaches can be identified to enhance stress reduction and management.

Rates of HIV infection continue to climb among minority populations and men who have sex with men (MSM), with African American/Black MSM being especially impacted. Numerous studies have found HIV transmission risk to be associated with many health and social disparities resulting from larger environmental and structural forces. Using anthropological and social environment-based theories of resilience that focus on individual agency and larger social and environmental structures, this dissertation employed a mixed methods design to investigate resilience processes among African American/Black MSM. Quantitative analyses compared African American/Black (N=108) and Caucasian/White (N=250) MSM who participated in a previously conducted randomized controlled trial (RCT) of sexual and substance use risk reduction interventions. At RCT study entry, using past 90 day recall periods, there were no differences in unprotected sex frequency, however African American/Black MSM reported higher frequencies of days high (P Qualitative data collected among a sub-sample of African American/Black MSM from the RCT (N=21) described the men’s experiences of living with multiple health and social disparities and the importance of RCT study assessments in facilitating reductions in risk behaviors. A cross-case analysis showed different resilience processes undertaken by men who experienced low socioeconomic status, little family support, and homophobia (N=16) compared to those who did not (N=5). The dissertation concludes that resilience processes to HIV transmission risk and related health and social disparities among African American/Black MSM varies and are dependent on specific social environmental factors, including social relationships, structural homophobia, and access to social, economic, and cultural capital. Men define for themselves what it means to be resilient within their social environment. These conclusions suggest that both individual and structural-level resilience-based HIV prevention interventions are needed.

Unwanted early sexual experiences (UESE) are traumatic experiences that many children worldwide are exposed to on a daily basis. Some of these victims struggle to adapt to life, whereas others become survivors, exhibiting post-traumatic growth after such an experience. South Africa has some of the highest UESE prevalence rates in the world, highlighting the importance of research conducted within this field in the country. With an overarching psychofortogenic framework, and through the implementation of a convergent parallel mixed methods research design, the study explored and described whether resilience and attachment act as mediators impacting upon the psychosocial sequelae which a UESE survivor might experience. The study was divided into three phases. Phase 1 consisted of a small-scale survey design which was conducted with 304 participants while Phase 2 consisted of nine semi-structure interviews with UESE survivors, who were volunteers from the original sample. Finally, Phase 3 provided an integrated summary of the findings from the first two phases. During Phase 1 significant findings relating to the survivors of UESE, their levels of resilience and attachment relationships were outlined. Of the total sample, 32.43% males and 30.5% females indicated that they had been exposed to a UESE. Most of the perpetrators were known to the survivors with friends being identified as the most common perpetrators. Parental relationships characterised by trust, open communication and less alienation were found to impact upon the degree to which participants reported being bothered by the UESE. Furthermore, parental alienation at the time of the UESE had a significantly negative impact on the survivors’ adult relationship styles. During Phase 2 a number of themes emerged including the manner of disclosure, reasons for delayed disclosure, relationship to the confidant, confidant’s response to disclosure, effects of the response to disclosure, the impact of the UESE upon the survivor, impact of the UESE on relationships, coping/resilience, advice to professionals, the confidant, and the survivor. The final phase confirmed the research hypothesis that resilience and attachment act as mediating factors impacting upon a variety of psychosocial sequelae which a UESE survivor might experience. Serendipitously, disclosure was found to be a mediating factor, securing a significant role within the study. In conclusion a future intervention titled ‘Post-Traumatic Growth: A UESE model of Disclosure, Resilience and Attachment’, was outlined, based on the study’s findings.

Cerebral Palsy is a complex, non-progressive condition that manifests in various forms of motor impairments. This life-long condition holds numerous challenges for the entire family throughout the family life-cycle. While the challenges that these families have to face are many, families seem to have the ability to "bounce back" and to be resilient. Research on the construct of resilience and more specifically family resilience has increased in recent times. South African family resilience research is relatively limited. This study aimed to identify, explore and describe the resiliency factors that facilitate adjustment and adaptation in families that include a child living with Cerebral Palsy. The Resiliency Model of Family Stress, Adjustment and Adaptation was used to conceptualise the level of family adaptation. The study was triangular in nature, with an exploratory, descriptive approach. Non-probability purposive and snowball sampling techniques were employed. The sample consisted of 30 female caregivers. Biographical questionnaires with two open-ended questions, in conjunction with seven structured questionnaires were used to gather the data. Descriptive statistics were used to analyse the biographical information. Correlation and regression analysis was used to analyse the quantitative data, while content analysis was used to analyse the qualitative data. The results of the quantitative component of the study indicated five significant positive correlations with the FACI8. These variables were family hardiness (measured by the FHI), family time together and routines (measured by the FTRI), social support (measured by the SSI), relative and friends support (measure by the RFS), and spiritual support (measured by the F-COPES). The results of the qualitative analysis revealed that social support, the caregivers' acceptance of the condition, and spirituality and religion were the most important strength factors that contributed to the families' adjustment and adaptation. Although the sample was small and the study has limitations, it could be used as a stepping-stone for future research on resilience in families living with a child with a physical disability and will contribute to the broader context of family resilience research in South Africa.

Nurses are confronted with numerous work-related stressors that can result in burnout. This can contribute to absenteeism and high turn-over rates in the nursing profession. A review of the literature indicated that psycho-educational interventions to increase resilience could be an effective way of addressing this problem. The study aimed to develop a positive clinical-psychology approach to increasing resilience in State employed nurses. The study used a mixed-method approach to determine the current psychological functioning of a sample of 87 nurses. Quantitative data on personality traits, character strengths and levels of resilience were obtained, using the NEO PI-R, VIA – IS, and Resilience Scale. Qualitative data on the coping responses of nurses were obtained through the thematic analysis of focus groups. These data were integrated to create a positive clinical psychology conceptualisation of resilience and to develop therapeutic guidelines for a group psycho-educational intervention. The results of the study indicated a struggling psychological profile. This was defined as the ability to deal with work-related stressors – but with the potential risk of developing symptoms of burnout. The moderate levels of resilience were attributed to elevated character strengths in the sample. The distribution of personality traits indicated that the nurses in the sample were at risk of developing burnout; and this prevented them from flourishing. These data were synthesised to create therapeutic guidelines for developing resilience aimed: (1) increasing emotional stability and invulnerability; (2) increasing agreeableness; and (3) increasing conscientiousness. These guidelines were based on the personality traits that were deemed to negatively impact the resilience of the nurses. These personality traits were correlated with several character strengths that displayed strong relationships with resilience. This indicated that resilience could be developed through the cultivation of the following character strengths: perspective; perseverance; fairness; forgiveness; leadership; love; zest; hope; curiosity; and appreciation of beauty and excellence. These character strengths were identified to facilitate the positive adaptation of the personality traits identified in the therapeutic guidelines. A group psycho-educational intervention was developed, using the positive clinical psychology conceptualisation of resilience. The literature was reviewed to identify techniques to cultivate the ten character strengths specified in the therapeutic guidelines. These techniques were adapted to create experiential learning processes for the intervention. This psycho-educational programme can be applied as a secondary and tertiary intervention. It can be used to increase resilience to prevent burnout among nurses. It can also be used to psychologically empower nurses that have existing symptoms of burnout.

Schizophrenia cuts across all racial, gender, and socioeconomic lines. Schizophrenia affects 1 percent of the population in Ireland: 35000 people (Schultz & Andreason, 1999); and affects 1.4 - 4.6 percent per 1000 people in the USA: 2.8 million - 9.8 million people (Jabelensky, 2004). In South Africa the figure is approximately 1 percent of the population or 500 000 people (Nicholas, Malcolm, Krosigk & Pillay, 2003). The median age of onset is 21.4 years for men and 26.8 years for women (Daubenton & van Rensburg, 2001), with only 10-20 percent recovering fully after the first psychotic episode (Saddock & Saddock, 2003). The schizophrenic patient is often unable to continue life as before diagnosis, and may progressively need more care as the years pass. Deinstitutionalization over the course of a number of decades has resulted in responsibility for care of mentally-ill individuals shifting to the individual’s family. The struggles faced by such a family can be overwhelming as they struggle with this responsibilty due to lack of training, lack of knowledge and insufficient professional support (Winefield & Harvey, 1994). The stress on the caregivers is often magnified as their support structures around them may ‘shut down’ out of fear of the schizophrenic illness (Williams & Mfoafo-M’Carthy, 2006). The characteristic symptoms used to define schizophrenia include various forms of delusions, hallucinations, thought disorders and abnormalities in emotional expression, social interaction, attention, volition and drives. The functional decline of the schizophrenic individual leads not only to social difficulties, but also economic difficulties that may cripple a family (Fadden, Bebbington & Kuipers, 1987). When first diagnosed, some families may be so overwhelmed by the ‘label’ given to their family member, that they see little hope or way to move forward. One explanation is offered by an American psychiatrist whose own son was diagnosed with schizophrenia, “We experience this terrible feeling of loss and grief for the son we knew. There is also this terrible loss of expectations. We feel cheated out of watching him mature…it is a mourning without end because, of course, Gary is not dead at all. He is very much still with us, seeming eternally twelve years old, needing constant care and attention” (Willick, 1994, p.14). Providing such care is associated with high levels of distress. Accordingly, much attention has been given to understanding the pressures faced by family members, with the hope of understanding how coping resources may be strengthened to sustain these care-giving relationships (Harvey, Burns, Fahy, Manley & Tattan, 2001). However, despite gains in understanding the needs of a schizophrenic family member once out of the hospital environment, care-giving relationships can still break down. The individual with the illness is often left more vulnerable to relapse, recurrent hospitalizations, homelessness and other negative outcomes (Jewel & Stein, 2002). The stress of not only interacting with the afflicted family member, but also with the grief associated with the illness, places an incredible strain on the day-to-day functioning of that family (Pollio, North, Reid, Miletic & McClendon, 2006). From the brief review provided, it is evident that research has been conducted regarding the stressors, strains and difficulties of caregivers of schizophrenic family members. However, the strengths of these families are under-investigated, and the current study will attempt to start filling this void.

A person’s career takes up a large portion of his or her life for a minimum of 8 hours per day. A large portion of their time is spent performing their duties which are often accompanied by various demands or pressure that can result in an employee experiencing stress. Over time this build-up of stress due to job demands affects their ability to perform at work. This study aimed to identify, explore and describe the factors that facilitate the resilience of healthcare professionals working at a Campus Health Service at a Higher Education Institution. An exploratory descriptive study consisting of a qualitative nature was employed. Data was obtained from semi-structured interviews. The questions that were posed to participants read as follows: (1) “Tell me about the demands placed on you in your current work situation”, (2) “How do you cope with the demands placed on you?”, (3) “What can be done to assist you to cope better at work?”, and lastly (4) “Any additional questions/comments?”. The fourth question was added by the researcher in order for participants to have the opportunity to add to what they have said previously. Data was gathered until data saturation was reached. Tesch’s model of content analysis as well as Guba’s model of trustworthiness was employed, in order to analyse the data. An independent coder was subsequently employed to ensure the trustworthiness of the data. The findings revealed that all participants found workplace demands to be stressful, in terms of physical, emotional and time-related demands placed on them. Participants identified strategies that could help them cope with their demands such as open air activities, debriefing with colleagues or making use of a wellness line, maintaining a positive attitude, support from management and colleagues, the ability to practice initiative and autonomous decision-making, and lastly, religious practices. In addition, participants made recommendations on how employers can help relieve their stress. The recommendations included developing an in-house wellness programme, providing sufficient staff of the correct categories, providing adequate facilities and equipment to improve efficiency, providing developmental opportunities, scheduling training programmes for less busy times of the year, and lastly, introducing elements of structured flexi-time for employees.

The placement of children in alternative care has become a critical challenge facing the nation. Established systems of care are unable to meet the increasing burden of caring for these children and to date extended family care is the most prevalent form of care for orphan and vulnerable children. Looking specifically at the prevalence of grandparent-headed households, this study focuses on the wellbeing and development of children who are placed in the care of their grandparents.The primary aim of the current study is to explore resilience in children raised by their grandparents. Central to the core of resilience in children is identifying elements that detract from their health and wellbeing (risk factors), while understanding those factors that moderate risk to their development (protective factors). A systematic review of existing literature was undertaken with the secondary aim of informing practice and policy regarding the care and placement of children in South Africa. Each primary study included in this review was appraised against best practice standards and salient themes and factors were extracted. The data was synthesized, integrated and applied to the context of child care policy in South Africa. Twelve themes emerged from the systematic review. With regards to protective processes, four broad themes emerged which were consistent with factors identified in literature in the development of resilience. These included a positive relationship with a caregiver, parenting style, providing a sense of continuity and belonging and the stability this placement offers. The remaining eights themes, related to risk factors were financial instability, relationship difficulties with their caregiver, intergenerational differences between grandparent and grandchild, poor caregiver health and wellbeing, ill-discipline and rigid parenting styles, educational difficulties,adverse past experiences of children and emotional difficulties. Based on these emergent themes, policy and intervention-focused recommendations were put forth with the aim of strengthening the capacity of grandparent-headed families to protect and care for orphans and vulnerable children.

Earth's species are disappearing at a rate unprecedented in human history, yet whether this loss will make the ecosystem "services" that support our civilisation more vulnerable to environmental change is poorly understood. This thesis investigates two different aspects of land surface modelling. It firstly models the role of biodiversity in ecosystem resilience using the Lotka-Volterra and single resource models to model diversity using competition coeffcients, stochastic noise and evolution inspired trait diffusion and then examines if higher diversity makes these simple models more resistant to temperature increases. It secondly develops a theoretical plant demography model, based on the continuity equation, to robustly represent forest size diversity. This avoids both the complexity and maintainability issues seen in Forest Gap models and improves the representation of land use and land cover change and of regrowth time-scales after disturbance, which can be unrealistic in some of the previous generation of Dynamic Global Vegetation Models (DGVMs), such as TRIFFID (Cox et al., 2001). While the Lotka-Volterra with competition coeffcients and the single resource with stochastic noise approaches are found to be impractical, the single resource model with trait diffusion successfully shows that higher diversity requires a faster critical rate of temperature change before system net primary productivity (NPP) collapses. The continuity equation model of vegetation demography is solved analytically with the size dependence of the growth rate approximated first by a power law and then with a quadratic. The power law solution can be reduced to a "self-thinning" trajectory, and the quadratic solution gives either a rotated sigmoid or 'U-shape' distribution of plant sizes, depending on the ratio of mortality to maximum growth gradient. The model is then extended to produce the basis of a new Dynamic Global Vegetation Model (DGVM) called "Robust Ecosystem Demography" (RED), adapting the plant physiology from TRIFFID DGVM to generate a size-dependent growth function. A proportion of the NPP from this growth is used for reproduction and the shading is modelled simply by random overlap. The model is found to better represent regrowth time-scales compared to TRIFFID and is also found to demonstrate an optimum proportion of NPP to reproduction which decreases with plant lifetime.