Thesis (PhD)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: A review of the past decade of literature on the subject of depression in South African women revealed a paucity of research that documents the perspectives of low-income women who have been diagnosed with depression. Informed by this and recent feminist critiques of the concept of depression, this study aimed to bring traditionally overlooked perspectives to the fore by providing rich descriptions of the subjectively lived experience of depression, as recounted by low-income women themselves. This feminist phenomenological study took place in a poor, rural community in the Western Cape Province of South Africa. Semi-structured in-depth interviews were conducted with ten low-income women who had been diagnosed with depression. The transcribed interviews were analysed using Interpretative Phenomenological Analysis. A number of important findings emerged. Firstly, participants were seen to express somatic complaints ahead of (and more frequently than) disclosures of sadness. Secondly, participants often described experiencing their psychological distress as anger, anxiety and a changed sense of self. Thirdly, participants generally attributed these experiences (and their overall distress) to a history of childhood trauma, the loss of important relationships, being physically, sexually or emotionally abused, feeling under supported and overburdened by multiple responsibilities, living in dangerous communities, and/or the various consequences of poverty. Finally, it was observed that while symptoms of suicidal ideation and intent were present in many of the women interviewed, strong religious and cultural norms existed and generally functioned to silence and deny the subject. Overall, the women’s subjective experiences, understandings and descriptions of depression allowed a more complex picture to emerge than that which is currently offered by mainstream biomedical models. Consequentially, the current conceptualisation of the term “depression” was deemed to be inadequate, specifically because it does not fully capture low-income women’s experiences of distress, and also because it tends to obscure the possible impact of socio-economic and political contexts on their mental health. Implications of these findings include firstly, that not only does the diagnosis of depression serve to medicalise women’s misery, but it may simultaneously serve to obscure their feelings of anger, anxiety, sadness, hopelessness and other symptoms of distress that are intrinsically linked to their disadvantageous social and living conditions. Secondly, the findings indicate that the use of traditional diagnostic and suicide assessment interviews may be unhelpful or even irresponsible in some South African contexts. Finally, many of the study findings warrant further investigation and psychological research. Recommendations to this end are thus included and stress the need to use theoretical perspectives and research methodologies that are sensitive to the multilayered, complex psychological experiences of depression in low-income women. / AFRIKAANSE OPSOMMING: ’n Oorsig van die afgelope dekade se literatuur oor depressie by Suid-Afrikaanse vroue dui op ’n gebrek aan navorsing oor die perspektiewe van vroue uit lae-inkomstegroepe wat met dié toestand gediagnoseer word. Na aanleiding hiervan sowel as onlangse feministiese kritiek op die konsep van depressie, was hierdie studie dus daarop toegespits om tradisioneel miskende perspektiewe na vore te bring deur middel van ’n ryke beskrywing van die subjektiewe ervaring van die lewe met depressie soos vroue uit lae-inkomstegroepe self daarvan vertel. Hierdie feministiese fenomenologiese studie is in ’n arm, landelike gemeenskap in die provinsie Wes-Kaap, Suid-Afrika, onderneem. Semigestruktureerde diepte-onderhoude is gevoer met tien vroue in die laeinkomstekategorie wat met depressie gediagnoseer is. Die getranskribeerde onderhoude is op vertolkende fenomenologiese wyse ontleed. ’n Aantal belangrike bevindinge is gemaak. Eerstens het die meeste deelnemers somatiese klagtes gehad voordat (en meer dikwels as wat) hulle oor hul neerslagtigheid en terneergedruktheid gepraat het. Tweedens het heelwat deelnemers hul sielkundige nood as woede, angs en ’n gewysigde selfbeskouing beskryf. Derdens het die vroue merendeels hul ervarings (en hul algehele nood) aan ’n geskiedenis van kindertrauma, die verlies van belangrike verhoudings, fisiese, seksuele of emosionele mishandeling, ’n gebrek aan ondersteuning tesame met ’n oormaat verantwoordelikhede, hul gevaarlike woonbuurte en/of die verskillende gevolge van armoede toegeskryf. Laastens is waargeneem dat hoewel die ideasie en voorneme van selfdood wél as simptome by baie van die respondente opgemerk is, daar terselfdertyd sterk godsdienstige en kulturele norme bestaan waarvolgens dié onderwerp oor die algemeen doodgeswyg en ontken word. In die geheel skets die vroue se subjektiewe ervarings, begrippe en beskrywings van depressie ’n meer komplekse prentjie as wat hoofstroom- biomediese modelle tot dusver gebied het. Dus blyk die huidige konseptualisering van die term ‘depressie’ onvoldoende te wees, veral omdat dit nie die ervarings en nood van vroue uit lae-inkomstegroepe ten volle vasvang nie, en ook geneig is om die moontlike impak van sosio-ekonomiese en politieke kontekste op dié vroue se geestesgesondheid te misken. Die implikasies van hierdie bevindinge sluit eerstens in dat die diagnose van depressie nie net hierdie vroue se nood ‘medikaliseer’ nie, maar terselfdertyd dalk ook hul gevoelens van woede, angs, hartseer, hopeloosheid en ander simptome van nood wat ten nouste met hul minderbevoorregte maatskaplike en lewensomstandighede verband hou, verberg. Tweedens dui die bevindinge daarop dat die gebruik van tradisionele diagnostiese en selfdoodevalueringsonderhoude in sekere Suid-Afrikaanse kontekste nutteloos en selfs onverantwoordelik kan wees. Laastens regverdig baie van die studie se bevindinge verdere ondersoek en sielkundige navorsing. Aanbevelings in hierdie verband word dus ingesluit, en beklemtoon onder meer die behoefte aan teoretiese perspektiewe en navorsingsmetodologieë wat gevoelig is vir die meervlakkige, komplekse sielkundige ervarings van depressie by vroue uit laeinkomstegroepe.

Thesis (MA)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The present research study formed part of a larger longitudinal project concerned with low-income South African women’s subjective experiences of depression (Lourens & Kruger, 2013). The present study specifically focussed on how depressed women experienced their relationships with their children. The study aimed to provide a descriptive overview of how one group of depressed South African mothers experience their relationships with their children, as well as to compare the findings with existing literature. Therefore, the scope of this study does not include in-depth analyses of findings. While numerous researchers have examined and identified the important negative effects of depression in mothers on children during the past decade, a very limited number of studies have been focussed on the opposite direction of the depressed mother-child relationship. Very few studies have explored how relationships with their children may influence the development and subjective experience of depression and emotional distress in mothers, as well as, on the other hand, may protect against depression and emotional distress (Dix & Meunier, 2009; Greig & Howe, 2001; Leung & Slep, 2006; Rishel, 2012; Turney, 2012). The present study attempted to address this gap in the literature. The feminist social constructionist perspective was utilised as theoretical framework (De Vos, Strydom, Fouché, & Delport, 2011). Consistent with social constructionism, the study was conducted within the qualitative research paradigm (De Vos et al., 2011). Convenience sampling was used to recruit participants most suitable for the aims of the study (APA Dictionary of Psychology, 2007). Data were collected by means of in-depth semi-structured interviews. A semistructured interview schedule was utilised as data collection instrument. Each interview was recorded by video camera, as well as by voice recorder, in order to ensure back-up recordings. The interviews were then transcribed. Social constructionist grounded theory was used to analyse the data (Charmaz, 1995). The results indicated that the depressed women and children in this study seem to be different from the stereotype of the depressed mothers and children in the literature. Depressed mothers are typically portrayed in the literature as not able to form a close and secure bond with their children, while the children of depressed mothers are almost always portrayed in the literature as showing behavioural and emotional problems, as well as being “parentified” (Coyne & Thompson, 2011; Dix & Meunier, 2009; Turney, 2012). Although the depressed women in the present study did report child factors which contributed to their depression, they - to the contrary - also emphasised that their children are an important protective factor against their experience of depression. The participants also highlighted that they have the ability to be protective, supportive and caring towards their children, despite their depressive symptoms. The majority of depressed women also described a “very good” mother-child relationship. As such, the participants in the present study showed us a brighter picture of the depressed mother-child relationship. / AFRIKAANSE OPSOMMING: Hierdie navorsingstudie het deel gevorm van ‘n groter longitudinale projek wat op lae-inkomste Suid-Afrikaanse vroue se subjektiewe ervarings van depressie gerig was (Lourens & Kruger, 2013). Die huidige studie was spesifiek gerig op hoe depressiewe vroue hul verhoudings met hul kinders ervaar. Hierdie studie het ten doel gehad om ‘n beskrywende oorsig te voorsien van hoe een groep depressiewe Suid-Afrikaanse vroue hul verhoudings met hul kinders ervaar, asook om die bevindinge te vergelyk met bestaande literatuur. Om hierdie rede sluit die omvang van hierdie studie nie ‘n diepgaande analise van bevindinge in nie. Terwyl talle navorsers die belangrike newe-effekte van moeders se depressie in terme van hul kinders gedurende die laaste dekade ondersoek het, is ‘n baie beperkte aantal studies op die teenoorgestelde rigting van die depressiewe moeder-kind verhouding gerig. Slegs ‘n paar studies het hoe verhoudings met hul kinders die ontwikkeling en subjektiewe ervaring van depressie in moeders kan beïnvloed, ondersoek, of daarteenoor, hoe dit die moeder kan beskerm teen depressie (Dix & Meunier, 2009; Greig & Howe, 2001; Leung & Slep, 2006; Rishel, 2012; Turney, 2012). Die huidige studie het gepoog om hierdie gaping in die literatuur aan te spreek. Die sosiaal konstruksionistiese feministiese perspektief is as teoretiese raamwerk gebruik (De Vos, Strydom, Fouché, & Delport, 2011). In ooreenstemming met sosiale konstruksionisme, is hierdie studie binne die kwalitatiewe navorsingsparadigma uitgevoer (De Vos et al., 2011). Gerieflikheid steekproeftrekking is gebruik om die mees gepaste deelnemers vir die doelstellings van hierdie studie te werf (APA Dictionary of Psychology, 2007). Data is deur middel van in-diepte semi-gestruktureerde onderhoude ingesamel. ‘n Semi-gestruktureerde onderhoudskedule is as data-insamelingsinstrument gebruik. Elke onderhoud is op videokamera, sowel as op band opgeneem, ten einde meer as een opname van elke onderhoud te verseker. Die onderhoude is getranskribeer. Data-analise het plaasgevind deur van sosiale konstruksionistiese gegronde teorie gebruik te maak (Charmaz, 1995). Die resultate het aangedui dat die depressiewe vroue en hul kinders in hierdie studie verskil van die stereotipe van depressiewe moeders en hul kinders in die literatuur. Depressiewe moeders word in die literatuur tipies voorgestel asof hulle nie in staat is om ‘n naby en veilige binding met hul kinders te vorm nie, terwyl die kinders van depressiewe moeders amper altyd in literatuur met gedrags- en emosionele probleme voorgestel word (Coyne & Thompson, 2011; Dix & Meunier, 2009; Turney, 2012). In teendeel – alhoewel die depressiewe vroue in die huidige studie wel gerapporteer het dat hul kinders bydra tot hul depressie – het hulle ook klem geplaas op die feit dat hul kinders ‘n belangrike beskermende faktor is teen hul ervaring van depressie. Die depressiewe vroue het ook beklemtoon dat hulle die vermoë het om beskermend en ondersteunend teenoor hul kinders te wees, ten spyte van hul depressiewe simptome. Die meerderheid deelnemers het ook ‘n “baie goeie” verhouding met hul kinders beskryf. As sodanig, het die depressiewe vroue in die huidige studie vir ons ‘n helderder prentjie van die depressiewe moeder-kind verhouding getoon.

Thesis (M. A. (Clinical Psychology)) University of Limpopo, 2017 / The study investigated the prevalence of Obsessive-Compulsive Disorder (OCD) symptoms and their relationship with pregnancy-related anxiety, prenatal depression and clinical anger among African pregnant women. The sample consisted of 206 pregnant women attending their antenatal check-ups at the Mankweng, Nobody and Rethabile clinics, and Mankweng hospital in the Capricorn District, Limpopo Province. When correlational analysis was conducted, the patient characteristics of age, having undergone a medical check-up, and having previously delivered a live baby generally did not correlate with any of the main scales measuring OCD, namely, perinatal depression, pregnancy-related anxiety and clinical anger (p > 0.05). Findings from the study indicated that almost 81% of the pregnant women could be classified as obsessive-compulsive disordered, when using the Foa et al. (2002) cut-off score of 21. Furthermore, findings from the regression analyses indicated that higher age, the number of gestation weeks, having previously experienced pregnancy-related complications, perinatal depression, pregnancy-related anxiety and clinical anger were variably positive predictors of OCI-R measured OCD symptoms. The predictors are specific to each of the symptoms. It can be concluded from the study that there is a relationship between OCD symptoms and all the independent variables used. / National Research Foundation

M.Sc. (Research Psychology) / Mental health is known to be adversely affected by gender inequality and poverty. The World Health Organization (WHO) reported that psychological disorders affect half the global population (WHO, 2010) and South African estimates posited that 16.5% of the population presented with common mental disorders in 2007 (Williams et al., 2008). Depression and anxiety disorders in women, specifically, are posing a major public health concern in developing countries due to inadequate treatment (Aidoo & Harpham, 2001). Protective factors, namely intrapersonal, interpersonal, community and cultural factors, were identified by Ungar (2008) as a mechanism that promotes resilience and alleviates the effects of adversity. In order to develop knowledge geared toward intervention strategies to promote mental health in socio-economically disadvantaged women in urban communities, this study employed an explanatory mixed methods research design (which included both quantitative surveys and qualitative interviews) to establish an incidence of depressive symptoms, and levels of ego-resilience, among women in Doornkop, Soweto. This was done in order to explore, first, the relationships between selected socio-demographic variables and depression and ego-resilience, and second, to investigate if there was a relationship between depression and ego-resilience. Finally, the study aimed to gain an understanding of how women perceived the role of protective resources in their lives which might promote positive mental health outcomes. The statistical component of the study found a weak negative correlation between the two constructs of depression and ego-resilience. Symptoms of depression appeared to be related by exposure to a high number of difficult life experiences, and particularly in instances of having been a victim of crime or violence. While ego-resilience seemed to be related to increased participation in community groups, it also correlated with adversity, namely, unemployment. This led the researcher to the conclusion that for this sample, depression and ego-resilience were independent constructs, and although they were divergent concepts, both were shaped by exposure to adversity. The interview data further explored exogenous sources of resilience as set out by Ungar (2008). These findings highlighted the importance of interpersonal relations on feelings of well-being. While the protective factors varied in the sources from which they arose (from children, romantic partners, parents, peers and community groups to music and television, and faith in God), they all provided a sense of purpose, belonging and self -worth, which enabled positive feelings. The main recommendation that arose from the research was the need for community education about mental illness, the services available to communities, and the importance of developing and maintaining family and community systems of support. These measures may go some way toward enhancing resilience in women and reducing vulnerability to mental disorders arising from experiences of adversity. Furthermore, a focus on community-based interventions, such as education and life skills, is vital in shifting the focus of interventions from mental illness to the promotion of mental health. Ongoing research is fundamental to developing our existing knowledge of both psychopathology and the promotion of mental well-being in women in socio-economically deprived communities. Research, in light of the challenges facing community mental health services in poor areas, could include foci on the beliefs of professionals including the knowledge and skills required to deliver effective mental health services. Knowledge of this nature should serve to enhance our understanding of the complexities of mental health and inform the development of innovative and appropriate treatment modalities that are oriented to the particular needs of women in resource-poor communities.

Women’s procreative capacities and the appreciation of birth experiences have always been recognised in civil society and the early days of psychology. Given that our culture is one that emphasises a woman’s capacity to bear children as one of the greatest social achievements, the social responsibility to procreate and ensure collective survival becomes a potent mandate, especially so for Black African women. To fulfil this social responsibility, traditional African culture dictates a very specific process of pregnancy which involves a series of watershed moments, each of which requires that social support, of whatever form, should be available. This study explored the role that social support from significant others and health professionals play in mediating psychological issues during pregnancy, childbirth and postnatally among Black African women in Madadeni Township in KwaZulu-Natal. The study was rooted in the interpretive, qualitative paradigm and a phenomenological research design was used. Purposive sampling was used to select participants who were aged from 18 to 25 years with a baby older than two weeks but less than six months. Semi structured interviews were conducted in the mother tongue of the participants until the point of saturation where no new information arose from the six participants interviewed. Thematic content analysis was used to extract recurrent themes across participants. The results indicate that social support, especially from parents and partners, plays a defining role in helping women to cope with the stress experienced during pregnancy, childbirth and postnatally. / Psychology / M.A. (Psychology: Research Consultation)

Women’s procreative capacities and the appreciation of birth experiences have always been recognised in civil society and the early days of psychology. Given that our culture is one that emphasises a woman’s capacity to bear children as one of the greatest social achievements, the social responsibility to procreate and ensure collective survival becomes a potent mandate, especially so for Black African women. To fulfil this social responsibility, traditional African culture dictates a very specific process of pregnancy which involves a series of watershed moments, each of which requires that social support, of whatever form, should be available. This study explored the role that social support from significant others and health professionals play in mediating psychological issues during pregnancy, childbirth and postnatally among Black African women in Madadeni Township in KwaZulu-Natal. The study was rooted in the interpretive, qualitative paradigm and a phenomenological research design was used. Purposive sampling was used to select participants who were aged from 18 to 25 years with a baby older than two weeks but less than six months. Semi structured interviews were conducted in the mother tongue of the participants until the point of saturation where no new information arose from the six participants interviewed. Thematic content analysis was used to extract recurrent themes across participants. The results indicate that social support, especially from parents and partners, plays a defining role in helping women to cope with the stress experienced during pregnancy, childbirth and postnatally. / Psychology / M. A. (Psychology: Research Consultation)