Thesis (MA)--University of Stellenbosch, 2004. / Hierdie artikel bied 'n teoretiese oorsig van stres en streshantering in die korporatiewe omgewing. Die artikel begin met 'n kort oorsig van die historiese ontwikkeling van die streskonsep, gevolg deur 'n kort bespreking van die konsep streshantering. Vervolgens word verskeie faktore wat tot stres in die werkplek bydra, in oënskou geneem. Dit word opgevolg deur 'n bespreking van stres wat kenmerkend is van bestuursposisies en 'n kort oorsig van onlangse navorsing oor streshanteringsprogramme. Sommige van die probleme wat met navorsing oor streshanteringsprogramme ondervind word, word kortliks oorweeg. Die artikel word afgesluit met 'n poging om, op grond van gepubliseerde bevindings, te illustreer watter stresverminderende intervensies doeltreffend is en watter nie. / AFRIKAANSE OPSOMMING: Hierdie artikel bied 'n teoretiese oorsig van stres en streshantering in die korporatiewe omgewing. Die artikel begin met 'n kort oorsig van die historiese ontwikkeling van die streskonsep, gevolg deur 'n kort bespreking van die konsep streshantering. Vervolgens word verskeie faktore wat tot stres in die werkplek bydra, in oënskou geneem. Dit word opgevolg deur 'n bespreking van stres wat kenmerkend is van bestuursposisies en 'n kort oorsig van onlangse navorsing oor streshanteringsprogramme. Sommige van die probleme wat met navorsing oor streshanteringsprogramme ondervind word, word kortliks oorweeg. Die artikel word afgesluit met 'n poging om, op grond van gepubliseerde bevindings, te illustreer watter stresverminderende intervensies doeltreffend is en watter nie.

Thesis (MA)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: The traumatic nature of spinal cord injury (SCI) imposes major and permanent life changes that necessitate physical, social and vocational adjustments for the individual, as well as placing strain on the family. The importance of psychological aspects of adjustment and rehabilitation has progressively become recognised as an integral part of facilitating a higher quality of life for individuals and their families living with SCI. While it has been established that psychological disturbance is not an inevitable long-term consequence of SCI, researchers have found that a proportion of this population has marked difficulty adapting psychologically to their new lifestyle and the challenges it poses. It has been found that the SCI population has an increased risk for divorce, substance abuse, self-neglect and suicide. In the mid-1990's, researchers involved in SCI rehabilitation started developing cognitivebehaviour therapy (CBT) interventions to assist individuals with their psychological adjustment to the traumatic injury. Lazarus and Folkman's (1984) cognitive theory of stress and coping has been the theoretical grounding for some of these interventions. The primary objective of this literature review is to ascertain the effectiveness of CBT in assisting individuals with their psychological adjustment to SCI and to make recommendations for future research in this area. / AFRIKAANSE OPSOMMING: Die traumatiese aard van 'n spinale koord besering (SKB) veroorsaak 'n beduidende en permanente lewensverandering, wat fisieke-, sosiale- en werksaanpassing vir die individu verg, asook spanning op die familie plaas. Die belangrikheid van sielkundige aspekte rakende aanpassing en rehabilitasie word toenemend herken as 'n integrale deel in die fasilitering van 'n hoër kwaliteit van lewe vir die individue en hulle families wat lewe met 'n SKB. Alhoewel daar gevind is dat sielkundige versteuring nie 'n noodwendige langtermyn gevolg van 'n SKB is nie, het navorsers wel gevind dat 'n gedeelte van die populasie beduidende sielkundige aanpassingsprobleme ervaar ten opsigte van hul nuwe lewenstyl en uitdagings. Daar is gevind dat die SKB populasie 'n verhoogde risiko loop vir egskeidings, substansmisbruik, self-verwaarlosing en selfmoord. In die middel van die 1990's, het SKB- en rehabilitasie-navorsers kognitiewe-gedragsterapie (KGT) intervensies ontwikkelom individue te help met sielkundige aanpassing na 'n SKB. Lazarus en Folkman's (1984) se kognitiewe teorie oor stres en streshantering, het die teoretiese grondslag gevorm vir sommige van hierdie intervensies. Die primêre doel van hierdie literatuuroorsig is om die effektiwiteit van KGT te bepaal in die ondersteuning van individue met sielkundige aanpassing na SKB, en om voorstelle te maak oor toekomstige navorsing wat met hierdie onderwerp verband hou.

Thesis (PhD)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: Both chronic trauma and shame, as well as the relation between them, are understudied phenomena. This is despite particularly high levels of both trauma- and shame-related psychopathology in South Africa (Edwards, 2005). I conducted a qualitative study exploring experiences of trauma, shame, post-traumatic reactions and coping mechanisms in single interviews with 19 South African survivors of chronic trauma (intimate partner violence) using narrative analysis. Results from the categorical content analysis indicated that all but one participant reported a history of physical violence perpetrated by her intimate partner. Sexual and emotional violence were also reported by the majority of the participants. The most significant reported mental health outcomes were persistent fear, depression and suicidality, dissociation and somatic complaints. Coping mechanisms included religion, support from family, counselling and substance misuse. Using smiling as a mask to conceal difficult feelings and keeping occupied were cited as the most effective defenses. Shame was viewed as a social emotion, and often described as humiliation (and sometimes embarrassment), which required the presence of a mocking, hostile audience. This was interpreted in socio-cultural terms. Eleven women presented with a split self – the authentic self who admitted to a great deal of shame when asked indirectly, and the false self who was described in surprisingly positive terms. I analysed this split using categorical content analysis and narrative analysis from a social constructivist point of view at individual (clinical) level, organisational (micro-cultural) level, and broader cultural level. I used Gee’s (1991) categorical form analysis to analyse five long complex shame and trauma narratives with the aim of determining if psychic fragmentation presents at linguistic level. I also analysed three short, compressed trauma and shame narratives. The structure of the short narratives tended to be circular, erratic, disjointed, and interrupted (Scarry, 1985; Simon, 2008). The three short, compressed trauma narratives were characterised by long pauses or silences, hesitations, avoiding eye contact, hunching over, covering the face with clothes, whispering, so making the narrative almost inaudible, crying, and defensive leaning in towards me, and laughing. These women were exceptions – most women expressed an urgency to talk about their experiences in great detail. Although the longer narratives are essentially fractured chaos narratives at linguistic level, they contain predominant trauma- and shame-related themes that are consistent throughout the narratives and that remain intact in spite of the signs of linguistic disruption and fragmentation. They are, in order of narratives, 1) shame/self-blame and deservedness; 2) truth/lies and bearing witness; 3) shame, humiliation and dissociation; 4) the concealed, shame-based self, including amnesiac-like disorientation of place and time; and 5) patterns of cyclical leave-return reflecting perpetrator-instilled abandonment terror, including disorientation of time. I have argued that although language, or narrative structure, continues to mimic and reflect narrative content (fractured narratives vs fractured selves) – there is also the intriguing possibility of a disconnection between form and content; and that thematic coherence or consistency and narrative fracturing can co-occur; co-exist. There are a number of clinical features in the narratives which are either related to, or comprise diagnostic criteria for chronic trauma syndromes such as chronic PTSD and DESNOS, and intersect with shame themes in the narratives I analysed. Consequently, I argue that there is a substantial intersection or co-occurrence between exposure to chronic trauma, and trauma-related clinical symptoms, including shame, which emerge from the narratives, which without exception, demonstrate significant linguistic fracturing. In conclusion, a number of gaps in the literature were identified. Future research should triangulate methods and chronic trauma prevalence and longitudinal studies are needed both internationally and locally. / AFRIKAANSE OPSOMMING: Sowel kroniese trauma as skaamte, en die verhouding tussen die twee, is tot dusver onvoldoende bestudeer – ondanks die besonder algemene voorkoms van trauma- en skaamte-verwante psigopatologie in Suid-Afrika (Edwards, 2005). Ek het ʼn kwalitatiewe studie onderneem en die ervaring van trauma, skaamte, post-traumatiese reaksies en oorlewingsmeganismes ondersoek in indiwiduele onderhoude met 19 Suid-Afrikaanse oorlewendes van kroniese trauma (geweld in intieme verhoudings). In my ondersoek het ek van narratiewe analise gebruik gemaak. Resultate van die kategoriese inhoudsanalise dui aan dat ál die vroue in die bestudeerde groep, behalwe een, ‘n geskiedenis van fisieke geweld gerapporteer het wat deur haar ‘partner’ gepleeg is. Seksuele en emosionele geweld is ook deur die meerderheid van die groep gerapporteer. Die mees betekenisvolle uitkomste in verband met psigiese gesondheid was voortdurende angs, depressie, selfmoordneigings, dissosiasie en somatiese klagtes. Oorlewingsmeganismes was onder andere godsdiens, berading en dwelms. Om ʼn glimlag te gebruik as masker vir die verberging van pynlike emosies, en om besig te bly, is genoem as die effektiefste verdedigingsmeganismes. Skaamte is gesien as ‘n sosiale emosie, en is dikwels ‘vernedering’ genoem (soms ʼn ‘verleentheid’), wat die teenwoordigheid van spottende, vyandige toeskouers impliseer. Skaamte is in die studie in sosio-kulturele terme geïnterpreteer. Elf vroue het 'n gesplete self vertoon – die outentieke self wat 'n groot hoeveelheid skaamte erken het wanneer hulle indirek daaroor uitgevra is, teenoor die valse self wat in verbasend positiewe terme beskryf is. Ek het hierdie gesplete self geanaliseer met gebruikmaking van kategoriale inhoudsanalise en ook van narratiewe analise uit 'n sosiaal-konstruktiewe perspektief – op 'n indiwiduele (kliniese), organisatoriese (mikro-kulturele) en ‘n breër kulturele vlak. Ek het Gee (1991) se kategoriale vorm-analise gebruik om vyf lang, komplekse skaamte- en traumanarratiewe te analiseer om te bepaal of psigiese fragmentering op 'n linguistiese vlak manifesteer. Ek het ook drie kort, gedronge trauma- en skaamtenarratiewe geanaliseer. Die struktuur van die kort narratiewe was geneig om sirkulêr, wisselvallig, onsamehangend en onderbroke te wees (Scarry, 1985; Simon, 2008). Die drie kort, gedronge traumanarratiewe is gekenmerk deur lang stiltes, aarseling, vermyding van oogkontak, vooroor buk, bedekking van die gesig met klere, fluistering (sodat die narratief byna onhoorbaar geword het), gehuil, defensiewe oorleun na my toe, en gelag. Hierdie drie vroue was uitsonderings – die meeste vroue het 'n dringende behoefte laat blyk om in fyn besonderhede oor hulle ervarings te praat. Alhoewel die langer narratiewe op 'n linguistiese vlak wesentlik gefragmenteerde chaos-narratiewe is, bevat hulle dominante trauma- en skaamte-temas wat konsekwent deur die verhale aanwesig bly ondanks die tekens van linguistiese disrupsie en fragmentering. Hulle is, in die volgorde van die narratiewe, 1) skaamte/selfblamering en verdiende loon; 2) waarheid/leuens en getuienis aflê; 3) skaamte, vernedering en dissosiasie; 4) bedekte, skaamte-gebaseerde self, insluitend die amnesieagtige disoriëntering van plek en tyd; en 5) patrone van sikliese vertrek en terugkeer, insluitend 'n disoriëntering van plek en tyd – 'n refleksie van die vrees om alleen gelaat te word, veroorsaak deur die gewelddadige optrede teen haar. Ek het geredeneer dat, alhoewel taal/ narratiewe struktuur geneig is om narratiewe inhoud na te boots en te reflekteer (gefragmenteerde narratiewe naas gefragmenteerde self) – is daar ook die interessante moontlikheid van 'n diskonneksie tussen vorm en inhoud; en dat tematiese samehang of konsekwentheid saam met narratiewe fragmentering kan voorkom. Daar is 'n aantal kliniese kenmerke in die narratiewe wat diagnostiese kriteria bevat vir kroniese trauma-sindrome soos kroniese PTSD en DESNOS, en wat verband hou met skaamtetemas in die betrokke narratiewe. Gevolglik redeneer ek dat daar 'n substansiële oorvleueling of saambestaan is van die blootstelling aan kroniese trauma en trauma-verwante kliniese simptome, insluitend skaamte. Dit kom na vore in die geanaliseerde narratiewe, wat sonder uitsondering deur linguistiese fragmentering gekenmerk word. Ten slotte is ‘n aantal leemtes in die literatuur geïdentifiseer. Toekomstige navorsing behoort metodes en algemeen-voorkomende kroniese trauma te trianguleer en longitudinale studies, plaaslik en internasionaal, word benodig.

Thesis (PhD)--Stellenbosch University, 2008. / ENGLISH ABSTRACT: Background South Africa is the country with the largest number of HIV infections in the world. As behaviour change initiatives have been suboptimal in curbing the spread of the pandemic, an HIV vaccine is likely to be an important development as a biological agent may circumvent some of the challenges of initiating widespread behaviour change. The development of an HIV vaccine will require several thousands of HIV negative participants who are at high risk of HIV infection to participate in HIV vaccine clinical trials. Before recruitment for such trials may begin, various scientific, ethical, and sociobehavioural issues need to be considered. One of the key sociobehavioural issues concerns the willingness of individuals at high risk of HIV infection to participate in HIV vaccine trials. However, a psychometric measure of willingness to participate (WTP) has not been constructed, and there is a paucity of theory to guide studies of WTP. Objectives The first objective of this study was to construct a psychometric measure of WTP in an HIV vaccine trial, and to derive the exploratory factor structure of the measure. The second objective was to examine the extent to which the Theory of Planned Behavior (TPB) could predict variance in WTP, and to determine whether the TPB was strengthened by the inclusion of mistrust of researchers, knowledge of HIV vaccines and HIV vaccine trials, altruism, and perceived risk of HIV infection as additional predictor variables. Methodology This study was a research survey with a cross-sectional design. A convenience sample of 399 participants was recruited from an urban-informal settlement near Cape Town. As 79 of the questionnaires were poorly completed, the final sample size was 320. To develop a measure of WTP in an HIV vaccine trial, an item pool was developed whereby items directly reflected inhibitors and facilitators of WTP. After an iterative process of refinement, the final scale consisted of 35 items and was named the Willingness to Participate Scale (WTPS). A principal component Kaiser normalised exploratory factor analysis (EFA) was conducted on the items that constituted the WTPS. This procedure was performed to identify latent factors which were informed by the items of the scale. To test the predictive capacity of the TPB and the additional predictor variables, a two-step linear hierarchical multiple regression analysis was performed. At step 1, the TPB variables were entered simultaneously. At step 2, the TPB variables along with the additional predictor variables were entered simultaneously. Results The WTPS demonstrated excellent internal consistency (α = 0.90) and initial construct validity, as evidenced by the presence of seven latent factors. The factors accounted for 53.15% of the variance in WTP and were: (i) Social approval and trust; (ii) Stigmatisation; (iii) Personal costs; (iv) Personal gains; (v) Personal risks; (vi) Convenience; and (vii) Safety. The TPB significantly accounted for 6.4% (R² = 0.06) of the variance in WTP [F(3, 316) = 7.16, p < 0.001], yielding a small effect size (ƒ2 = 0.06). The TPB, together with mistrust, knowledge of HIV vaccines and HIV vaccine trials, altruism, and perceived risk of HIV infection as additional predictor variables significantly accounted for 10.2% (R² = 0.10) of the variance in WTP [F(7, 312) = 5.06, p < 0.001], yielding a small to medium effect size (ƒ2 = 0.11). Subjective norms, mistrust of researchers, altruism, and perceived risk of HIV infection were significant independent predictors of WTP. Conclusion Against the backdrop of the study limitations, the results of this study provide initial support for the reliability and construct validity of the WTPS among the most eligible trial participants in the Western Cape of South Africa. The findings also suggest that the TPB may not be an appropriate theoretical framework for predicting WTP in an HIV vaccine trial in this context. Nonetheless, normative pressure by others, mistrust of researchers, altruism, and perceived risk of HIV infection may influence WTP in this population. Implications for future research are discussed. / AFRIKAANSE OPSOMMING: Agtergrond Suid afrika is die land met die hoogste getal HIV infeksies in die wêreld. Vir die ontwikkeling van 'n HIV entstof, sal daar vereis word dat duisende HIV negatiewe deelnemers, wat 'n hoë risko kans staan om HIV infeksie op te doen, moet deelneem aan 'n kliniese HIV vaksine proeftog. Verskeie, wetenskaplike, etiese en sosiale gedrags punte moet oorweeg word, voor die werwing van sulke proefnemings. Een van die hoof aspekte van sosiale gedrags punte is die bereidwillgheid van 'n individu om blootgestel te word aan die HIV infeksie tydens die proeftog. 'n Psigometriese skatting van bereidwiligheid om deel te neem (BODTN) is egter nog nie gekonstruktureer nie en daar is 'n skaarste/geringheid in studies om as gids te dien vir die BODTN. Doel Die eerste doel van hierdie studie was om 'n psigometriese skatting van BODTN in ’n HIV vaksiene proefneming te konstruktureer, en om die ondersoekings oorsaak/faktor struktuur daarvan te meet en af te lei. Die tweede doel was om ondersoek in te stel of die omvang van die Teorie van Beplande Gedrag (TBG) verskille kan voorspel in die BODTN, en om vas te stel of die TBG versterk word deur die insluiting van wantroue in navorsers, kennis van HIV vaksienes en HIV vaksiene proefnemings, altruïsme, en die begrypbare risko van HIV infeksie as adisionele voorspellers. Metode Hierdie studie is 'n navorsings ondersoek met 'n deursneeproef ontwerp. ’n Grieflike aantal van 399 deelnemers was gewerf van 'n informele nedersetting naby Kaapstad. Die finale getal was 320 omdat 79 nie die vraelys korrek on volledig ingevul het nie. Na 'n interaktiewe proses van suiwering/verfyning, het die finale skaal uit 35 items bestaan en word die skaal benoem na die Willingness to Participate Scale (WTPS). Die prinsipale komponent Kaiser normaliseer EFA wat gedoen was op die items wat die WTPS konstitueer. Hierdie prosedure was gedoen om die latente faktore te identifiseer wat beskikbaar gestel was deur die items van die skaal. Om die voorspelbare kapasiteit van die TBG en die adisionele voorspelbare verskille te toets, het ons 'n twee stap hiërargiese veelvoudige agteruitgaan analise gebruik. By stap 1 was die TBG veranderlikes gelyktydig ingedruk. By stap 2 is die TBG veranderlikes tesame met die adisionele voorspellers in gedruk. Resultate Die WTPS het uitstekende interne konsistensie en 'n aanvanklike geldigheid gedemonstreer, soos bewys deur die teenwoordigheid van die 7 latente faktore. Die faktore verantwoord 53.15% van die verskil in WTP en was: (i) Sosiale aanvaarding en vertroue; (ii) Stigma; (iii) Persoonlike koste; (iv) Persoonlike wins/profyt; (v) Persoonlike risiko's; (vi) Gerieflikheid; en (vii) Veiligheid. Die TBG verantwoord 6.4% (R²=0.06) van die verskil in BODTN [F(3.316) = 7.16, p<0.001] met 'n toegewende klein groote uitwerking/uitslag. Die TBG tesame met wantroue, kennis van HIV vaksienes en HIV vaksiene proefnemings, altruïsme, en begrypbare risko van HIV infeksie as adisionele voorspellers, verwantwoord 10.2% (R²=0.10) van die verskil in BODTN [F(7.312 = 5.06, p<0.001], met 'n toegewende klein tot medium groote uitwerking/uitslag (f²=0.11). Subjektiewe norme, wantroue in navorsers, altruïsme, en 'n beprypbare risko van HIV infeksie was betekenisvolle, onafhanklike voorspellers van die BODTN. Gevolgtrekking Teen die agtergrond van die studie beperkinge, het die resultate van hierdie studie ondersteuning voorsien aan die vertroubaarheid en konstruktiewe geldigheid van die WTPS onder die mees geskikste proef deelnemers in die Wes Kaap van Suid Afrika. Die bevinding stel ook voor dat die TBG nie altyd 'n geskikte teoretiese raamwerk is vir die voorspelling van die BODTN in 'n HIV vaksiene proefneming in hierdie konteks is nie. Des nie teen staande, normale druk van ander, wanrtroue in navorsers, altruïsme en die begrypbare infeksie van HIV kan die populasie deur die BODTN beinvloed word. Implikasies vir toekomstige navorsing is bespreek.

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 (PhD)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: Parental loss and orphanage placement can be stressful and can negatively influence the well-being of children. However, few studies have been conducted on the psychological well-being of Ghanaian orphans placed in orphanages. As a result, the impact of orphanage placement following parental loss in Ghana is not well understood. The present study aimed to explore the psychological functioning and experiences of orphaned children placed in orphanages in comparison to non-orphaned children in Accra, Ghana. A mixed-method design with elements of both quantitative and qualitative approaches was used. For quantitative data, questionnaires were used to source information pertaining to quality of life, stress (symptoms of depression and anxiety), problems experienced during the month, coping strategies, perceived social support, perceived self-efficacy and resilience. For qualitative data, follow-up interviews with selected orphaned participants were used to delve into participants’ experiences of placement in an orphanage. Purposive sampling was used to select participants who were aged between seven and 17 years. The sample comprised 100 orphaned children, placed in four orphanages, and 100 non-orphans sampled from two public schools in Accra. The quantitative data were analysed using the t-test, the chi-square test, Pearson product-moment correlation analyses, one-way analysis of variance (ANOVA) and regression analyses. The qualitative data were analysed through content and thematic analyses. The results revealed that orphaned children showed more anxiety symptoms than non-orphans but both groups of children presented with high levels of depressive symptoms. The predominant problems for both groups of children were problems with school and relationship problems with peers and caregivers. However, for orphaned children, relationship problems with peers were commonly cited whereas for non-orphans, problems cited were relationship difficulties with caregivers. Despite the heightened emotional distress, orphaned children reported high levels of self-efficacy and resilience as well as stronger perceptions of available support from friends than non-orphans. Non-orphaned children perceived significantly stronger support from families than orphaned children. Regression analyses also revealed that for orphaned children, anxiety and support-seeking coping emerged as significant predictors of qualify of life whereas depression emerged as a significant predictor of quality of life for non-orphaned children. Self-efficacy emerged as a significant positive predictor of resilience for orphaned children whereas self-efficacy and perceived social support emerged as significant positive predictors of resilience for non-orphans. The results of the thematic analyses of the follow-up interviews with selected orphans also revealed that orphanage placement evoked both negative and positive experiences. While orphanages provided structure, nurturance, a safe home environment and avenues for positive peer relationships that engendered a sense of belonging, they were also associated with financial constraints and relationship problems with peers and caregivers. In addition, the Christian-religious orientation of the orphaned children appeared to foster orphans’ well-being. The present study provided evidence that both the orphaned and non-orphaned children were vulnerable to psychological distress. Therefore, interventions should be effected to both groups of children. Furthermore, the study showed that orphanages provided sanctuary and nurturance to orphans who lack parental care and could be considered as a viable form of orphan care in Ghana. / AFRIKAANSE OPSOMMING: Ouerverlies en weeshuisplasing veroorsaak stres en kan die welstand van kinders negatief beïnvloed. Min navorsingstudies is egter gedoen oor die psigologiese welstand van Ghanese weeskinders wat in weeshuise geplaas word. Die gevolg is dat die impak van weeshuisplasing ná ouerverlies nie goed in Ghana verstaan word nie. Die studie is daarop gemik om die psigologiese funksionering en ervarings van kinders wat ouerloos gelaat en in weeshuise in Accra, Ghana, geplaas word, te ondersoek en dit met dié van nieweesgelate kinders te vergelyk. ’n Gemengdemetode-ontwerp met elemente van beide kwantitatiewe en kwalitatiewe benaderings is gebruik. Vraelyste is vir die kwantitatiewe data gebruik ten einde inligting te bekom oor lewenskwaliteit, stres (simptome van depressie en angs), daaglikse streswekkers of stressors, behartigingstrategieë, waargenome sosiale steun, waargenome selfbedrewendheid en veerkrag. Vir die kwalitatiewe data is opvolgonderhoude met geselekteerde weesgelate deelnemers gevoer ten einde die deelnemers se geleefde ervarings van plasing in ’n weeshuis indringend te bekyk. Doelgerigte steekproefneming is gebruik om deelnemers tussen die ouderdom van sewe en 17 jaar oud te selekteer. Die steekproef het bestaan uit 100 weesgelate kinders wat in vier weeshuise geplaas is, en 100 nieweesgelate kinders wat as steekproef uit twee openbare skole in Accra geneem is. Die kwantitatiewe data is ontleed met gebruikmaking van die t-toets, die chi-kwadraattoets, Pearson-produkmomentkorrelasieontledings, asook eenrigting-variansie- (VARO) en regressieontledings. Die kwalitatiewe data is aan die hand van inhouds- en tematiese ontledings geanaliseer. Volgens die resultate toon weesgelate kinders meer angssimptome as nieweesgelate kinders, terwyl beide groepe kinders met hoë vlakke van depressiewe simptome presenteer. Die oorheersende daaglikse stressors by beide groepe kinders is probleme by die skool, asook verhoudingsprobleme met die portuurgroep en sorggewers. Wat die weesgelate kinders betref, word verhoudingsprobleme met die portuurgroep egter as die mees algemene probleme aangevoer, terwyl nieweesgelate kinders verhoudingsprobleme met sorggewers aandui. Afgesien van die verhoogde emosionele nood, toon weesgelate kinders hoë vlakke van selfbedrewendheid en veerkrag, asook sterker persepsies van beskikbare bystand deur vriende, as wat die geval is by nieweesgelate kinders. Nieweesgelate kinders neem beduidend sterker bystand van families waar as wat die geval is by weesgelate kinders. Regressieontledings dui ook aan dat angs en bystandsoekende behartigingsgedrag by weesgelate kinders as beduidende voorspellers van lewensgehalte presenteer, terwyl depressie as ’n beduidende voorspeller van lewensgehalte by nieweesgelate kinders presenteer. Selfbedrewendheid presenteer as ’n beduidende positiewe voorspeller van veerkrag by weesgelate kinders, terwyl selfbedrewendheid en waargenome sosiale bystand as beduidende positiewe voorspellers vir veerkrag, by nieweesgelate kinders presenteer. Volgens die resultate van die tematiese ontledings van opvolgonderhoude met geselekteerde weeskinders, ontlok weeshuisplasing beide negatiewe en positiewe ervarings. Weeshuise skep struktuur, koestering, ’n veilige tuisomgewing en kanale vir positiewe portuurgroepverhoudings, en gevolglik ’n gevoel van samehorigheid, ofskoon hierdie instansies ook met finansiële beperkings en verhoudingsprobleme met portuurgroepe en versorgers verbind word. Verder blyk dit dat die Christengeloof-oriëntasie van die weesgelate kinders die welstand van die weeskinders bevorder. Die aangebode studie lewer bewys dat sowel die weesgelate as die nieweesgelate kinders kwesbaar is vir psigologiese nood. Gevolglik word intervensies vir beide groepe kinders aangedui. Die studie toon verder dat weeshuise ’n toevlugsoord en versorgingsplek bied vir weeskinders wat nie ouerlike sorg ontvang nie, en dat dit as ’n lewensvatbare vorm van weeskindsorg in Ghana beskou kan word.

Thesis (MSc)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: This study aimed to create an elaborate model that can shed light on the intra- and interpersonal functioning of middle childhood and early adolescent South African girls in child care. Data used included: 1) measures of self-concept that was measured by The Beck Youth Inventories: Self-concept inventory for Youths (Beck, Beck & Jolly, 2001), 2) a qualitative indication of perceived attachment towards a mother figure and 3) biographical data provided by the social workers associated with the children's homes that participated in the study. Participants included 70 girls between the ages of 9 and 14, of which 35 were assigned to the Children's Home Group. The Control Group comprised of the rest of the participants. Regression analysis, correlation measurement and the calculation of the significance of the differences between groups were used to test hypotheses. Results indicated that perceived attachment to a mother figure is a significant mediator of selfconcept, but that factors related to age seemed to have the most significant mediating effect during the developmental stages of middle childhood and early adolescence. The results were used to combine and elaborate on existing theories of intra- and interpersonal functioning in order to suggest a model that attempts to explain the functioning of South African girls in child-care in more depth. Implications for these findings are discussed. / AFRIKAANSE OPSOMMING: Die doel van hierdie ondersoek was om 'n gedetailleerde modelop te stel wat lig kan werp op die intra- en interpersoonlike funksionering van middel-kinderjarige en adolessente dogters in kindersorg in Suid-Afrika. Die data wat gebruik is, sluit in: 1) meetings van selfkonsep wat gemeet is deur die Beck Youth Inventories: Self-concept inventory for Youths (Beck, Beck & Jolly, 2001), 2) 'n kwalitatiewe indikasie van dogters se persepsie oor die binding tussen hulle en hulonderskeie moeders, asook. 3) biografiese data wat verskaf is deur die maatskaplike werkers wat geassosieer was met die kinderhuise wat deelgeneem het. Die deelnemers het bestaan uit 'n groep van 70 dogters tussen die ouderdomme van 9 en 14 jaar. Die helfte van die deelnemers het vanuit die kinderhuise gekom terwyl die res van die deelnemers die kontrolegroep gevorm het. Regressie analises, korrelasie metings en die berekening van die beduidendheid van verskille tussen groepe is gebruik om hipoteses te toets. Die resultate het daarop gedui dat dogters se persepsie van die kwaliteit van die binding tussen hulle en hul moeders, wel 'n beduidende mediator van self-konsep is gedurende middle-kinderjare en adolessensie is, maar dat faktore wat verband hou met ouderdom, die grootste mediërende effek het op self-konsep gedurende hierdie ontwikkelingsfases. Op grond van die resultate is 'n model saamgestel wat 'n voortbouing is op bestaande teorie, maar poog om meer lig te werp op die intra en interpersoonlike funksionering van Suid-Afrikaanse dogters in kindersorg te verduilik. Die implikasies hiervan word bespreek.

On t.p.: Magister in Lettere en Wysbegeerte (Voorligtingsielkunde) / Thesis (MA)--Stellenbosch University, 2004. / ENGLISH ABSTRACT: This study focuses on the identification and comparison of resilience factors in Belgian and South African single parent families. The participants (parents and children in single parent families) from the two countries were identified on the basis of the nature of the crisis and the stage of development of the families. Self-reporting questionnaires were completed separately by the parent and a child, as representatives of the family. The questionnaires comprised a biographical questionnaire (which also included an open-ended question), the Relative and Friend Support Index, the Social Support Index, Family Crises Oriented Personal Evaluation Scales, the Family Sense of Coherence Scale, and the Family Hardiness Index. The responses from parents and children were analysed separately, therefore dealing with them as four groups (Belgian parents, South African parents, Belgian children and South African children). Pearson product-moment correlations were calculated to determine which factors were most strongly related to family coherence (Family Sense of Coherence). Family coherence is a quality that provides an indication of the measure of success achieved with adaptation following a crisis (divorce). This was followed with regression analyses for identifying a group of resilience factors that would, in combination, provide the best predictor for successful family adjustment. The results of this study confirm that of previous research, namely in the findings that the different populations reveal similarities as well as differences with regard to qualities and resources utilized for successful adaptation after a crisis. Results reveal that the inherent strength of the family in all four groups (parents and children from both countries) is seen as one of the most important resilience factors (as measured by the Family Hardiness Index). Aspects that show strong correlation with family coherence are: a sense of control (the perception of how well the family is able to deal with a crisis) over the outcomes of life experiences; the family's orientation with regard to challenges that have to be faced; as well as an active orientation (tendency to do something about the situation) with regard to adaptation in a stressful situation (as measured by the Family Hardiness Index). The importance of redefining the problem (crisis) in terms of its significance for the family (positive, negative or neutral) was also identified as a core resilience factor. Results from the parents in both countries revealed that the number of years of separation/number of years that had elapsed since the divorce was a significant resilience factor. The longer the time period after the divorce, the better the adjustment. A significant difference was found between the results obtained for Belgian and South African children with regard to the duration of the parents' marriage and the duration of the period since the parents' divorce, and the relevance of this for the family's adaptation. The children from both countries revealed similarities with regard to the importance of the utilization and the support of members of the immediate family, the extended family and friends to overcome the crisis. The results obtained for parents in both countries did not confirm this aspect, i.e. the value of support from family and friends. / AFRIKAANSE OPSOMMING: Hierdie studie fokus op die identifisering en vergelyking van veerkragtigheidsfaktore van Belgiese en Suid-Afrikaanse enkelouergesinne. Die deelnemers (ouers en kinders in enkelouergesinne) wat in beide lande geïdentifiseer is, is op grond van die aard van die krisis en die ontwikkelingstadium van die gesinne geïdentifiseer. Selfrapporteringsvraelyste is afsonderlik deur die ouer en 'n kind, as verteenwoordigers van die gesin, voltooi. Die vraelyste het bestaan uit 'n biografiese vraelys (wat ook 'n oop-einde vraag ingesluit het), die Relative and Friend Support Index, die Social Support Index, Family Crises Oriented Personal Evaluation Scales, die Family Sense of Coherence Scale, en die Family Hardiness Index. Die ouers en kinders se response is afsonderlik ontleed, dus was daar vier groepe (Belgiese ouers, Suid-Afrikaanse ouers, Belgiese kinders en Suid-Afrikaanse kinders). Pearson produk-moment korrelasies is bereken om vas te stel watter faktore die sterkste verband toon met gesinskoherensie (Family Sense of Coherence). Gesinskoherensie is 'n eienskap wat 'n aanduiding gee van die mate van suksesvolle aanpassing ná 'n krisis (egskeiding). Daama is regressie-ontledings gedoen om 'n groepering van veerkragtigheidsfaktore te identifiseer wat gekombineerd die beste voorspellers vir suksesvolle gesinsaanpassing is. Die resultate van hierdie studie bevestig dié van vorige navorsing, naamlik dat die verskillende populasies ooreenkomste, maar ook verskille, toon ten opsigte van kenmerke en hulpbronne wat hulle vir suksesvolle aanpassing na 'n krisis benut. Uit die resultate blyk dit dat inteme sterkte in die gesin in al vier groepe (beide lande se ouers en kinders) as een van die belangrikste veerkragtigheidsfaktore beskou word (soos met die Family Hardiness Index gemeet). Die volgende aspekte, te wete: sin vir kontrole (die persepsie van hoe goed die gesin 'n krisis sal kan hanteer) oor die uitkomste van lewenservaringe, die oriëntering van die gesin ten opsigte van uitdagings wat aan die gesin gestel word, asook 'n aktiewe oriëntering (geneigdheid om iets aan die situasie te doen) wat betref die aanpassing in 'n stressituasie (soos gemeet met die Family Hardiness Index) toon 'n sterk korrelasie met gesinskoherensie. Die belangrikheid om die probleem (krisis) in terme van die betekenis wat dit vir die gesin het, te herdefinieer (positief, negatief of neutraal) is as nog 'n kem-veerkragtigheidsfaktor geïdentifiseer. Beide lande se ouers se resultate het getoon dat die aantal jare wat die ouers geskei was 'n beduidende veerkragtigheidsfaktor is. Hoe langer die tyd na die egskeiding hoe beter die aanpassing. 'n Beduidende verskil is gevind tussen die Belgiese kinders en Suid-Afrikaanse kinders se resultate ten opsigte van die tydsduur van die ouers se huwelik en die tyd sedert die ouers geskei is, en die verband wat dit met gesinsaanpassing het. Die kinders van beide lande het ooreengestem ten opsigte van die die belangrikheid van die gebruik van, en die ondersteuning van gesinslede, familie asook vriende om 'n krisis te bowe te kom. Die resultate van beide lande se ouers het nie die voorafgaande aspek, naamlik die waarde van ondersteuning deur gesins-, familielede en vriende, bevestig nie.

Thesis (MA) -- Stellenbosch University, 2005. / ENGLISH ABSTRACT: This study will review the literature on resilience in adult female childhood sexual abuse survivors with specific focus on incestuous abuse. Adults with histories of sexual abuse are categorised as either resilient or non-resilient on the basis of current functioning. Characteristics of the family of origin and its perceived contribution to the child sexual abuse are discussed. The developmental psychopathology literature addressing issues of resilience and vulnerability to stresses is addressed. The theoretical concepts of resilience, as they relate to protective mechanisms are discussed. / AFRIKAANSE OPSOMMING: Hierdie navorsingstuk bied 'n oorsig oor die literatuur met betrekking tot die herstelvermoe van volwasse vroulike persone wat as kinders seksueel mishandel is, met besondere klem op bloedskandelike mishandeling. Volwassenes met 'n geskiedenis van seksuele mishandeling word op grond van hulle huidige funksionering beskryf as Of in staat om te herstel of nie daartoe in staat nie. Kenmerke van die gesin van oorsprong en die waargenome bydrae van die gesin tot die seksuele mishandeling van kinders word bespreek. Die literatuur met betrekking tot ontwikkelingsgerigte psigopatologie gee aandag aan vraagstukke met betrekking tot herstelvermoe en kwesbaarheid teen die agtergrond van stres. Die teoretiese konsepte van herstelvermoe, en die verband daarvan met beskermende meganismes, word ook bespreek.

Assignment (MA)--University of Stellenbosch, 2005. / ENGLISH ABSTRACT: The transition to motherhood represents a critical period in a woman's life. It presents the mother with the opportunity for personal development, while simultaneously rendering her vulnerable to psychological problems. The South African low-income mother faces additional challenges in having to contend with a host of poverty-related stressors. The mother's at-risk status extends to her infant, who depends on her for the fulfilment of its needs. Current mental health policy does not consider the special needs of mother-infant dyads, despite its orientation to prevention. The current paper seeks to explore the potential of group therapy with low-income mother-infant dyads. It outlines the possible theoretical underpinnings for psychotherapeutic group work with low-income mothers and infants, by making use of attachment theory, feminist theory and community psychology. It reviews the theories' individual contributions and explores their compatibility in considering group therapy with low-income mother-infant dyads. Further, it reviews empirical studies and interventions with mother-infant dyads, with a particular emphasis on group therapy interventions. It argues that group therapy may be a viable and effective approach to psychological work with low-income mother-infant dyads. / AFRIKAANSE OPSOMMING: Die oorgang tot moederskap verteenwoordig 'n kritiese periode in 'n vrou se lewe. Dit bied die moeder die kans vir persoonlike ontwikkeling, terwyl dit haar gelykertyd kwesbaar maak vir sielkundige probleme. Die Suid-Afrikaanse lae-inkomste moeder moet boonop bykomstige uitdagings, in die vorm van 'n menigdom armoed-verwante stressors, die hoof bied. Die moeder se kwesbare status sluit ook haar baba in, wat op haar aangewese is vir die vervulling van sy/haar behoeftes. Huidige geestesgesondheids-beleid neem, ten spyte van 'n voorkomende oriëntasie, nie die spesiale behoeftes van moeder-kind pare in ag nie. Hierdie werksopdrag beoog om die potensiaal van groepsterapie met lae-inkomste moederkind pare te ondersoek. Dit beskryf kortliks die moontlike teoretiese begrondings van psigoterapeutiese groepswerk met lae-inkomste moeder-kind pare deur gebruik te maak van bindings-teorie, feministiese teorie sowel as gemeenskaps sielkunde. Dit hersien die teorieë se onderskeidelike bydraes en ondersoek hulle aanpasbaarheid met betrekking tot die ondersoek van groepsterapie met lae-inkomste moeder-kind pare. Hierdie werksopdrag hersien dan ook verder empiriese studies en intervensies gemik op moeder-kind pare, met 'n spesifieke fokus op groepsterapie intervensies. Daar word geargumenteer dat groepsterapie 'n geskikte en effektiewe benadering tot sielkundige werk met lae-inkomste moeder-kind pare is.