A dissertation presented in partial fulfilment of the requirements for the degree of Masters in Clinical Psychology in the Department of Psychology, University of Witwatersrand. March 2016. / Attachment theory is an extensive yet emerging body of research which emphasises the centrality of the mother-infant bond in healthy socio-emotional and cognitive development, particularly during infancy. The last two decades in particular have seen a proliferation of attachment research involving indigenous populations in the developing world. This has also seen our understanding of the concept of ‘mothering’ grow in breadth and depth. However, with the increased interest in these contexts, so questions are being raised by the scientific community as to the cross-cultural reliability and validity of the findings of such research. A central point of contention surrounds the measure’s suitability to the contextual and/or cultural idiosyncrasies of the sample’s characteristics. Related to this are issues of construct equivalence, item and/or methodological biases, as well as theoretical discordance between Western and non-Western principles which invariably underscore such research. Debate is particularly rife in situations where the measures have been imported and ‘imposed’ upon the sample under study without prior, appropriate adaptation. The mini Maternal Behaviour Q-Sort (MBQS-mini) was employed for the first time in a South African research initiative, the Ububele Mother-Baby Home Visiting Project (UMBHVP), to assess the maternal sensitivity scores of a group of mothers residing in Alexandra Township (Alex), Johannesburg. Maternal sensitivity is thought to be a key concept in the study of parent-infant interactions, and its influence on child development has been significantly correlated to the developmental outcomes of the infant. The MBQS-mini was designed and normed in Canada and is based on the notion of the ‘prototypically sensitive’, Canadian mother. This brings into focus some of the concerns raised above regarding the measure’s appropriateness for use in a distinctly high-risk context like Alex. This research aimed to explore the coders’ and trainer’s experiences of the first time use and application of the measure in the Ububele research initiative in Alex. A focus group and semi-structured interview elicited important information on the participants’ experiences of the training and reliability procedures and further highlighted some of the contextual/cultural constituents that were thought to have impacted the measure’s overall performance and thus also its suitability, utility and applicability to a South African setting. The analysis was inductive and exploratory in nature insofar as a prescribed theoretical interest did not necessarily inform the themes that were identified. The findings indicate that despite the significant impact of the context and the possibility of further adaptation to some items, the MBQS-mini is a suitable measure with utility for assessing maternal behaviours within South Africa. / GR2017

This study aimed to investigate teenage mothers’ experiences of motherhood and their internal representations of their infants and the relationship between them. In addition, this study aimed to investigate whether there was a connection between teenage mothers’ experiences of parenting and their internal representations of their infants and the relationship between them. Through the use of semi-structured interviews, adapted from the Parent Development Interview and the Working Model of the Child Interview, four teenage mothers from Alexandra were interviewed. The data collected from these interviews was analysed using narrative analysis through the hermeneutic lens of psychoanalytic attachment theory. From the analysis, this study found that teenage mother’s experiences of motherhood were marked by challenge. The two main challenges faced by these young mothers were the tension they experienced between their identities as teenagers and their identities as mothers, and their struggle to provide for their infants and feel like good enough mothers. In addition, this study found that teenage mother’s internal representations of their infants included a representation of both the good baby and the bad baby, but, with the exception of one mother, their representations tended to remain split and the mothers seemed defended against their representations of the bad baby. In terms of their representations of the relationship between them, this study found that these teenage mothers’ representations of their relationship with their infants was lacking. These representations either consisted of a superficial representation of a good relationship between mother and infant, or no relationship at all. Finally, this study found that teenage mother’s experiences of motherhood and their internal representations of their infants and the relationship between them were connected. A number of factors that were found to influence both their experiences and their internal representations include their own mental states, their memoires of their own childhood and their representations of their caregivers, as well as the levels of social support they received. The study therefore concluded that teenage mothers’ experiences of motherhood and their internal representations of their infants and the relationship between them were connected, however further research is required to establish the causal relationship between these factors.

Research Submitted in partial fulfillment for the degree MA in Psychology by Coursework and Research Report Wits School of Human & Community Development, University of Witwatersrand, Johannesburg, June, 2016 / Research has found that teenage mothers are less likely to develop a positive parent child relationship and to form an emotional bond with the child because they are not prepared to be parent as teenagers. Since there is high rate of teenage pregnancy in South Africa, this would mean that there is a vast amount of teenage mothers in the country. Therefore, it would be expected that, it would be a challenge for these teenage mothers to form an emotional bond with their children. Hence the purpose of the study is to look at the socio-emotional development of children born to teenage mothers in the South African context. This was done by first investigating whether there was a relationship between teenage childbearing and the child’s social-emotional development in middle and late childhood and to determine whether the socio-emotional development of children born to teenage mothers differs significantly with the children that are not born to non-teenage mothers. This study adopted a non-experimental Ex-Post-Facto correlational Design. A self-designed biographical information questionnaire was used to measure the demographics. To measure social-emotional development in children, an Emotional Quotient Inventory: The preliminary results of the research indicate that the type of mother was a statistically significant predictor of the child’s social and emotional development. Furthermore, that the socio-emotional development of children born of teenage mothers was different from the socio-emotional development of children born to non-teenage mothers, as the social and emotional development of children born to teenage mothers was higher than that of children born to non-teenage mothers. The conclusion can be drawn that teenage childbearing does not seem to negatively influence the social and emotional development of children born to teenage mothers

Research shows that maternal depression has adverse effects on mother-infant attachment and subsequent infant development (Cogill, Caplan, Alexandra, Robson & Kumar, 1986). The mechanisms through which this comes about are unclear. Murray & Cooper (1997) suggest an impaired pattern of mother-infant communication is responsible. Within this, Murray proposes that maternal speech may be a key factor. This study constitutes a preliminary exploration into the mechanisms through which maternal depression effects mother-infant interaction in South Africa. 147 predominantly Xhosa-speaking mother-infant dyads that took part in a broader epidemiological study on post-partum depression in Khayelitsha (Cooper, Tomlinson, Swartz, Woolgar, Murray & Molteno, 1999) made up the subjects. Maternal depression was assessed according to the Structured Clinical Interview for DSMIV (SCID). Maternal speech recorded from standard, five-minute, face-to -face mother-infant interactions was translated and analysed according to a coding system developed by Murray (Murray, Kempton, Woolgar & Hooper, 1993). The speech of depressed mothers to their two month old infants was compared to the speech of non-depressed mothers on dimensions of focus, affect and agency, and the role of infant gender was assessed. Results revealed no significant group differences for depression. Maternal speech to male infants was found to hold significantly less ascription of agency than to female infants. Findings suggest that maternal speech may be too narrow a marker of maternal depression in this context and that broader indices are needed. It is recommended that future research control for measures of social adversity, factor in cultural and language particularities, and consider contextual aspects of mother-infant interaction / attachment processes, in investigating the mechanisms through which post-partum depression leads to negative infant outcome in the developing world.

The aim of this study was to explore, describe and interpret the experiences of Immunodeficiency Human Virus (HIV) infected mothers regarding exclusive breastfeeding in the first six months of the infant’s life. This was a qualitative study with phenomenology as a design as the study was about lived experiences. The sample consisted of HIV infected mothers aged 18 years and above who opted for exclusive breastfeeding for the first six months of their infant’s lives. Purposive sampling was used. Data was collected through one to one semi structured interviews of fifteen mothers of babies aged six to twelve months. The study revealed that mothers had both positive and negative experiences which were influenced by among others; the level of support the mothers received, disclosure of HIV status and health education received at the health facility. The findings of the study revealed a low level of understanding of the Infant and Young Child Feeding Policy by health professionals / Health Studies / M.A. (Health Studies)

The early relationship between mother and child is formative of a child’s later wellbeing. Disruptions in the mother-infant bond can result in insecure attachments. There therefore exist certain interventions which endeavour to avoid the development of insecure relationships and instead begin to develop more secure mother-infant bonds. Such interventions include the Ububele Baby Mat project run in Alexandra township, Johannesburg. As this intervention is still developing, the Ububele team requested that research be conducted on this intervention. This research aims to better understand the Ububele Baby Mat’s influence on those caregivers who access the Baby Mat service, and also to record the subjective experiences of the therapists who facilitate the mat service. The current research was therefore aimed at exploring the subjective experiences of both the mothers and therapists involved in the Baby Mat intervention and further to explore any similarities or differences between these two groups’ experiences. Data was obtained through semi-structured interviews with mothers who accessed the Baby Mat service and with both the therapists who facilitated the mother participants’ sessions. Thematic content analysis was used to analyses the data. The findings showed that in general mothers had a positive experience of the Baby Mat service and of the therapists on the mat. Another finding was that there were more similar experiences than different ones between mothers and therapists.

The aim of this study was to explore, describe and interpret the experiences of Immunodeficiency Human Virus (HIV) infected mothers regarding exclusive breastfeeding in the first six months of the infant’s life. This was a qualitative study with phenomenology as a design as the study was about lived experiences. The sample consisted of HIV infected mothers aged 18 years and above who opted for exclusive breastfeeding for the first six months of their infant’s lives. Purposive sampling was used. Data was collected through one to one semi structured interviews of fifteen mothers of babies aged six to twelve months. The study revealed that mothers had both positive and negative experiences which were influenced by among others; the level of support the mothers received, disclosure of HIV status and health education received at the health facility. The findings of the study revealed a low level of understanding of the Infant and Young Child Feeding Policy by health professionals / Health Studies / M. A. (Health Studies)

Infant mental health in South Africa has been receiving more attention in recent years. Mothers appear to be the main caregivers of infants but they face many psychosocial, economic and cultural challenges. There exists very little evidence suggesting that mothers living in shelters or institutions have access to the necessary support and education to help them to understand their circumstances and how this may impact on the attachment with their infant. The New Beginnings Programme, as an early intervention model, is aimed at improving attachment between mother and infant so as to reduce the potential risk of mental health problems later in life for the infants, the mothers and future generations. This evidence based intervention focuses on the mother and her capacity for mentalisation, which refers to the mother’s capacity to hold her infant in mind and recognise and respond to the inner states of the infant. The pilot study of the New Beginnings Programme within a South African context took place in two shelters in the Greater Johannesburg area. This particular study formed part of this bigger research effort. The aim of this study was to explore the experiences of the mothers who attended the New Beginnings programme. A secondary aim was to explore these mothers’ experiences of the programme within the context of living in a shelter. The adaptation of this programme to a South African context could contribute significantly to bridging the gap in mother-infant attachment which could influence the future mental health of the infant and their ability to foster ongoing healthy attachments later in life. This qualitative study used semi-structured interviews and a narrative analysis from the theoretical perspective of psychoanalytic attachment theory. Thirteen mothers from two shelters participated in this research study.

Text in English / Breastfeeding is particularly important in resource-poor regions of the world, where limited access to clean water increases the risk of diarrhoeal disease if replacement feeding is used. However, human immunodeficiency virus type 1 (HIV-1) is transmitted through human milk. Purpose of the study The purpose of this study was to describe the determinants contributing to exclusive breastfeeding in HIV-infected mothers of infants aged 0 to 6 months who attend an NGO Health Centre in Elandsdoorn Village. Methods A quantitative research approach using a non-experimental cross-sectional study was undertaken to conduct this study. A self-reported study questionnaire was used to collect data from study participants. Purposive sampling was used to sample 75 mothers from 18 to 45 years of age who were HIV-positive. SPSS version 23 was used to analyse the data. Results The study results indicated that there are determinants contributing to exclusive breastfeeding and a need to establish a more comprehensive approach to educating pregnant women on reproductive health issues, and exclusive breastfeeding in particular. Factors contributing to low levels of exclusive breastfeeding included breast problems, societal influence, maternal health concerns, insufficient support, fear of stigmatisation, and babies’ health concerns. This caused mothers to discontinue exclusive breastfeeding. Conclusions The intention of this study was to reveal the determinants of exclusive breastfeeding affecting mothers who are HIV-infected and breastfeeding their infants. / Health Studies / M.P.H.

Infant feeding in the context of HIV/AIDS poses a challenge among mothers. The implementation of UNICEF guidelines on infant feeding, which state that “when replacement feeding is acceptable, feasible, affordable, sustainable and safe, avoidance of all breastfeeding by HIV-infected mothers is recommended” (WHO, 2003:12) are not easy to meet. In more developed countries, where these criteria are met, almost all HIV-infected mothers have ceased to breast feed. Consequently, infants of mothers in these countries are less likely to be infected with HIV postnatally. In South Africa, more specifically in the Eastern Cape, infant feeding is a challenge as a number of UNICEF criteria cannot be met. The Eastern Cape is one of the poorest Provinces in South Africa, with a number of rural communities. Earlier studies have shown that, if mothers select either exclusive breast feeding or exclusive formula feeding, this reduces mother-to-child transmission of HIV. A limited number of studies on adherence to the method of infant feeding selected before delivery were found in the literature, hence the need for the current study. The purpose of the study was to explore adherence to exclusive breast feeding and exclusive formula feeding among mothers with HIV infection and to determine the problems that mothers may be facing in implementing their pre-selected methods.