M.A. / Szasz (1961), in a book entitled, "The Myth of Mental Illness", argues about the age-old debate, whether the diagnosis of mental illness is culturally related or not. In today's multicultural milieu, clinicians are confronted with this same problem. For the purpose of the present qualitative study, Ancestral Possession (AP) and Multiple Personality Disorder (MPD), will be considered. The initial purpose of the study was to explore the fields of Ancestral Possession (AP) and Multiple Personality Disorder (MPD) amongst black subjects, and to explore how these two phenomena are understood within a cultural context. Due to practical problems encountered in finding a black subject diagnosed as suffering from MPD, the subject focus had to be slightly altered. The aim of the study was changed to investigating MPD, as a Western culture diagnosis, and AP, as an African culture diagnosis, and comparing these two phenomena. The phenomenological approach was used as a theoretical basis for the study. It was assumed that since this study focuses on subjective experiences, the phenomenological approach would be more applicable. Two case studies (MPD and AP) comprise the data of this study. A video tape, consisting of interviews of the two case studies, is part of the data, including a literature study on both phenomena. The data analysis focused on comparing the personal background of the two case studies and the manifestation and treatment of both phenomena within their cultural contexts. The differences and similarities that emerge, are discussed. It was found that there are some similarities and also some differences between the two phenomena. Similarities are found, for instance, in the symptom profile of the two phenomena. The core personality in MPD usually presents with a fragile appearance (physical and psychological) and will report losing time (having time that is unaccounted for, because other personalities had taken over). The same thing happens with isiguli (literally, patient), a person who is being called by the ancestors. She looks sick, she will find herself in places without knowing how she got there. In both phenomena the subjects appear tormented before integration. The two conditions are also alike in terms of their effect on the central personality. The ancestral spirits and the alter personalities seem to play the same role of enabling the core personality to be well-functioning. In terms of the differences found between the two phenomena, ancestral possession is socially approved in the African culture whereas multiple personality disorder is considered an illness from the Western perspective. The role of socio-cultural factors seems to complicate matters. As enculturation continues and white South Africans are becoming traditional healers, it would be interesting to see how many black South Africans will in future, be diagnosed as suffering from MPD as there are very few, if any, at present. In terms of etiological factors, MPD is usually a result of trauma whereas ancestral possession is a religious experience. The results were inconclusive in that some aspects, for instance, physiological manifestation of AP could not be clearly explained. This is due to the fact that there has not been any laboratory research done to examine the chemical and physiological changes of traditional healers when under the influence of ancestral spirits. As opposed to that, MPD subjects have been reported to have alter personalities that would indicate different EEGs and some other physiological differences.

M.A. / Health problems, physical and mental, in industry have an enormous influence on productivity of organisations in South Africa. Certain models of stress implied the perspective that many stressors may serve as possible inputs into the system, for example remuneration, substance abuse, teamwork, management support, change and self control. Outputs from the system include aspects such as accidents, illness, low productivity levels and psycho-social problems. The problem is that illness and absenteeism often have unspecific causes and a complex interaction perspective has been developed in looking at the employee as system in his working environment.

M.A. / The overall objective of the global research project of which the present study is a part, is to create a greater awareness and understanding of the association between physiology and psychology, specifically with regard to IBS. Investigations are being conducted into the contribution of such factors as stress, anxiety, depression, somatization, psychopathology. early sexual abuse and physical abuse to the development and management of IBS. The present study aims to assess the incidence of co-morbid psychopathology in patients with IBS as compared to the general population. 1.3.2 Specific Aims. The aim of the present study is to compare the incidence of concurrent psychopathology in a sample of white, female patients, aged from 25-55 years and diagnosed to have IBS, with the incidence of psychopathology in a sample of white female non-IBS controls aged 25-55 years. Of initial concern will be whether the results of this study confirm the findings of the numerous research projects which attest to the high incidence of comorbid psychopathology in patients with IBS (Chaudhary & Truelove, 1962; Liss et al., 1973; Young et al., 1976), or add support to the limited evidence that disputes these claims (Talley, Kramlinger et al., 1993; Thornton, McIntyre et al., 1990). The study then aims to consider whether the variable of gender has a significant effect on the incidence of co-morbid psychopathology in patients with IBS. As will be discussed in Chapter 3, most of the studies do not differentiate between male and female subjects even though this may well prove to be an important determining factor. As mentioned in section 1.2.1, there is a dearth of research in South Africa into IBS and, more specifically, into the incidence of co-morbid psychopathology and IBS. By restricting participants in this study to those of the white race, the aim of this study is to initiate a process in which the incidence of co-morbid psychopathology in IBS patients of all races will be assessed and compared. In addition, the present study aims to assess whether age and level of education are significant variables in determining the incidence of co-morbid psychopathology in patients with IBS. Inter-group comparisons will be made between three groups of patients with IBS divided first according to age and then according to level of education. Finally, the present study aims to be more methodologically sound than certain of the earlier research projects as reported in the literature. As will become clear in Chapters 2 and 3, a common thread running through much of the literature is the concern that the validity of results may be questionable due to methodological flaws in the design of certain research projects. Small sample size has been a problem in some studies (Liss et al., 1973; Young et al., 1976) whilst in others, the absence of a control group has limited the relevance of data (Liss et al., 1973). Furthermore, a diversity of measuring instruments have been used in the past with little if any standardisation or control of specific variables being assessed. The measuring instrument used in this study, namely the Personality Assessment Inventory (PAI), allows for an accuracy and comprehensiveness of assessment not found in many previous studies (see Chapter 6, section 6.2.1.4). The PAI assesses psychopathological trends in personality functioning. The word "psychopathology" will be used in this study as substitute for the phrase "psychopathological trends in personality functioning".