Background: Risky decision-making is strongly implicated in adverse real-world risk-taking behaviour, and is associated with Substance Use Disorder, including Methamphetamine Use Disorder. Laboratory neurocognitive tasks typically utilized to assess risky decision-making have been able to distinguish participants with Substance Use Disorder from controls, although considerable heterogeneity is still evident within substance-using populations, which remains largely unexplained. Preliminary evidence has also tied risky decision-making to treatment outcomes, although no research has investigated risk-decision-making within Methamphetamine Use Disorder in the context of Contingency Management treatment. Methods: This study aimed to investigate decision-making on the Iowa Gambling Task and the Balloon Analogue Risk at baseline as both a function and predictor of treatment response on an 8-week treatment of Contingency Management. Of 26 participants with Methamphetamine Use Disorder, 17 responded to Contingency Management treatment, whilst 9 were non-responders. Using various mixed-effect modelling techniques and ANCOVA, performance by nonresponders were compared to responders, as well as a group of 19 healthy, nonsubstance-using control participants. Results: Group differences between non-responders, responders and controls were exclusively obtained on the Iowa Gambling Task. A trend-level (p=.051), large effect size (g=-0.98) was observed in the effect of reward magnitude between non-responders and healthy controls. More specifically, non-responders tended to seek-out large short-term rewards in spite of long-term losses relative to controls, however, groups did not also differ in effect of short-term loss magnitude. Non-responders also appeared to demonstrate poorer learning than healthy controls, although this finding was also at trend-level (p=.081) with a medium effect size (g =-0.63). In addition, results showed that responders and non-responders were differentially influenced by the frequency of outcomes, where responders demonstrated a greater preference for frequent rewards and infrequent losses relative to non-responders. This difference was at trend-level (p=.053) and the effect was moderately sized (g =-0.74). Impulsivity did not moderate group differences in decision-making, but did positively predict a greater likelihood of relapse at least once during Contingency Management (p =.035), although this effect was small (OR=1.10). Poor overall performance on the IGT appeared to predict a greater likelihood of prolonged relapse on Contingency Management following initial relapse, although this was at trend-level (p =.071) with a small effect size (OR=1.80). Conclusion: Findings provide evidence for individual differences in risky decision-making within Methamphetamine User Disorder, suggesting that risky decision-making is unlikely to be a homogeneous characteristic of substance-using populations, as is typically treated in the literature. Risky decision-making may also act as a risk factor for poor treatment success on Contingency Management, which in turn suggests that assessing risky decision-making of individuals with Methamphetamine Use disorder prior to commencing Contingency Management treatment might assist in identifying those at high risk.

Bibliography: leaves 183-238. / There exists but one local detailed, documented study by Bergensen (1989) that focused on the effects of pet facilitated therapy on the self-esteem and socialisation of primary school children. In addition, a handful of articles have been published in South African journals. It is rather perturbing to note that a proven, highly effective adjunct to conventional therapeutic intervention is lacking in the South African therapeutic milieu. The marked ignorance and defence behind practitioners scorn for this form of therapy is rather perplexing, especially in light of its official existence for over thirty years. This dissertation probes the concept of pet-facilitated therapy by referring to extensive studies, focusing on various sub-populations, and concludes with a study investigating local opposition to pet therapy.

Includes bibliographical references (leaves 68-75) / Objectives: To investigate whether or not OSAS patients from the South African population showed any cognitive impairment relative to healthy individuals from the same population, and to assess whether or not untreated OSAS patients and patients on CPAP treatment differed in their cognitive functioning.

Children with fetal alcohol spectrum disorders (FASD) are frequently reported by caregivers and teachers to have difficulties in socio-emotional functioning. It has been suggested that deficits in emotion regulation underlie these deficits in socio-emotional functioning. Children with prenatal alcohol exposure (PAE) have also been found to demonstrate higher rates of insecure attachment, as well as disorganised attachment. Previous research proposes that the attachment relationship serves as a foundation for the development of emotion regulation. However, while this association has been examined in typically developing samples, the relation between attachment and emotion regulation has yet to be examined in individuals with FASD. Previous research has also suggested that a portion of individuals who are considered heavily exposed but are non-syndromal (HE) who do not present with the full phenotype characteristic of FAS or PFAS may nevertheless present with subtle facial dysmorphism only detectable using dense surface modelling and signature analyses of 3D facial images. Furthermore, it has been shown that HE children with this subtle facial dysmorphism perform more poorly on cognitive assessments than HE children who do not present with this subtle facial dysmorphism. These findings therefore suggest that presence of even subtle dysmorphism (i.e. only detectable on signature analyses of 3D facial images) consistent with FAS can be a good indicator of cognitive performance. Given this, the aims of the current study were to examine the association between FAS-dysmorphism and insecure as well as disorganised attachment. Furthermore, the study aimed to examine the extent to which FAS-dysmorphism was associated with emotion regulation difficulties in adolescence after controlling for the effects of attachment security in infancy. Participants included 77 adolescents (M age = 17.66, SD = .7): 13 with fetal alcohol syndrome (FAS), 12 with partial FAS (PFAS), 7 HE-dysmorphic (HE+), 18 HE-nondysmorphic (HE-) and 27 non- or minimally exposed controls. At the 13-month infant assessment, the mother-infant attachment relationship was assessed using the Ainsworth Strange Situation Paradigm (Hay, Jacobson, Molteno, Viljoen, & Jacobson, 2004; Jacobson & Jacobson, 2013). At the adolescent follow-up assessment, emotion regulation was assessed using two caregiver-report measures – the Emotion Regulation Checklist (ERC; Shields & Cicchetti, 1997) and the Affect Regulation Checklist (ARC; Moretti, 2003). Results showed that infants with FASdysmorphism+ did not demonstrate significantly higher levels of insecure and disorganised attachment than those in the FAS-dysmorphism- group. In terms of emotion regulation, FASdysmorphism+ did not significantly predict any of the adaptive or maladaptive emotion regulation subscales. However, insecure attachment predicted maladaptive emotion regulation, but not adaptive emotion regulation. These results suggest that while individuals with FASD are often reported to exhibit difficulties with emotion regulation, other variables, including IQ and attachment security in infancy, may explain some of the variation in the emotion regulation difficulties observed for individuals with FASD.

Includes bibliographical references / The use of language is significant in co-constructing reality. This highlights the way that speakers relate to each other through talk with the available discursive positionings in a specific context. An institutional context with particular asymmetrical relations introduces how the construction of reality is an area accessible to explore the use of language in maintaining and creating power relations. This research study explores institutional talk through conversation analysis. The focus is on asymmetrical working relations in medical settings. This considers the implications on individuals with a differentiating status with how power is managed in conversations. Nurses and doctors represent asymmetrical relations and their conversations illustrate differences in the way that language creates reality in a medical context, in this case a public teaching hospital in South Africa. Nurses and doctors were recorded during ward rounds, which spanned 22 hours of audio recordings. Approximately 40 ward rounds were followed where both a doctor and nurse were present. Ward rounds provided an opportunity to capture nurse-doctor conversations. The recordings were supplemented by ethnographic data that focused on the management of power. This focus is both at an individual interactional level and at a broader institutional level. Thus, showing how language coincides with the predominant subject positions available in a medical institution. The findings show how doctors do power overtly through various ways of speaking which show leadership in interactions. The findings also show how a doctor's subjectivity relates to qualities that continually build superiority in interactions. Nurses, on the other hand, manage power indirectly, by negotiating agency while enacting a passive actor role in conversations. Both doctors and nurses manage power and assertiveness, but continually show the sensitivity embedded in orienting themselves to one another. This aids in showing speaker support and is especially important for nurses, who are in a lower status, for managing their position in relation to doctors.

Includes bibliographical references (leaves 138-142). / In this study, the goal orientations of female riders between the ages of 7 and 20 and their parents are investigated. Goal orientations were identified by means of the Achievement Goal Questionnaire for Sport (AGQ-S) for: the daughter; the daughter's perceptions of her dominant-parent's goal orientation for the daughter; both parents' goal orientations; and both parents' stated goal orientations for their daughter. The rider's goal orientations were compared with: the rider's perception of her dominant-parent's goal orientation; both parents' goal orientations for the daughter; and both parents' own goal orientations.

Includes abstract. / Includes bibliographical references (p. 141-149). / The study serves as an example of a theory-based evaluation of a "real life" programme, highlights the strengths and weakness of this evaluation approach, and provides direction for future research on programmes that employ the purvey or method to distribute evidence-based programmes.

Includes abstract. / Includes bibliographical references. / The concept of the disinhibitory complex refers to a cluster of personality, psychiatric, cognitive, and electrophysiological inhibitory control impairments that have been documented in alcohol use disorders (AUDs). Previous AUD research has focused on treatment-seeking adults with comorbid psychopathology; with regard to the disinhibitory complex, such individuals are likely to differ from younger, treatment-naïve individuals, such as the sample here studied. Further, few studies have examined several domains of disinhibition simultaneously, and so little is known about relationships between the various correlates of disinhibition. This study aimed to (a) examine and characterize the disinhibitory complex in treatment-naïve adolescents with AUDs, (b) investigate sex differences in disinhibition, and (c) determine whether an underlying construct of disinhibition might explain elevated levels of disinhibition in AUDs observed on individual indices.

Includes bibliographical references (leaves 94-102). / Previous research has shown that stress affects processing in many different memory systems. This study aimed to investigate the effects of acute psychosocial stress on declarative memory (DM) and working memory (WM) performance, and to explore whether sex differences exist under stress in these two memory systems. DM was assessed using cued recall and recognition of a verbal paired-associates list. WM was assessed using an n-back test with various difficulty levels. One hundred (42 males) undergraduate psychology students from the University of Cape Town were recruited. Phase of menstrual cycle and oral contraceptive use were controlled for in female participants. Participants took part in two sessions, 24 hours apart, each beginning after 16h00. Day 1 involved learning and immediate cued recall of the word pairs, and completing a practice n-back protocol. During Day 2, 45 participants were exposed to a psychosocial stressor and 41 were exposed to a relaxation period. Physiological and self-report measures of stress were taken at three intervals pre- and post-experimental manipulation. Participants then completed delayed cued recall and recognition tests for the previously-learned word pairs, and the full version of the n-back test. Data were analysed only for participants characterised as 'cortisol responders' following the experimental manipulation. The final sample included 57 participants (30 males). With regard to DM, stress did not affect either delayed cued recall or recognition performance in either men or women. With regard to WM, stress negatively affected accuracy among men, but not women. These results are largely consistent with previous literature, but also elucidate a sex difference in working memory performance under stress (viz., while men's performance is negatively affected by stress, women show improved performance). The study provides important evidence for sex differences in WM performance under stress, and highlights several methodological issues that should be addressed in future studies.

Includes abstract. / The Boston Naming Test (BNT) is a popular confrontation naming test that is frequently used in the detection of naming deficits in Alzheimer's disease (AD). However, the test may not be appropriate when used outside of North America due to the influence of varying word frequency and familiarity between different cultures and languages. This study investigated the diagnostic validity of a South African 15-item adaption of the BNT (the BNT-SA-SF) in a Cape Town memory clinic population of patients with dementia and healthy, community-dwelling control participants. Between-groups comparisons, receiver operating characteristic (ROC) analyses, and other diagnostic efficiency statistics were used to assess the test's discriminative capacity between patients with AD (n = 46), patients with other types of dementia (n = 23), and controls (n = 51), matched on key demographic variables. The AD group performed worse than patients with other types of dementia and controls on the BNT-SA-SF, and patients with other types of dementia scored more poorly than controls. The test showed the most significant discriminative capacity between patients with AD and controls, however. A general linear model examining the effects of socio-demographic variables on test performance found that BNT-SA-SF performance was not significantly affected by the socio-demographic characteristics of participants, including age, education, language, or socio-economic status, with the exception that men appear to achieve higher scores than women. Further, an item analysis identified a number of problematic items and suggestions are made concerning how to deal with these in future studies. Preliminary normative data stratified by sex and education are presented. Results support the clinical utility of the BNT-SA-SF as a screening test to aid in the diagnosis of AD from normal aging with older adults in South Africa. This study is a valuable step forward in the ongoing attempt to provide culturally appropriate and valid neuropsychological tests and norms for clinical and research purposes in South Africa. Future studies should examine the functioning of the test in larger samples, representative of the other major population and language groups in South Africa.