Thesis (DPhil(Sielk.))--University of Pretoria, 2003. / Includes bibliographical references.

Bibliography: leaves 89-101. / The lifestyle and personality changes of 61 participants after a five day stress management programme were assessed. A pre-and post-programme lifestyle questionnaire was developed to investigate changes in areas covered on the programme: nutrition, fitness, health beliefs and behaviour, relationships, work life and coping resources. Participants were requested to complete this questionnaire before the course, and a follow-up questionnaire three weeks and six months after the course. Personality variables measured were Locus of Control, Sense of Coherence, and Type A behaviour. These variables were assessed prior to the course and at the six month follow-up. The effect of these personality variables on lifestyle and lifestyle change was examined. Three weeks after the course, significant changes in the self-reported lifestyle measures of nutrition, health beliefs and behaviour, and fitness were found. From the pretest to the six-month follow-up, significant changes in nutrition, health beliefs and behaviour, and relationships were found. The majority of delegates reported positive attitudes towards goals set on the course after three weeks and six months. No change was demonstrated in personality variables from the pre-test to six months after the course. No relationship was found between personality variables and lifestyle or lifestyle change. Implications for future evaluations, and for stress management programmes in general are highlighted.

Includes bibliographical references (leaves 78-88). / Currently, parental separation in South Africa affects an estimated 30 000 children under the age of 18 annually. These children spend a great part of their day at school where they have to interact with peers and teachers and are expected to perform academically, but parental separation could have a significant impact on their ability to do so. Although research has found that children can be adversely affected by parental divorce, schools in South Africa do not offer any group interventions in an attempt to assist and guide children through what could be an ordeal for them. This study aimed to evaluate the effectiveness of the school-based Children of Divorce Intervention Programme (CODIP) at two South African schools. CODIP is a preventively oriented 12-week group programme for nine to twelve year old children. The aims of the programme are to create a supportive group atmosphere in which children can share divorce-related feelings and clarify misconceptions about divorce. Participants are also taught problem-solving, communication and anger management skills. Twenty-five boys of divorce from two schools (ages 10 to 13 years) were randomly assigned to two experimental groups and one delayed intervention control group. The boys' understanding of divorce was assessed through the completion of the Children's Belief about Parental Separation (CBAPS) scale. The Self Perception Profile for Children (SPPC) was used to assess children's perceptions of themselves, while the Parent-Child Interaction Questionnaire for Children (PACHIQ-R-CH) was employed to determine the boys' perceptions of their families. Questionnaires to determine the boys' general adjustment were completed by the boys, teachers and parents. Boys completed the Strengths and Difficulties Questionnaire (SDQ), teachers the Teacher-Child Rating Scale (T-CRS), the AML-R Behaviour Rating Scale and the SDQ, and parents completed the Parent-Child Rating Scale (P-CRS) and the SDQ.

A study was done to ascertain the presence of dreams and the quality of language in dreams in patients with aphasia. 24 aphasic subjects were interviewed using Kagan's (1998) Supported Conversation for Adults with Aphasia (SCA) technique of communication. The main hypothesis investigated was that aphasic patients would experience a better quality of language while dreaming than while awake. Severity being kept constant, aphasia in its acute stage displays greater discrepancy between pre- morbid and morbid language abilities than in its recovering, chronic stage. Therefore, a secondary hypothesis was formulated whereby the difference between language in waking life and language in dreams would be more significant in acute aphasics than in chronic aphasics. Thirdly, it was hypothesized that fluent aphasics would experience less dreaming, if any, since posterior lesions have been found to correlate with cessation or reduction in dreaming. Language in dreams was found to be significantly better than language in waking life amongst the 63% of subjects who reported dreaming. Differences in trends between the categories i) acute and chronic and ii) fluent and non- fluent aphasics, that is the second and third hypotheses, did not achieve statistical significance.

Includes bibliographical references (leaves 88-106). / It has been proposed that autism is fundamentally a disorder of social relatedness. Severe deficits in theory of mind (ToM) - or the ability to understand that other people can have mental states different from our own and that these mental states influence behaviour - are commonly thought to explain the social-communicative deficits seen in autism spectrum disorders (ASDs). If deficits in ToM are responsible for the impairments found in ASD, these deficits should be found amongst all individuals with ASD (universality) and must be present throughout the course of the disorder (stability).

Bibliography: leaves 57-61. / The neuropsychological understanding of confabulation has recently been enriched by the finding that confabulating patients present positive emotional biases in their false recollections. The exact mechanisms of this motivational phenomenon have been heuristically linked to the frontal lobe impairment accompanying confabulation. The present study aims at providing direct support for this claim. A patient with damage to the prefrontal cortex is examined and his performance is contrasted with two confabulating patients, a patient with non-frontal neurological damage and twenty matched controls on a number of tests of emotional processing.

Includes bibliographical references (p. 75-90). / South Africa has one of the world's highest rates of HIV infection. Little previous research has focused on the relationship between individuals in different sexual contexts and their attitudes toward condom choice. I tested the hypotheses that (a) implicit and explicit measures of attitudes towards condom choice would show that individuals in casual sexual contexts, compared to those in the context of exclusive sexual relationships, would spontaneously associate more strongly with brand-name condoms over generic condoms, and (b) there would be a positive correlation between explicit and implicit attitudes towards condom choice.

Includes bibliographical references. / This dissertation explores the use of qualitative methods to research community health workers' (CHWs) perceptions of mental health problems in Khayelitsha and Nyanga, two peri-urban Black townships in the Cape Town area. Since the historic WHO-UNICEF meeting at Alma-Ata in 1978, there has been widespread interest in the concept of CHW s as the ideal work force for advancing the principles of the primary health care (PH C) approach. In seeking to transform the structure and delivery of mental health care in South Africa within the confines of limited financial and human resources, policy makers are shifting attention to the integration of mental health care within a PHC framework. Fundamental to the PHC agenda, as conceptualised at Alma-Ata, is health care that is based on appropriate technologies and that encourages effective community participation in making decisions about health issues. In the past few decades, anthropological perspectives gained from cross-cultural research into health beliefs and practices have made valuable contributions to the planning and implementation ofPHC programmes. In the field of medical anthropology, hermeneutically orientated approaches play an important role in advocacy, whereby the patient's perspective on illness and the meaning of illness is brought to the fore in an attempt to provide more patient-centred care. In this research, CHW s were interviewed to gain insight into the scope of primary mental health care, as perceived by them, and prevailing beliefs and practices surrounding mental health problems. Unstructured individual interviews were conducted with 20 CHW s working in community-based PHC projects in Khayelitsha and Nyanga to elicit their personal accounts of mental health problems in their geographical communities. This material was used to construct five vignette descriptions of mental health problems in the CHWs' own words. Kleinman's explanatory model approach was used in structured individual interviews to access CHW s' understandings of mental illness. Questions related to naming the problem; theories of illness causation; coping with the problem; and decision-making as regards treatment options. Focus group interviews were held with the participants of two of the CHW projects to explore their feelings about involvement in mental health care. This micro-level analysis was accompanied by the perspectives of critically-interpretive medical anthropology which shifts attention beyond the individual cultural construction of illness to the political and economic factors affecting the social organisation of health care. Within the PHC setting, the critical perspective entails challenging constraints to the attainment of health for all as a result of inequities in the distribution of power and wealth; barriers to achieving community participation in health issues; and inequitable access to basic primary health needs by the most disadvantaged.

Bibliography: leaves 96-103. / The purpose of this study was to explore definitions of an illness condition amafunyane and the subsequent help-seeking behaviour amongst Black Psychiatric patients who were attending a psychiatric community clinic in Guguletu, a residential area for Blacks in Cape Town). Psychiatrists have always been faced with the problem of having to deal with patients who present with this condition. The concern was to do an exploratory research in this area using the Explanatory Model framework as a method of enquiry in studying the condition of amafunyane. Within the parameters of this model, Black psychiatric patients presenting at the psychiatric clinic, were studied in order to explore the context of illness definitions regarding the condition of amafunyane. Of importance also was to explore the patterns of help-seeking behaviour employed by these patients, and the effect that the psychiatric orientation adopted at the clinic had on such patterns.

Includes bibliographical references (leaves 143-158). / As UCT Child Guidance Clinic (CGC) practice and policy shifted markedly in response to the political turmoil and parallel crisis in South African psychology during the 1980s, this study investigates the effects of the ""new"" South Africa on CGC practice and clientele during the 1990s.