Most children born with HIV are maturing into adolescence due to the accessibility of medical support, specifically the availability of antiretroviral drugs. During adolescence, children are faced with critical adolescent developmental tasks in that they develop physically, cognitively and psychosocially, including assuming independence. As the adolescents living with perinatally acquired HIV mature, their care-givers start disclosing the adolescents’ HIV status to them. Attaining the knowledge of living with HIV is encompassed with worries of how to manage the illness as well as other social ills such as taking care of sick loved ones and dealing with losses of loved ones. It is also during this stage of development that adolescents living with HIV begin to form intimate relationships, thus issues of self-disclosing their status become a concern. The aim of this study was to explore and describe the perceptions of adolescents perinatally infected with HIV regarding the self-disclosure of their status to others. Following this, it was hoped that the study would come to conclusions and make recommendations regarding the wellness of and support for adolescents living with perinatally acquired HIV. A qualitative descriptive research approach with an interpretive paradigm was used to explore and describe the perceptions of the adolescents. A multiple case study design was suitable to explore and describe the perceptions of participants as they see it. Ethical approval for the study was obtained from the relevant body. A sample of 10 adolescents perinatally infected with HIV, whose status had been disclosed to them and were receiving clinical care and psychosocial support at a local clinic in Port Elizabeth, were selected through purposive sampling. Consent to undertake the study was provided by the head of the clinic in Port Elizabeth as well as by the adolescents’ caregivers. Assent to partake in the study was also provided by the participants. A deeper understanding of participants perceptions was explored through utilising multiple sources of data collection methods which included reflective journals and semi-structured interviews. Multiple data collection methods were used in order to collect rich data and for crystallisation of the data to take place. After the data was analysed themes were identified and described leading to the findings of the study. The findings of the study confirmed the perceptions of adolescents living with perinatally acquired HIV regarding the self-disclosure of their status. Adolescents perinatally infected with HIV perceive certain conditions as conducive to self-disclose their status against other conditions that were perceived to be unfavourable for the self-disclosure of their HIV status. Conditions permitting self-disclosure included the availability of trusting relationships with people who understand them as well as the need for support which subsequently highlights the benefits of self-disclosure. Benefits included and are not limited to clinical support from healthcare professionals and an understanding from teachers when they are absent from school during their monthly clinical visits. Although adolescents see the benefits of selfdisclosing their status they are however aware of the possible negative effects to self-disclose their status such as stigmatisation and discrimination manifested through isolation from peers and through moral judgement and rejection from the community. Peers living with HIV are perceived to be the closest people providing them with trusting and open relationships that foster self-disclosure. Adolescents also perceived adulthood as a phase were self-disclosing their HIV status could be possible with the belief that they would be more mature when they are adults. Recommendations are made for healthcare professionals and policy makers to formulate and implement guidelines on supporting adolescents living with perinatally acquired HIV regarding the self-disclosure of their status. Providing measures of support for adolescents living with perinatally acquired HIV in their different ecological systems could widen the choice of to whom and when to self-disclose their HIV status. / M (Social Work), North-West University, Potchefstroom Campus, 2015

Most children born with HIV are maturing into adolescence due to the accessibility of medical support, specifically the availability of antiretroviral drugs. During adolescence, children are faced with critical adolescent developmental tasks in that they develop physically, cognitively and psychosocially, including assuming independence. As the adolescents living with perinatally acquired HIV mature, their care-givers start disclosing the adolescents’ HIV status to them. Attaining the knowledge of living with HIV is encompassed with worries of how to manage the illness as well as other social ills such as taking care of sick loved ones and dealing with losses of loved ones. It is also during this stage of development that adolescents living with HIV begin to form intimate relationships, thus issues of self-disclosing their status become a concern. The aim of this study was to explore and describe the perceptions of adolescents perinatally infected with HIV regarding the self-disclosure of their status to others. Following this, it was hoped that the study would come to conclusions and make recommendations regarding the wellness of and support for adolescents living with perinatally acquired HIV. A qualitative descriptive research approach with an interpretive paradigm was used to explore and describe the perceptions of the adolescents. A multiple case study design was suitable to explore and describe the perceptions of participants as they see it. Ethical approval for the study was obtained from the relevant body. A sample of 10 adolescents perinatally infected with HIV, whose status had been disclosed to them and were receiving clinical care and psychosocial support at a local clinic in Port Elizabeth, were selected through purposive sampling. Consent to undertake the study was provided by the head of the clinic in Port Elizabeth as well as by the adolescents’ caregivers. Assent to partake in the study was also provided by the participants. A deeper understanding of participants perceptions was explored through utilising multiple sources of data collection methods which included reflective journals and semi-structured interviews. Multiple data collection methods were used in order to collect rich data and for crystallisation of the data to take place. After the data was analysed themes were identified and described leading to the findings of the study. The findings of the study confirmed the perceptions of adolescents living with perinatally acquired HIV regarding the self-disclosure of their status. Adolescents perinatally infected with HIV perceive certain conditions as conducive to self-disclose their status against other conditions that were perceived to be unfavourable for the self-disclosure of their HIV status. Conditions permitting self-disclosure included the availability of trusting relationships with people who understand them as well as the need for support which subsequently highlights the benefits of self-disclosure. Benefits included and are not limited to clinical support from healthcare professionals and an understanding from teachers when they are absent from school during their monthly clinical visits. Although adolescents see the benefits of selfdisclosing their status they are however aware of the possible negative effects to self-disclose their status such as stigmatisation and discrimination manifested through isolation from peers and through moral judgement and rejection from the community. Peers living with HIV are perceived to be the closest people providing them with trusting and open relationships that foster self-disclosure. Adolescents also perceived adulthood as a phase were self-disclosing their HIV status could be possible with the belief that they would be more mature when they are adults. Recommendations are made for healthcare professionals and policy makers to formulate and implement guidelines on supporting adolescents living with perinatally acquired HIV regarding the self-disclosure of their status. Providing measures of support for adolescents living with perinatally acquired HIV in their different ecological systems could widen the choice of to whom and when to self-disclose their HIV status. / M (Social Work), North-West University, Potchefstroom Campus, 2015

Inledning: Psykodynamisk terapi har utvecklats från en strikt syn på neutralitetsprincipen i riktning mot en mer liberal hållning, där en del terapeuter väljer att använda personlig öppenhet, dvs. delar med sig av personlig information kring sig själva. På behandlingshem delar terapeuter och patienter flera vardagliga situationer och tillfällen uppstår där terapeuten måste förhålla sig till self disclosure. Frågeställningar: Vilka upplevelser har psykoterapeuter på behandlingshem av self disclosure? På vilka grunder använder man sig av self disclosure? Hur hanterar psykoterapeuter self disclosure i den vardagliga kontakten utanför terapisituationen? Metod:Kvalitativ metod, semistrukturerade intervjuer med 5 legitimerade psykoterapeuter verksamma på behandlingshem. Tematisk analys användes för att analysera resultatet. Resultat: Self disclosure förekommer såväl i den terapeutiska situationen som i det vardagliga behandlingsarbetet. Self disclosure används som en alliansskapande intervention för att möta patientgruppens besvärsbild med bristande tillit, låg uthållighet, och ibland bristande motivation. Vidare anses self disclosure bidra till att skapa trygghet och göra terapeuten mindre hotfull. Self disclosure används även som en pedagogisk intervention där psykoterapeuterna kan fungera som rollmodell i terapeutiska och vardagliga situationer. Det anses betydelsefullt att göra noggranna övervägande kring self disclosures och hålla det på en allmän nivå, som inte tangerar personliga problem och privata förhållanden. Diskussion: Self disclosure förekommer sannolikt i större omfattning på behandlingshem än vid individuell psykoterapi. Den klassiskt neutrala terapeutiska hållningen anses inte fungera då patientgruppens besvär främst bottnar i bristproblematik. / Introduction: Psychdynamic therapy has evolved from a strict view of the principle of neutrality towards a more liberal attitude, where some therapists choose to use self disclosure, and share some personal information about themselves. At institutions, psychotherapists and patients share everyday situations and several occasions arise where therapists has to relate to self disclosure. Questions: Wich experiences have psychotherapists at institutions of self disclosure? On what grounds uses psychotherapists self disclosure? How do psychotherapists handle self disclosure in everyday contact outside the therapeutic situation? Method: Qualitative method, semi-structured interviews with 5 licensed psychotherapists working at institutions. Thematic analysis was used to analyze the results. Results: Self disclosure appears both in the therapeutic situation and in the everyday treatment work. Sel disclosure is used as an alliance-building intervention to meet the patients problems with lack of confidence, low stamina, and sometimes lack of motivation. Futher considered self disclosure helping to create security and make thetherapist less intimidating. Self disclosure is also used as an educational intervention in wich the psychotherapist can serve as role model in the therapeutic and everyday situations. It is considered important to make careful consideration about the self disclosures and keep it at a general level,that is not tangent to personal problems and personal conditions. Discussion: Self disclosure is likely to occur to a greater extent at institutions than in individual psychotherapy. The classic neutral therapeutic stance is not considered to work because a majority of the patients problems is rooted in deficit.

This dissertation explores one family's experience of a son's disclosure of homosexuality, through the use of a second-order cybernetic epistemology, and social constructionist theory. Second-order cybernetics enables a description of patterns and themes that recursively connect the family's ideas and behaviour. Social constructionism enables the family's reaction to disclosure to be recursively linked to their fit with wider society. By using semantic and political frames of reference to describe the family's narratives around disclosure, this study indicates that disclosure is a relational metaphor, dependent on the family's locally co-constructed and transgenerational meanings. It also shows that although the family change with disclosure, stability is regained in a way consistent with the family's rules and norms. This study therefore demystifies viewing disclosure in one way only and creates alternative ways of conceptualising it. / Psychology / M.A. (Clinical Psychology)

Firstly, this research aimed to understand what behaviours are considered sensitive or private by university students (N=306) in respect of disclosure in the research context. A total of 71 items were extracted by factor analysis: 20 sensitive items, 26 related non-sensitive items and 25 non-related non-sensitive items. Differences in sensitivity were noted for gender and race, reported below. Furthermore, a three-phase exploration of data collection methods was used in determining which self-report method is most valid and reliable when researching sensitive topics. A quantitative experiment compared the effectiveness of the Unmatched Count Technique (Type I), Self-Report Questionnaires and Audio Computer-Assisted Self-Interviews, in terms of their ability to elicit honest answers when dealing with the sensitive topics (N=410). This section of the study used pairwise tests of proportions by Winks statistical software. The sensitive topics under investigation in this study are condom use,HIV/AIDS as well as relationships such as transactional and multiple and concurrent partners.The results of this study, reported below, indicate pairwise significant differences between the SRQ, ACASI and UCT Type I. Additionally, the Unmatched Count Technique (Type I), Self-Report Questionnaires and Audio Computer-Assisted Self-Interviews were compared in terms of Socially Desirable Responding scores as well as experience of participation. No statistically significant differences were obtained for overall scores across data collection methods for SDR and experience of participation. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2013.

"Distance" and Other Stories is a collection of four short stories and a novella that explore the themes of isolation and personal revelation. The dissertation opens with a preface which describes my background as a writer and the forces that shape my work, including science fiction, technology and the internet, cultural marginalization, and Joseph Campbell's hero's motif.

D.Litt. et Phil. / This study explored the impact of psoriasis on the self-concept (a multifaceted, hierarchical construct of self with both cognitive and emotional components) (Hattie & Marsh, 1996), of men and women who live with this cutaneous disease. Psoriasis is a common (frequently occurring), chronic inflammatory dermatological disease that can severely affect the sufferer's quality of life. While the underlying cause is unknown, the immediate cause of psoriasis is the rate of growth and differentiation of the outer layer of the skin. In a process known as hyper-proliferation (renewal of skin every four days as opposed to every 28 days), psoriasis is anatomically disfiguring. Symptoms include: the thickening of psoriatic plaques, the sloughing of silvery scales, severe itching of the affected areas and a thickening and yellowing of the fingernails. The severity of psoriasis varies from small scattered patches to total skin coverage (Young, 2005). Chronic skin diseases, such as psoriasis, can affect one's self-concept at the level of the physical, emotional, social and spiritual dimensions of self (Kew, Nevin & Cruickshank, 2002). According to Gupta and Gupta (1995), sufferers of psoriasis experience external shame (fear of negative evaluations and stigmatisation) as well as internal body shame (negative self-evaluations and self-focussed feelings). According to Stake, Huff and Zand (1995), a disturbance in one dimension of self (e.g. the physical self-concept), invariably effects other self-dimensions (e.g. the private, social self-dimensions). A study by Gupta and Gupta (1995) revealed that psoriasis was a major contributing factor to the onset of psychopathology such as depression, anxiety, unfocussed anger and obsessional behaviours. A study by Choi and Koo (as cited in Young, 2005), found that the impact of psoriasis on the psychological and emotional dimensions of self-concept to be comparable to that experienced by sufferers of more chronic diseases such as cancer, heart disease and clinical depression. General healthcare providers who treat the medical components of psoriasis may be surprised to learn that the emotional and social burdens of psoriasis are often greater than the physical toll of psoriasis on patients. Further, psoriasis is observed to be persistent, unpredictable and stressful over longer periods of time than more serious illnesses (Young, 2005). Although many people with disfiguring skin disorders cope remarkably well psychologically and socially, many do not and may require professional help in describing their bodily being in relation to the world and to come to terms with the positive and negative aspects of self (Van Deurzen-Smith, 1997). Significantly, studies in psychoneuroendocrineimmunology have shown the interconnectedness of emotions and mental attitude to physical health and which underscores the importance of treating the whole person and not just the symptoms (Linsteadt, 2002). Consistently, studies have shown the importance of self-concept to psychological health (Francis, 2002; Hattie & Marsh, 1996; Newell, 2000; Young, 2005) and body satisfaction as being pivotal in one's overall concept of self (Tiggemann & Williamson, 2000). Problematic however is that the literature indicates a dearth of dermatological studies detailing the meaning-making experiences of individuals who have undergone changes to their physical appearance as a result of this and the impact of cutaneous disease on the self-concept (Hill, 2004; Papadopoulos, Bor & Legg, 1999; Thompson & Kent, 2001). Our experiences and how we make sense of what we experience is primarily dependent upon the kinds of bodies we have and also on the ways we interact with the various environments we inhabit. It is through our embodied interactions that we inhabit a world, and it is through our bodies that we are able to understand and act within this world with varying degrees of success (Johnson, 1999). The importance of skin for an individual's psychosocial equilibrium can easily be appreciated. First, the skin represents the outward packaging of our being. Second, the cutaneous surface is what society initially perceives and with dermatological disease being the basis for social stigma. Arguably, having a healthy, unblemished skin can enhance one's self-esteem, self-identity and not infrequently, one's social standing (Koo & Yeung, 2002). Studies investigating the impact of disfiguring cutaneous disease on the self-concept appear to be lacking in the literature. In 2004, at a meeting of the Editorial Board for the Journal of Dermatology Nursing, the need for studies presenting the patient's experience of cutaneous disease was discussed. It was thought that qualitative exploration of the patient's experience of cutaneous disease would provide medical and mental healthcare professionals with valuable insights and important information to help improve dermatology patient care (Hill, 2004). Dermatology and self-concept phenomena tend to be investigated interdependently of each other. Furthermore, the majority of research in this area focuses on quantitative research design. Consequently, much of the depth of information regarding the experiential world of sufferers of cutaneous disease is invariably lost (Hill, 2004; Thompson & Kent, 2001). In light of that stated above, this study explored the meaning-making experience of men and women who suffer from psoriasis and the impact of this on the various dimensions of the self-concept. Due to the sparsity of South African studies investigating qualitatively, the experiences of persons suffering from a common, chronic dermatological condition, this study followed an existential phenomenological approach in describing the impact of psoriasis on the self-concept as told from the perspective of the men and women who live with this. Existential phenomenology seeks to explicate the essence, structure and form of both human experiences and behaviour as revealed through essentially descriptive techniques that includes disciplined reflection (Sokolowski, 2000). Given the apparent lack of awareness and knowledge of psychological processes, meaning-making and coping strategies utilised by psoriasis sufferers in their experience of this, this methodology was thought most appropriate (Hill, 2004; Newell, 2000; Papadopoulos, et al., 1999; Thompson & Kent, 2001). In terms of the areas of participation, three male and four female sufferers of psoriasis participated in the study. For all participants, psoriasis was in the active phase and covered most parts of their body. Data was collected using a questionnaire set consisting of semi-structured questions and the research question, which was open-ended. The method of data analysis was based on an integration of the works by various phenomenologists and involved six phases, namely: bracketing, intuitive grasp, eidetic reduction, textural and structural descriptions, composite textural and structural descriptions, and the final synthesis. The participants confirmed that the statements generated were accurately reflected. The results evidenced several prominent themes shared by the group, namely: (a) that the severity of the physical manifestations and the painful symptoms of psoriasis can result in negative self-concept evaluations; (b) a lack of empathy and a failure to provide knowledge on psoriasis and a priori caution of the side-effects of psoriatic medications by the medical doctors consulted was experienced by the participants as disempowering and adversely affected their emotional well-being; (c) the doctor/patient relationship was observed as pivotal in influencing the participants general concept of self; (d) the participants acceded that medical aids need to place psoriasis on the list of chronic medical conditions; (e) social stigma adversely affects self-concept evaluations; (f) public education on psoriasis is required; (g) drawing on various methods of coping was deemed crucial to the enhancement of the self-concept in the participants journey towards psychological health; (h) positive meaning-making from the psoriatic/self-concept experience enhanced quality of life issues; and finally, (i) trait self-esteem and healthy self-concept development may be important determinant factors in the psychological recovery of patients suffering from psoriasis. More specifically, in terms of self-evaluation, the participants experienced psoriasis as an assault on the physical self that was painful, embarrassing and humiliating. In redefining psoriasis in this way, the participants redefined their body image (mental construct of the body), and with the pervasiveness of negative self-evaluations an offshoot of continuous negative cognitive and emotional schemas of the body. Regarding the doctor/patient relationship, the results of the study show a need for medical doctors to expand their focus of treating the symptoms of psoriasis to incorporate a more holistic treatment approach that places emphasis on psychological, social and nutritional processes. The willingness of medical professionals to network with psychologists and other healthcare professionals and also being prepared to integrate the concept of holism into their treatment programmes was thought one method of attaining a holistic approach to the treatment and management of dermatology patients. Significantly, the doctor/patient relationship was also experienced as being an important factor in the patients drive to want to heal (healing is not here equated with cure but rather being able to approach living with psoriasis more positively). The participants in this study experienced doctors to be largely unsympathetic and not well versed in the physiology of psoriasis. Additionally, the degree of psychological trauma experienced by the participants in their suffering with psoriasis seemed to go unnoticed by the treating doctors. To this end, helplessness and feelings of disempowerment were heightened. In terms of treatment implications, the participants claimed that their treating doctors failed to inform them of the severity of the side-effects, the dangers of various treatments, and the possible inefficacy of many treatments utilised. The participants experience of this resulted in the following: a) diminished trust in the doctor/patient relationship and the medical profession generally; b) heightened body shame and repulsion of self (as opposed to feeling repulsed by the psoriasis alone); c) intense anger and with some participants describing emotional anarchy; and finally, d) in feeling left out of the treatment decision-making process, participants felt as though they had lost control over their own body. In terms of medical aid support, the participants pointed out that psoriasis is not on the government approved list of chronic conditions and as such, given their experiences, acceded that this is something that needed to be challenged. Regarding social stigma, the participants’ experience of this appeared to result in re-enforcing a sense of their feeling socially shunned and physically alienated from their familiar body. Furthermore, it would appear that social stigma might play a participatory role in increasing the severity of the psoriatic condition due to the stress evoked in the experience of feeling socially stigmatised and also the heightening of psychological difficulties experienced as participants moved from pride to shame. All participants felt public education and awareness of the onset, cause and course of psoriasis was required. Methods of coping utilised by the participants included: the seeking out of empathetic medical practitioners, psychotherapy, hypnotherapy, assertiveness skills training, implementing spirituality in their lives, and drawing upon the support of family and friends. Finally, in the midst of much adversity, the participants found an inner strength from which to reclaim their sense of self and which they attribute to having had a positive demeanour prior to suffering from psoriasis. In the deconstruction (fracturing) of self, the participants seemed to have felt compelled into a process of change that could be characterised as a reconstruction of self - an evolving of the old and new dimensions of self that would evolve further into a stronger and more resilient sense of self that characterises the participants today. The participants to this study embarked upon a journey of self-empowerment and which was a defining factor in their making meaning from their suffering. Not alluded to in the literature is that, for the participants, psoriasis became a tool that they utilised to reclaim their lives and to re-build the self anew. The results of this study reveal many important areas for future research with persons suffering from psoriasis and dermatological conditions generally, such as: i) the focussing on levels of trait self-esteem in effecting how positive change in one's self-concept may or may not occur; ii) the exploration of disfiguring skin conditions as an impetus for self-concept enhancement and creating meaning in one’s life; iii) exploring the efficacy of combining psychotherapy with medical treatments in the management of dermatology patients; iv) exploring the role of the doctor/patient relationship in the patient’s drive towards psychological health and treatment compliance; and finally, v) exploring the impact of dermatological disease on the family of the sufferer, especially given the significance of the familial system in the sufferers coping. Importantly, the results of this study suggest that having a healthy self-concept prior to the development of illness or disease is pivotal in accounting for why some people recover remarkably well psychologically and others do not. The findings of this study are valuable and will have important implications for all within the healing profession in helping to effect positive change in their future endeavours with persons who suffer from dermatological disease.

The current research identifies the impact of sharing day-to-day information in social network sites (SNS) on the relationships we hold within and outside of them. Stemming from the literature on self-disclosure, uncertainty reduction, personal relationships, privacy and computer-mediated communication (CMC), a concurrent triangulation research strategy is adopted to identify the patterns of relationship development and interaction in SNS. Using a mixed methods approach, five studies were conducted to determine how young adults interact via SNS. Empirical findings suggest SNS users are driven by the need to reduce uncertainty and gather information about their interaction partners. An interaction between several factors was found to impact on relationships between communication partners: the frequency of information sharing; the content of the shared information; the type of relationship held between the sender and recipient; the stage of relationship development; the medium of communication, and; an expected social contract. A conceptual model of interpersonal interaction within SNS environments is proposed, identifying the links between sharing, certainty and relationship quality, and manifested communication behaviour throughout relationship development. Implications for the fields of communication science, CMC, and social and behavioural psychology are discussed.

No description available.

This study investigates the transactional relationship between father involvement and adolescent self-disclosure from early to midadolescence. Four hundred and ninety-six adolescents reported on their general self-disclosure to fathers, and mothers reported on father involvement behaviors and maternal involvement behaviors at ages 11, 13, and 15. Results from a longitudinal cross-lagged model indicated a unidirectional relationship from father involvement to child self-disclosure in both early and midadolescence, and a transactional relationship from adolescent self-disclosure to father involvement in early adolescence. A multiple group analysis by gender revealed that both unidirectional and transactional relationships were significant for boys only. Future research efforts should be sensitive to developmental changes and gender differences within father-child communication processes across adolescence.