Thesis (PhD)--Stellenbosch University, 2003. / ENGLISH ABSTRACT: The conciliatory discourse of the South African Deaf social movement claims a commonality across South Africa's historical divides on the basis of a 'Deaf culture'. This claim in view of South Africa's deeply entrenched 'racial' divisions triggered this study. The study investigates the construction of Deaf identity and emphasizes the crossing of social boundaries in Cape Town, a society with a long history of discriminatory boundaries based on race. The study was carried out among adults who became deaf as children, the group for whom deafness, commonly viewed as both sensory and social deficit, is said to pose considerable linguistic, social and cultural challenges. It focused on strategies that deal with being deaf in a predominantly hearing world. To identify strategies, for this population without a geographical base, the study traced networks of social relationships. Fieldwork was carried out from September 1995 to December 2001. Between September 1995 and December 1997 research included systematic participant observation and informal interviews. Between January 1998 and December 2001 , continuing with participant observation and informal interviews, the study added formal interviews with a sample population of 94 deaf people across Cape Town, collected by the snowball method. The profile of this sample shows a relatively heterogeneous population on the basis of demographic factors and residential area but similarity on the basis of first language, Sign. The study demonstrates that history imposed boundaries. It categorized the Deaf as different from the hearing and in addition, in South Africa, produced further differentiation on the basis of apartheid category, age, Deaf school attended, method of education and spoken language. In this historical context the study identified a key strategy, 'Signing spaces'. A Signing space, identifiable on the basis of Sign-based communication, is a set of networks that extends from the deaf individual to include deaf and hearing people. On analysis it comprises a Sign-hear and a Sign-Q.e.gfspace. In Sign-~ networks, hearing people predominate. Relationships are domestic and near neighbourhood. In Sign-~ networks, deaf people predominate. Relationships are sociable and marked by familiarity. The study found that via the Signing space, the Deaf subvert deafness as deficit to recoup a social identity that is multi-faceted and dispersed across context. Boundaries crossed also vary by context and by networks. Sign-~ networks address the hearing boundary. Limits could be identified in the public arena, when barriers to communication and a poor supply of professional Sign language interpreters again rendered deafness as deficit. The boundaries of the Sign-deaf networks were difficult to determine and suggest the potential, facilitated by Sign language, to transcend South Africa's spoken languages and the related historical divisions. Sign-~ networks also suggest the additional potential, in sociable contexts, to transcend spoken language, trans-nationally. But mutual intelligibility of Sign language and the familiarity, communality and commonality it offered did not deny an awareness of historical differentiation and discrimination, as a case of leadership succession presented as a 'social drama' shows. However, the process of the 'social drama' also demonstrates that conflict, crises, and a discourse that reflects South Africa's historical divisions need not threaten a broader commonality. / AFRIKAANSE OPSOMMING: Die oorsteek van maatskaplike grense en verbreiding van maatskaplike identiteit: die nagaan van netwerke vir Dowes van Kaapstad Die bemiddelende diskoers van die Suid-Afrikaanse maatskaplike beweging vir Dowes maak op grond van 'n 'Dowe kultuur' aanspraak op 'n algemeenheid wat oor Suid-Afrika se geskiedkundige verdeeldhede heen strek. Hierdie aanspraak het, in die lig van Suid- Afrika se diepgewortelde 'rasseverdelings' , tot hierdie navorsing aanleiding gegee. Die navorsing ondersoek die vorming van 'n Dowe identiteit en beklemtoon die oorsteek van maatskaplike grense in Kaapstad, 'n gemeenskap met 'n lang verlede van diskriminerende grense wat op ras gebaseer is. Die navorsing is gedoen onder volwassenes wat as kinders doof geword het. Vir hierdie groep, waar dit gewoonlik as 'n sensoriese en sosiale gebrek beskou word, hou doofheid aansienlike linguistiese, sosiale en kulturele uitdagings in. Die navorsing fokus op strategieë wat te make het met doof wees in 'n oorheersend horende wêreld. Om vir hierdie bevolking sonder 'n geografiese basis strategieë te identifiseer, het die navorsing maatskaplike verhoudingsnetwerke nagegaan. Veldwerk is tussen September 1995 en Desember 2001 gedoen. Tussen September 1995 en Desember 1997 het die navorsing stelselmatige waarneming van die deelnemers en informele onderhoude met hulle behels. Hierdie waarneming en informele onderhoude is tussen Januarie 1998 en Desember 2001 voortgesit, maar die navorsing het nou ook formele onderhoude met 'n steekproefbevolking van 94 dowe mense van regoor Kaapstad ingesluit. Hiervoor is van die sneeubalmetode gebruik gemaak. Die profiel van hierdie steekproef toon 'n relatief heterogene bevolking op grond van demografiese faktore en woongebied, maar ooreenkoms op grond van eerste taal, naamlik Gebaretaal. Die navorsing toon aan dat grense deur die geskiedenis opgelê is. Dit het Dowes as verskillend van horendes gekategoriseer, en het daardeur in Suid-Afrika tot verdere differensiasie op grond van die apartheidskategorie, ouderdom, watter doweskool bygewoon is, wyse van onderrig en gesproke taal aanleiding gegee. In hierdie geskiedkundige konteks het die navorsing 'n belangrike strategie, 'Gebare-ruimtes', geïdentifiseer. 'n Gebare-ruimte wat uitgeken kan word op grond van Gebaar-gebaseerde kommunikasie, is 'n stel netwerke wat van die dowe individu af uitbrei om dowe en horende mense in te sluit. Uit 'n analise blyk dit dat dit 'n Gebaar-horende en Gebaar-dowe ruimte behels. In Gebaar-horende netwerke oorheers horende mense. Verhoudinge word in die huis en met die naaste bure aangegaan. In Gebaar-dowe netwerke oorheers dowe mense. Verhoudings is gesellig van aard en word deur ongedwongenheid gekenmerk. Die navorsing het bevind dat die Dowe doofheid as gebrek deur middel van die Gebaarruimte omkeer om 'n veelvlakkige maatskaplike identiteit wat dwarsoor die konteks versprei is, te behels. Grense wat oorgesteek word, varieer ook in konteks en ten opsigte van netwerke. Gebaar-horende netwerke fokus op die horende grens. Beperkinge kon in die openbare arena geïdentifiseer word in gevalle waar hindernisse ten opsigte van kommunikasie en gebrekkige voorsiening van Gebaretaal-tolke weer doofheid as 'n gebrek voorgestel het. Dit was moeilik om die grense van die Gebaar- ~ netwerke te bepaal en dit suggereer die potensiaalom, gefasiliteer deur Gebaretaal, Suid-Afrikaanse tale en die gepaardgaande geskiedkundige verdelings te transendeer. Gebaar-dowe netwerke suggereer ook die addisionele potensiaal om gesproke taal, in gesellige kontekste trans-nasionaal te transendeer. Maar onderlinge verstaanbaarheid van Gebaretaal en die ongedwongenheid, gemeenskaplikheid en algemeenheid wat dit gebied het, het nie 'n bewustheid van geskiedkundige differensiasie en diskriminasie ontken nie, soos 'n geval van opvolging van leierskap, wat as 'n 'sosiale drama' aangebied is, getoon het. Die proses van die 'sosiale drama' toon ook dat konflik, krisisse en 'n diskoers wat Suid-Afrika se geskiedkundige verdelings weerspieël, nie 'n wyer algemeenheid hoef te bedreig nie.

The purpose of this study was to measure correlations of stigma with self-esteem among individuals who are receiving treatment for a mental illness.

Urbach-Wiethe Sindroom (beter bekend as lipo"ied prote"inose of hyalinosis cutis et mucosae) is 'n seldsame, outosomaal-oorerflike siekte. Die kenmerkendste simptome van die siekte is vel- en slymvliesveranderinge wat deur 'n neerslag van ekstrasellulere hialienagtige materiaal van onbekende oorsprong veroorsaak word. Die vel word maklik beseer, genees stadig en lelike, pokagtige letsels ontstaan. 'n Fyn, korrelagtige neerslag op die ooglede, die sogenaamde "kralestringvoorkoms" kenmerk die siekte, sowel as heesheid, die prominentste en lastigste simptoom, wat sedert geboorte teenwoordig kan wees. Radiografie en tomografie toon bilaterale,boontjievormige verkalking op die temporale lobbe van die brein, wat tot epileptiese aanvalle en ander neuropsigiese simptome soos geremde geheue en aggressie lei. Heesheid veroorsaak kommunikatiewe beperkinge vir die lyer,terwyldie opsigtelike velletsels aversiewe- en die verkalkings onsigbare beperkinge meebring. Die lyer aan Urbach-Wiethe Sindroom kan volgens die beginsels en kriteria van die medies-kliniese, die persoonsgeorienteerde en die sosio-omgewingsperspektiewe gestremdheid ondervind. Teoreties kan die lyer se belewinge van sy andersheid en die nie-aanvaardingdeurdie gemeenskap, soos by gestremdes,die handhawing van sy selfagting rem, sodat 'n negatiewe selfkonsep tot skuldgevoelens, angsbelewinge en depressie kan lei. 'n Betekenisvolle verband is in die empiriese ondersoek tussen die graad van aantasting en wanaanpassing in die lyer se leefwereld gevind. Die lyers wat ernstig aangetas is, identifiseer moeilik met hulle fisieke voorkoms. ldentiteitsvorming word gerem en die selfagting is negatief. Hulle openbaar 'n negatiewe selfkonsep en depressiewe gevoelens met selfmoordgedagtes. Hulle relasies en sosialisering is problematies en hulle voel hulle word nie deur die gemeenskap aanvaar nie. Die lyers ondervind 'n algemene wanaanpassing in hulle leefwereld. 'n Geval van paranoia is ook gevind. Alhoewel die ouers vrae oor die toestand het en sekere emosies beleef, kan die meeste van hulle die situasie hanteer. Riglyne vir 'n terapeutiese begeleidingsprogram vir lyers aan Urbach-Wiethe Sindroom, wat op die verbetering van die selfkonsep; die hantering van depressie, aggressie en woedebuie, asook die verbetering van relasies en sosialisering gerig is, is saamgestel. 'n Ondersteuningsgroep waarby lyers en hulle ouers kan inskakel, is gestig. / Urbach-Wiethe Syndrome, also known as lipoid proteinosis or hyalinosis cutis et mucosae, is a rare, recessively inherited, autosomal disorder characterized by lesions of the skin and mucosae, caused by widespread deposition of hyaline material of unknown etiology. The skin injures easily and heals slowly with "pock­ like" lesions. Bead-like deposits on the eyelids, called "string of pearls",are often found. Present since early infancy, hoarseness is the first, and most striking, irritating symptom. Bean-shaped intracranial calcification within the temporallobes of the brain in the area of the hippocampus, shown up by radiography and tomography, may cause epileptic seizures and other neuropsychological complications like impaired memory and aggression. The sufferer experiences communicative impairment through hoarseness, aversive impairment because of the conspicuous lesions, and concealed impairment as a result of the calcifications. According to the medical-clinical,person-orientated and socio-environmental perspectives on disability, a sufferer of Urbach-Wiethe Syndrome may experience disability. Like disabled persons, the sufferer finds it difficult to identify with his physical appearance. Impaired identity formation and low self-esteem cause a negative self­ concept. Feelings of guilt,anxiety and depression result from perceived dissimilarity, social rejection and low self-esteem. Socialising is adversely affected. A significant relationship was found in the empirical study between the extent to which the sufferer is affected and the degree of maladjustment in his life-world. Seriously affected sufferers display a negative self-concept and feelings of depression with suicidal thoughts. Socialisation and relationships are problematic and sufferers feel unaccepted by the community. General maladjustment in the life-world is experienced. A case of paranoia was reported. Except for some questions and unresolved feelings about the disease,most parents are able to cope with the situation. Guidelines have been set for a therapeutic programme for sufferers from Urbach­ Wiethe Syndrome aimed at enhancing self-concept, coping with depression and aggression, and improving relationships and socialising. A support group has been ounded for sufferers and their parents. / Psychology of Education / D. Ed. (Sielkundige Opvoedkunde)

This thesis explores how the general public understands and responds to dementia. In the context of this study the word ‘understanding' is used to convey the complex co-construction of knowledge and establishing of beliefs that constitutes public understandings of dementia. The study also examines the responses of members of the public to dementia, in the context of their understanding. Data were collected over a 12 month period and included a module in the Northern Ireland Life and Times (NILT) survey, five focus groups and nine interviews with participants from the focus groups. The survey module included thirty measures examining levels of knowledge and attitudes towards dementia. 1200 participants were targeted and the survey was administered by the Northern Ireland Research & Statistics Agency with a response rate of 58%. The focus groups and interviews provided the mechanism to gather a more nuanced picture, exploring the beliefs behind the attitudes and the self-reported responses of participants to people with dementia. Findings indicate that the general public has a reasonable knowledge of the symptoms and pathway of dementia in line with a bio medical model. However the findings also indicate that the general public holds a mix of theoretical and empirical knowledge and that this is often contradictory. A complex mix of scientific or medical information, experience, anecdote and assumptions contribute to the discourse. This information is stored and conveyed in the form of stories and a consequence of this interplay is that individual experiences told in the form of stories are generalised to become building blocks in the construction of what the general public understands dementia to be. The current construction of dementia among the general public is found to be both nihilistic and ageist with clear evidence that dementia is stigmatised. I will argue that that the relationship between dementia and ageing in the minds of the general public is a symbiotic one. Dementia has become a cultural metaphor for unsuccessful ageing marking entry to the fourth age. The stigmatising response of the general public is the result of a complex interplay of multiple factors. I have expanded on previous ideas of multiple jeopardy and intersectionality, suggesting that the stigma associated with dementia is unique and driven as much by emotional responses as by the social location of the person with dementia. I have borrowed Brooker’s (2003) term “Dementia-ism’ to describe this stigma. This thesis argues for a more complex and sophisticated approach to changing public attitudes and reducing stigma. Dementia-ism must be addressed with the same strength of purpose currently applied to sexism, racism and ageism.

Urbach-Wiethe Sindroom (beter bekend as lipo"ied prote"inose of hyalinosis cutis et mucosae) is 'n seldsame, outosomaal-oorerflike siekte. Die kenmerkendste simptome van die siekte is vel- en slymvliesveranderinge wat deur 'n neerslag van ekstrasellulere hialienagtige materiaal van onbekende oorsprong veroorsaak word. Die vel word maklik beseer, genees stadig en lelike, pokagtige letsels ontstaan. 'n Fyn, korrelagtige neerslag op die ooglede, die sogenaamde "kralestringvoorkoms" kenmerk die siekte, sowel as heesheid, die prominentste en lastigste simptoom, wat sedert geboorte teenwoordig kan wees. Radiografie en tomografie toon bilaterale,boontjievormige verkalking op die temporale lobbe van die brein, wat tot epileptiese aanvalle en ander neuropsigiese simptome soos geremde geheue en aggressie lei. Heesheid veroorsaak kommunikatiewe beperkinge vir die lyer,terwyldie opsigtelike velletsels aversiewe- en die verkalkings onsigbare beperkinge meebring. Die lyer aan Urbach-Wiethe Sindroom kan volgens die beginsels en kriteria van die medies-kliniese, die persoonsgeorienteerde en die sosio-omgewingsperspektiewe gestremdheid ondervind. Teoreties kan die lyer se belewinge van sy andersheid en die nie-aanvaardingdeurdie gemeenskap, soos by gestremdes,die handhawing van sy selfagting rem, sodat 'n negatiewe selfkonsep tot skuldgevoelens, angsbelewinge en depressie kan lei. 'n Betekenisvolle verband is in die empiriese ondersoek tussen die graad van aantasting en wanaanpassing in die lyer se leefwereld gevind. Die lyers wat ernstig aangetas is, identifiseer moeilik met hulle fisieke voorkoms. ldentiteitsvorming word gerem en die selfagting is negatief. Hulle openbaar 'n negatiewe selfkonsep en depressiewe gevoelens met selfmoordgedagtes. Hulle relasies en sosialisering is problematies en hulle voel hulle word nie deur die gemeenskap aanvaar nie. Die lyers ondervind 'n algemene wanaanpassing in hulle leefwereld. 'n Geval van paranoia is ook gevind. Alhoewel die ouers vrae oor die toestand het en sekere emosies beleef, kan die meeste van hulle die situasie hanteer. Riglyne vir 'n terapeutiese begeleidingsprogram vir lyers aan Urbach-Wiethe Sindroom, wat op die verbetering van die selfkonsep; die hantering van depressie, aggressie en woedebuie, asook die verbetering van relasies en sosialisering gerig is, is saamgestel. 'n Ondersteuningsgroep waarby lyers en hulle ouers kan inskakel, is gestig. / Urbach-Wiethe Syndrome, also known as lipoid proteinosis or hyalinosis cutis et mucosae, is a rare, recessively inherited, autosomal disorder characterized by lesions of the skin and mucosae, caused by widespread deposition of hyaline material of unknown etiology. The skin injures easily and heals slowly with "pock­ like" lesions. Bead-like deposits on the eyelids, called "string of pearls",are often found. Present since early infancy, hoarseness is the first, and most striking, irritating symptom. Bean-shaped intracranial calcification within the temporallobes of the brain in the area of the hippocampus, shown up by radiography and tomography, may cause epileptic seizures and other neuropsychological complications like impaired memory and aggression. The sufferer experiences communicative impairment through hoarseness, aversive impairment because of the conspicuous lesions, and concealed impairment as a result of the calcifications. According to the medical-clinical,person-orientated and socio-environmental perspectives on disability, a sufferer of Urbach-Wiethe Syndrome may experience disability. Like disabled persons, the sufferer finds it difficult to identify with his physical appearance. Impaired identity formation and low self-esteem cause a negative self­ concept. Feelings of guilt,anxiety and depression result from perceived dissimilarity, social rejection and low self-esteem. Socialising is adversely affected. A significant relationship was found in the empirical study between the extent to which the sufferer is affected and the degree of maladjustment in his life-world. Seriously affected sufferers display a negative self-concept and feelings of depression with suicidal thoughts. Socialisation and relationships are problematic and sufferers feel unaccepted by the community. General maladjustment in the life-world is experienced. A case of paranoia was reported. Except for some questions and unresolved feelings about the disease,most parents are able to cope with the situation. Guidelines have been set for a therapeutic programme for sufferers from Urbach­ Wiethe Syndrome aimed at enhancing self-concept, coping with depression and aggression, and improving relationships and socialising. A support group has been ounded for sufferers and their parents. / Psychology of Education / D. Ed. (Sielkundige Opvoedkunde)