The aim of the study was to investigate the application of aspects of Lazarus and Folkman's theory of Stress, Appraisal and Coping, to the chronic pain experience. In this context, the researcher explored the relationship between pain intensity and stress level. The association between pain intensity and the intensity of negative or positive attitudes towards the pain experience was also investigated. In addition, the relationship between pain intensity and the frequency of employing active, problem focused coping-strategies, or passive, emotion focused strategies, was explored. 105 subjects completed the South African Chronic Pain Questionnaire; an assessment tool based on adapted internationally validated measures. Findings suggest that there is a proportional relationship between pain intensity and stress level in the present chronic pain population. A positive relationship between pain intensity and the intensity of negative attitudes was revealed. A positive relationship was also reflected between pain intensity and the employ of passive, emotion-focused coping-strategies. There is a paucity of research that provides a theoretical framework in which to conceptualize the association between stress, appraisal and coping in chronic pain. To this end, the researcher has employed Lazarus and Folkman's theory in order to conceptualize the relationship between these variables and chronic pain intensity. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 2001.

There is a growing library of literature on the relationship between self and culture. Most studies (Cousins, 1989; Markus & Kitayama, 1991; Sampson, 1989) in this area are quantitative and approach culture as a concept that is "intemally homogenous and externally distinctive" (Hennans & Kempen, 1998, p.1113). Such studies have found cross-cultural differences in how people define their sense of self. This has led to a classificatory approach to self and culture such that the western and non-western self have been defined as distinct from one another. This thesis explores the appropriateness of such cultural dichotomies from a novel, dialogical perspective of self (Hennans, Rijks & Kempen, 1993) which allows for the special investigation of self and culture A qualitative methodology was adopted for this investigation, within the narrative paradigm. Narrative interviews were conducted with a sample of twelve women between the ages of 35 and 50 years and these women were varied by ethnicity as one measure of culture. A voicecentred relational method (Mauthner & Doucet, 1998) was used to analyse the interviews. Both investigative and methodological aims were forn1Ulated during the analysis. Investigative aims explore the appropriateness of the dichotomisation of the self as western and non-western. The results of the analysis question such cultural dichotomies criticised by Spiro (1993) and yet so prevalent in self and cultural studies (Cousins, 1989; Markus & Kitayama, 1991; Sampson, 1989). Frequently in the narratives there is an interweaving of individualistic and collectivist characteristics. Such a co-existence of traits is accommodated by the dialogical view of self, which provides a large enough framework to account for both interdependent and independent characteristics in the same self. The methodological aims directed the researcher to investigate the appropriateness of the measurements of self and culture adopted by traditional approaches (Cousins, 1989; Markus & Kitayama, 1991 ; Sampson, 1989). The results of the thesis suggest that as intercultural connections are becoming increasingly common, culture needs to be recognised as a complex concept that is no longer homogenous. Cross-cultural approaches to this area are questioned by this investigation because of their tendency to simplify and categorise the self and culture. It is proposed that future research should approach this area of self and culture as an intersection or interface of complex factors that are not easily homogenised or dichotomised. The findings point to the value of qualitative research, and in particular the framework of the dialogical self, for exploring this interface. / Thesis (M.A.)- University of Natal, Pietermaritzburg, 2001.

The quality of early infant-caregiver interactions determines the path of an infant's social, cognitive and emotional development. Theoretical and empirical evidence supporting this claim is reviewed, and the implications for early relationship-focussed interventions are considered. The study focuses on infants from birth to three years of age. Developmental psychology research findings are presented, and the role of risk and protective factors in planning preventative interventions are discussed. Recommendations are made for developing a centre-based relationship-enhancing early intervention program for infants and their depressed caregivers. The program is intended for implementation in a rural or periurban South African Primary Health Care setting. / Thesis (M.A.)- University of Natal, Pietermaritzburg, 2002.

This thesis tests the hypothesis proposed by Liemkuhler (1994) relating to the development of a cluster of personality styles among ADHD adolescents. Liemkuhler suggests that it is a neurobiological dysfunction, through its interaction with psychodynamic and cognitive processes that predisposes the ADHD adolescent to the development of certain personality styles. An absence of appropriate intervention and support increases the risk of these personality styles developing into clinical syndromes. To determine whether differences in personality styles do exist between ADHD adolescents and adolescents without ADHD, the NED Five Factor Inventory (NEDFFI) was group administered to a sample of 25 adolescents who were previously diagnosed as having ADHD (referred to as the ' research group') and 25 controls (referred to as the ' control group') who were matched for age and educational level. Five testable hypotheses were formulated for each of the five personality scales. A comparison of each of the five scales between the research group and the control group yielded no significant result to support Liemkuhler's hypothesis. However, a comparison of the five scales within each group (either the research group or the control group) produced several significant differences. Significant correlations were also found between scales for each group. On the basis of these results it is suggested that specific differences in the facets (traits) that are measured by each of the five personality scales may exist for each group, as opposed to overall group differences in personality styles. It is further proposed that the facets that are tapped may be explained on the basis of assumed differences in the neurobiological and cognitive functioning of both groups. It is tentatively concluded that the results may provide partial support for Liemkuhler's hypothesis. However, it is acknowledged that the complexity of Liemkulher's argument warrants further and more detailed research. / Thesis (M.Sc.)-University of Natal, Pietermaritzburg, 2003.

This meta-analytic study analyses the relationship between racial prejudice and racial policy attitudes. Specifically, it examines the effects of race attitudes (i.e., symbolic racism, oldfashioned racism, racial affect and stereotypes) on attitudes towards racial policies such as affirmative action, busing and fair housing laws, among others. Furthermore, the effects of specific policy types (i.e., preferential treatment, compensatory programmes, desegregation and general legal policies) on racial policy attitudes were also examined. Finally, as a matter of interest, a racial attitude by racial policy type interaction was also analysed. 28 studies (N = 187 191,216 effect sizes) were collected for analyses. Overall, results indicate that there is in fact a statistically significant correlation between race prejudice and racial policy attitudes. In terms of racial attitudes, all four dimensions of racial attitude types were significantly correlated with racial policy opinions, with symbolic racism presenting the strongest relationship. All four racial policy types were also significantly correlated with the four racial attitudes. / Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2006

Schizophrenia is a debilitating mental illness. The prevalence of schizophrenia is of concern and highlights the chronicity of the illness (Kaplan & Sadock, 1998; Warner & de Girolamo, 1995). It is therefore important that greater understanding ofthe variables affecting and potentially contributing to schizophrenia is sought. This study deals with three separate areas: 1. Creating a database and describing the socio-demographic profile of 615 certified patients diagnosed with schizophrenia between the years 1995 and 1996, hospitalised at Fort Napier. 2. Exploring whether a meaningful geographical model of socio-demographic variables of schizophrenia can be built, and whether it can determine areas of high schizophrenia sensitivity. Such a perspective of schizophrenia (exploring the combined effect of all the variables connected to schizophrenia) has not been previously researched rather each variable has been studied independently. The model utilised in the Geographical Information Systems (GIS) offers an opportunity to graphically overlay these individual variables and then examine the potential effect. It was only possible to explore sociodemographic variables within this Masters research project. 3. Determining the geographical accessibility ofthe public provincial hospitals offering psychiatric services to the population, (particularly to persons with schizophrenia). This is relevant to the provision of maintenance programmes and early intervention as encouraged by recent research (Hodges, Byme, Grant & Johnstone, 1999; Yung et al, 1998). The socio-demographic profile of the certified patients at FNH correlated with most of the international findings. The presentation of schizophrenia remained constant in South Afiica in comparison to international countries and cultures (Warner & de Girolamo, 1995). Overall, the pattern produced by the schizophrenia sensitivity model was unclear other than high and low schizophrenia sensitivity ranges being evenly spread throughout KZN. The model has yet to be further refined to increase its sensitivity to schizophrenia risk. Although statistical significance was not established, the accessibility model suggested that large parts ofKZN fall within the range of easy accessibility in relation to the 19 provincial hospitals that provide a psychiatric service. The potential of the schizophrenia sensitivity model and accessibility model, in spite of the crude and incomplete variables utilised was evident. The GIS was a powerful tool and utilised in this study to collect (from surveys and other databases), store (retrieval and query), manipulate (transforming data, analysis and modelling) and produce data output (data reporting, such as maps and reports) (Foote & Lynch, 1995). The GIS has been a very effective tool in working with epidemiological information and it would be of great use in service planning. It is strongly recommended that there be greater collaboration between mental health services and the GIS Unit, Department of Health. / Thesis (M.Soc.Sc.)-University of Natal, Pietermaritzburg, 2002.

This thesis provides some evidence of variability in cognitive style, and refutes the notion of it being a stable, generalisable personality trait. The study is statistical in nature and uses the cognitive style construct tolerance/intolerance of ambiguity as the main dependent variable. The main independent variables are context, content, ideological conservatism and ideological commitment. The theoretical context for this thesis is the long.,.standing debate about the nature of cognitive style within the field of social psychological research. The four major theories constituting this context are the theory of authoritarianism, the theory of extremism, context theory and value pluralism theory. However, these appear to be inadequate to explain the contextual variability of value conflict. Hence an attempt has been made to develop a new theory, tentatively named the contextual value conflict theory. The founding hypothesis of contextual value conflict theory is that the different characteristics of the manipulated contexts would present subjects with different levels of contextual value conflict, thus resulting in the expression of different levels of tolerance of ambiguity. The assumption was that higher conflict leads to higher attitudinal ambiguity tolerance and lower conflict to lower attitudinal ambiguity tolerance. The quantitative part of the research is constituted by two studies in which the Attitudinal Ambiguity Tolerance (AAT) Scale (Durrheim, 1995) was used to measure cross-context and crosscontent variations in tolerancelintolerance of ambiguity. This was done by first administering the scale across two different contexts with a fixed university student sample. This procedure was repeated in a follow-up study in two different contexts with a fixed church sample. The AAT scale was used in conjunction with 3 scales measuring ideological conservatism/ideological belief, and two scales measuring ideological commitment. These were the Subtle Racism scale (Duckitt, 1991), the Conservatism scale (Durrheim & Foster, 1997) and the Right-Wing Authoritarian Scale (Duckitt, 1990). Scales measuring ideological commitment included the Religiosity Scale (Rohrbaugh & Jessor, 1975) and the Political Interest scale (an adaptation of the one used by Sidanius, 1988b). Results have indicated that it is important to distinguish between the various dimensions of ideological conservatism as the shape and direction of the relationship with attitudinal ambiguity tolerance depend on these dimensions. Although contextual value conflict has managed to better account for the vast variability in patterns of associations than any of the four other theories mentioned above, it too has its limitations. It was found that conflict caused by context is difficult to control and pre-define, and future studies need to address this shortfall by finding ways of determining more efficiently the level of contextual value conflict inherent in different situations. A recommendation for further research is that an attempt be made to develop an instrument for quantifying the level of contextual value conflict present in a particular situation. These shortfalls resulted in the major limitation of this study, i.e. the post hoc nature of explanations offered for the results. Thus, although contextual value conflict theory was not confirmed without contradiction, this thesis did uncover a degree of support for it. Due to the small sample size in both studies, but in particular that of the church study it is important, however, to treat the findings with caution. In conclusion, although the support for contextual value conflict was not conclusive, some confIrmation was found. What was most strongly evidenced though, was that tolerance of ambiguity cannot be seen as a stable, generalisable personality trait, but should rather be seen as performance in context that is fluid in nature. / Thesis (M.A.) - University of Natal, Pietermaritzburg, 2000.

The aim of this study was to assess the attitudes of community psychiatric nurses, mental health professionals and primary health care nurses towards mental illness, mentally ill people and deinstitutionalisation. The sample of this study comprised 38 community psychiatric nurses, 20 mental health professionals and 55 primary health care nurses, all of whom were from Durban, Pietermaritzburg and their surrounding areas. Each participant completed a biographical questionnaire, the Opinions of Mental Illness scale (1962) and the Community Mental Health Ideology scale (1967). Four focus groups on attitudes towards deinstitutionalisation, comprising 25 participants in total, were also conducted. Statistical analyses were computed using the Statistical Programme for Social Scientists. Krueger's (1984) methodology was employed to analyse the focus groups results. The quantitative results revealed that community psychiatric nurses, mental health professionals and primary health care nurses generally tended to express neutral attitudes towards mental illness, mentally ill people and deinstitutionalisation. Significant differences in attitudes towards mental illness and mentally ill people were found amongst respondents in different categories of race, educational levels and treatment of a friend for a mental illness. The focus groups results revealed that while the community psychiatric nurses and mental health professionals were positive about the concept of deinstitutionalisation, they did not favour it's implementation within the current South African economic and social contexts. Based on their fear of mentally ill patients, the primary health care nurses displayed negative attitudes towards the concept of deinstitutionalisation and were also cautious about it's implementation within the current South African context. Implications and recommendations arising from this study are discussed. / Thesis (M.A.)-University of Durban-Westville, 1998.

This study focuses on the process and complexities of disclosure and decision-making amongst HIV-positive ex-offenders. In addition, this study highlights the history and circumstances of HIV infection and how this influences disclosure. The process of disclosure was explored amongst seven HIV positive male ex-offenders who fell in the African racial category. Data was collected through qualitative in-depth interviews and analyzed using thematic analysis. Results revealed that within this target group disclosure initially occurred within prison and thereafter upon release from prison, continues depending on the contextual factors. Because disclosure initially took place within prison, the prison environment was a defining feature during the process of disclosure. Factors that enabled ex-offenders to disclose their HIV status included social support, witnessing of HIV – related deaths amongst other offenders, as well as the challenging nature of the prison environment. Factors that compromised the disclosure process included their access to treatment and a more nutritional diet. Upon release from prison, access to financial and material support and responsibility to significant others were reasons that facilitated the process of disclosure. Overall, stigma was a main barrier that contributed to non - disclosure. These findings highlight that the process of disclosure is a relational factor as it depends largely on the availability and accessibility of significant others. The conclusion that can be drawn from this study is that HIV disclosure is a process that occurs on a continuum whereby there is no clear end-point as ex-offenders weighed up the enabling factors against the barriers before disclosing. Once disclosure had occurred, ex-offenders had to integrate the outcomes and reactions from significant others into their lives. The process of HIV disclosure is also a never – ending process as there are always significant others to disclose to. It is recommended by this study that more research is conducted regarding how prison conditions influence HIVpositive offenders, how HIV-positive ex-offenders can be better re-integrated into the community and how significant others deal with the ex-offenders HIV disclosures.T / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2010

Aim: This study aims to provide a qualitative understanding of the health-seeking behaviour of adult in-patients with multidrug-resistant tuberculosis in a public health sector setting. Methodology: A qualitative methodological approach was used in this study since it allows for an in-depth investigation and understanding of the health-seeking behaviour of MDR-TB patients. The study is seated in the arena of ethnographic inquiry, since ethnography investigates human behaviour as it is understood and experienced within a particular subtext and given reality, as it is created by the people of concern. In this regard, ethnography deals with developing an understanding of shared systems of meaning in societies that share similar social and cultural characteristics and can be applied to the study of any isolated group who have something in common. A total of four (4) 90-minute focus groups discussions were conducted with adult MDR-TB in-patients, comprising two male and two female groups. The data transcripts were analysed thematically in order to identify commonalties and variances among the responses of participants. Comparative analyses were made across the variable gender. Findings: The findings are discussed within the context of relevant empirical literature and theory, including the Health Belief Model, Health Locus of Control Theory and the Theory of Reasoned Action. These findings were constructed temporally in terms of pre-admission, admission and post-admission behaviour. What has emerged in this study is that health-seeking behaviours that are traditionally defined as "poor patient adherence" and " treatment delay" are mediated by a number of variables operating in both institutional and community contexts. At a community level, large-scale community ignorance and lack of knowledge of MDR-TB, social stigma, conflation of TB and MDR-TB and the lack of recognition of symptoms coalesce to produce poor treatment adherence and treatment delays. This situation is exacerbated by cultural practices that result in patients using dual healing systems and multiple remedies. The net result for TB sufferers is the advent of MDR-TB. At an institutional level a hierarchical biomedical bureaucracy conspires to produce a hostile, disempowering and inhumane experience for MDR-TB in-patients, which further compromises adherence behaviour and positive health actions. Recommendations: Within the context of a number of systemic recommendations, a range of practical patient-centered and staff centered interventions are suggested, followed by recommendations for future research and an appraisal of the limitations of this study. / Thesis (M.A.)-University of Durban-Westville, 2000.