An overview of recent literature indicates that mood and anxiety disorders are the most prevalent of all psychiatric disorders. Depression and anxiety are estimated to be two of the most important causes of disease burden in the world and appear to be more prevalent among women than men. A skewed distribution exists in mood and anxiety research with limited research being done into the area of gender, more specifically females with these disorders. The present study therefore intended to explore and describe the psychofortology of female psychiatric out-patients living with mood and anxiety disorders. An exploratory descriptive research design was used and participants were selected by means of non-probability purposive sampling. The sample consisted of 60 female psychiatric out-patients who were selected for inclusion based on predetermined inclusion criteria. Data were gathered through the administration of a biographical questionnaire, Hammer and Marting’s Coping Resources Inventory (CRI), Antonovsky’s Sense of Coherence Scale (SOC-29), Diener, Emmons, Larson and Griffin’s Satisfaction with Life Scale (SWLS) and Kamman and Flett’s Affectometer-2 (AFM-2). These data were then analyzed according to the aims of the study by the use of descriptive statistics, inferential statistics and multivariate data analysis, namely, K-means cluster analysis. The results indicated that the female psychiatric out-patients with mood and anxiety disorders were generally experiencing lower levels of coping and subjective well-being. The results indicated three clusters which appeared to have no statistical or practical significance to each other. The first cluster could be characterized as being “of relatively high psychofortology” and patients in this cluster presented with better coping and subjective well-being. The patients in cluster two could be characterized as being “of relatively average psychofortology” and the third cluster as being “of relatively low psychofortology”. The third cluster was characterized by patients who were experiencing poorer levels of coping and subjective well-being.

A dissertation submitted to the Faculty of Arts, University of the Witwatersrand, in partial fulfilment of the requirements for the Degree of Master of Arts, Clinical Psychology. Johannesburg, September 1992 / No abstract provided.

In a resource-rich environment, WS of CSA, wanting to enter therapy in order to deal with their early life trauma, can choose from an array of potential treatment modalities. One such intervention is called wilderness therapy. Although a number of studies have investigated various facets ofthis fairly new therapeutic modality, this is not the case for WS as potential clients. This study with its focus on how WS ofCSA experience and perceive therapeutic change as a result of participating in wilderness therapy, intended to explore how this intervention facilitates change. The research aimed to elicit phenomenological insights that could assist in the development and refinement of the therapeutic approach and its intricate constituents. The sample included twelve WS ofCSA (21 years and older) ofwhom four took part in a fourday therapeutic wilderness experience in the Drakensberg Mountains, a World Heritage Site, while another four joined a traditional time-limited therapy group. Four participants opted to withdraw from the study. Factors that influenced the decision to withdraw were explored. Ethical considerations necessitated a pre-interview with each participant. It allowed the researcher to screen each WS for her suitability, but also to identify her unique therapeutic needs, while also providing an opportunity to acquaint her with the research project as a whole, and more specifically with the respective therapeutic intervention. The researcher gathered interview data after each intervention, which after transcription was analysed using an experience-near, phenomenological research model (Colaizzi, 1978; Giorgi, 1994; Polkinghorne, 1989) that included validation through the participants. The themes that the participants of each group described were analysed and then presented in diagrammatical form. A comparison of the results elicited elements common to both therapeutic interventions, but more importantly the unique features ofwilderness therapy. These included (a) the reality of therapeutic change in terms of CSA-related issues, (b) nature as a significant therapeutically containing space, and (c) silence as a tool for facilitating catharsis. The reality of post-hike depression and the change-inducing quality ofanticipatory anxiety evolved as other significant elements of therapy within a nature setting. The themes were examined in greater depth leading to the conclusions that wilderness therapy is a valuable therapeutic modality for WS of CSA, possibly best used as an adjunct, and offers unique therapeutic change mechanisms to these trauma survivors. Because of its exploratory nature, the study was unable to outline these mechanisms in more detail and hence suggestions for further in-depth research were made. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2004.

Thesis (MA (Psychology))--University of Stellenbosch, 2006. / This study aimed to determine whether low-income women residing in a rural community in South Africa experienced any significant difference in the prevalence rates of depressive symptoms postpartum as compared to depressive symptoms prepartum. Thirty women between the ages of 16 and 38 were recruited during pregnancy from the local community clinic in Kylemore, South Africa. The women where assessed for elevated levels of depressive symptomatology using the Beck Depression Inventory (BDI) during pregnancy and again at three and six months postpartum. It was found that 18 (60%) of the women reported elevated levels of depressive symptomatology during the prepartum assessment, with 11 (37.9%) and 12 (48%) women reporting elevated levels of depressive symptomatology at the three months and six month postpartum assessment respectively. It was further found that the sample from the current study did not experience any significant difference in the rate of depressive symptomatology from the prepartum assessment to either of the postpartum assessments. The results also suggests that a relationship exists between the levels of depressive symptomatology prepartum and the levels of depressive symptomatology postpartum, as those women who experienced high levels of depressive symptomatology during pregnancy continued to show high levels of depressive symptomatology at the postpartum assessments. The findings from the current study thus suggest that the classification of postpartum depression as a unique and separate entity, that differs from depression occurring in women at other times and from depression as experienced by men, may be misleading. The term suggests a depression that develops following childbirth, while in the current study it seemed that when depressive symptoms were reported postpartum, they were also already apparent during pregnancy. The findings from the current study therefore suggest that the existence of postpartum depression as a distinct diagnosis or illness is problematic – a suggestion that has frequently been suggested in the literature (Aderibigbe, Gureje, & Omigbodun, 1993; Chandran, Tharyan, Muliyil & Abraham, 2002; Cooper, Campbell, Day, Kennerly & Bond, 1988; Cox, Murray & Chapman, 1993; O’Hara, Zekoski, Phillips & Wright, 1990; Patel, Rodrigues, & DeSouza, 2002).

Thesis (MA)--Stellenbosch University, 2013. / ENGLISH ABSTRACT: The topic of perinatal depression (i.e. depression during and after pregnancy) remains a subject of continued research interest, as a broad literature body reports that a large proportion of women suffering from this mental disorder do not receive appropriate treatment. This is worrisome, firstly, because mental health treatment is often readily available to the public and at no cost. Secondly, untreated perinatal depression not only holds dangerous consequences for the mother but also for the infant and the rest of the family. It is therefore important to identify those factors that act as barriers to mental health care utilization for perinatal depression. Although this is a persistent problem within the South African context, to date, little is known about the barriers to the utilization of available mental health services experienced among pregnant South African women. For this reason, the Perinatal Mental Health Project (PMHP) aims to provide mental health services at the same location where women receive obstetric services. However, despite their efforts, the number of women who decline available treatment is still of great concern. The present study offers a unique perspective on counselling for perinatal depression appointment-keeping barriers as it provides a holistic view of these barriers that exist not only within the women but also in their multi-levelled environments. Secondly, it addresses the problem of nonattendance to mental health care treatment offered by the PMHP and consequently also addresses the gap in South African research on the topic. The sample for this study was selected from PMHP files of those patients who failed to attend scheduled counselling appointments. The participants included in this study were selected by means of purposeful sampling to participate in face-to-face and telephonic semi-structured interviews. Participants were assured of confidentiality and anonymity. The semi-structured interviews were audio-recorded and transcribed after which transcriptions were entered into MS Word for textual analysis. Transcriptions were thematically analysed. The main themes that emerged from the present study included individual-related barriers, social-related barriers, institution-related barriers, community-related barriers and poverty-related barriers. The results of the present study reflect the motivations for depressive pregnant women to decline available and free mental health services provided by the PMHP, according to five main themes. These themes were then discussed according to Bronfenbrenner’s (1977; 1979) Ecological Systems Theory, which categorised the main themes identified according to the different systems operating within the patient’s environment, i.e. the individual-, micro-, meso-, exo-, and macrosystem. The individual system comprised the individual-related barriers, which included poor mental health, and ambivalent feelings toward the pregnancy. The microsystem comprised the social-related barriers, which included low social support and self-help strategies. Community-related barriers were considered within the mesosystem of the patient’s ecological environment, with stigma and pity as sub-barrier. The exosystem comprised the institution-related barriers, including referral protocol barriers, lack of information provided by the nurses, and nurses’ attitudes as experienced by participants. Lastly, poverty-related barriers were considered within the macrosystem, with financial life hardship, constant child-care demands, and transportation barriers as sub-barriers. The significance of this study lies in the original perspective offered on mental health care appointment-keeping behaviour within the South African context. Future research could, in addition to conducting interviews with hospital patients, include health care professionals and focus groups as this will allow for triangulation of the perspectives of all significant players. Also, having identified the problems and concerns with regards to attending counselling appointments, future research direction may be aimed at creating interventions designed to reduce the identified barriers to mental health care service use. / AFRIKAANSE OPSOMMING: Perinatale depressie (d.w.s. depressie voor en na swangerskap) bly ʼn onderwerp van voortdurende navorsings belang, aangesien ʼn breë navorsingsveld aandui dat ʼn groot proporsie van vroue wat aan hierdie geestesversteuring lei, nie die gepaste behandeling ontvang nie. Dit is kommerwekkend, eerstens, aangesien behandeling vir geestesgesondheid meestal openlik verkrygbaar is aan almal sonder enige koste. Tweedens, onbehandelde perinatale depressie hou nie slegs gevaarlike gevolge vir die moeder in nie, maar ook vir die baba en die res van die gesin. Dit is daarom belangrik om daardie faktore te identifiseer wat as hindernisse optree tot geestesgesondheid sorg diensgebruik vir perinatale depressie. Alhoewel dit ʼn voortdurende probleem binne die Suid-Afrikaanse konteks is, is daar tot op hede geen navorsing wat hindernisse tot gebruik van beskikbare geestesgesondheidsdienste bekend gemaak nie, veral wat ervaar word onder swanger Suid-Afrikaanse vroue nie. Vir hierdie rede, beoog die Perinatal Geestesgesondheid Projek (Perinatal Mental Health Project - PMHP) om geestesgesondheidsdienste te lewer by dieselfde plek waar vroue verloskundige dienste kan ontvang. Nietemin, ten spyte van hul pogings, is die getal vroue wat beskikbare behandeling van die hand wys steeds van groot kommer. Dié studie bied ʼn unieke perspektief op hindernisse tot berading vir perinatale depressie afspraak-ooreenkoms gedrag, aangesien dit ʼn algehele uitkyk bied op hindernisse wat nie slegs binne die vroue bestaan nie, maar ook in hul veelvlakkige omgewings bestaan. Tweedens, spreek dit die probleem van nie-bywoning van geestesgesondheidsbehandelingsdienste wat aangebied word deur die PMHP aan en gevolglik ook die gaping wat binne Suid-Afrikaanse navorsing rakende dié onderwerp bestaan. Die steekproef vir die studie was gekies van PMHP lêers van daardie pasiënte wat nie hul geskeduleerde terapie afsprake bygewoon het nie. Die deelnemers ingesluit in die studie is deur middel van doelgerigte-steekproefneming geselekteer om aan aangesig-tot-aangesig of telefoniese semi-gestruktureerde onderhoude deel te neem. Deelnemers is van hul vertroulikheid en anonimiteit van die proses verseker. Die semi-gestruktureerde onderhoude was oudio-opgeneem en transkripsies is daarvan gemaak, waarna die transkripsies in MS Word gelaai is vir tekstuele analise. Transkripsies is tematies geanaliseer. Die hooftemas wat na vore gekom het, sluit in individuele-verwante hindernisse, sosiale-verwante hindernisse, institusie-verwante hindernisse, gemeenskapsverwante hindernisse en armoede-verwante hindernisse. Resultate van dié studie reflekteer die motiverings van depressiewe swanger vroue om beskikbare en gratis geestesgesondheidsdienste wat verskaf is deur die PMHP van die hand te wys, volgens die vyf hooftemas. Hierdie temas is toe volgens Bronfenbrenner (1972) se Ekologiese Sisteemteorie verdeel in die verskillende sisteme teenwoording in die pasiënt se omgewing, naamlik die individuele-, mikro-, meso-, ekso-, en makrosisteem. Die individuele sisteem het die individuele-verwante hindernisse ingesluit, wat swak geestesgesondheid, en teenstrydige gevoelens teenoor die swangerskap omvat het. Die mikrosisteem het die sosiale-verwante hindernisse ingesluit, wat swak sosiale ondersteuning, en self-help strategieë omvat het. Gemeenskapsverwante hindernisse is binne die mesosisteem van die pasiënt se ekologiese omgewing beskou, en het stigma en jammerte as sub-hindernisse ingesluit. Die eksosisteem het die institusie-verwante hindernisse ingesluit, wat verwysing protokol hindernisse, gebrek aan inligting verskaf deur die verpleegsters, en verpleegsters se houdings soos ervaar deur die deelnemers omvat het. Laastens is die armoede-verwante hindernisse binne die makrosisteem beskou, en het finansiële lewens swaarkry, konstante kindersorg eise, en vervoer-verwante struikelblokke as sub-hindernisse ingesluit het. Die belang van dié studie lê in die oorspronklike perspektief van geestesgesondheidsbehandeling dienste afspraak-ooreenkoms gedrag binne die Suid-Afrikaanse konteks, wat aangebied is. Toekomstige navorsing kan, bykomend tot die voer van onderhoude met hospitaal pasiënte, fokus daarop om gesondheidsorg kenners en fokus groepe in te sluit, aangesien dit die triangulasie van perspektiewe moontlik maak van al die belangrike rolspelers. Ook, aangesien die probleem en bekommernisse rakende bywoning van terapie afsprake reeds geïdentifiseer is, mag toekomstige navorsing in die rigting beweeg met die doel om intervensies te omskep wat beoog om die geïdentifiseerde hindernisse tot geestesgesondheidsorg diensgebruik te verminder.

Thesis (DPhil (Psychology))—University of Stellenbosch, 2006. / Statistics show that young, heterosexual, low-income women are the fastest growing HIVinfected population in South Africa and in the rest of the world. Despite the rapidly growing numbers of women with HIV (human immunodeficiency virus) and AIDS (acquired immune deficiency syndrome), there is a scarcity of research that focuses primarily on how poor minority and disadvantaged women of colour experience being HIV-positive, how these women actually live and cope with their diagnosis. Furthermore, no research studies on minority groups, such as the Coloured women in the Western Cape, exploring these issues have been reported. Consequently, there is an urgent need for research studies in South Africa to explore the range of discourses revealed by low-income and minority women regarding their lives and experiences of HIV/AIDS, in order to generate understanding and knowledge which could contribute to possible interventions, support and care. The present study aimed to: 1) explore the psychosocial concerns and mental health needs of HIV-infected low-income Coloured mothers in everyday life; 2) construct a testable Grounded Theory regarding the illness experience of low-income Coloured mothers; and 3) recommend guidelines for health workers. The study was a systematic analysis and documentation of how the illness (HIV/AIDS) was constructed in narratives of one particular group of women in South Africa. Eleven suitable and willing HIV-infected Coloured mothers were recruited by means of convenience and theoretical sampling. The research study was conducted within a socialconstructionist framework where the focus was on how HIV-infected, low-income Coloured women make sense of their world and illness experience. Grounded Theory was applied within the framework of qualitative research to analyse the data and to explore the participants’ constructions of the illness. As qualitative measure, a semi-structured in-depth interview schedule was developed according to Grounded Theory protocol. To reach the aims of the present study, questions focused on specific behaviours, experiences, thoughts and feelings that related to living with a positive HIV-diagnosis. In the participants’ accounts of their illness experience, two dominant discourses were identified: a discourse of HIV/AIDS, within which the illness was constructed as an stigmatised, incurable and deadly illness; as a shameful illness that someone should be blamed for; and as being associated with secrecy, silence, separation, pain and suffering, loss, and loneliness, as well as a discourse of mothering, what it means to be a “good” woman/mother; constructed as someone that should primarily take care of her children and family, and not be separated from them, or neglect or abandon them through illness or death. It is suggested that the two dominant discourses found in the participants’ accounts of their illness experiences, namely the meaning of HIV/AIDS as an illness (a stigmatised, incurable, and deadly illness, a shameful and blameworthy illness, an illness of secrecy, silence, separation, pain and suffering, loss, and loneliness), and the imperatives of mothering, what it means to be a “good” woman/mother (the primary caregiver of children, someone who is connected, physically strong, healthy and productive, and someone who is able to cope with her caregiving responsibilities even when in distress herself) are irreconcilable. It seems that these distressing and disempowering experiences of being HIV-infected, while also being a primary caregiver and mother of children, caused the participants in the present study severe psychological distress and suffering. Given these discourses and the context of the participants’ lives within their specific socio-economic circumstances, namely their lack of emotional and social support from friends and family, abusive relationships, substance abuse, economic hardships, absence of treatment options, as well as their experience of an incapacitating, incurable, stigmatised illness causing them severe physical and psychological distress, it was argued that the majority of the participants in the present study were in some state of depression and were in need of psychosocial support and mental healthcare.

The study investigated the lived experiences of women suffering from Multiple Sclerosis in Johannesburg and the East Rand. The study aimed at describing how these experiences affect their lives, and how these women cope after being diagnosed. A qualitative approach was utilised following an exploratory, descriptive, phenomenological, contextual research design. An in-depth literature study was conducted for information used as a basis for the study. Data collection included semi-structured interviews and a focus group. Data-analysis revealed a lack of understanding for the emotional, physical and social problems encountered. Recommendations proposed that the community be sensitised to the reality of MS and disabled persons, and that comprehensive support structures be put in place to attend to the needs of women suffering from Multiple Sclerosis. / Health Studies / M.A. (Health Studies)

This study aims to gain an understanding of the mental health and acculturative experiences of Portuguese women who immigrated to South Africa in the 1960s. A qualitative research design was utilised with semi-structured interviews to gain information from four Portuguese female immigrants. Thematic analysis reveals experiences of acculturative stress and a difficult assimilation process. The main difficulties were: poor proficiency in the host country’s local languages; availability of social and organisational support; access to medical services; and access to mental health services. These factors were linked to the occurrence of the mental health problems of: depression, isolation, and being actively discriminated against by the dominant Afrikaner community during the apartheid years. The respondents’ poor proficiency in English and their unwillingness to learn Afrikaans, combined with a fear of stigmatisation hampered their willingness to access psychological and mental health services. The negative factors were mitigated by the protective factors of: the traditional family structure, formal community organisations (societies and clubs), and the church. / Psychology / M.A. (Clinical Psychology)

The study investigated the lived experiences of women suffering from Multiple Sclerosis in Johannesburg and the East Rand. The study aimed at describing how these experiences affect their lives, and how these women cope after being diagnosed. A qualitative approach was utilised following an exploratory, descriptive, phenomenological, contextual research design. An in-depth literature study was conducted for information used as a basis for the study. Data collection included semi-structured interviews and a focus group. Data-analysis revealed a lack of understanding for the emotional, physical and social problems encountered. Recommendations proposed that the community be sensitised to the reality of MS and disabled persons, and that comprehensive support structures be put in place to attend to the needs of women suffering from Multiple Sclerosis. / Health Studies / M.A. (Health Studies)

Unintended and unwanted pregnancies are major reproductive health problems impacting negatively on women’s health globally. When faced with these pregnancies, many women choose termination of pregnancy (TOP) as their recourse. The purpose of the study was to explore and describe physical, psychological and social implications of TOP on the woman’s health. A qualitative and descriptive research design was used. The population comprised women who had TOP three months to one year before the study and were willing to participate in the study. A non-probability purposive sampling was used to select participants for the study. In-depth phenomenological interviews were used for data collection until data saturation was reached with 20 participants. The findings reveal that women had psychological, physical and social implications after TOP which impacted negatively on their health. Recommendations were made to improve the services of women choosing to terminate a pregnancy to lessen negative implications. / Health Studies / M.A. (Health Studies)