The diagnosis of children with Attention Deficit Hyperactivity Disorder (ADHD) has increased over the last few years in Australia. ADHD is currently understood largely through a medical perspective, and in that context, the treatment recommended is stimulant medication. ADHD is a mental health label given to children who exhibit challenging behaviour. These children are diagnosed according to the categories stated in the Diagnostic Statistical Manual (DSM) – IV. To date, there is no medical test children can undertake to show that they ‘have’ ADHD. This research focuses on an alternative view of ADHD. Focussing upon families’ experience of ADHD, and the medicalisation of children’s behaviour, it argues that behaviour is socially influenced and constructed. It is because insufficient attention has been given to the family experience and the social implications of ADHD, that the child is often seen as ‘the problem’. The gap in our understanding of ADHD is situated in our understanding of the broader social context. To challenge this I will explore perceptions of the ‘good child’, ‘good mothers’ and the social consequences of inappropriate behaviour. Each family was interviewed five times every three months over a two-year period. Their stories and experiences are presented in this thesis.

Hospitalization, surgery and anaesthesia are for some children associated with anxiety and could be a frightful experience which may result in later problematic behaviour. Pain is associated with the fears of hospitalization. The first aim was to investigate how pain in children is treated in Swedish hospitals as well as to assess the results of this treatment. Behaviour after hospitalization has been measured by the Post Hospital Behaviour Questionnaire (PHBQ). A second aim was to translate this instrument into Swedish and to validate it. The third aim was to analyze which factors (sociodemographic back¬ground; earlier experience; events at the hospital) that might be associated with changes in behaviour. Methods: A questionnaire regarding acute pain, its treatment methods and results of treatments as well as contributing factors to inadequate results, was sent to all departments in hospitals that might treat children. One form was answered by phy¬sicians and another form by nurses. In the second part of the study, a cohort of 340 children ages 2-13 were followed from two weeks before hospitalization until two weeks after. Data regarding socio¬demography and earlier health care experience were collected. The Child Behav¬iour Checklist was issued before and after hospitalization, the PHBQ was issued after. During hospitalization staff and parents assessed anxiety, pain and nausea mainly by VAS and Likert scales, (parents assessed own and child emotions). Children, older than 4-5 years of age, assessed their own pain using a faces scale. Results: Despite treatment, moderate to severe pain occurred postoperatively in 23% of patients and in 31% of patients with pain of other origin. Postoperative pain seemed to be a greater problem in units where children were treated together with adults and in departments where fewer children were treated. Pain could often or always be treated more efficiently according to 45% of physi¬cians and nurses. Of all departments, pain assessments were performed regularly in 43%, but pain measurement was less frequent. Opioids were never or infrequently used by 15 %. A five factor model fitted data better than the original 6 factor model when confir¬mative factor analyse was performed. Cronbach’s alpha was adequate for factors and excellent for the total score (0.92). Risk factors for increased problematic be¬haviour included the following: age less than 5 years of age, living in a one adult family, anxiety at anaesthesia induction, nausea at hospital and pain at home. Liv¬ing in a rural area and midazolam in premedication seem to be protective. Conclusions: Acute pain in children is still a problem. Inadequate pain treatment is mainly associated with organisational factors (missing prescriptions; a low rate of pain assessments). The PHBQ in Swedish translation is a reliable instrument and its relation to CBCL warrants its further use in research and quality control espe¬cially in younger children. Hospital-induced stress in older children needs further investigation. One third of the children who have been hospitalized and exposed to anaesthesia will have in¬creased problematic behaviour when returning home. Pro¬active interventions are suggested to prevent this by improving pain treatment at home.

<p>To date most research on long-term outcomes of childhood trauma has focused on traumatic brain injuries, but less is known about traumatic injuries not involving the brain. Since traumatic brain injuries can have persistent effects on child behaviour, I investigated whether other types of traumatic injuries could also affect child behaviour in the long term. Currently, limited information is available on possible associations between family function and child behaviour after child trauma; knowledge of the long-term costs of pediatric trauma is also lacking. The main goal of this study was to determine whether family function was associated with behaviour in children who experienced a traumatic injury eight to ten years ago. Additional goals were to determine current expenditures and use of health and social services by child trauma victims and their parents. Pediatric trauma victims were selected from a trauma database at a tertiary care hospital in the Hamilton-Wentworth region. The parents of these children were interviewed to obtain children’s current behaviours and the family’s use of health and social services. The results showed that injury severity was not associated with child behaviour, but associated with family functioning. No relationship was found between health and social service expenditures for children and their injury severity, but there was a relationship between parent health and social service expenditures and child injury severity. The results do not support an association between child behaviour and injury severity following trauma, but they do suggest that expenditures and use of services by injured children and their families are affected long-term. The results suggest that future health and social service uses of injured children and their families may be better understood and planned for by recognizing the continuing effects of trauma. This information could help making appropriate health and social service programs more available to this population.</p> / Master of Science (MSc)

Thesis (MEdPsych (Educational Psychology)--University of Stellenbosch, 2009. / ENGLISH ABSTRACT: Bowlby (1969) described infant attachment as the emotional bond that ties the infant to one or a few figures across time and distance. He claimed that internal working models are shaped by early experiences and that attachment behaviour is programmed within these models. According to Bowlby, internal working models are carried forward and have an effect on the development of personality, emotion regulation characteristics and behaviour later in life (Goldberg, 2000). Attachment Theory and emotion regulation are closely linked. The parent-child relationship plays an important role in the development of emotion regulation skills. According to research and subsequent literature, children with attention deficit/hyperactivity disorder (ADHD) have difficulty with emotion regulation. A limited number of studies have focused on the emotion regulation characteristics of children with ADHD, using Attachment Theory as lens. In this study, Attachment Theory was applied to explore the emotion regulation characteristics of a ten-year-old girl with ADHD. A series of observations were central to the process of producing data, as observation plays an eminent role in the history of attachment research. Within the series of observations, together with three semi-structured interviews, the child‟s emotion regulation characteristics were identified. The parent-child relationship and the parents‟ level of reflective functioning played a significant role to identify the characteristics of emotion regulation. A literature review and information from documents (e.g. reports from multi-disciplinary professionals) contributed to the validity of the findings. It was found that the girl with ADHD was significantly insecure in her general functioning. The themes that emerged elicited the interface and interaction between attachment behaviour, emotion regulation and ADHD. Future research should focus on Attachment Theory and ADHD. Parents, teachers and multi-disciplinary professionals who have or work with children diagnosed with ADHD will benefit from Attachment Theory. / AFRIKAANSE OPSOMMING: Bowlby (1969) het gehegtheid of binding beskou as die emosionele band wat tussen die jong baba aan een of meer versorgers gevorm word. Hy het beweer dat hierdie band mettertyd „n interne model van gehegtheid vorm, en dat latere gedrag volgens hierdie modelle uitgeleef word. Volgens Bowlby word interne werksmodelle oorgedra van die primere versorger na die kind. Hierdie modelle het n uitwerking op spesifieke aspekte van die persoonlikheid, op die regulering van emosies en op gedrag binne verhoudings asook tydens konflik later in die lewe (Goldberg, 2000). 'n Noue verbintenis bestaan tussen gehegtheidsteorie en die regulering van emosie. Die ouer-kind-verhouding speel 'n belangrike rol in die ontwikkeling van vaardighede om emosie te reguleer. Volgens navorsing vind kinders met aandagtekort-hiperatiwiteitversteuring (ATHV) dit moeilik om emosies te reguleer. 'n Beperkte aantal studies gebruik gehegtheidsteorie om die regulering van emosies by kinders met ATHV na te vors. In hierdie studie is gehegtheidsteorie toegepas om die eienskappe van emosie – regulering by 'n tienjarige dogter wie met ATHV gediagnoseer is, te verken. 'n Reeks observasies was sentraal tot die proses van dataversameling, omdat observasie 'n besondere rol in die geskiedenis van gehegtheidsnavorsing speel. Binne „n reeks van waarnemings, tesame met drie semi-gestruktureerde onderhoude, is die eienskappe van die kind se regulering van emosies geïdentifiseer. Die ouer-kind-verhouding en die ouers se vlak van reflektiewe funksionering speel 'n belangrike rol in die identifisering van eienskappe om emosie te reguleer. 'n Literatuuroorsig en inligting uit dokumente (bv. verslae van multidissiplinêre professionele persone) het bygedra tot die geldigheid van die bevindings. Dit is gevind dat die dogter met ATHV beduidend onveilig in haar algemene funksionering was. Die temas wat na vore gekom het, het die skakeling en interaksie tussen gehegtheidsgedrag, die regulering van emosie en ATHV aan die lig gebring. Ouers, onderwysers en multidissiplinêre professionele persone wat kinders het of wat werk met kinders wat met ATHV gediagnoseer is, sal baat vind by gehegtheidsteorie.

Background: Conduct problems (CPs), a persistent pattern of challenging, oppositional, defiant or aggressive behaviour are a significant concern to educators, families and other professionals. CPs in preschool children are related to poorer educational and social outcomes in addition to a range of behavioural and emotional difficulties. Although there is evidence for hereditary and temperamental influences, parental factors are widely considered to be significant in the development of CPs. Parents experiencing psychological or social distress are considered to be at risk for challenging behaviour in their children. Psychologists and other theorists have suggested several possible reasons for this association. Firstly, it is possible that parents in distress have difficulty managing stress and as a result use harsh, inconsistent or coercive approaches to parenting. Secondly, parents with children who have CPs may be low in parental self efficacy, a consistent belief in their capacity to parent, which leads them to parent ineffectively and inconsistently. A third possibility is that parents in distress struggle to form stable attachments with their children which can lead to later behavioural difficulties. Finally, it is possible that parent’s distress is influenced by external contextual factors which also influence children such as family or social conflict. Studies suggest that training programmes for the parents of preschool children are effective in reducing child behaviour problems. Training approaches are influenced by a combination of psychological theories including behaviourist, social-cognitive, attachment and ecosystemic approaches. There have been many quantitative evaluations supporting the use of parent training programmes (PTPs). However, there has been limited inquiry into the process of PTPs from the perspective of those who attend them. Aims: The first part of this study was designed to evaluate vulnerability factors related to conduct problems; parental self efficacy, stress and child behaviour problems over the course of a community parent training programme designed to help participants to understand and manage the behaviour of young children. The overall research aim was to evaluate the outcomes and process, using different methodologies to address several questions. A realist methodology was applied to evaluating: 1. was there an association between parental stress, parental self efficacy and child behaviour problems at the start of the programme consistent with the established theory? 2. Did the parents attending the course experience higher than expected levels of stress and child behaviour problems? 3. Did quantitative and qualitative data indicate that these vulnerability factors changed over the duration of the course? Finally, an interpretivist methodology was used to explore how parents of young children evaluated as at risk of challenging behaviour described the experience of learning in the programme. Methods: The study utilised a pragmatic approach to evaluation with mixed methods and differing methodologies. At the start of the programme, a cohort of 38 parents agreed to participate in the study prior to the programme and completed self report measures related to parental stress and parental self efficacy. Parents with concerns about the behaviour of a child aged over three also completed a questionnaire relating to child behaviour problems. Of the original cohort, 27 completed self report measures at the end of the programme. 17 parents completed the same measures at a follow up meeting at the Children’s Centre, five to six weeks after the programme was completed. At this meeting 16 parents were interviewed to discuss their experience of the programme and any subsequent changes which had occurred. Results The results of the first part of the evaluation suggested a significant relationship between parental self-efficacy and stress and between stress and child behaviour problems. However, there was no statistical association between self-efficacy and child behaviour problems, as expected. This tentatively indicates that parental self-efficacy is less important in the development of child behaviour problems than has been previously suggested. The analysis of stress data at the start of the programme indicated that the frequency of parents reporting moderate to extremely severe stress was 4.42 times that which would be expected in a typical British cohort. At the start of the programme, frequency of child behaviour problems in the cohort were 5.9 times higher with conduct problems being 9 times what would be expected based on British norms. This suggests that the programme is being accessed by parents whose children are evidencing behaviour problems and, in particular, conduct problems. However, methodological issues are likely to have led to a slight overestimate of relative prevalence of child CPs in the cohort. Results indicated that parents reported significantly increased self efficacy, significantly reduced stress and child behaviour problems, including conduct problems, between the start and end of the programme. Thematic analysis and subsequent content analysis of outcome themes from interviews suggested that the majority of parents interviewed identified changes in parenting behaviour, knowledge, confidence, reduced stress and improved child behaviour as outcomes from the programme. However, changes in the quantitative data were not observed as frequently, reliably or to the same extent in the interview subgroup as they were in the main cohort, suggesting a sampling bias or a discrepancy in findings between methods. The self report data and interviews for all interviewees were then reviewed and interviews with six parents evaluated as having moderate to high stress, social or psychological difficulties and possible child behaviour problems were sampled. These were then re-analysed using a rigorous inductive approach to Thematic Analysis to identify emergent themes relating to the experience of participating and learning through the programme. Six themes emerged from analysis including; Understanding Difficulties, Identifying and Connecting, New Knowledge, Stopping and Thinking, Approach and Interaction and Reconstructing. The Understanding Difficulties theme described the different ways in which parents understood of their difficulties relating to themselves, their children and others which motivated them to attend the programme. The Identifying and Connecting theme described the importance to parents of personal identification with several aspects of the programme in terms of “being understood” in addition to identifying connections with established support, learning objectives and personal development goals. New Knowledge was categorised into three sub-themes of theoretical, practical and contextual. Contextual knowledge was constructed as understanding the experience of other parents, for example, identifying that other parents had similar difficulties. Theoretical knowledge about child behaviour and development encouraged parents to “stop and think” about the reasons for their children’s behaviour. Practical knowledge was constructed as parenting strategies which, when used, helped parents to feel more confident in themselves, more relaxed and more in control. The Stopping and Thinking theme described parents withholding action and considering the motivations for their children’s behaviour or the best approach to interacting with them. Approach and Interaction described changes to the way parents interacted with their children. The parents in question described changed or reconstructed understandings of their children, themselves and their difficulties as a result of participating in the programme. The theoretical implications of analysing the learning experience are that it highlights the importance of personal identification with the course objectives and experience.

This thesis presents a program of research evaluating the implementation of a primary care intervention program for disruptive child behaviour, and the process of dissemination of the intervention to primary care staff. The specific aims were to: 1) evaluate the effectiveness and acceptability of a brief, preventive behavioural family intervention (BFI) administered by primary care staff in improving parenting skills and confidence and reducing targeted child behaviour problems; 2) assess the process of disseminating the intervention to primary care professionals by evaluating aids and obstacles for program implementation in the workplace; and 3) provide recommendations for future dissemination of psychological interventions. Childhood disruptive behaviour problems are becoming increasingly prevalent and are associated with significant personal and societal costs. Much is now known about the development of such problems, including individual, family and social risk and protective factors. There is considerable evidence that BFI programs are effective in reducing child behaviour problems and the family risk factors associated with the development and maintenance of these problems. Unfortunately, many evaluated programs have not been disseminated effectively, and have primarily been provided to clinical or high-risk populations in efficacy trials. Primary care settings have been increasingly identified as ideal settings for detection and early intervention for child mental health problems. However, there is limited research in the area of primary care BFI. While dissemination of psychological innovation to psychologists has historically been poor, with little impact on the professional practices of practitioners in the field, documentation of dissemination of these interventions to non-psychologists is rare. Although dissemination and diffusion theory have expanded, there is little controlled research evaluating the necessary or optimal conditions for the adoption and ongoing implementation of evidence-based programs. To address the problem of poor dissemination and limited access to evidence-based parenting programs in the community, a multilevel parenting and family support initiative, the Triple P-Positive Parenting Program, has been developed at the University of Queensland. One level of this system, Primary Care Triple P, encompasses a preventively oriented, early intervention program that aims to promote positive, caring relationships between parents and their children and to help parents develop effective management strategies for a variety of common behavioural and developmental issues. This primary care intervention was trialled and disseminated in the current research. Study 1 examined the effectiveness of Primary Care Triple P implemented by child health nurses with clients requesting help for child behaviour problems. A randomised group methodology was employed, comparing the intervention with a waitlist control condition. Assessments were completed at pre, post and 6-month follow-up. Data are presented for 26 families. In comparison to the waitlist condition, families receiving the intervention showed a significant reduction in targeted child behaviour problem/s according to monitoring and mother-report. Mothers receiving the intervention also reported significantly reduced dysfunctional parenting practices, greater satisfaction with their parenting role, and decreased anxiety and stress following the intervention in comparison to waitlist mothers. No group differences were found for observed parent-child interaction. However, rates of observed disruptive child behaviour and aversive parent behaviour were low from the outset. Consumer satisfaction with the program was high, and intervention gains were primarily maintained at 6-month follow-up. These results provide some of the first effectiveness outcomes from a randomised controlled trial of BFI in a primary care setting, and establish the effectiveness and acceptability of Primary Care Triple P conducted by child health nurses as part of usual practice. Study 2 examined the implementation of Primary Care Triple P following professional training in the program. Results of a survey of 1078 professionals are presented. A model of the personal, program, training and workplace factors influencing program implementation was tested. Structured equation modelling confirmed that practitioner self-efficacy mediated the relationship between program characteristics and program implementation. Prior professional experience and satisfaction with training did not predict self-efficacy or uptake. Workplace support was also directly associated with program implementation. These results advance our knowledge of the aids and obstacles faced by practitioners in implementing a new program in the workplace. This research provides important new knowledge in relation to improving early access to empirically-supported intervention services and has implications for the potential scope of service delivery in primary care settings. It also advances our understanding of the factors influencing a professional’s ability to implement a new intervention program following training. This information may inform the development of future dissemination efforts, allowing them to address necessary program, personal and workplace supports, and optimise program implementation following training.

This thesis presents a program of research evaluating the implementation of a primary care intervention program for disruptive child behaviour, and the process of dissemination of the intervention to primary care staff. The specific aims were to: 1) evaluate the effectiveness and acceptability of a brief, preventive behavioural family intervention (BFI) administered by primary care staff in improving parenting skills and confidence and reducing targeted child behaviour problems; 2) assess the process of disseminating the intervention to primary care professionals by evaluating aids and obstacles for program implementation in the workplace; and 3) provide recommendations for future dissemination of psychological interventions. Childhood disruptive behaviour problems are becoming increasingly prevalent and are associated with significant personal and societal costs. Much is now known about the development of such problems, including individual, family and social risk and protective factors. There is considerable evidence that BFI programs are effective in reducing child behaviour problems and the family risk factors associated with the development and maintenance of these problems. Unfortunately, many evaluated programs have not been disseminated effectively, and have primarily been provided to clinical or high-risk populations in efficacy trials. Primary care settings have been increasingly identified as ideal settings for detection and early intervention for child mental health problems. However, there is limited research in the area of primary care BFI. While dissemination of psychological innovation to psychologists has historically been poor, with little impact on the professional practices of practitioners in the field, documentation of dissemination of these interventions to non-psychologists is rare. Although dissemination and diffusion theory have expanded, there is little controlled research evaluating the necessary or optimal conditions for the adoption and ongoing implementation of evidence-based programs. To address the problem of poor dissemination and limited access to evidence-based parenting programs in the community, a multilevel parenting and family support initiative, the Triple P-Positive Parenting Program, has been developed at the University of Queensland. One level of this system, Primary Care Triple P, encompasses a preventively oriented, early intervention program that aims to promote positive, caring relationships between parents and their children and to help parents develop effective management strategies for a variety of common behavioural and developmental issues. This primary care intervention was trialled and disseminated in the current research. Study 1 examined the effectiveness of Primary Care Triple P implemented by child health nurses with clients requesting help for child behaviour problems. A randomised group methodology was employed, comparing the intervention with a waitlist control condition. Assessments were completed at pre, post and 6-month follow-up. Data are presented for 26 families. In comparison to the waitlist condition, families receiving the intervention showed a significant reduction in targeted child behaviour problem/s according to monitoring and mother-report. Mothers receiving the intervention also reported significantly reduced dysfunctional parenting practices, greater satisfaction with their parenting role, and decreased anxiety and stress following the intervention in comparison to waitlist mothers. No group differences were found for observed parent-child interaction. However, rates of observed disruptive child behaviour and aversive parent behaviour were low from the outset. Consumer satisfaction with the program was high, and intervention gains were primarily maintained at 6-month follow-up. These results provide some of the first effectiveness outcomes from a randomised controlled trial of BFI in a primary care setting, and establish the effectiveness and acceptability of Primary Care Triple P conducted by child health nurses as part of usual practice. Study 2 examined the implementation of Primary Care Triple P following professional training in the program. Results of a survey of 1078 professionals are presented. A model of the personal, program, training and workplace factors influencing program implementation was tested. Structured equation modelling confirmed that practitioner self-efficacy mediated the relationship between program characteristics and program implementation. Prior professional experience and satisfaction with training did not predict self-efficacy or uptake. Workplace support was also directly associated with program implementation. These results advance our knowledge of the aids and obstacles faced by practitioners in implementing a new program in the workplace. This research provides important new knowledge in relation to improving early access to empirically-supported intervention services and has implications for the potential scope of service delivery in primary care settings. It also advances our understanding of the factors influencing a professional’s ability to implement a new intervention program following training. This information may inform the development of future dissemination efforts, allowing them to address necessary program, personal and workplace supports, and optimise program implementation following training.

Cette étude vise à examiner la relation entre les pratiques parentales utilisées durant la période de l'enfance et les dimensions principales du du trouble déficitaire de l'attention avec hyperactivité (TDAH) à l'adolescence, soit l’inattention, l’hyperactivité et l’impulsivité. Les pratiques spécifiques parentales (engagement, pratiques parentales appropriée, supervision, punitions corporelles, discipline appropriée, discipline sévère et incohérente, discipline verbale positive, félicitations et récompenses, et les attentes claires) et les aspects du fonctionnement familial (communication, résolution de problèmes, rôles dans la famille, sensibilité affective, engagement affectif, contrôle comportemental) ont été examinés par rapport à l'inattention et d'hyperactivité. Trente-six enfants de 6 à 9 ans et leurs parents ont participé à une étude longitudinale de 5 ans. Il y a un manque d'études longitudinales dans ce domaine et cette étude vise à combler cette lacune. Les résultats ne montrent pas de résultats significatifs dans la relation entre les pratiques parentales utilisées dans l'enfance et les symptômes principaux de l'hyperactivité et l'inattention à l'adolescence. Les études futures devraient se concentrer sur la relation entre la psychopathologie parentale et les principaux symptômes du TDAH de l'enfance à l'adolescence, ainsi que l'impact des pratiques parentales sur ces principaux symptômes. / This study aims to examine the relationship between parenting practices used in childhood on one hand and the core symptoms of Attention deficit hyperactivity disorder (ADHD) in adolescence on the other hand. Specific parenting practices ( involvement, positive parenting, monitoring/supervision, corporal punishment, appropriate discipline, harsh and inconsistent discipline, positive verbal discipline, praise and incentives and clear expectations) and aspects of family functioning were examined ( communication, problem solving, roles, affective responsiveness, affective involvement, behavioural control and general functioning) in relation to inattention and hyperactivity. The sample consisted of 36 participants involved in a 5 year study from childhood (6 to 9 years old) to adolescence (11 to 14 years old). The results do not show significant results in the relationship between parenting practices used in childhood and the core symptoms of hyperactivity and inattention in adolescence. There is a lack of longitudinal studies in this area and this study attempts to fill in this gap. However despite a lack of significant results, past research suggests an important relationship between parental psychopathology, which has been linked with ineffective parenting practices and the persistence of ADHD from childhood to adolescence. Future studies should focus on the relationship between parental psychopathology and the core symptoms of ADHD from childhood to adolescence, as well as the impact of parenting practices on these core symptoms.

The present investigation evaluated the efficacy of a Cognitive-Behavioural Therapeutic Approach for the anger management of three adolescent males. The study is noteworthy because it utilised essential features of Beck's Cognitive Therapy in the cognitive restructuring phase of treatment. Previous studies have commonly employed Rational Emotive Therapy's disputation of irrational beliefs for this phase. For this reason it is considered to be an original contribution to the literature. A multiple (three) single-case study research design was employed. The three adolescents, aged 13 to 17 years, attended seven to nine one-hour counselling sessions over a two to three month period. Pre-, post-treatment and long-term followup psychometric measures of aggression and anecdotal reports of anger-control were obtained from parents and teachers. Self-reports in the affective and cognitive domain, progress in therapy, psychometric measures (aggressive behaviour subscale of the Child Behaviour Checklist, Adapted Novaco Anger Inventory and Piers-Harris Children's Self-Concept Scale) and continuous (including pre-, post-treatment and long-term follow-up) assessments of the frequency of angry outbursts were obtained. Counsellor assessments of cognitive homework and behaviour in therapy were also made. Results reveal marked reductions in the average daily frequencies of angry outbursts in all cases by post-treatment and treatment effects were maintained throughout the three-month follow-up period. It was concluded that the cognitive-behavioural therapeutic approach warrants further investigation as it is proposed that it is a comprehensive and efficacious treatment for male adolescent anger problems.

There is limited research on the utility of specific assessment measures for cross-cultural psychological and research measurement within the South-African context. In addition limited knowledge exists on cross-cultural measurement of resilience in young children. This study analyses purposefully selected (existing) data from the Kgolo Mmogo project (which investigated psychological resilience in South African mothers and children affected by HIV/AIDS) with the aim of exploring the utility of a Düss fable as projective story-telling technique to measure resilience in young children. The primary research question that guided this study was: ‘What is the utility of a Düss fable as cross-cultural measure of resilience in young children?’ Using the ecological and social cross-cultural model as theoretical framework, the concurrent mixed method study compares inductively derived themes from the Düss fables (qualitative: content analysis) with quantitative scores obtained from secondary analysis of Child Behavior Checklist scores. Subsequent to the data analysis themes of resilience and non-resilience emerged from the Düss fables as well as from the CBCL. The themes of both resilience (protective resources) and non-resilience (risk factors) emerged and where significantly situated within the children’s environments. The core themes of resilience as expressed by the child-participants related to their coping strategies, their sense of belonging, the availability of material resources and their ability to navigate towards positive institutions. The most prominent themes of non-resilience that emerged from the participants’ Düss fables related to their coping strategies (maladaptive coping), their awareness of chronic risk, adversity and death. The CBCL was included in the study to provide insight into the perspective of the participants’ mothers with regards to their children’s functioning. Predominantly the mothers mostly perceived their children as well adjusted. The risk-related behaviours mostly reported by the mothers were externalising problems that manifested as rule-breaking and aggressive behaviour. The Düss fables provided meaningful insights into the life experiences of the children. There were instances where the participants’ responses were rich and detailed. The majority of the participants’ stories were age-appropriate and informative, while in some instances the participants gave limited responses. Nonetheless, the Düss fable provided valuable insights into the child-participants’ thoughts, emotions and life-experiences. / Dissertation (MEd)--University of Pretoria, 2011. / Educational Psychology / unrestricted