Psychology in South Africa is facing a dire need for valid and reliable mental health instruments for all its citizenry. There presently exists a reliance on instruments of foreign origin. Very often such instruments are used without their psychometric properties having been tested in the local setting. The present study employed a multi-stage process for translating the General Health Questionnaire (GHQ) into Zulu. A simplified English version of the GHQ and the translated Zulu version were subsequently administered to a sample of two hundred and fifty seven (257) bilingual high school students. The data from this sample was used to assess the equivalency between the Zulu version and the English version. At the scale level, both versions of the GHQ showed adequate internal consistency and reliability. Item analysis revealed certain differences between the two versions. Possible explanations regarding semantic differences are discussed. Substantial overlap between the factor solutions of the two versions was found. These factor solutions were found to correspond well with those recorded in the literature. The present sample scored much higher on the GHQ than foreign samples do. Suggestions for raising the cutting scores for South African samples are made. On the whole, the Zulu version displayed evidence of reasonable equivalence to the English version. A comprehensive research programme for the GHQ in South Africa is presented. / Thesis (M.A.)-University of Natal, Pietermaritzburg, 1996.

No description available.

Depression is a common mental health disorder and is a major contributor to the overall global burden of disease. Improving the instruments that are used to detect and assist in the diagnosis of depression is of importance due to the impact that the disorder has on the individual and society. The study aimed to explore and improve the measurement of depression. Seventy-one participants’ results on the PHQ-9 (that measures frequency of depressive symptoms) and the Borg CR scale® (measuring intensity of depressive symptoms) were analysed. It was also of interest to measure mental health patients’ (n = 16) self-rated depression and compare it to mental health staffs’ (n = 7) observer-rated depression. The overall correlation between intensity and frequency of depressive symptoms was found to be positively strong (r =. 695), the Borg CR scale showed high internal consistency when used for measuring intensity of depressive symptoms (.846), self-reported depression was lower than observer-rated depression (p = .167). In addition, inter-individual differences in frequency and intensity of depressive symptoms were also examined. Overall, the outcome of this study showed that intensity of depressive symptoms can differ considerably between individuals, despite similar overall depression scores.

Personer som drabbats av depression återfaller/återinsjuknar ofta en eller flera gånger i livet. Forskning har visat att b la demografiska faktorer, residualsymtom och insomni är prediktorer för återfall. Syftet med studien var därför att undersöka betydelsen av demografiska faktorer, residualsymtom och insomni för nivån av depression 6-12 månader efter avslutad behandling på en psykiatrisk specialistmottagning. Urvalet var alla patienter som diagnosticerats med depression eller recidiverande depression och genomgått KBT-terapi under perioden 2008 – september 2013, och som hade uppföljningsdata vid sex eller tolv-månader, vilket sammanlagt var 111 patienter. Beroendevariabel var resultat på formuläret Patient Health Questionnaire (PHQ-9). Resultaten visade att patienter med residualsymtom inte försämrades signifikant mellan eftermätningen och uppföjningsmätningen, ett fynd som inte överensstämmer med forskning på området. Regressionsanalyser visade ingen signifikant påverkan av kön, ålder och utbildningsnivå på senare nivå av depression vid uppföljningsmätning. Däremot visade regressionsanalyser att sömnbesvär, mätt med formuläret Insomnia Severity Index (ISI), vid framför allt eftermätning hade ett samband med senare nivå av depression vid uppföljningsmätningen. Resultaten indikerade att kvarstående sömnbesvär då behandlingen avslutades predicerade senare nivå av depression. Slutsatsen är att ett tillägg av en sömnintervention för de patienter som har insomni då behandlingen avslutas kan minska sannolikheten för återfall i depression. Då många patienter saknade uppföljningsdata kunde inga säkra slutsatser dras.

The lifetime prevalence of clinical depression in patients living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) is approximately 22% compared to 3% to 10% in the primary care population. The nursing practice problem at the project site concerned nurses' lack of knowledge and understanding of procedures to help ensure that all patients living with HIV/AIDS were properly screened for depression and referred for further evaluation and treatment. The purpose of this project was to implement a staff education module to address the use of the PHQ-9 screening tool to identify depression in people diagnosed with HIV/AIDS. The theoretical framework for this educational module was the theory of planned behavior. The practice-focused question explored the extent to which the implementation of an evidence-based practice education model in a primary care clinic treating patients living with HIV/AIDs would increase staff knowledge on the use of the PHQ-9 tool to screen for depression. A staff education project incorporating a pretest and posttest design was conducted to determine whether a significant change existed in the test scores of the participants between the pretest and the posttest. After completion, the posttest measures showed an improvement of 35%. The implications of this project for social change might include improvement in the knowledge, attitudes, and practices of the nurses in the treatment of depression in adults living with HIV/AIDS.

Cortisolkonzentrationen steigen während der Schwangerschaft und sind essentiell für die Organogenese und Einleitung der Geburt (Smith & Shearman, 1974). In dieser Studie haben wir einen Anstieg der HCC und HCNC vom 2. zum 3. Trimester in der Schwangerschaft nachgewiesen. Dabei stieg die HCC um den Faktor 1,3 und die HCNC um den Faktor 1,5. Frühere Studien konnten bereits einen ähnlich hohen physiologischen Anstieg von Cortisol nachweisen um den Faktor 1,5 im Haar und Speichel (D’Anna- Hernandez et al., 2011) und um den Faktor 3 im Urin und Plasma (Jung et al., 2011). Nach bestem Wissen wird in dieser Dissertation zum ersten Mal ein Anstieg der HCNC in der Schwangerschaft beschrieben. Dabei war die HCNC um das Dreifache höher als die HCC in beiden Trimestern, welches die Bedeutung der Inaktivierung von Cortisol zu Cortison durch das Enzym 11B- HSD Typ 2 hervorhebt. Höhere Werte für die HCNC wurden auch in nichtschwangeren Probanden beschrieben (Ullmann et al., 2016). In unserer Studie ergaben sich negative Assoziationen mit den PHQ- Subscores und der HCNC und dem Verhältnis von HCNC/HCC jedoch nie mit der HCC allein. Die gleichzeitige Bestimmung beider Steroide ist somit sinnvoll, gerade im Hinblick auf deren Verhältnis, welches ein indirekter Marker für die 11B- HSD Typ 2 Aktivität ist (Ghaemmaghami et al., 2014, Wilson & Thayer, 2017). Der Zusammenhang zwischen steigenden Stressscores und sinkender HCNC sowie sinkendem Verhältnis von HCNC/HCC lässt vermuten, dass Schwangere mit steigenden Stresssymptomen eine geringere Cortisonkonzentration aufweisen, möglicherweise durch niedrigere Aktivität der 11B- HSD Typ 2, und damit eine geringere Umwandlung von Cortisol zu Cortison. Als einziger Einflussfaktor auf die Konzentration der Steroide im Haar konnte häufiges Haarewaschen identifiziert werden (signifikant niedrigere Konzentrationen beider Steroide). Dies unterstreicht die Bedeutung einer genauen Datensammlung bei Probenabnahme durch gezieltes Erfragen der Haarbehandlung, nicht nur über Manipulation durch Haarfärbung und -tönung, sondern auch über alltägliche Handhabung des Waschens. Das Verhältnis HCNC/HCC wurde weder signifikant durch häufiges Haarewaschen noch durch andere untersuchte potentielle Einflussfaktoren beeinflusst und stellt daher einen robusteren Messparameter auch für zukünftige Studien dar.:I. Abkürzungsverzeichnis 1. Vorbemerkung ……………………………………………………………....…….. 1 2. Einführung in die Thematik 2.1 Definition Stress ……………………………………………………………....... 3 2.2 Physiologische Stressreaktion ……………………………………………....... 3 2.3 Modulation der Stresshormone durch das Enzym 11β- Hydroxysteroid-Dehydrogenase Typ 2 ……………………………………………………...........…… 5 2.4 Messung von Stress ……………………………………………………..……... 6 2.4.1 Messung von Stress durch Biomarker ………………………………..... 6 2.4.2 Messung von Stress durch Fragebögen ……………………………….. 8 2.5 Stress in der Schwangerschaft ………………………………………………... 9 3. Fragestellung …………………………………………………………………….... 11 4. Publikation …………………………………………………………………………. 13 5. Zusammenfassung der Arbeit ……………………………………………………. 21 6. Literaturverzeichnis ………………………………………………………………... 27 II. Anlagen II.A Tabellen ………………………………………………………………………........ 37 II.B Ergänzungsunterlagen zur wissenschaftlichen Publikation …………………. 41 III. Darstellung des eigenen Beitrags ……………………………...……………….. 46 IV. Erklärung über die eigenständige Abfassung der Arbeit ……….…………….. 47 V. Danksagung …..……………………………………………………....................... 48

The purpose of this study was to examine the mental health among young elite athletes aged16-19 years old at Växjö municipality sports high schools. The focus area was anxiety anddepression disorders, which were measured using the General Health Questionnaire. Theprimary issues was to examine how common these disorders are and whether it differsbetween individual and team athletes. By actualizing the subject, there are also hopes that thesubject will be less stigmatized.A quantitative method has been used to reach out to as many people as possible. Thequestionnaire included for example questions about injury background and amount oftraining, to have a material for an analysis. Some of the conclusions are that anxiety anddepression disorders are common among students at Växjö municipality sports high schoolsand that many students consider that they don’t receive sufficient support for mental illness.

Indiana University-Purdue University Indianapolis (IUPUI) / Importance: Despite its widespread use in clinical settings and in behavioral medicine research, little is known about the psychometric performance of the PHQ-9 across major U.S. sociodemographic groups. Thus, utilizing a large sample representative of the U.S. population and confirmatory factor analysis (CFA), we determine the factor structure and measurement invariance of the PHQ-9 across groups based on sex, race/ethnicity, and education level. Objective: Our objective was to address key knowledge gaps by definitively determining the factor structure and measurement invariance of the PHQ-9 across major U.S. sociodemographic groups based on sex, race/ethnicity, and education level. Design: The continuous National Health and Nutrition Examination Survey (NHANES) is a cross-sectional, epidemiologic study designed to assess the health and nutritional status of the U.S. population. We examined data from the 2005-2014 survey years. Setting: NHANES is uses a stratified multistage probability sampling approach to enroll civilian, non-institutionalized adults and children in the U.S. Participants: For our final sample, we selected the 26,202 adult respondents with no missing PHQ-9 data. The factors of interest were sex (49.3% men, 50.7% women), race/ethnicity (48.9% non-Hispanic White, 23.7% non-Hispanic Black, 17.8% Mexican American, 9.7% other Hispanic), and education level (9.9% less than 9th grade, 16.6% 9th-12th grade but no diploma, vii 23.7% high school graduate/GED or equivalent, 28.9% some college or Associate’s degree, 20/8% college graduate or above). Main Outcome(s) and Measure(s): The Patient Health Quessionnaire-9 (PHQ-9) Results: Results revealed that the best solution for the PHQ-9 consists of a cognitive/affective factor (items 1. anhedonia, 2. depressed mood, 6. feelings of worthlessness, 7. concentration difficulties, 8. psychomotor disturbances, and 9. thoughts of death) and a somatic factor (items 3. sleep disturbance, 4. fatigue, and 5. appetite changes; RMSEA = 0.034, RMSEA 90% CI = 0.032–0.036, TLI = 0.984, CFI = 0.988). To evaluate measurement invariance, we then conducted single-group and multiple-group CFAs to carry out the 5 steps of measurement invariance testing. Dimensional, configural, weak factorial, strong factorial, and strict factorial invariance was established for the PHQ-9 across the sex, race/ethnicity, and education level groups, as all models demonstrated close fit and the ΔCFI was < 0.010 for all steps. Conclusions and Relevance: Using a U.S. representative sample, we determined that a two-factor solution for the PHQ-9 with a cognitive/affective factor and a somatic factor is invariant across sex, race/ethnicity, and education level groups. Therefore, clinically, the PHQ-9 is an acceptable measure to utilize in major U.S. sociodemographic groups, extending the use of this depression screener from the primary care clinic to the community. Additionally, we show that PHQ-9 cognitive/affective and somatic subscale scores have the same meaning and can be compared across major U.S. sociodemographic groups and provide a consistent, evidence-based approach to computing PHQ-9 subscale scores to be used in future studies.

Syftet med studien var att kvantitativt undersöka förekomsten av negativ kroppsuppfattning samt sambandet mellan negativ kroppsuppfattning och psykisk ohälsa hos unga män. Frågeställningarna var hur vanligt det var med negativ kroppsuppfattning hos unga män på gymnasieskolor i södra Sverige, samt om det fanns ett samband mellan negativ kroppsuppfattning och psykisk ohälsa hos samma målgrupp. Urvalet bestod av 116 deltagare ( M = 17 år), vilka besvarade en enkät där negativ kroppsuppfattning och psykisk ohälsa mättes med hjälp av mätinstrumenten Appearance Evaluation respektive Global Health Questionnaire 12 . Resultaten visade att 23 % av deltagarna hade en negativ kroppsuppfattning, och att det fanns ett signifikant samband med medium effektstorlek mellan negativ kroppsuppfattning och psykisk ohälsa. Slutsatsen blev att negativ kroppsuppfattning förekom hos unga män på gymnasieskolor i södra Sverige, samt att det fanns ett samband mellan negativ kroppsuppfattning och psykisk ohälsa hos de unga männen. Emellertid bidrog metodologiska svårigheter till att resultaten inte är generaliserbara. / The purpose of this study was to quantitatively investigate the prevalence of negative body image and the correlation between negative body image and psychological distress in young men. The research questions were how common negative body image was in young men in high schools in southern Sweden, and if negative body image correlated with psychological distress within the target group. The sample consisted of 116 participants ( M = 17 years), who answered a survey where negative body image and psychological distress was measured by Appearance Evaluation and General Health Questionnaire 12. Results showed that 23 % of the participants had a negative body image, and that there was a significant correlation with medium effect size between negative body image and psychological distress. The conclusion was that negative body image existed in young men in high schools in southern Sweden, and that there was a correlation between negative body image and psychological distress among these young men. However, the methodological difficulties contributed to the results not being generalizable.

The aim of this study was to explore whether general self–efficacy would moderate the relationship between stress and positive mental health in participants from an African context. Literature supported the concept that stress has a negative influence on mental health and that this interaction may be moderated by cognitive resources. General self–efficacy is a cognitive resource that may act as a moderator in the negative association between stress and positive mental health. Although general self–efficacy is thought to be a universal construct, little empirical research on it has been conducted in an African context. An African socio–cultural context is often described as more collectivistic and characterised by social harmony and interdependence. A sample of 1050 participants from both urban (n=451) and rural (n=599) settings completed Setswana versions of the four relevant questionnaires, i.e. the Mental Health Continuum - Short Form (MHC–SF, Keyes, 2006), used to measure positive mental health, the General Health Questionnaire (GHQ, Goldberg & Hillier, 1979), used to measure the experience of stress, the Generalized Self–Efficacy Scale (GSE, Jerusalem & Schwarzer, 1992) and the New General Self–Efficacy Scale (NGSE, Chen, Gully & Eden, 2001), both measuring general self–efficacy. Data were collected in a quantitative cross–sectional survey design with the aid of 16 trained bilingual (English and Setswana speaking) fieldworkers. Results showed negative correlations between the GHQ (SS, AS, SD, and DS) and MHC–SF (EWB, PWB, and SWB). Results indicated that general self–efficacy moderated the negative effect of manifestation of stress as shown by indices of psychological distress on emotional, psychological and social well–being. Thus, it is found that higher levels of self–efficacy are beneficial for the well–being of individuals in this African sample. / Thesis (M.A. (Clinical Psychology))--North-West University, Potchefstroom Campus, 2011.