Thesis (MA)--University of Stellenbosch, 2001. / ENGLISH ABSTRACT: This study investigated the incidence of depression, post-traumatic stress symptomatology, anger and guilt in a shelter sample of 40 battered women. In addition, the presence of dysfunctional, evaluative beliefs, as viewed from a Rational-emotive perspective, was investigated, as well as the relationship between dysfunctional beliefs and symptoms of psychopathology. Participants completed the Beck Depression Inventory, Post-traumatic Stress Diagnostic Scale, Anger Diagnostic Scale, Trauma Related Guilt Inventory and Survey of Personal Beliefs. It was found that 63% of the participants showed moderate to severe levels of depression, while 59% manifested high post-traumatic stress symptomatology. Between 38% and 50% experienced problems with anger whilst 48.5% showed moderate guilt. In general, these symptoms did not correlate with the age of participants or with the duration or frequency of abuse, except for anger which was related to a history of childhood sexual and/or physical abuse. The results of the Survey of Personal Beliefs indicated that the group displayed Otherand Self-directed Demands, Awfulizing, Low Frustration-tolerance and Negative Selfworth. Only Low Frustration-tolerance (underestimation of coping skills) correlated significantly with levels of depression, anger and guilt. / AFRIKAANSE OPSOMMING: Hierdie studie het die insidensie van depressie, post-traumatiese stressimptome, woede en skuldgevoelens in 'n groep van 40 vroulike slagoffers van gesinsgeweld, wat die huweliksverhouding verlaat het en in 'n skuiling vir mishandelde vroue opgeneem is, ondersoek. Die disfunksionele, evaluerende kognisies, soos deur die Rasioneel-emotiewe gedragsterapie gepostuleer, asook die korrelasie tussen hierdie kognisies en die simptome van psigopatologie, is ook ondersoek. Deelnemers het die Beck Depression Inventory, Post-traumatic Stress Diagnostic Scale, Anger Diagnostic Scale, Trauma-Related Guilt Inventory en Survey of Personal Beliefs voltooi. Die resultate het aangedui dat 63% van die deelnemers matige tot ernstige vlakke van depressie getoon het, terwyl hoë post-traumatiese stressimptomatologie by 59% voorgekom het. Tussen 38% en 50% het probleme met woede getoon, terwyl matige skuldgevoelens by 48.5% voorgekom het. Oor die algemeen het hierdie simptome nie verband getoon met die ouderdom van deelnemers of met die duur of frekwensie van die mishandeling nie, behalwe die vlak van woede wat 'n verband getoon het met 'n geskiedenis van kindermolestering. Tellings op die Survey of Personal Beliefs het aangedui dat die groep die disfunksionele, evaluerende kognisies van Self- en Ander-gerigte Eise, Katastrofering, Lae Frustrasie - toleransie en Negatiewe Selfwaarde getoon het. Slegs Lae Frustrasie-toleransie (onderskatting van hanteringsvaardighede) het beduidend met vlak van depressie, woede en skuldgevoelens gekorreleer.

The performances of 114 eating disordered females on measures of individual and family functioning were examined via t-tests, analyses of variance, and chi squares analyses. Subjects met DSM-III-R criteria for anorexia nervosa, anorexia nervosa with bulimia nervosa, bulimia nervosa, or eating disorder not otherwise specified. Measures included selected scales of the MMPI, Rotter's Internal-External Locus of Control Scale, the Bem Sex Role Inventory, the Eating Disorder Questionnaire, the Moos Family Environment Scale, and the Berren-Shisslak Family Dynamics Survey. First, performances on the measures were compared to normative samples and across diagnostic groups. As expected, the subjects differed from normative samples on many dependent measures, but the diagnostic groups differed little among themselves. Next, an examination of 45 clinical features suggested that subjects were not as symptomatically distinct as diagnosis might imply. Finally, diagnosis was set aside to examine the relationships of specific clinical features to the measures of individual and family functioning. These features included age, weight history, food binges, vomiting, laxative and diuretic use, food restriction, menstrual history, exercise, drug and alcohol abuse, symptom severity, inpatient treatment history, and additional diagnosis. Surprisingly, a history of anorectic weight was not related to any of the measures, but amenorrhea emerged as a clinical feature of some import, not just among the anorectic subjects but among subjects generally. Other findings suggested that patients who binge have difficulty with separation, that binges may be a metaphor for unsatisfied cravings for nurturance, and that vomiting and exercise may enhance a sense of separateness while laxative use may represent the private expulsion of anger. The need for family involvement in treatment was highlighted by many relationships between the clinical features and indices of family dysfunction.

The purpose of this study was to explore the relationship between urinary incontinence and self-esteem and also social participation. A convenience sample of 25 women 60 years of age and older participated. Forty-eight percent of the women had urinary incontinence at the time of the study. No significant differences were found in the level of self-esteem between those women with urinary incontinence and those women without urinary incontinence. Two subjects with urinary incontinence reported refusing social participation due to urinary incontinence. However, no difference in the overall level of social participation was found when comparing those with to those without urinary incontinence. A nonsignificant correlation was found between self-esteem and the overall level of social participation. In addition, the relationship between self-esteem and the level of social participation for women with urinary incontinence was nonsignificant. Only two of the 12 subjects with urinary incontinence reported receiving treatment.

Introduction: There is a large literature across disciplines aimed at understanding the causes of the depression gap, defined as an excess of depression among women compared with men. Based on the totality of evidence to date, social stress appears to be an important explanation for the depression gap. Social stress theory highlights women’s disadvantaged social position relative to men, positioning gender differences in socio-economic opportunities as social stressors, while also acknowledging how gender socialization teaches women to respond to stressors in depressogenic ways from an early age. This dissertation applied social stress theory to better understand the social causes of the depression gap with three related aims. Aim 1 summarized the evidence for variation or stability in the depression gap in recent decades, through a systematic review and meta-regression of depression gap studies over time and by age. Aim 2 examined the evidence for a changing depression gap across birth cohorts, and tested the extent to which any changes over time were mediated by changing gender differences in education, employment, and housework rates, three indicators of broader trends in gendered social position through the 21st Century. Aim 3 examined whether women in the workforce with competing domestic labor roles were at increased risk of depression, and whether pro-family workplace benefits buffered the effects of competing roles. Methods: In aim 1, depression gap estimates were extracted through a systematic review of published literature (from 1982-present). Analytic datasets were comprised of 76 diagnostic-based estimates and 68 symptom-based estimates. For each dataset, meta-regression models estimated time and age variation in the depression gap, as well as the interaction between time and age group, to estimate the variation in the gap over time by age. Data from the National Longitudinal Surveys were utilized for aims 2 and 3. Depression was measured with the Center for Epidemiologic Studies Depression Scale (CESD), and the depression gap was defined as differences in mean CESD scores for women vs. men. The aim 2 sample included 13,666 respondents interviewed from 1992-2014. Hierarchical mixed models estimated the magnitude of the gender depression gap over time, and its relationship with 10-year birth cohort (range: 1957-1994) and whether any variation was mediated by gender differences in: those with a college degree or more, those who were employed full-time, and the average number of hours spent doing housework per week. The sample in aim 3 was limited to employed women ages 17-57 (n=3993). Generalized estimating equations estimated the relationship between competing roles and depression, and the interaction between competing roles and pro-family employee benefits on depression. Interaction results were compared to models estimating the effect of non-family-related benefits on the relationship between competing roles and depression. Results: In aim 1, there was no evidence of change in the depression gap over time. Compared with the reference group (i.e., respondents ages 60+), the age effect was appreciable among the youngest age group (age 10-19) (RR=1.44; 95% CI=1.19, 1.74), but did not differ for any other age groups. The age by time interaction was elevated for youngest age group (RR=1.27; 95% CI=1.0, 1.61), suggesting that, compared to the oldest age group, the diagnostic depression gap had increased among the youngest ages from 1982 to 2017. There was no evidence of time changes among any other age group. Results were similar for symptom-based studies. In aim 2, there was a linear decrease in the depression gap by 0.18 points across birth cohort (95% CI= -0.26, -0.10). The results of the mediation analysis estimated that an increasing ratio of college degree attainment mediated 39% of the gender depression gap across cohorts (95% CI= 0.18, 0.78). There was no evidence of mediation due to changing employment or housework ratios. In aim 3, there was evidence that women in competing roles reported a 0.56-point higher CESD score (95% CI= 0.15, 0.97), compared with women not in competing roles. The interaction between pro-family benefits and competing roles was associated with CESD scores (B=-0.44, p=0.023). More specifically, among women without access to pro-family benefits, those in competing roles reported a 6.1 point higher CESD score (95% CI=1.14, 11.1), compared with those not in competing roles, however, among women with access to these benefits, there was no association between competing roles and CESD scores (difference=0.44; 95% CI=-0.2, 1.0). Results were similar for non-family-related benefits. Women in competing roles without non-family-related benefits reported a 3.59 point higher CESD score than those not in competing roles (95% CI=1.24, 5.95) while among women with access to these benefits, there was no association between competing roles and CESD symptoms. Conclusion: This dissertation provided evidence to partially support the hypothesis that the depression gap is changing over time and is meaningfully related to the social environment, through which gender roles, responsibilities, and opportunities available to women and men are defined and reinforced. The results of these studies suggest that the depression gap may be expanding and contracting over time for different age groups. Understanding the social causes of the depression gap is important to reduce the present and future burden of the depression gap, and to understand the fundamental processes through which depression disparities may be perpetuate or attenuated in adolescence and beyond.

This ethnographic study explored the social and cultural context of Maldivian women???s emotional, social and psychological well-being and the subjective meanings they assign to their distress. The central question for the study was: How is suffering and distress in Maldivian women explained, experienced, expressed and dealt with? In this study participant observation was enhanced by lengthy encounters with women and with both biomedical and traditional healers. The findings showed that the suffering and distress of women is embedded in the social and economic circumstances in which they live, the nature of gender relations and how culture shapes these relations, the cultural notions related to being a good woman; and how culture defines and structures women???s place within the family and society. Explanations for distress included mystical, magical and animistic causes as well as social, psychological and biological causes. Women???s experiences of distress were mainly expressed through body metaphors and somatization. The pathway to dealing with their distress was explained by women???s tendency to normalize their distress and what they perceived to be the causes of their distress. This study provides an empirical understanding of Maldivian women???s mental well-being. Based on the findings of this study, a multi dimensional model entitled the Mandala for Suffering and Distress is proposed. The data contributes a proposed foundation upon which mental health policy and mental health interventions, and curricula for training of health care providers in the Maldives may be built. The data also adds to the existing global body of evidence on social determinants of mental health and enhances current knowledge and developments in the area of cultural competency for health care. The model and the lessons learnt from this study have major implications for informing clinicians on culturally congruent ways of diagnosing and managing mental health problems and developing patient-centred mental health services.

The mental well-being of individuals has been studied for centuries. Yet a full understanding of the causal mechanism of mental distress has not been achieved. The prevalence of depression in women has spurred much of the research in this area. The goal of this dissertation is to contribute to the understanding of the determinants of women's mental and physical functioning. The means to this end is to incorporate a concept from each of the following disciplines, sociology and psychology. The sociological discipline lends the stress model to this research, while psychology contributes the concept of worry. To date, sociologists have not studied the effects of worries on women's mental health, while psychologists have not included socio-demographic indicators and stress variables in their studies of worry. The purposes of this dissertation are to add worry to the Traditional Stress Model, explore the determinants of worry, and observe the consequences of worry on mental distress and physical functioning. / A community sample of 170 mothers is employed to test the hypothesis that adding worry to the Traditional Stress Model, while controlling for socio-demographic indicators, stress, social support, and coping measures, will significantly increase the explanatory power when predicting the Total Mood Disturbance Score (TMDS) and the Total Physical Health Score (TPHS). Results from a series of multiple regressions indicate that worry measures do significantly contribute to the understanding of the TMDS and TPHS. / Other conclusions are also reached regarding several determinants of women's mental and physical functioning included throughout the analyses. In the case of married women, a measure of their marital status is a better indicator of their TMDS and TPHS than a measure of their social support from friends and family. In the case of employed women, the most significant indicator for both the TMDS and TPHS is their level of employment stress. / Research and policy implications emerge from these results. For example, general practitioners should be trained to detect employment or marital stress, and poor mood states which are likely to affect their patients' perceptions of their mental and physical health.

This cross-cultural study examines eating disorders, Anorexia nervosa, Bulimia, and compulsive overeating in Japanese and Canadian women. Through qualitative interviews with nine Japanese and nine Canadian women with eating disorders, it was found that factors contributing to the onset of eating disorders were similar in the two groups. Similarities included the value placed upon thinness by society which is widely perpetuated by the media, being told they were fat and made to feel they needed to lose weight, wanting attention for their eating disorder, and a history of sexual abuse. The Canadian women interviewed, revealed that their mothers also had eating disorders. On the other hand, the Japanese women reported stress from the education system, which led to abnormal eating behavior. Japanese women also reported gender-role conflicts as a cause. / A questionnaire regarding attitudes towards food and weight was given to 100 Japanese and 55 Canadian female university students. It was found that the women's desire to lose weight was strong in both samples. Sixty-six percent of the Japanese women and 38.1 percent of the Canadian women reported that they are "always," "usually," or "often" terrified that their weight will increase. This study postulates that the women with eating disorders want to empower themselves by controlling their food intake and their body weight. The implication is that any factor that creates a sense of ineffectiveness in the woman may trigger an eating disorder if the woman believes the only thing she can control is her food intake. Evidence to support this argument will be shown through discussions of actual experiences of women with eating disorders.

This ethnographic study explored the social and cultural context of Maldivian women???s emotional, social and psychological well-being and the subjective meanings they assign to their distress. The central question for the study was: How is suffering and distress in Maldivian women explained, experienced, expressed and dealt with? In this study participant observation was enhanced by lengthy encounters with women and with both biomedical and traditional healers. The findings showed that the suffering and distress of women is embedded in the social and economic circumstances in which they live, the nature of gender relations and how culture shapes these relations, the cultural notions related to being a good woman; and how culture defines and structures women???s place within the family and society. Explanations for distress included mystical, magical and animistic causes as well as social, psychological and biological causes. Women???s experiences of distress were mainly expressed through body metaphors and somatization. The pathway to dealing with their distress was explained by women???s tendency to normalize their distress and what they perceived to be the causes of their distress. This study provides an empirical understanding of Maldivian women???s mental well-being. Based on the findings of this study, a multi dimensional model entitled the Mandala for Suffering and Distress is proposed. The data contributes a proposed foundation upon which mental health policy and mental health interventions, and curricula for training of health care providers in the Maldives may be built. The data also adds to the existing global body of evidence on social determinants of mental health and enhances current knowledge and developments in the area of cultural competency for health care. The model and the lessons learnt from this study have major implications for informing clinicians on culturally congruent ways of diagnosing and managing mental health problems and developing patient-centred mental health services.

The problem of this study was to determine the effectiveness of a stress-reduction training program for women. The purposes were (1) to compare the training program with a group counseling program, (2) to determine the effect of the selected personality characteristics of field dependence, perceived anxiety, and anxiety proneness on perceived stress, and (3) to provide counselors with information concerning the reduction of stress in women.

Research has shown that a high number of South Asian people suffer with mental health problems and that South Asian women specifically, are at high risk of attempting self -harm or suicide. However, there seems to be a low uptake of the mainstream services offered by the South Asian community as a whole, compared to their white counterparts. Furthermore, the existing literature in this area is scarce and focuses on identifying barriers that South Asian women face in accessing help. This mixed methods study explored the mental health help seeking experiences of British born South Asian women. For the first part of the study, six (N=six) women who had successfully accessed therapy were interviewed and the qualitative data was analysed using Braun and Clarke’s (2006) framework for thematic analysis. The main superordinate themes identified included: therapy as a positive experience, perseverance and persistence, need to know basis, fears about being judged, the need for more publicising and awareness, recovery as an ongoing process, medical professionals needing to be more proactive, developing autonomy and putting your own needs first, developing understanding and the importance of the first step. Various subordinate themes were identified for some of these main superordinate themes. The second part of this study involved delivering a psycho educational workshop (which was partly based on the qualitative data generated in the first part of the study) to a group of South Asian women (N=25). Their attitude towards help seeking was measured before, immediately after and four weeks after the workshop using Fischer and Farina’s (1995) Attitudes toward Seeking Professional Psychological Help Scale. An ANOVA Test indicated a statistically significant difference in attitudes to help seeking before, immediately after and four weeks after the workshop. This study helped to get a better understanding of the experiences of a marginalised group and demonstrated how such information can be used to develop new and innovative interventions that can be used with a client group that appear to have low levels of engagement with and referral to mental health services.