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A systematic review of mental health care access in disadvantaged communities in South Africa

- Dube, Nkosingiphile Zama

Authors: Dube, Nkosingiphile Zama
Date: 2025-04-25
Subjects: Mental health services South Africa , Rural mental health services South Africa , Social psychiatry South Africa , Healers South Africa , Help-seeking , Systematic reviews (Medical research)
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/478295 , vital:78174
Description: Background: Access to mental healthcare in disadvantaged rural communities in South Africa faces numerous challenges, particularly due to cultural beliefs that impact help-seeking behaviours. Systematic reviews provide critical insights into the barriers and facilitators of healthcare access in such contexts. This review aims to evaluate the available literature on mental healthcare access in rural South African communities, with a specific focus on the influence of cultural beliefs on help-seeking behaviours. Methods: A systematic search was conducted across databases, including PubMed, Scopus, and Web of Science, to identify studies published between 2010 and 2023. Studies were included if they examined barriers to mental healthcare access in rural South African settings and involved culturally relevant factors. Screening, selection, and appraisal of studies were carried out using PRISMA guidelines, with data extracted and synthesized through qualitative thematic analysis. Results: A total of 24 studies met the inclusion criteria. Key findings identified barriers such as financial constraints, scarcity of mental health facilities, stigma, long distances to services, language barriers, and cultural beliefs. Cultural practices, such as attributing mental distress to witchcraft or ancestral displeasure, were found to influence perceptions of mental health and discourage professional intervention, with traditional healers and community elders frequently being the preferred resource. Some community members, despite limited knowledge, utilized smartphones for mental health applications, while others relied on traditional practices and community support networks. Conclusion: This review underscores the need for a culturally sensitive, integrated approach to mental healthcare in rural South Africa, blending traditional and modern practices. Recommendations include conducting rural needs assessments, fostering collaboration between mental health practitioners and traditional healers, and enhancing teacher training. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
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Date Issued: 2025-04-25

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Massed prolonged exposure therapy for PTSD and alcohol use: a single case experimental study of a university student

- Abrahams, Sherwin Owen

Authors: Abrahams, Sherwin Owen
Date: 2025-04-25
Subjects: Prolonged exposure therapy , Post-traumatic stress disorder , Alcoholism , Flooding , College students Alcohol use South Africa , College students Psychology
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/478284 , vital:78173
Description: Post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) are common among university students in South Africa. Bantjies et al. (2023) found a PTSD prevalence of 21.0% (n=28,268), and McGowan and Kagee (2013) reported that 90% (n=1337) had experienced at least one traumatic event. There is a high comorbidity between PTSD and AUD, especially in hazardous drinkers (Peltzer & Pengpid, 2015). Despite the prevalence, research on effective trauma-focused therapies (TFTs) in low-resource settings is limited (Booysen & Kagee, 2021). This study evaluates the effectiveness of massed-prolonged exposure (MPE) therapy for comorbid PTSD and AUD among South African university students, using a Single-Case Experimental Design (SCED). The participant (n=1) underwent comprehensive assessments using CAPS-5, AUDIT, PDS-5, and PCL-5, confirming PTSD and AUD diagnoses. Regular PCL-5 assessments during the intervention showed significant symptom improvement, and post-intervention assessments indicated the participant no longer met PTSD criteria. AUDIT scores also improved from 11 (harmful/hazardous drinking) to 6. The participant found MPE therapy to be feasible, acceptable, and appropriate. This study supports the effectiveness, feasibility and acceptability of MPE therapy and highlights the importance of evidence-based interventions to improve PTSD outcomes within university settings and in low-to-middle-income countries. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
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Date Issued: 2025-04-25

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Mental healthcare users’ perceptions of mental health services at a primary healthcare level

- Zwane, Siphelele

Authors: Zwane, Siphelele
Date: 2025-04-25
Subjects: Mental health services South Africa Makhanda , Primary care (Medicine) , Mental health consumer , Mental health education South Africa , Help-seeking
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/478372 , vital:78181
Description: This study interrogates the complexities of mental healthcare in primary healthcare settings, focusing on the experiences and perceptions of participants within the Makana municipality in the Eastern Cape Province, which is characterised by a low socio-economic status. The matter of mental healthcare is of great significance within the context of South Africa, a country grappling with multifaceted challenges. Over the years, mental health has progressed from being marginalised to being more widely acknowledged. While the integration into tertiary and urban healthcare settings has become smoother, primary healthcare has encountered numerous obstacles. This presents a concern, due to the socioeconomic difficulties faced by individuals accessing primary care, which predispose them to mental health issues. Consequently, it is imperative to conduct research focusing on the experiences and perspectives of mental healthcare users within primary healthcare, a relatively underexplored area. The primary objective of the current research study was to contribute to the existing knowledge base, providing valuable insights for relevant stakeholders and policymakers, such as the National Mental Health Policy Framework 2023-2030, to reference when formulating strategies to enhance the integration of mental healthcare into primary healthcare. The study used purposive sampling to interview mental healthcare users within the Makana municipality. Employing a qualitative design facilitated in-depth dialogue between the participants and the researcher, generating valuable data. Thematic Analysis was employed to analyse and present meaningful data, providing an overview of the participants' shared experiences. The study identified four significant themes: the utility of primary health clinic; the urgent need for mental health education; socioeconomics, and mental health, and the complex dynamics of help-seeking behaviours. The findings underscore the pressing need to integrate quality mental health into PHC, emphasising the importance of mental health education, increased resources, task-sharing, and the prioritisation of both physical and mental illnesses. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
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Date Issued: 2025-04-25

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Perceptions and reflections of primary healthcare professionals on mental health services in Makhanda

- Piliso, Zandisiwe

Authors: Piliso, Zandisiwe
Date: 2025-04-25
Subjects: Primary care (Medicine) , Mental health services South Africa Makhanda , Medical personnel , Ecological Systems Theory , Mental health personnel South Africa Makhanda
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/478344 , vital:78179
Description: Primary mental healthcare in South Africa is still in its early stages, despite policies that have been developed, such as the National Mental Health Framework Policy. Provinces such as the Eastern Cape are far behind development, which can be attributed to limited resources. The scarcity has been noted in the literature, but not extensively. Literature concentrated on healthcare professionals’ perspectives towards primary health greatly narrow, particularly in the Makhanda area. With the integration of primary mental health services, healthcare workers’ viewpoints have impacted on service delivery. This study aims to add knowledge and explore the perspectives of healthcare professionals on primary mental healthcare in Makhanda. The ecological systems theory was used as a theoretical framework for the study. Thematic analysis was used to examine the healthcare professionals’ insights and to extract meaning for the participants involved in the study. Thirteen participants were used, using purposive sampling in four primary healthcare settings. Data were collected using semi-structured and one-on-one interviews. The study revealed three themes including, (i) Scarcity of Mental Health Services, (ii) Mental Health Literacy, (iii) Barriers to the Provision and Use of Physical and Mental Health Services. The findings suggest that there are limited mental health care services in primary care and that there is a gap between service provision and physical and mental healthcare. The data also revealed that mental health literacy is limited, which links to the stigma around mental illness. Furthermore, evidence points out that more mental health education, human resources and training of healthcare professionals would further improve the mental health services in the Makhanda area. In addition, there are barriers to the provision of not only primary mental health care but healthcare, as well as a lack of medical equipment, human resources, and structural space that make it difficult for healthcare professionals to perform their jobs and affect clinic functioning, at times. Another barrier is that the perception of mental health service provision is simultaneously viewed in a positive and negative light and mainly received negatively by service users. In conclusion, healthcare professionals experience a deficiency of resources and a limited provision of mental healthcare, which highlights the lack of implementation of policies that have developed nationally and globally. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
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Date Issued: 2025-04-25

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The feasibility and acceptability of Prolonged Exposure Therapy for PTSD at a community trauma centre in Cape Town: a qualitative analysis

- Markham, Kate Emily

Authors: Markham, Kate Emily
Date: 2025-04-25
Subjects: Prolonged exposure therapy , Post-traumatic stress disorder , Psychic trauma Treatment , Community-based corrections South Africa Cape Town , Social workers South Africa Cape Town
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/478339 , vital:78178
Description: South Africa deals with pervasive trauma stemming from its history of political violence, high crime rates, and social challenges, ultimately contributing to a significant burden of trauma exposure and post-traumatic stress disorder (PTSD) among its population. Despite the prevalence of PTSD, evidence-based psychological treatments (EBTs) such as Prolonged Exposure Therapy (PE) remain underutilised, particularly in low-resourced areas. This study aimed to assess the feasibility and acceptability of PE among social workers at The Trauma Centre for Survivors of Violence and Torture in Cape Town. This study used a qualitative research design, with special emphasis on Implementation Science. The study used the concepts of feasibility and acceptability to guide the research. The results revealed several key themes. Social workers’ pre-implementation themes included the perceptions around PE and implementation in South Africa, with three subthemes emerging. First, the impact of South African socioeconomic and political factors on The Trauma Centre. Second, perceptions surrounding the implementation of PE. And finally, the improvements and feasibility of PE; the social worker’s post-intervention findings focused on the feasibility and improvement of PE, post-treatment views, and the hurdles and limitations to implementation. The client's post-intervention findings explored refugee struggles, associated psychological distress, with two sub-themes of self-worth and suicidal ideation, and second, a lack of support and helplessness, loneliness, and isolation. The final theme looked at the experiences of PE, more specifically the positive client experiences with PE, and the challenges of PE. The implementation of PE at The Trauma Centre revealed both successes and challenges. Findings from this study suggest that PE can be effectively administered through task-shifting in low-resource settings. However, this study also highlighted significant challenges in the feasibility of implementing PE long-term in this context. Clients revealed ambivalent feelings regarding PE. Those who experienced positive outcomes demonstrated the potential for PE to be utilised in resource-limited settings. Those who did not find PE beneficial, highlight the need for future research to adapt PE to be culturally specific and feasible for a resource-constrained setting. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
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Date Issued: 2025-04-25

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The process of translating the Experiences in Close Relationship (ECR) Scale into isiXhosa

- Hadebe, Mandisa Zandile

Authors: Hadebe, Mandisa Zandile
Date: 2025-04-25
Subjects: Interpersonal relations South Africa , Psychological tests Translating , Xhosa language , Xhosa (African people) Mental health , Intimacy (Psychology)
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/478306 , vital:78175
Description: Intimate relationships are highly influenced by each individual’s attachment style. These attachment styles play a significant role in how romantic partners engage with each other and yet there are few tools that measure them. Not only are the tools few but also, they are not easily available in South African languages. Implementing isiXhosa language screening tools widens and enhances mental healthcare access for isiXhosa-speaking populations. This study aimed to develop an isiXhosa language version of the Experiences in Close Relationship Scale (ECR). The ECR is a 36-item self-report questionnaire designed to assess adult attachment styles in the context of close relationships. The scale evaluates the presence of anxious and avoidant attachment styles in adult romantic relationships. Anxious attachment is characterized by heightened anxiety about the relationship and a constant need for reassurance, while avoidant attachment involves a tendency to distance oneself emotionally from partners, often leading to difficulties in forming close connections. By measuring these styles, the scale provides deeper insights into how individuals relate to their partners and navigate intimacy in their romantic lives. The ECR was translated into isiXhosa using a four-stage translation design, which included: 1. Forward translation, 2. Back translation, 3. Committee meetings, and 4. Qualitative piloting of the resultant translation in a small sample of first language isiXhosa speakers. A quantitative pilot will follow this study. The results indicate that while broad concept equivalence was easier to achieve, participants struggled with understanding some of the items due to the difference in academic, written language and spoken language. The questions about emotions proved more difficult to translate. South African languages differ in dialect across different areas of the country. The isiXhosa terms chosen for this translation often conveyed distinct meanings or could be interpreted differently, depending on the specific geographical region and local dialect. This rich linguistic diversity posed a considerable challenge throughout the translation process, as it required careful consideration of context and cultural nuance to ensure accurate communication. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
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Date Issued: 2025-04-25

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Translation of the Composite Abuse Scale (Revised) Short Form (CASR-SF) into isiXhosa

- Mankantshu, Buncwanekazi

Authors: Mankantshu, Buncwanekazi
Date: 2025-04-25
Subjects: Psychological tests Translating , Xhosa language , Intimate partner violence , Self report , Translating and interpreting Social aspects
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/478328 , vital:78177
Description: Intimate partner violence (IPV) is a common occurrence in South Africa, yet appropriately validated tools that screen for IPV are not easily available, particularly in African languages. Establishing isiXhosa language versions of screening tools broadens and improves access to mental healthcare services for isiXhosa-speaking groups. This study aimed to develop an isiXhosa language version of the Composite Abuse Scale Revised Short Form (CASR-SF). The CASR-SF is a self-report measure designed to gauge the presence, intensity, and severity of IPV across three domains: physical, psychological, and sexual abuse. Previous translations of this questionnaire indicated its transportability across different languages and contexts, which in addition to the cost and time effectiveness of adapting instead of developing a new questionnaire, led to the decision to translate and adapt it into isiXhosa. The CASR-SF was translated using a four-staged translation design, which included: 1. Forward translation, 2. Back translation, 3. Committee discussion, and 4. Qualitative pilot in a small sample of first language isiXhosa speakers. Four independent translators worked independently to produce the forward and back translation in stages 1 and 2 and the translations team met in stage 3 to discuss and resolve challenging items with the goal of producing an equivalent final isiXhosa version of the CASR-SF. The resulting preliminary version was piloted on a sample of 7 first-language isiXhosa speakers who partook in cognitive interviews as a confirmatory step. The results indicated that for the most part broad concept equivalence was easier to achieve than linguistic equivalence, and participants generally did not struggle with understanding the items. However, questionnaire items on emotions and relatively new terms such as social media were far more complex to translate. African languages such as isiXhosa use metaphors as more respectful/acceptable expressions for topics such as sexual acts, which complicated the translation process at times. There were also various terms that could be used for different English concepts and the aim of this translation was to find one term that would be appropriate and meaningful across different isiXhosa language dialects, which proved challenging at times. , Thesis (MA) -- Faculty of Humanities, Psychology, 2025
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Date Issued: 2025-04-25

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Alcohol-related harm in relation to demographic factors: a longitudinal analysis of South African university students

- Chakabuda, Tatenda

Authors: Chakabuda, Tatenda
Date: 2025-04-04
Subjects: College students Alcohol use South Africa , College students Social conditions , Alcoholism Age factors , Alcoholism Sex differences , Drinking of alcoholic beverages Social aspects South Africa , Alcohol Use Disorders Identification Test
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/480139 , vital:78400
Description: Introduction: Substance abuse, particularly alcohol abuse, has been widely studied. Due to its nature as a legal substance, the negative effects of alcohol are seemingly undermined. However, studies over time have constantly shown that despite being legal, alcohol has detrimental effects that should not be ignored. The consequences of alcohol can be divided into two broad categories: short-term and long-term. Short-term effects include blackouts, poor decision-making, engaging in unsafe sexual practices, and vandalism. On the other end, long-term effects include physiological harm and declining neurocognitive capacity. These and many other forms of harm have been studied, mainly in diagnosed alcoholic populations. Overtime, the population of interest in terms of alcohol-related harm broadened and it increasingly became evident that university students are susceptible to alcohol-related harm and alcohol use disorders due to their drinking patterns. Student drinking patterns involving binge drinking, pre-drinking, and drinking games are common due to the fact that in university, young adults have less supervision and more freedom. University students are also in an environment where excessive alcohol use is normalised, which makes them prone to alcohol-harm. However, it is important to note that different demographics are predisposed to alcohol-harm differently. Gender, age, racial and socio-economic differences are some factors that have been proven to differentiate individuals’ likelihood of experiencing alcohol-related harm. Unfortunately, the differences across these different demographics within a South African university population are yet to be adequately explored. A large percentage of existing literature on demographic differences in the experience of alcohol harm in university cohorts has been largely amongst Western student populations. Methods: The present longitudinal study aimed to rectify this research gap by providing an evidence-based outcome analysis of demographic differences in the experience of alcohol-related harm in a South African student population. Data were collected using the Alcohol Use Disorders Identification Test (AUDIT) over a three-year period (2015, 2016 & 2017) from the same Rhodes University student cohort. Demographic data in the form of age, race, gender, and socio-economic status was analysed to study alcohol-related harm. Results: Data indicated that male students did not significantly experience greater alcohol-related harm compared to female students (p > 0.05). Similarly, white students did not experience significantly more alcohol-related harm compared to non-white students (p > 0.05). Findings further indicated that younger students experienced significantly greater alcohol-related harm in comparison to older students (p < 0.05). Lastly, students from a higher socio-economic background did not experience significantly greater alcohol-induced harm when compared to those from a lower socioeconomic status background (p > 0.05). Conclusion: Differences by age could be related to early brain development being linked to greater risk-taking, resulting in greater alcohol-related harm. Moreover, the absence of guardians may place younger student populations at greater risk for unhealthy drinking patterns, which may result in alcohol-related harm. Findings from the study suggest a greater need for interventions to target younger student populations. Future studies should explore why younger students are at greater risk for alcohol-related harm and seek to develop interventions that are more effective for this population. , Thesis (MSocSci) -- Faculty of Humanities, Psychology, 2025
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Date Issued: 2025-04-04

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A case study of GADRA’s community-engaged praxis for educational transformation

- Msomi, Nqobile Nomonde

Authors: Msomi, Nqobile Nomonde
Date: 2024-10-11
Subjects: Non-governmental organizations South Africa , Community psychology , Afrocentrism , Foucauldian discourse analysis , Education South Africa , Transformative learning South Africa
Language: English
Type: Academic theses , Doctoral theses , text
Identifier: http://hdl.handle.net/10962/464864 , vital:76552 , DOI https://doi.org/10.21504/10962/464864
Description: Although South Africa has achieved considerable steps in development over the last thirty years, post-apartheid South Africa is characterised by widespread poverty, high unemployment and systemic inequality. According to the country’s National Planning Commission, education is central to achieving the overarching democratic goals of eliminating poverty and reducing inequality. This positions education as an important site for the liberation and well-being of our country’s majority. This case study takes a community psychology perspective on education; more specifically the education-development nexus wherein Non-Governmental Organisations (NGOs) are centrally positioned. NGOs are contentiously positioned in the development discourse. Nonetheless, they have played a key role with regards to siding with the poor, the excluded, persistently marginalised and oppressed majority and to bringing about social justice, following South Africa’s colonial and apartheid histories, as well as in the current democratic dispensation. This study situates a local NGO, GADRA Education, within the country’s socio-political and educational landscape. Founded in the 1950s and located in Makhanda, it has been operating in the rural Eastern Cape province for more than sixty years. In the present-day, GADRA Education positions itself at the centre of a dense network of education institutions in Makhanda, including Rhodes University, and collaborates with a number of education stakeholders in the small city. The case study consisted of two consecutive phases: a Foucauldian discourse analysis of GADRA’s annual reports between 2012 and 2021, followed by individual narrative interviews with 13 organisational members. An Africa(n)-centred community psychology orientation, revealed counter-discourse to the national “crisis in education” discourse surrounding the NGO. The discourse of crisis produced the legitimation for GADRA Education’s continued existence, action and embeddedness in Makhanda. The discourse of transformation informed their modes of support across primary, secondary and higher education. The discourse of access and participation constructed the NGO as a bridge and link between phases of education. The discourse of collaborative partnerships enabled solidarity between state and non-state actors towards educational change. Finally, the discourse of development positioned development at a grassroots level. These constellations formed GADRA Education’s counter-discourse, which produced the Organisation’s apparatus of resistance, formulated as situated praxis. The 5 organisational members’ narratives revealed the apparatus’s impacts on the subjectivities of youth in Makhanda in engendering hope and driving educational change in the city. In contrast to conceptions of education NGOs who work in the public schooling sector making little progress in dismantling educational inequity, this study illustrates the techniques of resistance leveraged, in the context of collaborative partnerships, by the local NGO. These techniques have wider applicability for education-development practitioners concerned with transformative change in their educational locales. It illustrates the principles and modes by which NGOs can operate in solidarity with the persistently marginalised majority, and thus contribute to shaping our imagined educational futures. I argue that psychology is a useful site to think about justice. Critical psychological theory can enable a deeper understanding of practice that contributes to impactful community organisation, intervention and resistance in the country’s education sector. The operationalisation of the values and principles of community psychology can make important contributions at the nexus of theory and practice in working towards educational, and ultimately social, change. , Thesis (PhD) -- Faculty of Humanities, Psychology, 2024
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Date Issued: 2024-10-11

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A content analysis of the framing and representation of Black Lives Matter protests by South African mainstream media

- Manyike, Lerato Gladys

Authors: Manyike, Lerato Gladys
Date: 2024-10-11
Subjects: Black lives matter movement , Social movements South Africa , Race in mass media South Africa , Frames (Sociology) , Race discrimination South Africa
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/465799 , vital:76654
Description: This study conducted a detailed analysis of 277 headlines using content analysis, focusing on how News24 portrays racial protests, particularly within the Black Lives Matter (BLM) movement. It explored News24's coverage of BLM protests from March to December 2020, uncovering various framing strategies and language nuances in news headlines. The research aimed to identify thematic frames, linguistic patterns, and overall media framing of BLM protests. The findings highlighted different framing strategies, including legitimising, conflict, and delegitimizing frames, along with the impact of descriptive language on audience perceptions. The study concluded that media framing is dynamic, responding to evolving events and public discourse, and provided recommendations for media transparency, diversity in newsrooms, media literacy, and ethical reporting. Future research suggestions include comparative analyses, audience reception studies, and policy impact assessments to deepen understanding and inform strategic interventions in media representations and public discourse on racial justice. Overall, the study contributes valuable insights into media framing practices and their impact on societal perceptions of racial justice issues. , Thesis (MA) -- Faculty of Humanities, Psychology, 2024
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Date Issued: 2024-10-11

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A scoping review on problematic Internet use and Substance Use Disorder among men

- Adolph, Miché Tania

Authors: Adolph, Miché Tania
Date: 2024-10-11
Subjects: Internet addiction , Substance abuse , Men Mental health , Scoping review protocol , Compulsive behavior Sex differences
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/465788 , vital:76653
Description: Problematic Internet Use (PIU) and Substance Use Disorder (SUD) interact in complex ways that influence the current mental health landscape. Concurrently, the advent of the digital era has presented new difficulties, one of which is the emergence of problematic internet use as a significant issue that negatively impacts mental health. The increasing popularity of internet use has led to an increasing number of reports highlighting the potential negative consequences of overuse, such as substance use. Thus, the study aimed to synthesise literature on problematic internet use and substance use disorder, including the way in which they affect men, given that prior research has predominantly focused on women. The methods employed follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) which is largely based on a PRISMA statement and checklist, the JBI methodological guidance, and other approaches for undertaking scoping reviews. A total of 16 studies were eligible for final review, and the themes identified from the reviewed studies were obtained using Braun and Clarke’s thematic analysis. An analysis of the articles showed a large focus on gender differences in addiction patterns, vulnerability to problematic internet use across age groups, associations between substance use and behavioural addictions, problematic internet use and mental health disorders, the psychological consequences of problematic internet use and substance use disorders, and the various risk factors associated with the development of problematic internet use and substance use disorder. A clear understanding and conceptualisation of this behavioural addiction is vital, including the development and utilisation of appropriate and validated diagnostic and screening tools to measure its presence and, in turn, address it as an emerging mental health disorder. Focus should be given to the assessment of problematic internet use by distinguishing the two different forms, namely the generalised and specific forms of problematic internet use. Additionally, given that there were very few to no qualitative studies conducted on the topic of problematic internet use, much less addressing the possible association with substance use disorder, an assessment of the individual’s experience, especially that of men, is lacking. Future research could therefore aim to incorporate more qualitative studies to address the above. Further research is also needed to clarify the nature of the relationship between problematic internet use and substance use disorder for the purpose of establishing possible causality, including the neurobiological substrates involved. , Thesis (MA) -- Faculty of Humanities, Psychology, 2024
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Date Issued: 2024-10-11

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Determining the relationship between perceptions of HIV susceptibility and HIV status of women who have sex with women

- Zuccarini, Aimee Frances

Authors: Zuccarini, Aimee Frances
Date: 2024-10-11
Subjects: Teenage girls Attitudes , Young women Attitudes , Women who have sex with women , Stigma (Social psychology) , Informed consent (Medical law) , HIV infections Susceptibility
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/465859 , vital:76660
Description: Background: Adolescent girls and young women (AGYW) who have sex with women (WSW) are at potential risk for HIV, contradicting the common belief that WSW have low HIV susceptibility, a misperception persists despite evidence to refute it. Objective: This study examined the relationship between perceived HIV susceptibility and actual HIV status among South African AGYW WSW, focusing on those reporting at least one same-sex sexual experience, using data from the DREAMS Evaluation survey. Methods/Design: An archival study employing the Expanded Health Beliefs Model (EHBM) analysed secondary de-identified data from the DREAMS Evaluation Survey with a multistage stratified cluster sampling design. The sample comprised 18,296 AGYW aged 12-24 across four districts in South Africa, including 1,362 identified as WSW. ANOVA was conducted using SPSS 28 to explore the relationship between perceived HIV susceptibility and actual HIV status. Results: WSW’s perceived HIV susceptibility was low (38.5%) to very low (25%), while HIV prevalence in this sample/group was 15.9%. No significant relationship was found between perceived HIV susceptibility and actual HIV status (p = 0.126). Conclusions: WSW do not perceive themselves as being susceptible to contracting HIV despite the high prevalence of the virus in this group. Public health interventions should focus on raising awareness about risk factors, such as low use of barrier protection, substance use, and other behaviours highlighted in the literature, to better inform and protect this population. , Thesis (MA) -- Faculty of Humanities, Psychology, 2024
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Date Issued: 2024-10-11

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Examining the direct and indirect effect that individual and contextual risk factors have in predicting substance abuse

- Fouten, Elron Steve

Authors: Fouten, Elron Steve
Date: 2024-10-11
Subjects: Structural equation modeling , Substance abuse South Africa , Ecological Systems Theory , Path analysis (Statistics) , Personality , Confirmatory factor analysis
Language: English
Type: Academic theses , Doctoral theses , text
Identifier: http://hdl.handle.net/10962/467006 , vital:76806 , DOI https://doi.org/10.21504/10962/467006
Description: Substance abuse levels in South Africa have continued to rise, with the age of first experimentation with drugs reported as being 10 years. Several studies have shown that substance abuse has an adverse impact on users, their families and their communities, resulting in a number of social, psychological and economic struggles. Moreover, substance abuse places an increased psychological, social and financial burden on the individual and the family, as it has been related to the destabilisation of the nuclear and extended family units, permeating every area of life and affecting the very social fabric of society. This study therefore endeavoured to determine which of the individual and contextual risk factors measured by the South African Substance Use Contextual Risk Instrument (SASUCRI) best predicts substance abuse in a sample of self-identified substance abusers. Additionally, the study sought to determine the magnitude, strength and direction of the interaction of the individual and contextual risk factors in predicting substance abuse. The specific aims of the study were: 1) to build a theoretical model that best approximates the identified and measured individual and contextual factors associated with substance abuse, 2) to use structural equation modelling (SEM) to test the adequacy of the model’s fit to the data that have been collected, 3) to use SEM to statistically determine which of the perceived individual or contextual factors best predict substance abuse, and 4) to use SEM to statistically determine which combination of perceived individual and contextual factors best predict substance abuse. To achieve these aims, the study applied SEM to data collected from individuals seeking either inpatient or outpatient treatment for substance abuse in the Eastern Cape and Western Cape Provinces of South Africa, respectively. The purpose of SEM is to a priori specify a theoretical causal model consisting of a set of predicted covariances between variables, and then test whether it is plausible when compared to the observed data. The appropriateness of performing SEM exists in its ability and suitability to examine the nature and magnitude of postulated dependence relationships, while simultaneously assessing the direct and indirect relations of the variables. The theoretical causal model that was tested contained latent and manifest variables that were identified as risk factors for substance abuse. The causal model was informed by Bronfenbrenner’s (1977a, 1986) ecological systems theory (EST) and was specified to approximate the different systems of the theory. Data for the study were collected using the relatively newly developed and validated SASUCRI. The results of the confirmatory factor analysis (CFA) showed that the SASUCRI was a reliable and valid instrument to use with this population, and that the results of the structural model can be interpreted with confidence. The fit statistics, for the normal theory and related bootstrap latent path SEM, all indicate that the model is an excellent fit to the data CMIN/DF = 2.82, NFI = .946, CFI = .97, RMSEA = .04., thus achieving the study’s objective. The normal theory analysis of the paths in the diagram identified the microsystem, “Access/proximity to drugs” (APTD) and “Concerns for future” (CFF) as significant predictors of substance abuse, whereas the bootstrap analysis of the paths identified the macrosystem, APTD and CFF as significant predictors of substance abuse. This study identified 10 risk profiles that interact in the prediction of substance abuse; these are: individuals with low self-efficacy (SE) who perceive their family as lacking or having low intra-family communication, who lack positive peer support, who perceive criminal behaviours as normal, who feel a strong need to fit in, who are less religious, who have easy access to drugs, who lack a sense of community traditions and belonging, who see public displays of substance use (SU) as normal, and who lack concern for the future, are at 59% greater risk of substance abuse. Though micro level factors (low SE, lack of or low intra-family communication, and a lack of positive peer support) and meso-level factors (normalisation of criminal activity, a strong need to fit in, and being less religious) does not significantly predict abuse, they significantly interact with external factors in predicting substance abuse. Thus, it is only when they interact with factors located in the other systems (exosystem, macrosystem and chronosystem) that they become significant predictors of substance abuse. Conversely, exosystem (easy access to drugs), macrosystem (lack of a sense of community traditions and belonging, commonplace public displays of SU), and chronosystem factors (lack of concern for the future), independently are significant predictors of substance abuse. These findings carry significant public health implications by challenging the prevailing focus on individual-based interventions. Recognising that the drivers of substance abuse extend beyond individual factors, this study therefore advocates for interventions that address the broader systems contributing to the issue. This has the potential to inform more effective and holistic public health strategies. Finally, this study emphasises the need for comprehensive strategies that span different systems, acknowledging the role of family, community and societal factors. This call for complex interventions aligns with the ecological systems perspective, advocating for a paradigm shift in how we address SU by considering the broader environmental influences that contribute to the problem. In summary, this study not only contributes to the academic understanding of SU, but also has practical implications for public health policies and interventions. , Thesis (PhD) -- Faculty of Humanities, Psychology, 2024
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Date Issued: 2024-10-11

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Investigating the relationship between Adverse Childhood Experiences (ACE) and attention skills in children living with HIV

- Ngomane, Sibongile

Authors: Ngomane, Sibongile
Date: 2024-10-11
Subjects: Adverse childhood experiences , Attention in children , HIV-positive children , Cognition disorders in children , Cognitive effects of HIV
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/465821 , vital:76656
Description: Background: While persons living with HIV (PWH) have benefited from significant advances in antiretroviral (ARV) treatment, neurocognitive deficits sequent HIV, remain elevated in this population. Notwithstanding HIV, adverse childhood experiences (ACEs) have been implicated in compromised neurocognitive outcomes in children living with HIV. There however, continues to be a dearth of research, investigating the intertwined nature of HIV, ACEs, and neurocognition in pediatric and adolescent HIV. Objectives: This study investigated the relationship between ACEs (High vs Low) and attention outcomes, in children and adolescents, living with HIV, a residing at HIV care shelters in South Africa. Methods: A non-experimental quantitative research design, inclusive of 42 participants (n = 22 males; n = 20 females), was employed to answer the research questions pertinent to the study. Measures of neurocognition were assessed using the NEPSY-II. Adverse childhood experiences were assessed using the ACE CYW-Qs. Independent Sample t-test and Hierarchical regression analysis were conducted to answer research goals, using jamovi 2.3.21 statistical software. Results: The study found that participants who reported a high number of ACEs also performed poorly on attention measures. There were inconclusive findings on the effect of biological sex and age, on attention outcomes. Conclusion: Higher levels of childhood adversities are associated with poorer outcomes in attention scores among children living with HIV. , Thesis (MA) -- Faculty of Humanities, Psychology, 2024
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Date Issued: 2024-10-11

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Post migration factors associated with elevated symptoms of posttraumatic stress disorder, depression, and anxiety, among refugees in Cape Town

- Mujuru, Agnes

Authors: Mujuru, Agnes
Date: 2024-10-11
Subjects: Post-traumatic stress disorder , Refugees South Africa Cape Town , Social work with refugees , Anxiety , Depression, Mental , Refugees Counseling of
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/465810 , vital:76655
Description: There has been a heavy influx of refugees in South Africa due to wars, conflicts, political persecution, and economic recessions around the world. As a result, South Africa hosts the highest number of African refugees, who are susceptible to mental health problems because of their exposure to war, violence, and post migration stressors. The current study assessed post migration predictors of post-traumatic stress disorder (PTSD), depression and anxiety symptoms among refugees in Cape Town South Africa. A cross-sectional survey of refugees from war- and conflict-torn countries settled in Cape Town was conducted between February and May 2023. Study participants (N = 147) were selected using respondent driven sampling technique. Data were collected using a questionnaire made up of the Post-traumatic Stress Disorder Checklist (PCL-5), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder-7 (GAD-7), and the Post- Migration Difficulties Checklist (PMLDs), to assess PTSD, depression, anxiety and PMLDs, respectively. Descriptive and inferential statistics were used to analyse the questionnaire data. The prevalence of PTSD, anxiety and depression symptoms was 26.5%, 33.3% and 33.3%, respectively. Regression analyses identified discrimination, poor access to health services, and poor access to food as the major predictors of common mental disorders among refugees. The document-seeking process, unemployment stress, language difficulties, not getting help with welfare, fears of being sent home and isolation, were also associated with symptoms of mental health conditions. These results suggest that psychological distress symptoms are highly elevated among refugees and are associated with post-migration stressors. Mental health interventions for refugees should not only address psychological difficulties but also consider the socio-economic needs of refugees. , Thesis (MA) -- Faculty of Humanities, Psychology, 2024
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Date Issued: 2024-10-11

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The acceptability of Prolonged Exposure Therapy for Primary Care (PE-PC) for the treatment of PTSD in a low resourced community in the Eastern Cape

- Leboho, Lerato

Authors: Leboho, Lerato
Date: 2024-10-11
Subjects: Post-traumatic stress disorder , Prolonged exposure therapy , Primary care (Medicine) South Africa Eastern Cape , Trauma therapy , Poor Medical care South Africa Eastern Cape
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/466191 , vital:76706
Description: Post-traumatic stress disorder (PTSD) is a global mental health concern, especially in low- resourced communities that are characterised by limited access to health professionals, limited healthcare infrastructure, and limited access to evidence-based mental healthcare at primary care level. Over the last decade, several psychological trauma-focused therapies (TFTs), such as prolonged exposure therapy (PE) have been developed to treat PTSD. In the context of the existing literature, studies done in HICs have explored the implementation and acceptability of prolonged exposure therapy at primary care level (PE-PC) as a first-line treatment for PTSD. Contrary to this, there is little to no implementation studies done to date that have examined the acceptability of empirically supported treatments (ESTs), such as PE in low-resourced countries, such as South Africa. Using the Implementation Science framework, ten participants were recruited to be interviewed, using semi-structured interviews, about their experiences and perceptions of PE-PC as a treatment for PTSD, and to also share their experiences of living with PTSD. The interview data was analysed using the reflexive thematic analysis (RTA) method to determine whether PE-PC is an acceptable treatment for PTSD that can be administered at community level and highlights the importance of integrating mental health within primary healthcare practice. Based on the analysis four superordinate themes were identified, namely, lack and absence of social support; factors preventing trauma survivors from accessing EBTs; lack of knowledge regarding mental health literacy, and adaptation of a brief trauma-focused therapy in a low-resource community. The evidence this study shows that some of the factors that hinder the acceptability of trauma-focused therapies (TFTs) at community level, include stigma and discrimination, the absence of social support, limited resources, and inadequate knowledge on mental health and illness. Therefore, it makes sense of the urgency to implement evidence-based treatments (EBTs) in LMICs. Findings of this thesis suggest that (a) PE-PC should be adopted at community level, and that (b) PE-PC is an acceptable treatment for PTSD in low-resourced communities. , Thesis (MSocSci) -- Faculty of Humanities, Psychology, 2024
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Date Issued: 2024-10-11

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The effects of Human-Wildlife Conflict (HWC) on mental health: the case of Shezongo Community of Kafue National Park (KNP), Zambia

- Smith, Loryn Janine

Authors: Smith, Loryn Janine
Date: 2024-10-11
Subjects: Human-animal relationships Zambia Kafue National Park , Human–wildlife conflict , Wildlife management areas Zambia , Environmental psychology , Mental health , Well-being , Human-animal relationships Psychological aspects
Language: English
Type: Academic theses , Master's theses , text
Identifier: http://hdl.handle.net/10962/465843 , vital:76658
Description: Background: Human-wildlife conflict (HWC) is a bi-directional relationship affecting man and wild animals. Both species suffer extreme consequences, including encroachment of man into wildlife habitats and the destruction of crops and livestock by wildlife foraging for food sources. HWC is particularly prominent in Game Management Areas (GMAs), situated as buffer zones around national parks. Subsequent conflict between man and wildlife leads to not only physical harm but also psychological distress, exacerbating the consequences for mental health. Objectives: A mixed methods design was used to investigate the effects of HWC on mental health. The study aimed to determine the hidden nature of HWC within a population residing in a GMA region in Kafue National Park, Zambia. Methods: Forty-two participants took part in this study, representing a diverse range of demographic characteristics. Of these, 40 participants completed quantitative measures investigating the effect of HWC on mental health. Additionally, eight participants participated in interviews on the nature of mental health in the context of HWC. Some interview participants also completed the quantitative measures, while others did not. Thematic analysis guided qualitative investigations, while Chi-Square Analyses and Fisher’s Exact Test were used to investigate the association between HWC and mental health. Results and Conclusions: The study found an association between HWC and heightened psychological distress in rural communities residing in GMA areas. Further research is required to improve the symbiotic relationship between man and wildlife, considering the consequences of HWC on human well-being and mental health. , Thesis (MA) -- Faculty of Humanities, Psychology, 2024
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Date Issued: 2024-10-11

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Togetherness, care and exclusion: adolescents’ experiences of living with a disabled sibling in a South African context

- Foote, Tamlyn Lou-Ann

Authors: Foote, Tamlyn Lou-Ann
Date: 2024-10-11
Subjects: Siblings of people with disabilities South Africa , Interpretative phenomenological analysis , Sibilings Family relationships , Sibilings Psychological aspects , South Africa Social conditions
Language: English
Type: Academic theses , Doctoral theses , text
Identifier: http://hdl.handle.net/10962/466995 , vital:76805 , DOI https://doi.org/10.21504/10962/466995
Description: The importance of the sibling relationship in an individual’s life has been established, and various aspects of siblingship have been studied. Recently researchers have begun to explore what it means to be a sibling and how siblingship is embodied. Where disability is present in the siblingship, however, there is very little literature, particularly in the Global South. This cross-cultural, cross-language, Interpretative Phenomenological study explores how isiXhosa speaking adolescent non-disabled people, living in a socio-economically disadvantaged context in South Africa, experience their lives in relation to their disabled sibling. Through the use of semi-structured interviews and photo-production with 9 isi-xhosa speaking adolescents from a disadvantaged socio-economic context in South Africa, three master themes emerged. Firstly, non-disabled siblings (NDSs) experienced togetherness in their relationships with their disabled brothers/sisters. In their experiences of togetherness, where reciprocity was prominent, they felt a sense of we-ness. In these instances, disability did not play a central role in their relationships. Secondly, NDSs living in disadvantaged socio-economic contexts experienced care in different ways. Some experienced wanting to care and some experienced having to care for their disabled brother or sister. Where care was voluntary it was experienced as an act of love, contributing to their self-esteem or a family value. Where care was experienced as obligatory, NDSs felt lonely and unsupported, and this contributed to ambivalent feelings toward their disabled sibling. Finally, NDSs experienced themselves as outsiders. Experiences of being an outsider sometimes occurred because of their socio-economic status, and sometimes because of experienced stigma related to their sibling’s disability. In both instances this contributed to feelings of inadequacy and exclusion. To overcome these feelings, NDSs focused on becoming successful, wealthy or famous. These findings have important implications in terms of how NDSs may be supported. Furthermore, this study has important methodological implications for using Interpretative Phenomenological Analysis in a cross-cultural, cross-language context. , Thesis (PhD) -- Faculty of Humanities, Psychology, 2024
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Date Issued: 2024-10-11

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