Department of Psychology

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Attempted suicide among South African adolescents living in a low resource environment : contested meanings, lived experience, and expressed support needs
(Stellenbosch : Stellenbosch University, 2020-12) Pasche, Sonja Christine; Bantjes, Jason; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
ENGLISH ABSTRACT: Adolescent suicide is a serious public health concern, yet we do not understand the reasons South African adolescents give for their suicide attempts and the meanings they attach to their behaviour. Nor do we know how the adolescents’ caregivers and clinicians perceive their attempts, or how these experiences and understandings are framed by the socio-cultural context. The aim of this research was to provide a contextualised understanding of the phenomenon of suicide attempts by South African adolescents living in a low resource environment. I used a multiperspectival research design situated within a theoretical framework of hermeneutic phenomenology. All participants were recruited via the Child and Adolescent Mental Health unit of a large psychiatric hospital located in Cape Town. In-depth semi-structured interviews were conducted with 10 adolescents, their caregivers (n=10), and the clinicians who treated them (n=9). The adolescents also took photographs to illustrate their experience, and these were discussed during a second interview using the technique of photo-elicitation. I analysed data using Interpretative Phenomenological Analysis. All participants foregrounded the relational context of the adolescents’ suicide attempts, especially relationships with family members, which were described as both a mitigating and contributing factor to the suicide attempt. The adolescents explained how caregivers’ failure to acknowledge sexual and physical abuse, which they perceived as betrayal, led to emotional disconnection and subsequently, to precipitating a suicide attempt. In contrast, adolescents said that attachment to younger siblings and pets ameliorated their suicidality. The adolescents recounted how bonding with other suicidal peers reduced feelings of isolation, but that they also learned about suicidal behaviours from each other. Participants also spoke about how the adolescents’ suicide attempts were shaped by the socio-economic context, including exposure to poverty and high levels of violence. Both caregivers and clinicians described feelings of anxiety, powerlessness, and helplessness elicited by the adolescents’ suicidality, echoing the powerlessness reported by the adolescents. Participants did not endorse a purely psychiatric understanding of adolescent suicidal behaviour; instead they described the adolescents’ suicide attempts as an escape from pain, or an attempt to alleviate perceived economic burdensomeness. The adolescents experienced admission to a psychiatric hospital as providing safety, but also as exacerbating a loss of autonomy. Participants discussed how improved connectedness, belonging, communication, and validation of the adolescents’ experiences, to counter the adolescents’ sense of isolation and invisibility, were important for support after the attempt, and for the prevention of adolescent suicide. The participants’ accounts of the adolescents’ suicide attempts were incongruent with existing theories of suicidal behaviour, highlighting the need for adolescent specific, contextualised theories of suicidal behaviour. These findings also suggest that adolescent suicide prevention cannot solely be the responsibility of the mental health care sector, that the wellbeing of caregivers is essential for adolescent suicide prevention, and they emphasise the importance of adolescent-specific services that enhance feelings of autonomy. Potential areas for future research in the field of adolescent suicide prevention include the role of siblings, pets, and feelings of betrayal.
Attitudes, beliefs and myths about suicidal behaviour : a qualitative investigation of South African male students
(Stellenbosch : Stellenbosch University, 2013-03) Meissner, Birte Linda; Bantjes, Jason; Kagee, S. A.; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
ENGLISH ABSTRACT: Suicidal behaviour is a serious public health problem. Globally and in South Africa a gendered pattern of suicide rates has been observed, with males being more likely to kill themselves than females. To date little quantitative and qualitative research is available on young male suicidal behaviour in South Africa. This study investigated the attitudes, beliefs and myths young male students hold about suicidal behaviour. Thirteen male university students (ages 20 to 25 years; with and without a history of suicidal behaviour), who volunteered to take part in the present study in response to an email invitation, were interviewed. The attitudes, beliefs and myths identified from the qualitative data are grouped into four themes: 'Moral acceptability of suicidal behaviour', 'Perceived causes and risk factors of suicidal behaviour', 'Perceived motives of suicidal behaviour', and 'Perceived prevention and protective factors of suicidal behaviour'. Besides these four themes, two underlying narratives are identified and discussed: (1) 'Apart or a part: Belonging and suicidal behaviour' is centred on the idea that perceiving oneself to be an integral part of a social system is protective against suicidal behaviour, while a thwarted sense of belonging increases vulnerability to suicidal behaviour. (2) 'Dying to be a man: (Re) negotiating masculinity and suicidal behaviour' is concerned with participants' views that men's relational position to hegemonic (socially most dominant) forms of masculinity is a factor in male suicidal behaviour. Participants regard hegemonic forms of masculinity to be both a part of the problem of suicidal behaviour and a potential solution to suicidal behaviour. These findings are interpreted through a social constructionist lens of gender as performance. Finally, implications of findings for future research, prevention and treatment are discussed.
Black female first-generation students’ lived experiences at an historically white South African university
(Stellenbosch : Stellenbosch University, 2022-04) Mbatyoti, Nombasa; Bantjes, Jason; Painter, Desmond; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
ENGLISH SUMMARY: It is public knowledge that the foundation of South African higher education (HE) is primarily laid by colonial and apartheid policies, particularly in historically white institutions (HWI’s). In this research literature, whiteness was used to unearth the historical conduct of HWI’s and exclusion of historically marginalised students. It is within this context that I sought to investigate the lived experiences of Black female first-generation postgraduate students in an HWI to understand perceptions of gendered and racialized microaggressions and/or institutionalized exclusionary practices, strategies employed to negotiate the university system, and expressed support needs. Located within an interpretivist research paradigm, I used a qualitative research method, semi-structured interviews and thematic analysis to examine the lived experiences of three Black students who identify as Black African, female and first-generation. Phenomenology was used as a theoretical lens to interpret findings. Findings revealed the experience of culture shock, vulnerability to gendered racism and pressures of being a first-generation student. Ultimately the tensions of navigating intersected and marginalised social identities at an HWI was elucidated in the findings. As a result of navigating these tensions, participants expressed an impact on their emotional and psychological wellbeing. Despite it all, participants found ways to resist marginalisation by employing coping mechanisms, exercising agency and staying woke. The expressed support needs highlight the need for urgency in transformation and representation of Black African female academics. To conclude, the research suggests a holistic transformation approach that understands the experiences and needs of students with intersecting and marginalised identities. That transcend the idea of diversifying numbers of historically marginalised students as the only form of transformation. Keywords: campus culture; first-generation students; gendered racism; historically white institution; intersectionality of historically marginalised identities; transformation.
The effect of self-talk as an anxiety regulation intervention on coincident anticipation timing and batting performance in cricket.
(Stellenbosch : Stellenbosch University, 2017-12) Seymour Hall, Rochel; Bantjes, Jason; Bressan, E. S.; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
ENGLISH SUMMARY: Ways, in which anxiety levels can be managed, in order to achieve optimal performance, has constantly been given attention in the sport psychology literature. Theories, hypotheses and explanations on how anxiety can be managed, using different strategies, are proposed, but little scientific research has tested these strategies. Previous research in the field of sports psychology suggests that the topic of anxiety has been a particularly strong focus of research. Little is however known about the use of self-talk as an anxiety regulation strategy. Therefore the intervention programme in this study focused on piloting the implementation and use of self-talk as an anxiety regulation strategy to improve coincident anticipation timing and batting performance in cricket The sample used in this study included fifteen cricket players, who played at an intermediate level, who were randomly divided into a control group (n= 8) and an experimental group (n=7). They performed in the pre-test, post-test and retention test, which consisted of a coincident anticipation timing test (CAT) and a batting performance test (BPT). The BPT tested the batsmen in shot accuracy and their quality of interception. At each testing stage the batsmen were required to fill out a revised version of the Competitive State Anxiety Questionnaire (CSAI-2R) and the Self-Talk Questionnaire (STQ). Only the experimental group received the 3 week intervention programme. Results indicated that although the performance of both groups improved during the study, in the CAT and BPT tests, no significant improvements were seen as a result of the Self-Talk Anxiety Regulation Strategy. The experimental group showed a decrease in anxiety levels. However, the results were not significant. From this study, it can be concluded that self-talk as an anxiety regulation intervention, did not have a significant effect on the coincident anticipation timing or batting performance (shot accuracy or quality of interception) of cricket batsmen. Self-talk as an Anxiety Regulation Strategy did not have a significant reduction on the anxiety levels of cricket batsmen. The implication of these findings suggests that self-talk may not an effective anxiety regulation strategy for cricket batsmen. However, more research needs to be done specifically on the implementation and use of self-talk as an anxiety regulation strategy, on an individual basis and how it can be used effectively in order to achieve optimal performance.
Everyone has the right to participate : exploring the lived experiences of adolescents with cerebral palsy and their involvement in physical activity
(Stellenbosch : Stellenbosch University, 2014-04) Conchar, Lauren; Bantjes, Jason; Swartz, Leslie; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
ENGLISH ABSTRACT: Engagement in physical activity is a basic human right and has numerous benefits for mental well-being. Persons with disabilities are often denied this right due to a number of barriers existing on physiological, psychological and structural levels. Adolescents with motor impairments may be even further marginalised due to the physical nature of their impairment as well as being at a developmental stage where their opinions may not be taken into account based on their age. Research that has been conducted in this area has mostly focused on the accounts of parents and teachers with little voice being given to adolescents. This research aimed to explore the lived experiences of a group of adolescents with cerebral palsy (CP) and their involvement in physical activity. The sample group consisted of 15 adolescents with CP between the ages of 12 and 18 in the Western Cape. Semi-structured interviews were conducted with the participants. In addition, three staff members were interviewed in order to add a secondary layer of data to the study. The interviews were analysed using interpretative phenomenological analysis which aims to give voice to participants and to make meaning of these accounts through interpretation by the researcher. Five major themes emerged from the data, namely: (1) “When they call me cripple” – what it means to have a motor impairment, (2) My experience of physical activity – perceived benefits, facilitators and barriers to participation, (3) Protective factors and coping strategies employed by participants to overcome barriers to participation, (4) What I would like and what I recommend, and (5) Perceptions of staff members at the school. These themes were discussed through a theoretical framework focused on the psychological and social factors which influence an individual’s participation in (or avoidance of) physical activity. While this theoretical framework is based on able-bodied persons, it was interesting to compare the experiences of adolescents with CP. The findings were further discussed in comparison to the relevant literature, although the purpose of qualitative research is not to necessarily generalise findings. This discussion yielded similarities and differences in terms of experiences relating to barriers and facilitators to participation. In addition, the findings supported the notion that adolescents with disabilities know what they want and have valuable input to offer in terms of their own experiences. Recommendations include further studies being conducted with groups of adolescents with disabilities other than CP as well as in other areas of South Africa. This could give a more rounded understanding of the experiences of adolescents with disabilities and could better inform projects that could be developed.
From incarceration to successful reintegration : an ethnographic study of the impact of a halfway house on recidivism amongst female ex-offenders
(Stellenbosch : Stellenbosch University, 2014-04) Van Wyk, Stephanie Anne; Bantjes, Jason; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
ENGLISH ABSTRACT: This thesis examines the psychological and social reasons for recidivism among women offenders of the law and explores the impact halfway houses could have on reducing recidivism in SA. Despite the problem of high crime and offender recidivism in SA there is a lack of research into projects within the country that are attempting to address the situation. This paper ascribes to be an authentic voice from one who has had the unique opportunity of observing the SA prison system from within, over a period of 15 years, and one who has sought to assist ex-offenders in their reintegration from prison to society by providing support once outside of prison over the past 10 years. The thesis is auto-ethnographic in design and method. This research examines the reasons for criminal acts among women and seeks to investigate and determine the unique complexities surrounding women and crime. A high prevalence of sexual and physical abuse is corroborated as common precursors to conduct problems in female offenders, while mental ill health is found to be marked among women in prison. Recommendations are made for the establishment of halfway houses in SA and strategies are suggested for the development of such halfway houses.
Help-seeking intention in an adult population with obsessive-compulsive disorder (OCD): predictors and barriers in South Africa
(Stellenbosch : Stellenbosch University, 2021-12) Hathorn, Sarah Kate; Lochner, Christine; Bantjes, Jason; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
Introduction: Obsessive-compulsive disorder (OCD) is associated with significantly impaired functioning, psychological distress, and reduced quality of life. Despite the availability of evidence-based treatments, a large percentage of individuals with OCD fail to seek help for their condition or delay help-seeking for many years. Although variables associated with OCD help-seeking have been identified internationally, patterns of help- seeking for OCD have not yet been described in South Africa, a developing country with many mental health service challenges. Aim: Using the health belief model (HBM) as a framework, the aims of this study were two-fold: first, to investigate whether HBM constructs significantly predict help-seeking intention among a group of South African adults with OCD, and second, to determine the most endorsed barriers to help-seeking for OCD in this sample. Methods: Fifty adult participants (n=50) with a lifetime primary diagnosis of OCD based on the Structured Clinical Interview for the DSM-5 (SCID-5) were recruited to participate. Participants subsequently completed a comprehensive online survey to assess the following HBM constructs: 1) socio-demographic characteristics, 2) OCD symptom severity, 3) treatment barriers, 4) perceived treatment benefits, 5) self-efficacy, and 6) help-seeking intention. Multiple linear regression analysis was used to establish whether HBM constructs significantly predict help-seeking intention. Descriptive statistics were calculated to determine the most endorsed barriers to help-seeking. The Statistical Package for Social Sciences (SPSS) version 27 was used to analyse the data. Results: The findings suggested that 42.6% of variance in help-seeking intention can be explained by the six HBM constructs (𝑅2 = 0.426, F(7,42) = 4.45 p<0.01). Of all predictor variables, perceived treatment benefits was the only significant predictor of help-seeking ntention (B=1.37, t(42= 5.16), p<0.01). In terms of help-seeking barriers, 36% of the sample endorsed wanting to handle the problem independently as a highly significant barrier, followed by concerns about treatment (endorsed by 26% of the sample), then affordability (22% of the sample), and finally embarrassment and shame factors (20% of the sample). Conclusion: This is the first study to investigate help-seeking patterns among South African adults with OCD. The results lend partial support for the utility of HBM constructs in predicting help-seeking intention, with perceived treatment benefits as the only significant predictor of help-seeking intention in this setting. Psychoeducation and mental health literacy programmes may be useful in increasing public appreciation of the benefits of OCD treatment, and to mitigate key help-seeking barriers. Studies with a qualitative angle, revealing a more in-depth understanding of the use of services from the patient’s perspective, would complement these findings.
An inquiry into the organisation of care for deliberate self-harm patients in a South African hospital
(Stellenbosch : Stellenbosch University, 2016-03) Nel, Annemi; Bantjes, Jason; Stellenbosch University. Faculty of Arts and Social Sciences. Department of Psychology
ENGLISH ABSTRACT : Deliberate Self-Harm (DSH) is a significant problem in South Africa. Individualsengaging in DSH have an elevated risk for a subsequent presentation of DSH and for completed suicide. DSH patients also place a burden on the health care system and have shorter life expectancies than the general population. Research suggests that hospital Emergency Departments (EDs) are a site of potential intervention for DSH patients. This study sought to investigate how an ED of a SA urban hospital responded to DSH patients. An ethnographic inquiry was employed to examine the policies, practices, attitudes and knowledge that generated the response by health care professionals. Specifically, the organisational structure of the ED was studied, both in relation to the hospital as well as in relation to the broader health care system. Three different data method collection techniques were used; observations, semistructured interviews and document analysis (pertaining hospital policies). Data was collected over a period of eight months (May – December 2014). Semi-structured interviews were conducted with 28 health care professionals. This sample included medical officers, a medical registrar, medical interns, medical students, nurses, a student nurse, psychiatry registrars, psychologists and social workers. Thematic analysis was implemented to group findings into meaningful themes. This study found that health care professionals are doing their best, under difficult circumstances, to respond to the needs of DSH patients. Nonetheless a number of barriers and opportunities to the provision of care were identified. Significant barriers included the lack of resources, a discontinuity of care, the impossibility of a relationship with the DSH patient, as well as negative attitudes and emotional responses of health care professionals, such as stigmatisation, and negative perceptions. Opportunities to the provision of care included health care professionals’ positive attitudes, such as empathy and a willingness to provide quality care to DSH patients. This research has found that an under-resourced system and negative attitudes of health care professionals prevent the ED from being optimally utilised as a space for intervening with the DSH population. The implementation of existing resources in the ED may be re-examined as to use them optimally.
The lived experience of university students with visual impairments and their sighted partners’ participation in inclusive social ballroom dance
(Stellenbosch : Stellenbosch University, 2016-03) Bisset, Faine; Bantjes, Jason; Bressan, E. S.; Stellenbosch University. Faculty of Arts and Social Sciences. Department of Psychology
ENGLISH ABSTRACT : Ballroom and Latin American dance appear to be gaining popularity among people with disabilities, as a form of exercise and leisure activity. However, the majority of research conducted in this field seems to have focused on the physicality of dancers’ movements, while overlooking their unique interpretations of such an experience. Furthermore, there appears to be a dearth of literature on the experience of dance for visually impaired individuals. The aim of this study was to give a voice to the lived experience of visually impaired dancers and their sighted partners who participate in inclusive social ballroom and Latin American dance. The participants were members of the Differently-abled Dance Class that was held by the dance society of a university situated in the Western Cape, South Africa. This qualitative study was conducted within the theoretical framework of the social theory of disability. Method: The processes of data collection and data analysis were conducted according to the principles of interpretative phenomenological analysis. The sample consisted of nine participants (i.e. four visually impaired dancers and five of their sighted partners) with whom I conducted semi-structured, in-depth, individual interviews. Findings and discussion: The experiences of the visually impaired and sighted participants in dance consisted of the accumulation of findings discussed herein. The dancers described many physical, social and psychological benefits of, and challenges from, their participation in inclusive social dance. Such benefits appear to have encouraged and promoted the dancers sustained participation in the class. Ballroom and Latin American dance were described by both the visually impaired and sighted dancers as being a setting in which heteronormative, stereotypical gender roles were reinforced, regardless of a dancer’s (dis)ability. The visually impaired dancers expressed a desire to look good and to fit in with their sighted partners, as well as to disguise their impairment as far as possible when performing for an audience. As such, these dancers appear to believe that there is an expectation imposed on them by society to appear sighted when they participate in the visual spectacle of dance. The concerns of inclusion and accessibility seemed to be a point of contention between the visually impaired and the sighted dancers, with the latter holding the belief that the dance society may have achieved a higher level of inclusion than was described by the former. However, the participants agreed that more could be done to establish the further inclusion and integration of all of the dancers in the society, regardless of their (dis)ability. Dancing with a visually impaired partner appears not only to have challenged and changed the sighted participants’ preconceptions of their visually impaired partners, but also of the people with disabilities with whom they came into contact outside of the dance society. The changing of such preconceptions, however, might lend itself to the admiration and idealisation of visually impaired individuals, which was evident in the sighted participants’ reports. Insights into the world of disability were discussed in terms of the reports given by the participants.
Mental health care providers talk about suicide prevention among people with substance use disorders in South Africa
(Stellenbosch : Stellenbosch University, 2017-12) Goldstone, Daniel Graham; Bantjes, Jason; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
ENGLISH SUMMARY: Introduction. Substance use is a well-established and potentially modifiable risk factor for suicidal behaviour. As a result, the World Health Organization has suggested that suicide prevention efforts should target people with substance use disorders (PWSUDs). Most suicide prevention strategies are largely framed within the biomedical paradigm and suggest somewhat generic approaches to suicide prevention. As such, they lack specificity for high-risk populations (such as PWSUDs) and for the different contexts in which they are implemented. Few studies have focused on the experiences of mental health care providers (MHCPs) who provide care for suicidal PWSUDs; the clinical, health care, and contextual factors they perceive to hinder suicide prevention; and their specific ideas for preventing suicide in PWSUDs. In my study, I sought to investigate MHCPs' experiences of preventing suicide in PWSUDs in South Africa (SA); their perceptions of the factors impacting on suicide prevention in this context; and their context- and population-specific suggestions for preventing suicide in PWSUDs. Methods. I conducted in-depth, semi-structured interviews with 18 mental health care providers (psychiatrists, psychologists, counsellors, and social workers) working in Cape Town, SA, who had experience providing care for suicidal PWSUDs. I used thematic analysis to analyse the data inductively with Atlas.ti software. Findings. I identified three superordinate themes: (1) experiences of preventing suicide; (2) perceptions of barriers to suicide prevention; and (3) ideas for suicide prevention. Participants described feeling hopeless, helpless, impotent, and guilty, and said they needed to debrief from their work. They perceived their experiences to be related to difficulties they encountered treating substance use disorders and assessing and managing suicide risk, and their perceptions that treating substance use might increase suicide risk. Structural issues in service provision (such as inadequate resources, insufficient training, and fragmented service Stellenbosch University https://scholar.sun.ac.za iii provision) and broad contextual issues (such as poverty and inequality, the breakdown of family, and stigma) were perceived as barriers to suicide prevention. Participants thought that PWSUDs were not receiving the psychiatric, psychological, and social care that they needed. Participants suggested a number of evidence-based strategies to prevent suicide, but also made novel, context- and population-specific suggestions for suicide prevention, including: improving training of health care providers to manage suicide risk; optimising the use of existing health care resources; establishing a tiered model of mental health care provision; providing integrated health care; and focusing on early prevention. Conclusion. These findings suggest that the ways MHCPs think about suicide and make sense of their experiences impact on their perceived abilities to prevent suicide. Additionally, these findings indicate that structural, social, and economic issues pose barriers to suicide prevention. Participants highlighted specific strategies that take account of sociocultural contexts that may be effective in preventing suicide among PWSUDs in SA. These findings challenge individual, biomedical risk-factor models of suicide prevention and highlight the need to consider a broad range of social, cultural, economic, political, and health care factors when planning suicide prevention interventions. Tailoring suicide prevention interventions to the specific needs of high-risk groups and to specific contexts may be important to prevent suicide.
Pilot study of an e-intervention for symptoms of depression among university students in South Africa
(Stellenbosch : Stellenbosch University., 2020-03) Gericke, Franco; Bantjes, Jason; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
ENGLISH ABSTRACT: Background. Major Depressive Disorder (MDD) is associated with a range of adverse outcomes among university students, including academic failure, suicidal thoughts and behaviours, and severe role impairment. Despite the variety of effective treatments available, most university students do not seek or receive help. Evidence suggests that internet-based interventions (e-interventions) might be as effective as existing treatments available to treat MDD. Therefore, e-interventions have been suggested to address the treatment gap among university students. However, e-interventions have not been extensively used or evaluated in low- and middle-income countries (LMIC) like South Africa (SA). Therefore, I set out to pilot the use of an e-intervention, namely iCare, aimed at addressing depressive symptoms among SA university students. Aims. This randomised external pilot study had two primary aims: (1) to assess the key feasibility aspects of iCare, namely (a) recruitment, (b) randomisation, and (c) implementation (utilisation, retention and follow-up rates, and the assessment of the outcome measures); and (2) to investigate students’ experiences of using iCare and to document their suggestions on improving iCare and making it more culturally appropriate for use in the SA context. Methods. All first-year university students (n=5094) were invited to complete a voluntary mental health survey. A total of 138 participants met the inclusion criteria and were randomised (according to a 2:1 ratio) to iCare (n=91) and treatment-as-usual (TAU) (n=47). iCare participants received one-month and three-month post-intervention follow-up assessments to monitor symptom change. Each iCare participant also received an email inviting them to participate in an individual in-depth post-intervention interview. The key feasibility aspects were quantified and assessed using various statistical analyses. A large proportion of the participants did not complete he follow-up assessments. The outcome measures were, therefore, assessed using three iii approaches commonly used to handle missing data in clinical trials: (1) complete case analysis (CCA), (2) intention-to-treat analysis using multiple imputations (ITTA-MI), and (3) per-protocol analysis (PPA). Sample size estimations to scale this study to a randomised control trial were conducted based on the ITTA-MI, using (1) safeguard power analysis, and (2) the minimal clinically significant effect. The interviews were transcribed and analysed through thematic analysis following a data-driven approach. Findings. Only 31.87% (n=29) of participants indicated their willingness to use iCare, of which 24.18% (n=22) started with iCare’s first session. A substantial number (72.73%, n=16) of participants dropped out during treatment. Low follow-up rates were observed at the one-month (65.9%, n=60) and three-month (71.4%, n=65) post-intervention follow-up assessments. However, the ITTA-MI indicated a significant small to moderate decrease in iCare participants’ depressive symptoms at these assessments. The PPA indicated that a large proportion (50%, n=3) of iCare completers achieved a successful treatment outcome. I identified seven superordinate themes and several sub-themes. The majority of participants felt the anonymity and accessibility of iCareen-abled them to overcome the barriers they faced to traditional face-to-face therapy; others found the lack of direct human contact to be problematic, expecting iCare to mimic the responsiveness and reflectiveness of face-to-face therapy. The perceived time-consuming nature of iCare was put forward by some participants for their discontinuation of iCare; while others discontinued due to symptom improvement. The majority of participants indicated the need for more engaging and interactive content and suggested that iCare should be used in addition to, rather than replacing, traditional face-to-face therapy.Conclusion. The findings of this study indicate that there is a proportion of students for whom e-interventions may provide the first step to accessing mental health services, although nota replacement for traditional face-to-face therapy. A randomised control trial is needed to determine the efficacy of iCare. I also offer recommendations for addressing the key feasibility aspects that were identified, and for future research on e-interventions among university students in SA.
A qualitative investigation of previously disadvantaged adult men’s psychological experiences of a sport development programme
(Stellenbosch : Stellenbosch University, 2014-04) Penderis, Kirsten; Bantjes, Jason; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
ENGLISH ABSTRACT: Considering the growing poverty and unemployment in South Africa, there is clearly an urgent need for development, particularly among the historically disadvantaged communities where the level of inequality is the highest. Sport has been viewed by a number of scholars as a possible vehicle for developing communities. In this regard, involvement in sport and exercise has been linked to psychological wellbeing, capacity building and skills development among adolescents, which leads to the empowerment of individuals. This study investigates the functioning of a Sport Development Academy, which uses canoeing as a mechanism to improve the quality of lives of people living in a rural community in The Valley of a Thousand Hills in Kwa-Zulu Natal. This qualitative investigation targeted a group of seven young men, between the ages of nineteen and twenty-nine years old, who were interviewed in order to examine their lived experiences as a result of participating in the Academy and the extent to which the Academy impacted positively on their lives. The Positive Youth Development Paradigm, Bronfenbrenner’s Eco-Systems Theory and the Athlete-Coach relationship view, was used as a lens through which the research findings were examined. The Athletes in the Academy learnt a number of values and skills such as hard work, determination and respect. They became involved in pro-social behaviors as opposed to anti-social behaviors due to their participation in the sport development programme. This participation resulted in the gaining of social capital which can lead to upward social mobility. The capacity of these athletes has also been improved. These above factors improve the psychological wellbeing of the individuals and equip them with essential values and skills that make them more employable. The research findings suggest that the involvement of the seven young men in the Academy produced a number of positive impacts. Therefore, the results of the research indicate that sport can be used, to a certain extent, as a vehicle through which development can occur.
The role impairment associated with common mental disorders among first-year university students in South Africa
(Stellenbosch : Stellenbosch University, 2021-12) Mostert, Frederik; Bantjes, Jason; Saal, Wylene; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
ENGLISH ABSTRACT: Rationale: Mental health statistics, such as the prevalence of CMDs and role impairment, are used to estimate the need for mental healthcare and are therefore central to the planning of services and interventions. Previous studies have determined the rates of 12-month CMDs among first-year students in South Africa, yet it is unclear what proportion of these students are severely impaired by their disorders. Aims: The purpose with the study is to determine the need for mental healthcare among first- year university students in South Africa. The study has the following aims: 1. To determine the prevalence and severity of role impairment among first-year university students. 2. To determine if there are statistically significant differences in the prevalence of role impairment between students with and without 12-month CMDs. 3. To explore associations between severe role impairment and CMDs, when controlling for sociodemographic factors. 4. To identify which CMDs are the most impairing and prevalent in the population. Methods: Web-based, self-report surveys were used to screen incoming first-year students at SUN and UCT (n = 1402) for DSM-IV mental disorders and health-related role impairment (Sheehan Disability Scale). Impairment was assessed in four domains: home management, university-related work, close relationships and social life. Results: Findings showed that 42.7% of students had at least one 12-month CMD. Furthermore, 25.7% of students reported severe impairment in at least one domain of functioning (42.2% of students with at least one 12-month CMD vs. 13.3% of students without a 12-month CMD, p < 0.01). In total, 18% of students had 12-month CMDs and were severely impaired by their disorders. Multiple logistic regression showed that BP (aOR = 7.00; 95% CI = 1.70-28.91), DUD (aOR = 6.20; 95% CI = 2.77-13.88), and GAD (aOR = 5.60; 95% CI = 3.59-8.74) were associated with the highest odds of severe role impairment. However, when both role impairment and the prevalence of disorders were taken into account, ADHD, GAD and MDD were shown to account for the largest proportion of the need for care in the student population. Certain subgroups of students, such as sexual minority students, self-identified Black students, and older first-generation students, were more likely to report severe role impairment than their peers, independently of CMDs. Conclusion: About a quarter of first-year university students in South Africa reported severe role impairment, and 12-month CMDs were strongly associated with severe role impairment. Mental health-related impairment has the potential to severely disrupt the development of young people, and contributes to academic failure. It is therefore critical that the South African government and institutions of higher education invest in student mental health.
Students’ attitudes and beliefs towards e-mental health interventions
(Stellenbosch : Stellenbosch University, 2022-12) Van Der Poll, Ryan Deon; Coetzee, Bronwyne Jo'sean; Bantjes, Jason; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
ENGLISH ABSTRACT: Background. Mental health problems among university students are common and, left-untreated, are associated with multiple adverse effects such as academic failure, suicidal thoughts & behaviour (STB) and severe role impairment. Despite the high rates of mental health problems amongst university students, most students do not seek out or receive support and those who do, face long waiting times and high costs. Available evidence suggests that e-mental health interventions may hold promise in bridging the mental health treatment gap amongst university students. However, the acceptability and feasibility of using e-mental health interventions among South African university students has not been extensively researched. Aims. In this exploratory qualitative study, I aimed to explore the acceptability and feasibility of e-mental health interventions by eliciting the attitudes and beliefs toward the use of e-mental health interventions amongst a sample of university students registered at Stellenbosch University (SU). The following three research questions helped me to achieve my aim, namely: (1) What are students’ lived experiences of using e-mental health interventions? (2) What are students’ beliefs and attitudes towards the use of e-mental health interventions? And (3) What suggestions do students have for the potential use of e-mental health interventions on campus? Methods. Undergraduate students registered at SU during 2021 were invited by me to participate in a focus group, either in-person or online. A total of 51 participants took part in 11 online (N=37) and four in-person (N=14) focus groups. Both online and in-person focus groups were audio-recorded with permission from the participants. These recordings were then transcribed verbatim and analysed using reflexive thematic analysis. Finally, the results were interpreted within the framework of the Health Belief Model. Findings. I identified six themes and 15 sub-themes that provided insight into participants’ attitudes and beliefs towards e-mental health interventions. Participants reported having used e-mental health applications (apps) before and mostly had positive experiences of using these apps. Students reported that the anonymity, privacy, informality, accessibility and flexibility of these apps were amongst their many benefits. However, students reported some concerns around the effectiveness of these apps and whether any professionals in mental health were involved in the development of these apps. Students also reported that some connection (whether in person or online) with a mental health professional was necessary and important to them. Participants suggested that essential app features were those that promoted social connection, peer support, and links to mental health support services. Conclusion. Taken together, the findings of this study suggest that students are familiar with e-mental health apps and have mostly had positive experiences with them suggesting acceptability and feasibility of e-mental health interventions. However, the extent to which an e-mental health intervention can practically, and effectively be implemented and delivered to university students in South Africa still needs to be determined.
Substance use and self-harm at an urban South African hospital: implications for suicide prevention, service delivery and future research
(Stellenbosch : Stellenbosch University, 2018-03) Breet, Elsie; Bantjes, Jason; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
ENGLISH SUMMARY: Self-harm is a form of suicidal behaviour which constitutes a serious public health problem in low-income and middle-income countries (LMICs). The World Health Organization identifies substance use as a potentially modifiable risk factor for suicidal behaviour, including self-harm. Little is known about the prevalence, correlates, nature, and context of substance use among self-harm patients in South Africa. In this thesis, I explored the relationship between substance use and self-harm among patients who presented for treatment at an urban hospital in the Western Cape, South Africa. I employed a mixed methods research design and present my findings in the form of four journal articles. In the first article, I report on the results of a systematic review to investigate what is known, and what remains unknown, about the relationship between substance use and suicidal behaviour in LMICs. From the review results, I argue that: (1) the assessment and management of substance use should be integral to the care of at-risk patients; (2) suicide prevention research in LMICs should focus on reducing hazardous use of alcohol, tobacco, cannabis, opioids, sedatives, stimulants and non-medical use of medications; and (3) more research is required to understand the nature of the relationship between substance use and suicidal behaviour. In articles two and three, I report on two quantitative studies, consisting of a retrospective review of patient files to establish the demographic characteristics, patterns of medical service utilisation, and sociocultural differences between self-harm patients who report substance use and other self-harm patients (i.e. those who reported no substance use) among 238 self-harm patients. I focused on acute use of substances (i.e. substance intoxication) (AUS) in article two and chronic substance use (i.e. recurrent substance use over an extended period) (CSU) in article three. In article two, bivariate and multivariate statistical analysis showed that one in five selfharm patients reported AUS. Compared to other self-harm patients, the AUS sub-group were more inclined to: have depressed levels of consciousness on admission; utilise more medical resources; report previous acts of self-harm; and state an intention to die as a result of their injuries. In article three, 37% of self-harm patients reported CSU. Compared to other self-harm patients, the CSU sub-group were more likely to be male; to inflict damage to their body tissue; and to have a history of self-harm. A significantly smaller proportion of CSU patients, compared to other self-harm patients, were referred for psychiatric assessment (p<0.001). For article four, I conducted a qualitative study by analysing semi-structured interviews of 80 self-harm patients who were admitted to the hospital. I made use of a multiple-case study methodology and identified seven ways in which patients understood their substance use was implicated in their self-harm: impulsivity, poor judgment, and aggression; auditory hallucinations or paranoia related to substance use; substance use to facilitate self-harm; substance use as a method of self-harm; unsuccessful treatment for substance use disorder; the breakdown of substance use as a means of coping; and third-party substance use. I conclude this thesis by, reflecting on the broad aim and offering recommendations for future research and suicide prevention at the hospital where data were collected.

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