Browsing by Author "Bishop, Melanie"

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    An analysis of early developmental trauma in social anxiety disorder and posttraumatic stress disorder
    (BioMed Central, 2014-05) Bishop, Melanie; Rosenstein, David; Bakelaar, Susanne; Seedat, Soraya
    Background: The early contributions of childhood trauma (emotional, physical, sexual, and general) have been hypothesized to play a significant role in the development of anxiety disorders, such as posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD). The aim of this study was to assess childhood trauma differences between PTSD and SAD patients and healthy controls, as measured by the Early Trauma Inventory. Methods: We examined individuals (N = 109) with SAD with moderate/severe early developmental trauma (EDT) (n = 32), individuals with SAD with low/no EDT (n = 29), individuals with PTSD with EDT (n = 17), and healthy controls (n = 31). The mean age was 34 years (SD = 11). Subjects were screened with the Mini-International Neuropsychiatric Interview (MINI), Liebowitz Social Anxiety Scale (LSAS), Clinician-Administered PTSD Scale (CAPS), and Childhood Trauma Questionnaire (CTQ). Analysis of variance was performed to assess group differences. Correlations were calculated between childhood traumas. Results: Although not statistically significant, individuals with PTSD endorsed more physical and sexual childhood trauma compared with individuals with SAD with moderate/severe EDT who endorsed more emotional trauma. For all groups, physical and emotional abuse occurred between ages 6 and 11, while the occurrence of sexual abuse in individuals with PTSD was at 6–11 years and later (13–18 years) in individuals with SAD with moderate/severe EDT. For emotional abuse in all groups, the perpetrator was mostly a primary female caregiver; for sexual abuse, it was mostly a nonfamilial adult male, while for physical abuse, it was mostly a caregiver (male in PTSD and female in SAD with moderate/severe EDT). Conclusions: The contribution of childhood abuse to the development of PTSD and SAD and the differences between these groups and other anxiety disorders should not be ignored and attention should be given to the frequency and severity of these events. The relationship of the perpetrator(s) and the age of onset of childhood abuse are also important considerations as they provide a useful starting point to assess impact over the life course. This can, in turn, guide clinicians on the optimal timing for the delivery of interventions for the prevention of PTSD and SAD.
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    Association between childhood adversities and long-term suicidality among South Africans from the results of the South African stress and health study : a cross-sectional study
    (BMJ Publishing Group, 2014-11) Bruwer, Belinda; Govender, Ravi; Bishop, Melanie; Williams, David R.; Stein, Dan J.; Seedat, Soraya
    Objective: Suicide and suicidal behaviours are significant public health problems and a leading cause of death worldwide and in South Africa. We examined the association between childhood adversities and suicidal behaviour over the life course. Methods: A national probability sample of 4351 South African adult participants (aged 18 years and older) in the South African Stress and Health (SASH) study was interviewed as part of the World Mental Health Surveys initiative. Respondents provided sociodemographic and diagnostic information, as well as an account of suicide-related thoughts and behaviours. Suicidality or suicidal behaviour were defined as were defined as suicide attempts and suicidal ideation in the total sample, and suicide plans and attempts among ideators. Childhood adversities included physical abuse, sexual abuse, parental death, parental divorce, other parental loss, family violence, physical illness and financial adversity. The association between suicidality and childhood adversities was examined using discrete-time survival models. Results: More than a third of the respondents with suicidal behaviour experienced at least one childhood adversity, with physical abuse, parental death and parental divorce being the most prevalent adversities. Physical abuse, sexual abuse and parental divorce were identified as significant risk markers for lifetime suicide attempts, while physical abuse and parental divorce were significantly correlated with suicidal ideation. Two or more childhood adversities were associated with a twofold higher risk of lifetime suicide attempts. Sexual abuse (OR 9.3), parental divorce (OR 3.1) and childhood physical abuse (OR 2.2) had the strongest associations with lifetime suicide attempts. The effect of childhood adversities on suicidal tendencies varied over the life course. For example, sexual abuse was significantly associated with suicide attempts during childhood and teen years, but not during young and later adulthood. Conclusions: Childhood adversities, especially sexual abuse, physical abuse and parental divorce, are important risk factors for the onset and persistence of suicidal behaviour, with this risk being greatest in childhood and adolescence.
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    Resilience in families in which a member has been diagnosed with schizophrenia
    (Stellenbosch : Stellenbosch University, 2014-04) Bishop, Melanie; Greeff, A. P.; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
    ENGLISH ABSTRACT: The primary aim of this study was to identify family resilience qualities that families use to adapt after a member has been diagnosed with schizophrenia. Family resilience refers to the family’s ability to adjust and adapt after a crisis. A secondary aim of this study was to determine whether there are significant differences between groups with regard to biographical variables (i.e. relationship to the ill member, home language, racial groups, family structure, and annual household income) and potential resilience variables. The primary theory utilised in this study was proposed by McCubbin and McCubbin (1996a), namely the Resiliency Model of Family Stress, Adjustment and Adaptation, and the secondary theory utilised is the Family Resilience Framework described by Walsh (2012). Qualitative and quantitative data were collected and analysed in order to answer the research question. Data were collected from 51 participants, who represented 42 families. Families were recruited from three support groups within the Western Cape, South Africa. Qualitative data were obtained through an open-ended question in which the participant was asked to indicate the strengths and resources used by the family to adapt after a member had been diagnosed with schizophrenia. Resilience qualities within the qualitative data were identified through a process of thematic theme analysis. Quantitative data were collected using seven self-report questionnaires, which collectively gave an indication of possible family resilience qualities within the family. Quantitative data were analysed using a mixed model repeated measures analysis of variance (ANOVA), Pearson’s product-moment correlations, and a bestsubset regression analysis. Ten statistically significant correlations were found between independent variables and family adaptation. Nine of these variables had a significant positive correlation with family adaptation, namely family income; the degree to which the family finds support in their community; special events and family time; the style of communication during crises; positive communication patterns during crises; family hardiness; the ability of the family to work together and their internal strengths; positive reframing and ability to learn; and the internal locus of control within families. Only one negative correlation with family adaptation was found, namely incendiary communication during times of crisis. The quantitative results were compared with the qualitative themes, and additional findings from the qualitative data were reported. An additional theme that emerged from the qualitative analyses was factors relating to the diagnosed family member, and a subtheme, namely passive appraisal of a crisis. Differences were also found between groups with regard to the measured variables. It is evident from the findings that the identified qualities and resources may be used in interventions to strengthen other families in which a member has been diagnosed with schizophrenia.