Masters Degrees (Psychiatry)
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- ItemAssociations between exposure to community violence, symptoms of psychological distress, and school performance in high-risk peri-urban communities(Stellenbosch : Stellenbosch University, 2024-03-01) Smith, Matthew James; Naidoo, Anthony Vernon; Rabie, Stephan; Stellenbosch University. Faculty of Arts and Social Sciences. Department of Psychology.ENGLISH ABSTRACT: Research has shown that masculinities are socially and culturally constructed. How one particular social group constructs what it means to be a man varies depending on changing cultural values and beliefs. By unpacking how individuals understand their own masculinity as well as the masculinity of those around them, more can be learned about these cultural values and beliefs. This is important as these beliefs and norms that are tied to masculine identity can influence behaviour. There is considerable evidence finding that strict adherence to masculine norms results in limited help-seeking behaviour and poorer mental health outcomes. There is limited research in the South African context regarding young adolescent men’s mental health and help-seeking behaviours. Adolescence is a formative development period as this is when internalised masculine norms become entrenched within their masculine identity and can have long term impacts on their behaviour. By exploring personal constructions and understandings of masculinity by adolescent males, more can be learnt about the masculine norms that are endorsed and internalised by young men within the geographical location of the Stellenbosch district. The extent to which these norms influence help-seeking behaviour will allow for the identification of social norms that have a detrimental impact on health behaviours and can be targeted in future interventions. This qualitative study adopted a constructivist approach to meaning making, framing the research question, analysing the data, and reporting the research findings. A combined grounded theory and narrative inquiry methodology and case study design were used. The combined grounded theory and narrative inquiry approach worked well given the research aims of making sense of the participants’ personal understandings of masculinity, while still respecting their unique story and situation. The case study design was necessary given the sample size of the study. Qualitative data that were collected from individual interviews and a focus group were transcribed analysed using Braun and Clarke’s (2006) six phase framework for conducting a thematic analysis. Data from the individual interviews were presented separately from the data from the focus groups, as the focus group data was used to back up and validate the themes identified during the individual interviews. Findings indicated that traditional masculine gender norms associated with hegemonic masculinity were present and endorsed within this sample of young men. The participants stated that these masculine norms manifested as expectations on themselves, and they felt a great deal of pressure to meet these expectations. This pressure to maintain what they perceived as the norm for men would influence behaviour. For instance, practicing stoicism, crying in private, and emphasising emotional control were all behaviours undertaken by the participants so as to not jeopardise their status as a man. Help-seeking behaviour was viewed as a gendered behaviour, being seen as feminine. Other factors, such as perceived financial inaccessibility of therapy and lack of mental health knowledge were identified as playing a role in limited help-seeking behaviour. This research serves as a good snapshot of the masculine norms that are endorsed by young men in the Stellenbosch district, as well as how these masculine norms influence help-seeking behaviour.
- ItemThe impact of perinatal trauma and HIV exposure on maternal mental health and infant social-emotional development in Khayelitsha, South Africa.(Stellenbosch : Stellenbosch University, 2023-12) Motingoe, Kediemetse; Lachman, Anusha; Laughton, Barbara; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry.ENGLISH SUMMARY: There is limited knowledge on the impact of HIV and trauma exposure on maternal mental health and infant social-emotional development. This study investigated pregnant women living with HIV, with either late or early initiation of antiretroviral therapy, and those not living with HIV and their infants. These mother-child dyads were followed up for 12 months postnatally. Maternal trauma levels, infant social withdrawal and symbolic play were evaluated using the Harvard Trauma Scale, Alarm distress baby scale, and the Belsky tests, respectively. This study showed low rates of PTSD compared to previous studies in this setting, with HIV status not showing significant differences in trauma exposure. There was insignificant impact of maternal HIV and trauma causing infant withdrawal and poor symbolic play. Larger, longer-term studies are necessary for further exploration.
- ItemExperiences of Xhosa women providing kangaroo mother care in a tertiary hospital in the Western Cape, South Africa(Stellenbosch : Stellenbosch University, 2023-12) Mpongwana-Ncetani, Sibongile; Lachman, Anusha; Roomaney, Rizwana; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry.ENGLISH SUMMARY: Kangaroo mother care (KMC) has been recognized as one of the interventions to improve preterm birth outcomes by the World Health Organization. KMC requires high user engagement and consists of continuous skin‐to‐skin contact between the mother and infant and exclusive breastfeeding. We conducted a qualitative study of Xhosa women (n=10) practicing KMC in a tertiary hospital in the Western Cape, South Africa. All interviews were conducted in IsiXhosa, audio recorded, and transcribed. The transcribed data were analysed using thematic analysis. Four themes emerged: (1) KMC, a beneficial but foreign concept; (2) distress in the KMC ward; due to factors like poor milk supply, uncomfortable nursing positions and sleep deprivation; (3) themissing umbilical cord: experiences ofmothers in theKMC ward reflecting on respect for cultural and traditional practices but having limited knowledge of its significance themselves; and (4) the KMC village: interpersonal relations in the ward that oscillates between staff and fellow patient mothers. Our study showed that cultural practices still pose a challenge to fully accepting KMC. We suggest more studies on cultural sensitivity to encourage acceptance of interventions that affect culturally diverse groups.
- ItemPsychotropic medication prescribing patterns during pregnancy in two South African Maternal Mental Health clinics(Stellenbosch : Stellenbosch University, 2023-12) Farmer, Catherine; Niehaus, Daniel Jan Hendrik; Koen, Liezl; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry.ENGLISH SUMMARY: Background: There is a significant burden of mental illness during pregnancy and the safety of medication use in pregnancy is an ongoing focus of research. There is potential risk for the developing fetus and the mother from the increased risk for psychiatric illness and medication effects. Psychotropic polypharmacy during pregnancy is common, but not well- researched and there is a paucity of data on the use of psychotropic medication during pregnancy in South African women suffering from a mental illness. Aim: To determine the psychotropic medication prescription patterns in pregnant patients attending one of two maternal mental health clinics in Cape Town in terms of: the general classes of medication prescribed, the frequency and duration of psychotropic use, medication exposure according to pregnancy trimester and the prevalence of polypharmacy use. Methods: Pregnant women attending two maternal mental health clinics were studied from presentation to six weeks postpartum. Demographic data, psychiatric history, medical comorbid illnesses, pregnancy related data and medication prescription was collected and tabulated at treatment-as-usual visits. Polypharmacy prevalence was determined by using the definition of the use of two or more psychotropic medication prescriptions for a period of at least ninety days. Results: Data was collected on 303 pregnancies and the majority of pregnant women (51.8%) were diagnosed with major depressive disorder. Anti-depressant medication was the most commonly prescribed medication class (64.3%). A third of participants received prescriptions in all three trimesters. Polypharmacy criteria was met in 18.8% of the sample population. Conclusion: Prescribing psychotropic drugs in pregnancy is challenging because of the need to weigh up the potential risks of drug- related effects on the mother and child against those of discontinuing treatment. Our data contributes to raising awareness and aids medical professionals with regards to the rational use of psychotropic medication in pregnant women.
- ItemThe mental health of caregivers of children with atopic dermatitis at Tygerberg hospital(Stellenbosch : Stellenbosch University, 2023-12) Suresh, Shwetha; Lachman, Anusha; Kannenberg, Suretha; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry.ENGLISH SUMMARY: Background: Atopic dermatitis (AD) is a chronic and often debilitating illness for children but also has a significant effect on caregiver quality of life (QOL) and mental health. Aim: To explore the relationship between AD in children on the QOL and the mental health of their caregivers. Methods: We conducted a cross-sectional study of patients and their caregivers attending the Dermatology Clinic at Tygerberg Hospital in Cape Town, South Africa. Participants were recruited between February 2021 and August 2021. Results: Most of the children in this study experienced mild AD symptoms. Almost 90% of the children had an identifiable trigger, with the most common triggers being an environmental temperature change (66.7%) and stress (57.4%). We noted a weak but significant correlation between QOL and AD severity (rs = 0.395, p = 0.003) and a strong positive correlation between the caregivers’ QOL and their mental health (rs = 0.650, p < 0.001). Conclusions: The use of uncomplicated and rapid screening tools for caregiver mental health and QOL should be implemented when treating patients with AD. Understanding the burden and allowing room for mitigation of these modifiable factors will play a large role in ensuring a better therapeutic outcome for those children with a chronic illness like AD.