The forensic mental health profile of women offenders in the Eastern Cape, South Africa
- Authors: Nagdee, Mohammed
- Date: 2020
- Subjects: Female offenders -- Mental health , Female offenders -- South Africa -- Psychology , Female offenders -- South Africa -- Mental health , People with mental disabilities and crime , Women murderers -- South Africa , Forensic psychology -- South Africa , Fort England Psychiatric Hospital
- Language: English
- Type: text , Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10962/167109 , vital:41438
- Description: Introduction There is a dearth of research on mental health issues in women offenders in South Africa, especially regarding their socio-demographic backgrounds, offence characteristics, and forensic mental health profiles. Objectives This study examined the psychosocial and forensic mental health profile of women offenders referred by eastern Cape courts for forensic evaluation. A range of socio-demographic, criminological, clinical and forensic mental health variables were systematically explored. Methods A bi-phasic, mixed methods study design was adopted. The clinical and forensic records of all women referred for forensic evaluation to Fort England forensic psychiatric hospital in the Eastern Cape, South Africa were retrospectively reviewed, comprising 173 individual cases in the study period of 1993-2017. Inferential statistical analyses (chi-squared and multivariate logistic regression) were applied to explore relationships between variables and offending outcomes of nterest. Detailed semi-structured interviews were subsequently conducted with a sub-sample of 8 women with mental disorder and violent offending ackgrounds. Interview transcripts thematically analysed. Results Most women came from impoverished and disadvantaged backgrounds. Whilst the majority were first offenders, a high proportion had violent index offences, with murder, attempted murder and assault with intent to do grievous bodily harm accounting for over half of cases. The majority of victims of violence were well known to the perpetrator, especially as biological children, intimate male partners or close family members. Biological children in their first year of life were particularly vulnerable to being victims of homicidal violence. Disproportionately high rates of pre-offence mental illness, alcohol misuse, HIV infection and prior abuse of the offender (especially by intimate male partners) were present. High rates of severe mental disorders (especially psychiatric comorbidity and psychotic-spectrum disorders), and relatively low rates of personality disorders and substance disorders were diagnosed. The majority of women were declared to lack trial competence and criminal capacity, respectively, following forensic evaluation. Women who had backgrounds of prior abuse themselves had over three mes the odds of subsequent violent offending in general, and almost six times the odds of homicidal offending in particular. Homicidal offences were significantly more commonly committed by women with no prior psychiatric history and no psychiatric comorbidity. Women who committed homicide had over eleven times of killing children as opposed to adults. Women over the age of 30 years, and those without psychiatric comorbidity, were significantly less likely to have killed children. Thematic analysis of interviews emphasized the important roles played by gender, self-image, and mental health in violent offending pathways. Conclusions A complex array of socio-demographic, criminological, clinical and forensic variables interact in women offenders of the Eastern Cape referred by courts for forensic evaluation. Exploration of these factors improves understanding of the broader psychosocial context of female offending, and of the personal experiences of the women themselves. This in turn provides an enhanced gender-focus to guide the progressive changes required in policy, legislative, clinical and research endeavours in this field.
- Full Text:
- Date Issued: 2020
- Authors: Nagdee, Mohammed
- Date: 2020
- Subjects: Female offenders -- Mental health , Female offenders -- South Africa -- Psychology , Female offenders -- South Africa -- Mental health , People with mental disabilities and crime , Women murderers -- South Africa , Forensic psychology -- South Africa , Fort England Psychiatric Hospital
- Language: English
- Type: text , Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10962/167109 , vital:41438
- Description: Introduction There is a dearth of research on mental health issues in women offenders in South Africa, especially regarding their socio-demographic backgrounds, offence characteristics, and forensic mental health profiles. Objectives This study examined the psychosocial and forensic mental health profile of women offenders referred by eastern Cape courts for forensic evaluation. A range of socio-demographic, criminological, clinical and forensic mental health variables were systematically explored. Methods A bi-phasic, mixed methods study design was adopted. The clinical and forensic records of all women referred for forensic evaluation to Fort England forensic psychiatric hospital in the Eastern Cape, South Africa were retrospectively reviewed, comprising 173 individual cases in the study period of 1993-2017. Inferential statistical analyses (chi-squared and multivariate logistic regression) were applied to explore relationships between variables and offending outcomes of nterest. Detailed semi-structured interviews were subsequently conducted with a sub-sample of 8 women with mental disorder and violent offending ackgrounds. Interview transcripts thematically analysed. Results Most women came from impoverished and disadvantaged backgrounds. Whilst the majority were first offenders, a high proportion had violent index offences, with murder, attempted murder and assault with intent to do grievous bodily harm accounting for over half of cases. The majority of victims of violence were well known to the perpetrator, especially as biological children, intimate male partners or close family members. Biological children in their first year of life were particularly vulnerable to being victims of homicidal violence. Disproportionately high rates of pre-offence mental illness, alcohol misuse, HIV infection and prior abuse of the offender (especially by intimate male partners) were present. High rates of severe mental disorders (especially psychiatric comorbidity and psychotic-spectrum disorders), and relatively low rates of personality disorders and substance disorders were diagnosed. The majority of women were declared to lack trial competence and criminal capacity, respectively, following forensic evaluation. Women who had backgrounds of prior abuse themselves had over three mes the odds of subsequent violent offending in general, and almost six times the odds of homicidal offending in particular. Homicidal offences were significantly more commonly committed by women with no prior psychiatric history and no psychiatric comorbidity. Women who committed homicide had over eleven times of killing children as opposed to adults. Women over the age of 30 years, and those without psychiatric comorbidity, were significantly less likely to have killed children. Thematic analysis of interviews emphasized the important roles played by gender, self-image, and mental health in violent offending pathways. Conclusions A complex array of socio-demographic, criminological, clinical and forensic variables interact in women offenders of the Eastern Cape referred by courts for forensic evaluation. Exploration of these factors improves understanding of the broader psychosocial context of female offending, and of the personal experiences of the women themselves. This in turn provides an enhanced gender-focus to guide the progressive changes required in policy, legislative, clinical and research endeavours in this field.
- Full Text:
- Date Issued: 2020
The lived experiences of women with human immunodeficiency virus (HIV) in Malawi: an interpretative phenomenological analysis (IPA)
- Authors: Nkhalamba, Mathero Michelle
- Date: 2020
- Subjects: HIV-positive women -- Malawi , HIV infections -- Sex factors -- Malawi , HIV infections -- Social aspects -- Malawi , HIV-positive women -- Malawi -- Social conditions , HIV-positive women -- Malawi -- Economic conditions , Poverty -- Malawi , Antiretroviral agents -- Malawi , Phenomenological psychology
- Language: English
- Type: text , Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10962/145291 , vital:38425
- Description: Research on African women and HIV, particularly research that investigates their experiences of living with the virus, has been relatively peripheral. As a response to the apparent knowledge and research gaps, this project is a qualitative study involving women living with human immunodeficiency virus (WLHIV) and attending an anti-retroviral treatment (ART) clinic at Zomba Central Hospital in Southern Malawi. The study utilised an interpretative phenomenological analysis (IPA) approach, which informed all aspects of the data-collection and data-analysis processes. Using purposive sampling, 12 women were recruited and interviewed on three occasions over a period of six months. The interviews were conducted in Chichewa and audio recorded and later transcribed into English. Fourteen superordinate themes emerged from the analysis representing the women’s prominent life experiences, how they received their diagnosis, and how they contained the trauma of their diagnosis. The analysis also developed themes regarding how they coped with the challenges of living with the human immunodeficiency virus (HIV) and made sense of their experiences. The results showed that the women struggled with multiple challenges experienced through their various identities as WLHIV. The findings also pointed to interlocking disadvantages that put the women at risk of infection, and which were present from childhood. This has implications for more structural and multidisciplinary interventions for WLHIV.
- Full Text:
- Date Issued: 2020
- Authors: Nkhalamba, Mathero Michelle
- Date: 2020
- Subjects: HIV-positive women -- Malawi , HIV infections -- Sex factors -- Malawi , HIV infections -- Social aspects -- Malawi , HIV-positive women -- Malawi -- Social conditions , HIV-positive women -- Malawi -- Economic conditions , Poverty -- Malawi , Antiretroviral agents -- Malawi , Phenomenological psychology
- Language: English
- Type: text , Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10962/145291 , vital:38425
- Description: Research on African women and HIV, particularly research that investigates their experiences of living with the virus, has been relatively peripheral. As a response to the apparent knowledge and research gaps, this project is a qualitative study involving women living with human immunodeficiency virus (WLHIV) and attending an anti-retroviral treatment (ART) clinic at Zomba Central Hospital in Southern Malawi. The study utilised an interpretative phenomenological analysis (IPA) approach, which informed all aspects of the data-collection and data-analysis processes. Using purposive sampling, 12 women were recruited and interviewed on three occasions over a period of six months. The interviews were conducted in Chichewa and audio recorded and later transcribed into English. Fourteen superordinate themes emerged from the analysis representing the women’s prominent life experiences, how they received their diagnosis, and how they contained the trauma of their diagnosis. The analysis also developed themes regarding how they coped with the challenges of living with the human immunodeficiency virus (HIV) and made sense of their experiences. The results showed that the women struggled with multiple challenges experienced through their various identities as WLHIV. The findings also pointed to interlocking disadvantages that put the women at risk of infection, and which were present from childhood. This has implications for more structural and multidisciplinary interventions for WLHIV.
- Full Text:
- Date Issued: 2020
Minding your own game : self-regulation and psychological momentum among golfers
- Authors: Kingma, Graham
- Date: 2015
- Subjects: Golf -- Strategic aspects , Golf -- Psychological aspects , Athletes , Self-control , Golfers -- Conduct of life
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3260 , http://hdl.handle.net/10962/d1017883
- Description: Psychological momentum (PM) is often regarded as an important phenomenon that influences athlete performance. Nevertheless, conceptualisations of PM are criticised for being speculative, vague and impractical for scientific inquiry. In contrast, self-regulation is a long-standing, well researched concept used to explain performance outcomes, yet not clearly integrated in current PM conceptualisations. Hence, this thesis explores self-regulation relative to PM. Golf was considered to be an appropriate context for the empirical inquiries on the basis that it serves as a metaphor for managing life’s challenges. Three studies were conducted. The first study entailed a systematic conceptual analysis of PM based on previous conceptualisations and studies in relevant scientific literature. Self-regulatory processes were identified among the key psychological mechanisms and moderators related to PM. The second study aimed to identify key self-regulation strategies in PM experiences among 16 golfers. A mixed method approach including novel “walk-along” and “think aloud” data collection techniques was used. An inductive thematic analysis yielded a comprehensive typology golfing strategies. Nevertheless, the study did not find consistent strategy patterns in positive or negative PM phases. The third study explored the self-regulation of identity (ego-regulation) in relation to PM phases. A staggered multiple-baseline single-case research methodology was used with five golfers (three professionals and two amateurs). Ego-regulation was manipulated through a mindfulness-based schema mode program tailored to golf (Mindfulness for Golf; MFG). Pre-, mid- and post-intervention data showed positive changes among the participants on two dimensions of PM as well as performance outcomes. Overall the results suggest that golfers use idiosyncratic self-regulation processes to facilitate performance, but these are not directly linked to PM phases. Nonetheless, there are promising indications that enhancing ego-regulation through the MFG program facilitates positive momentum among golfers. Based on the results of the studies in this thesis, and for the sake of scientific parsimony and pragmatism, it is recommended that self-regulation models incorporating motivation are used to explain momentum in athletic activity. In this view, PM has the function of describing, not influencing, goal-driven performance
- Full Text:
- Date Issued: 2015
- Authors: Kingma, Graham
- Date: 2015
- Subjects: Golf -- Strategic aspects , Golf -- Psychological aspects , Athletes , Self-control , Golfers -- Conduct of life
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3260 , http://hdl.handle.net/10962/d1017883
- Description: Psychological momentum (PM) is often regarded as an important phenomenon that influences athlete performance. Nevertheless, conceptualisations of PM are criticised for being speculative, vague and impractical for scientific inquiry. In contrast, self-regulation is a long-standing, well researched concept used to explain performance outcomes, yet not clearly integrated in current PM conceptualisations. Hence, this thesis explores self-regulation relative to PM. Golf was considered to be an appropriate context for the empirical inquiries on the basis that it serves as a metaphor for managing life’s challenges. Three studies were conducted. The first study entailed a systematic conceptual analysis of PM based on previous conceptualisations and studies in relevant scientific literature. Self-regulatory processes were identified among the key psychological mechanisms and moderators related to PM. The second study aimed to identify key self-regulation strategies in PM experiences among 16 golfers. A mixed method approach including novel “walk-along” and “think aloud” data collection techniques was used. An inductive thematic analysis yielded a comprehensive typology golfing strategies. Nevertheless, the study did not find consistent strategy patterns in positive or negative PM phases. The third study explored the self-regulation of identity (ego-regulation) in relation to PM phases. A staggered multiple-baseline single-case research methodology was used with five golfers (three professionals and two amateurs). Ego-regulation was manipulated through a mindfulness-based schema mode program tailored to golf (Mindfulness for Golf; MFG). Pre-, mid- and post-intervention data showed positive changes among the participants on two dimensions of PM as well as performance outcomes. Overall the results suggest that golfers use idiosyncratic self-regulation processes to facilitate performance, but these are not directly linked to PM phases. Nonetheless, there are promising indications that enhancing ego-regulation through the MFG program facilitates positive momentum among golfers. Based on the results of the studies in this thesis, and for the sake of scientific parsimony and pragmatism, it is recommended that self-regulation models incorporating motivation are used to explain momentum in athletic activity. In this view, PM has the function of describing, not influencing, goal-driven performance
- Full Text:
- Date Issued: 2015
"I felt that I deserved it" : an Investigation into HIV-related PTSD, traumatic life events, and the personal experiences of living with HIV : a mixed-method study
- Authors: Boulind, Melissa Jane
- Date: 2014
- Subjects: Post-traumatic stress disorder -- Psychological aspects -- Research -- South Africa -- Kwazulu HIV infections -- Psychological aspects -- Research -- South Africa -- Kwazulu HIV-positive persons -- South Africa -- Kwazulu -- Interviews Psychic trauma -- Research Stress (Psychology) -- Research
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3211 , http://hdl.handle.net/10962/d1012172
- Description: There appears to be a growing body of literature focusing on PTSD and HIV-related PTSD (the diagnosis of HIV being the significant traumatic event) amongst HIV-positive samples, but only a few African studies that attempt to estimate the prevalence of PTSD amongst HIV-positive people, and even fewer that attempt to estimate the prevalence of HIV-related PTSD. The systemic review presented in this study is currently fully inclusive and is the most up-to-date available. Estimates of the prevalence of PTSD and HIV-related PTSD in South Africa range from 0.7 to 54.1% and, 4.2 to 40% respectively. The current cross-sectional study made use of a mixed-method approach to investigate traumatic life events, PTSD and HIV-related PTSD within a primary health-care centre in KwaZulu-Natal. The quantitative sample consisted of 159 adults (18-50 years) who were compliant on ARV medication. Using the CIDI-PTSD module, the adapted CIDI-PTSD module for HIV, and IES-R, findings indicated that 62% had reported some kind of traumatic event in their lifetime, with 29.6% of participants meeting the criteria for lifetime PTSD, and 40.9% meeting the criteria for lifetime HIV-related PTSD. Altogether, 57.9% of individuals met the criteria for some form of PTSD (either regular PTSD or HIV-related PTSD), and 12.6% met the criteria for both PTSD and HIV-related PTSD. Of the different categories of traumatic events, interpersonal violence has the highest rate of PTSD, followed by a diagnosis of and living with HIV, and then disaster. Furthermore, the IES-R was compared for its usefulness as a screening measure for PTSD against both the CIDI, but results suggest that it is an inferior screening measure to the PDS. The qualitative study consisted of six participants who were examined using IPA methodology informed by the Ehlers and Clark (2000) Model of trauma. Their experiences revealed experiences of stigma, a number of negative appraisals, negative emotions and coping behaviours. Some of the latter might serve as compensatory mechanisms to avoid negative judgements. Hypervigilance seems to be a feature of ARV-compliance that might confer added vulnerability to PTSD and other anxiety disorders.
- Full Text:
- Date Issued: 2014
- Authors: Boulind, Melissa Jane
- Date: 2014
- Subjects: Post-traumatic stress disorder -- Psychological aspects -- Research -- South Africa -- Kwazulu HIV infections -- Psychological aspects -- Research -- South Africa -- Kwazulu HIV-positive persons -- South Africa -- Kwazulu -- Interviews Psychic trauma -- Research Stress (Psychology) -- Research
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:3211 , http://hdl.handle.net/10962/d1012172
- Description: There appears to be a growing body of literature focusing on PTSD and HIV-related PTSD (the diagnosis of HIV being the significant traumatic event) amongst HIV-positive samples, but only a few African studies that attempt to estimate the prevalence of PTSD amongst HIV-positive people, and even fewer that attempt to estimate the prevalence of HIV-related PTSD. The systemic review presented in this study is currently fully inclusive and is the most up-to-date available. Estimates of the prevalence of PTSD and HIV-related PTSD in South Africa range from 0.7 to 54.1% and, 4.2 to 40% respectively. The current cross-sectional study made use of a mixed-method approach to investigate traumatic life events, PTSD and HIV-related PTSD within a primary health-care centre in KwaZulu-Natal. The quantitative sample consisted of 159 adults (18-50 years) who were compliant on ARV medication. Using the CIDI-PTSD module, the adapted CIDI-PTSD module for HIV, and IES-R, findings indicated that 62% had reported some kind of traumatic event in their lifetime, with 29.6% of participants meeting the criteria for lifetime PTSD, and 40.9% meeting the criteria for lifetime HIV-related PTSD. Altogether, 57.9% of individuals met the criteria for some form of PTSD (either regular PTSD or HIV-related PTSD), and 12.6% met the criteria for both PTSD and HIV-related PTSD. Of the different categories of traumatic events, interpersonal violence has the highest rate of PTSD, followed by a diagnosis of and living with HIV, and then disaster. Furthermore, the IES-R was compared for its usefulness as a screening measure for PTSD against both the CIDI, but results suggest that it is an inferior screening measure to the PDS. The qualitative study consisted of six participants who were examined using IPA methodology informed by the Ehlers and Clark (2000) Model of trauma. Their experiences revealed experiences of stigma, a number of negative appraisals, negative emotions and coping behaviours. Some of the latter might serve as compensatory mechanisms to avoid negative judgements. Hypervigilance seems to be a feature of ARV-compliance that might confer added vulnerability to PTSD and other anxiety disorders.
- Full Text:
- Date Issued: 2014
The adaptation of the 'Clinical Outcomes in Routine Evaluation-Outcome Measure' (CORE-OM) from English into a valid Xhosa measure of distress
- Authors: Campbell, Megan Michelle
- Date: 2013 , 2013-06-06
- Subjects: Psychometrics -- Research -- South Africa Psychology -- Mathematical models -- Research -- South Africa Psychological tests -- Research -- South Africa Mental health services -- Research -- South Africa Health services accessibility -- Research -- South Africa Language disorders -- South Africa
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2894 , http://hdl.handle.net/10962/d1001538
- Description: In South Africa access to mental healthcare resources is restricted for a number of reasons including language barriers that prevent suitable communication between mental healthcare professionals and African language speaking South Africans. The translation of psychometric tools into African languages has been identified as one method in improving access to psychological services for African language speakers. The Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) has demonstrated its clinical utility within the United Kingdom (UK) National Healthcare Service (NHS) as a standardised psychotherapy outcome measure that evaluates the degree of psychological distress individuals present with at the start of psychotherapy treatment, and the degree of change that has been effected at the termination of therapy. A measure like the CORE-OM holds valuable clinical utility for the South African context. This thesis argues that the availability of a valid Xhosa version of the CORE-OM would allow for improved access to psychotherapy resources for Xhosa speaking individuals, and allow for the evaluation of the effectiveness of psychotherapy interventions conducted in Xhosa. The CORE-OM developers have provided a translation design and set of guidelines to standardise the translation of the CORE-OM into different languages. However this thesis argues that these guidelines are incomplete. Instead International Test Commission (ITC) guidelines are recommended as a culturally sensitive method to supplement current CORE-OM translation guidelines, in order to generate a valid Xhosa measure of distress. A mixed methods approach is applied which first investigates the construct equivalence and bias of the CORE-OM English version within a South African student population sample, both qualitatively and quantitatively, in order to establish the degree of adaptation required to generate a valid Xhosa version of distress. Next the CORE-OM English version is translated into Xhosa using the five-stage translation design prescribed by the CORE System Trust, supplemented by ITC guidelines. All changes made to the CORE-OM during translation into Xhosa are documented. The CORE-OM Xhosa version is then investigated for reliability and validity. This investigation reveals low internal reliability within the subjective wellbeing domain indicating that these items are less meaningful as depictions of distress within the Xhosa language. A reduced version of the CORE-OM demonstrates strong psychometric properties as a valid Xhosa measure of distress.
- Full Text:
- Date Issued: 2013
- Authors: Campbell, Megan Michelle
- Date: 2013 , 2013-06-06
- Subjects: Psychometrics -- Research -- South Africa Psychology -- Mathematical models -- Research -- South Africa Psychological tests -- Research -- South Africa Mental health services -- Research -- South Africa Health services accessibility -- Research -- South Africa Language disorders -- South Africa
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:2894 , http://hdl.handle.net/10962/d1001538
- Description: In South Africa access to mental healthcare resources is restricted for a number of reasons including language barriers that prevent suitable communication between mental healthcare professionals and African language speaking South Africans. The translation of psychometric tools into African languages has been identified as one method in improving access to psychological services for African language speakers. The Clinical Outcomes in Routine Evaluation - Outcome Measure (CORE-OM) has demonstrated its clinical utility within the United Kingdom (UK) National Healthcare Service (NHS) as a standardised psychotherapy outcome measure that evaluates the degree of psychological distress individuals present with at the start of psychotherapy treatment, and the degree of change that has been effected at the termination of therapy. A measure like the CORE-OM holds valuable clinical utility for the South African context. This thesis argues that the availability of a valid Xhosa version of the CORE-OM would allow for improved access to psychotherapy resources for Xhosa speaking individuals, and allow for the evaluation of the effectiveness of psychotherapy interventions conducted in Xhosa. The CORE-OM developers have provided a translation design and set of guidelines to standardise the translation of the CORE-OM into different languages. However this thesis argues that these guidelines are incomplete. Instead International Test Commission (ITC) guidelines are recommended as a culturally sensitive method to supplement current CORE-OM translation guidelines, in order to generate a valid Xhosa measure of distress. A mixed methods approach is applied which first investigates the construct equivalence and bias of the CORE-OM English version within a South African student population sample, both qualitatively and quantitatively, in order to establish the degree of adaptation required to generate a valid Xhosa version of distress. Next the CORE-OM English version is translated into Xhosa using the five-stage translation design prescribed by the CORE System Trust, supplemented by ITC guidelines. All changes made to the CORE-OM during translation into Xhosa are documented. The CORE-OM Xhosa version is then investigated for reliability and validity. This investigation reveals low internal reliability within the subjective wellbeing domain indicating that these items are less meaningful as depictions of distress within the Xhosa language. A reduced version of the CORE-OM demonstrates strong psychometric properties as a valid Xhosa measure of distress.
- Full Text:
- Date Issued: 2013
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