Health care practitioners' perceptions of public mental health care in the Eastern Cape,South Africa

This qualitative study explored the perceptions of health care practitioners (HCPs) concerning public mental health care in the Eastern Cape Province of South Africa. Data were collected from thirteen purposively selected HCPs using in-depth unstructured interviews (males?=?6, females?=?7). Data were transcribed verbatim and later thematically analysed. The findings suggest that mental health professionals perceive mental health services to be both inadequate and of suboptimal quality. Specifically, they perceived public mental health care to have lower priority, to be poorly resourced and lacking in patient-oriented care qualities.     

Cultural conceptions of a bereavement-related illness in a South African indigenous community

This study explored cultural conceptions of a bereavement-related illness among elderly (aged 34–85yrs) Northern Sotho-speaking people in Limpopo province. The participants (n = 14, females = 50%, mean age = 59 years, SD: 13.7 years) were purposively selected and interviewed using in-depth interviews. Data were analysed using Hycner’s adapted phenomenological method. Three themes emerged from the analysis: debilitating and life-threatening symptoms of the illness; aetiology explained by ritual taboo violations; and management of the illness through ritual cleansing. The cleansing process incorporates the administration of traditional herbs. The findings suggest bereavement-related illness in an African cultural community to be explained by their cultural concept of distress understandings.     

A Bibliometric Analysis of the Quantitative Mental Health Literature in Occupational Therapy

ABSTRACT

A bibliometric analysis was performed to examine the impact and use of the peer-reviewed occupational therapy intervention effectiveness literature addressing adults with mental illness, 2000–2016. Of 2,597 articles, 68 were quantitative studies assessing an intervention for adults with mental illness. These studies had a collective citation count of 1,455 and were published in 29 journals in 14 countries. The majority (n?=?36; 52.94%) were randomized controlled and two-group controlled studies. The most commonly assessed interventions were life skills and community reintegration (n?=?20, 29.41%) and supported employment (n?=?16, 23.52%). Sixty-five (95.58%) studies found statistically significant results on the primary or secondary outcomes.     

Impact of psychiatric illness upon asthma patients’ health care utilization and illness control. Are all psychiatric comorbidities created equal?

The impact of psychiatric illnesses upon asthma patients' functioning is not well understood. This study examined the impact of psychiatric comorbidity upon illness management in asthma patients using empirically-derived psychiatric comorbidity groups. Participants were a clinic sample of Greek-speaking asthma patients (N = 212) assessed using the Patient Health Questionnaire (PHQ) Somatoform, Depression, Panic Disorder (PD), Other Anxiety Disorder, Eating Disorder (ED) and Alcohol sub-scales. The associations between sub-scales were examined using multiway frequency analysis. The following groups were derived: Somatoform disorder and/or Any Depressive disorder (n = 63), Somatoform disorder and/or Other Anxiety disorder (n = 51), Somatoform disorder and/or Any ED (n = 60), and Any Anxiety group including PD and/or Other Anxiety disorder (n = 24). Across all groups, psychiatric illness was associated with significantly worse asthma control (p < .01). Participants in Any Anxiety group, OR = 4.61, 95% CI [1.90, 11.15], Somatoform and/or Any Depressive disorder, OR = 2.06, 95% CI [1.04, 4.09] and Somatoform and/or Other Anxiety disorder, OR = 2.75, 95% CI [1.35, 5.60] were at higher risk for asthma-related Emergency Room (ER) visits compared to controls. However only Somatoform and/or Any Depressive disorder, OR = 3.67, 95% CI [1.60, 8.72], Somatoform and/or Other Anxiety disorder, OR = 5.50, 95% CI [2.34, 12.74], and Somatoform and/or Any ED, OR = 4.98, 95% CI [2.14, 11.60] group membership were risk factors for asthma-related hospitalizations. Results suggest that while comorbid psychiatric disorders generally negatively impact asthma illness management, different psychiatric comorbidities appear to have disparate effects upon illness management outcomes.     

Unwanted attention: The psychological impact of cyberstalking on its survivors

This exploratory study investigated experiences of cyberstalking by analysing the psychological impact on young adult users (n = 12; females = 9). The participants completed in-depth e-mail interviews documenting their lived experiences as cyberstalking survivors. The data were thematically analysed. The findings indicate that young adults who have experienced cyberstalking report a wide-ranging psychological impact on them; including feelings of stress, hurt, paranoia, insomnia, betrayal, anger, fear, and in some cases even depression. These findings advocate the need for tailored interventions to alleviate the impact on cyberstalking survivors.     

Patient and spouse perceptions of the patient's heart disease and their associations with received and provided social support and undermining

Numerous empirical studies have investigated the relationships between cardiovascular diseases (CVD) and patients’ psychological well-being, with a focus almost exclusively on its dark side. Very little is known on the impact of illness severity on both negative and positive indicators of patients’ well-being, as well as on the psychosocial variables that may mediate this association. Aim of the study was to investigate the impact of illness severity on depression as well as on health satisfaction and life satisfaction of patients undergoing a cardiovascular rehabilitation. It also aimed at testing the mediation of illness perception and self-efficacy beliefs in managing cardiac risk factors. The study involved 172 patients (mean age?=?66.43?years; SD?=?9.99?years; 76.2% men). Illness severity was measured in terms of left ventricular ejection fraction at discharge from the cardiology department, whereas all psychological dimensions were assessed one week later. Results showed significant relationships among illness severity, depression and health satisfaction that were fully mediated by illness perception and self-efficacy beliefs, but not significant relation between disease severity and life satisfaction (χ ²(1)?=?2.30, p?=?n.s.). Overall, findings underline the importance of working on illness perception and self-efficacy beliefs to contrast depression and to improve health and life satisfaction in patients with CVD.     

Adaptation to an autoimmune disorder: Does mental flexibility impact illness-related self-regulation?

Objective: To examine whether mental flexibility moderates the relationship between illness representations of control and coping behaviour in individuals suffering from rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE).

Design: Recently, diagnosed RA (N = 80) and SLE (N = 75) patients completed questionnaires about illness representations of personal and treatment control and four coping behaviours: instrumental coping, adherence to medical advice, palliative coping and wishful thinking. Mental flexibility was assessed with the Trail Making Test Part B (TMT-B), while visuomotor processing speed, as a confounder, was assessed with the Trail Making Test Part A (TMT-A). Moderated mediation models were tested within a bootstrapped multiple regression framework.

Results: TMT-A scores had no statistically significant moderation effects on the relation between representations and coping behaviour. Conversely, in those participants with SLE, TMT-B scores moderated the relation of personal control to wishful thinking and palliative coping, as well as the relation of treatment control to both wishful thinking and palliative coping. All significant effects were restricted to the SLE group.

Conclusion: Interactions between neurocognitive factors and the process of illness adaptation may emerge early during the course of SLE. The present findings highlight the role of cognitive functioning as an integral part of the illness-related self-regulation mechanism.     

Development and Validation of the False Disorder Score: The Focal Scale of the Inventory of Problems

Abstract

This article introduces the Inventory of Problems (IOP)—a new, computerized, 181-item tool designed to discriminate bona fide from feigned mental illness and cognitive impairment—and presents the development and validation of its focal, feigning scale, the False Disorder Score (IOP–FDS). The initial sample included (a) 211 patients and 64 offenders who took the IOP under standard conditions, and (b) 210 community volunteers and 64 offenders who feigned mental illness. We split this sample into three subsamples. The first (n?=?301) was used to select the variables to generate the IOP–FDS; the second (n?=?148) scaled the IOP–FDS into a probability score; and the third (n?=?100) tested its validity with an independent data set. In this third subsample, the IOP–FDS had sensitivity?=?.90, specificity?=?.80, and a greater area under the curve (AUC?=?.95) than the IOP–29 (.91). For 40 participants, the Personality Assessment Inventory (PAI) was available, too. Within this subgroup, the IOP–FDS outperformed the selected PAI validity scales (AUC?=?.99 vs. AUC ≤ .85).     

Infertility-Related Stress and Life Satisfaction among Chinese Infertile Women: A Moderated Mediation Model of Marital Satisfaction and Resilience

The present study investigated the effects of infertility on Chinese women’s life satisfaction. Infertile women (n?=?466) who were seeking medical help completed a survey that included the Fertility Problem Inventory (FPI), the Dyadic Adjustment Questionnaire (DAS), the Connor-Davidson Resilience Scale (CD-RISC), the Satisfaction with Life Scale, and demographic variables. We used a moderated mediation model to test our hypotheses, with life satisfaction as the dependent variable, representations about the importance of parenthood as the independent variable, the impact of infertility on life domains as a mediator, and marital satisfaction and resilience as moderators. Results showed that representations about the importance of parenthood and the impact of infertility on life domains are two main types of infertility-related stress, which could play independent roles in predicting life satisfaction. Representations about the importance of parenthood had a negative indirect effect on life satisfaction through the impact of infertility on life domains, and the indirect effect of the impact of infertility on life domains was moderated by marital satisfaction and resilience. Specially, representations about the importance of parenthood had a weaker indirect effect (through the impact of infertility on life domains) on life satisfaction in individuals with higher marital satisfaction or resilience. Therefore, the type of infertility-related stress and both marital satisfaction and resilience should be addressed in psychological interventions for women coping with infertility in mainland China.

     

More Than a Sex Machine: Accomplishing Masculinity Among Chinese Male Sex Workers in the Hong Kong Sex Industry

Situated in the masculinity and deviance literature, this article examines a “deviant” masculinity, that of the male sex worker, and presents the ways men who engage in sex work cope with the job. Based on in-depth interviews of Chinese male sex workers (n = 18) in the Hong Kong sex industry, I argue that the stigma management techniques these men employ are simultaneously gender strategies they use to accomplish masculinity. It is through this process that they negotiate a masculine identity within the hierarchy of masculinities in order to become “respectable” and “responsible” Chinese men.     

Learning to Live with OCD: Labeling,the Self,and Stigma

Researchers have long questioned relationships among self-conceptions, “mental illness,” and stigma. This article looks at these issues through the lens of Obsessive-Compulsive Disorder (OCD), as minimal research has focused on the lived experience of OCD. We examine the impact of OCD on constructions of identity and the management/resistance of stigma. We do this through in-depth interviews with an untraditional Internet-based sample. We find respondents experience a crisis of self that leads them to a variety of strategies to deal with self-stigma, experienced stigma, and anticipated stigma.     

Providers’ Perceptions and Practices Regarding <Emphasis Type="BoldItalic">BRCA1/2</Emphasis> Genetic Counseling and Testing in African American Women

We examined healthcare providers’ perceptions of genetic counseling and testing in African American women at moderate to high-risk of carrying a BRCA1/2 mutation. We conducted 20 in-depth interviews with genetic counselors (n = 5), medical oncologists (n = 8), obstetrician/gynecologists (n = 2) and surgeons (n = 5). Interviews were audiotaped, transcribed and independently coded by two individuals using a content analysis approach. Seven themes emerged relevant to providers’ perceptions of African American women’s use of BRCA1/2 genetic services: access factors, cultural beliefs and preferences, effects of testing, patient motivators for genetic counseling and testing, patient-provider communication, reasons for provider referral, and reasons for patient refusal. Providers identified individual- and system-level barriers to African American women’s use of genetic services, including lack of follow-up after referrals to genetic specialists and challenges to obtaining financial coverage for under- and uninsured high-risk women. Results have implications for physician and patient education regarding appropriate referrals to and uptake of genetic services in at-risk African American women.     

Relationships between identity domains and life satisfaction in minority and majority youth in Albania,Bulgaria, Czech Republic,Kosovo, and Romania

Abstract

The purpose of this study was to examine relationships between identity domains (educational and relational identity) and life satisfaction in a cross-national perspective, by targeting minority (Roma) and majority youth in Albania, Bulgaria, Czech Republic, Kosovo, and Romania. Based on the three-factor identity formation model, we investigated the interplay between three identity processes (i.e., commitment, in-depth exploration, and reconsideration of commitment) and life satisfaction. Participants were 1860 adolescents aged 12–19 years from Albania (n = 350), Bulgaria (n = 398), the Czech Republic (n = 293), Kosovo (n = 542), and Romania (n = 277). They completed self-reports of the Utrecht-Management of Identity Commitments Scale (U-MICS) and the Life Satisfaction Scale (SWLS). We adopted a structural equation modelling approach to test (a) measurement invariance of identity and life satisfaction models across groups and (b) associations between identity domains (educational and relational) and life satisfaction. Findings indicated measurement invariance for identity and life satisfaction measures across cultural groups. In the total sample, life satisfaction was consistently associated with high commitment, high in-depth exploration, and low reconsideration of commitment in the educational identity domain. Sample-specific associations highlighted important cultural differences. Implications of these findings for identity and well-being in minority and mainstream youth across the countries under investigation are discussed.     

Religion,Spirits, Human Agents and Healing: A Conceptual Understanding from a Sociocultural Study of Tehuledere Community,Northeastern Ethiopia

This paper explores the relationship among religion, spirits and healing in the Tehuledere community in the northeastern part of Ethiopia and focuses on how this knowledge can inform primary healthcare reform. The study employed qualitative ethnographic methods. Participatory observation, over a total of 5 months during the span of 1 year, was supplemented by focus group discussions (96 participants in 10 groups) and in-depth interviews (n = 20) conducted with key informants. Data were analyzed thematically using narrative strategies. The present study revealed that members of the study community perceive health, illness and healing as being given by God. Many of the Tehuledere people attribute illness to the wrath of supernatural forces. Healing is thought to be mitigated by divine assistance obtained through supplication and rituals and through the healing interventions of nature spirit actors. We found that the health, illnesses and healing were inextricably linked to religious and spiritual beliefs. Our findings suggest that religious and spiritual elements should be considered when drafting and implementing primary healthcare strategies for the study communities and similar environments and populations around the globe.

     

Where,O death,is thy sting? The meaning-providing function of beliefs in literal immortality

Terror management theory suggests that humans invest in cultural worldviews that allay mortality-related anxiety by promising death transcendence. Many religious individuals adhere to belief in literal immortality – believing that one will live on after death. Across two studies (n?=?1137), we explored the terror management function of such beliefs by exploring whether these beliefs are associated with lower death anxiety and greater meaning among individuals of varying religiousness. In both Study 1 (n?=?236) and Study 2 (n?=?901), belief in literal immortality was related to lower death anxiety only among intrinsically religious participants. Moreover, meaning in life mediated the relationship between belief in literal immortality and death anxiety. Study 2 clarified that this mediational relationship was only present for intrinsically religious individuals. We discuss the importance of particular religious beliefs in the provision of meaning in order to manage existential concerns.     

Experiences of stereotyping among individuals employed in selected South African organisations

This study investigated the effects of stereotypes among individuals working in selected South African organisations. The participants were 336 employees within the following sectors: banking (n?=?40), higher education institutions (n?=?72), mining (n?=?63), municipalities (n?=?24), nursing (n?=?4), police services (n?=?20), schools (n?=?85), and the restaurant industry (n?=?28). Data were collected using open ended interviews, and thematically analysed. The findings indicated that stereotypes influence individuals on three different levels: cognitive, behavioural, and emotional levels. Predominantly, participants reported that they mostly react in a cognitive manner when confronted with stereotypes.     

Psychological and existential vulnerability among clinical young women: a quantitative comparison of depression-related subgroups

The objective was to explore psychological and existential vulnerability among clinical young women in Sweden. Females (n?=?53) with depression as the most common preliminary diagnosis were investigated through an online questionnaire. Included measures were Karolinska Scales of Personality, Self-concept, Strategies to Handle Negative Emotions, Sense of Coherence, and questions pertaining to existential meaning-making, including religious/spiritual belief. The sample was divided into High (n?=?35) and Low/Inter (n?=?18) groups according to scores on the anxiety- and depression-related personality scale Inhibition of aggression. Using independent samples t-test, the High group showed signs of significantly higher psychological and existential vulnerability than the Low/Inter group. Salutogenic factors being (1) coming from socially and societally engaged families and (2) being in a functional existential meaning-making process. The conclusion is that vulnerabilities in the psychological and existential domains are linked, especially in individuals high on depression-like aspects of personality. However, no significant differences for religion/spirituality were found. Treatment implications were addressed.     

Bereavement counselling in Uganda and Northern Ireland: a comparison

Therapeutic interventions for bereavement in Northern Ireland and in the Sub-Saharan African country of Uganda are compared. Semi-structured interviews were conducted with Ugandan (n?=?18) and Northern Irish (n?=?20) therapists. These were thematically analysed. The findings focused on: the counselling context, the characteristics of counsellors, the characteristics of clients and counselling practices. Whilst there were many similarities in practice, core differences arose from the demands of these regions’ predominately collectivist or individualist settings. Findings suggest that counselling interventions require adjustment to reflect cultural practices where there is less emphasis on an individualised ego, and where bereavement responses must concur with social norms.