Research Articles (Psychology)

Permanent URI for this collectionhttp://hdl.handle.net/2263/1798

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Psychosocial factors influencing the sexual risk behaviour of adolescents living with and affected by HIV who reside in HIV-affected homes in Uganda
Kiirya, Stephen Kisembe; Visser, Maret; Masenge, Andries (Springer, 2026)
We examined the psychosocial factors that predict sexual risk behaviour of adolescents who reside in HIV affected homes in Uganda, to provide evidence for developing suitable interventions. Structured questionnaires were used to collect data about these adolescents’ psychosocial and sexual experiences. The scales and data were verified for precision and reliability using factor analyses, while the predictors of sexual risk behaviour were examined using general linear models. Results showed that having been female, in the younger adolescence stage and a Muganda or Lango, living with one caregiver, being a recipient of HIV/psychosocial care and vulnerable to negative peer influence, personal threats, interpersonal problems, psychosocial distresses (e.g. psychosis and delinquency) and coping by deflecting problems, significantly enabled sexual risk behaviour in these adolescents. However, attending school, religious conviction, experiencing orphanhood especially of the mother, living with two caregivers, and experiencing poverty, judgmental HIV stigma, distress (e.g. inattention and depression), self-control and social support significantly deterred it. These results highlight the centrality of gender, age, HIV care, family situations, sociocultural and peer norms, community stressors, psychosocial distresses, and negative coping methods in influencing sexual risk behaviour of adolescents who reside in HIV affected homes. Interventions by families, schools and agencies are needed to prevent or mitigate these risk factors.
Psychosocial experiences and sexual risk behaviour of the adolescents living with and affected by HIV who reside in HIV affected homes in Uganda
Kiirya, Stephen Kisembe; Visser, Maretha; Masenge, Andries (Taylor and Francis, 2026)
We compared the levels of psychosocial and sexual experiences of adolescents aged 10–19 years who were living with (ALHIV) and affected by HIV who resided in HIV-affected homes of Uganda. Data were collected using a questionnaire that was validated using factor analysis. The levels of psychosocial and sexual experiences of these adolescents were compared using variance and Kruskal–Wallis tests. Results showed that whereas these adolescents were exposed to each observed factor, the ALHIV were significantly more vulnerable to lower education levels, living with sick people, death of both parents, changing homes, living with caregivers who were relatives or alcohol users, negative peer influence, poverty, personal and interpersonal problems, distress, sexual risk behaviour, and negative coping methods, compared to those not living with HIV or unaware of their HIV status. Hence, despite the higher primary education achievement and access to HIV services, ALHIV face a lesser sense of belonging, a higher burden of caring for their family members’ sicknesses, higher vulnerability to sexually transmitted diseases, and poorer coping abilities compared to the other adolescents in the same home. Interventions are needed from families, schools and agencies to address the risk and protective factors among these adolescents.
Cognitive behaviour therapy-informed guidelines for type 2 diabetes self-management : a Delphi method study
Visagie, Elné; Deacon, Elmari; Kok, Rumando (Sage, 2026)
This study aimed to evaluate the content and quality of cognitive-behavioural therapy-informed guidelines that healthcare professionals can implement to improve self-management of adults with type 2 diabetes. A qualitative design using the Delphi method was employed. This method facilitated two rounds of feedback from a panel of 12 healthcare professionals, enabling collaborative refinement of the guidelines. Four major themes emerged during the first round of feedback: (1) the CBT-informed guidelines are clear and concise, (2) a need for information regarding role clarification, (3) the need to consider the patient’s readiness to change and (4) the consideration that the guidelines may be time-consuming. The second round reiterated the clear, practical nature of the guidelines. The guidelines propose a framework that supports a holistic approach to self-management. The guidelines’ flexibility enables healthcare professionals to adapt them to the diverse needs of individuals with type 2 diabetes.
A synthesis of dimensions of wellbeing among adolescents and young people living with HIV from Sub-Saharan Africa for measurement in economic evaluation : a qualitative overview of reviews
Carries, Stanley; Nyasulu, Juliet; Moyo, Audrey; Davids, Eugene Lee; Odendaal, Willem; Govindasamy, Darshini (BioMed Central, 2026-03)
BACKGROUND : Adolescents and young people living with HIV (AYPLHIV) in sub-Saharan Africa (SSA) face intersecting structural and psychosocial challenges that compromise their wellbeing, yet these realities are poorly captured by generic wellbeing measures used in economic evaluations. This overview of reviews synthesised evidence from SSA to identify key determinants of social wellbeing to inform the co-development of a contextually relevant wellbeing scale suitable for economic evaluations in the region. METHODS : We searched reviews published between January 2000 and September 2023 across ten databases on EBSCOhost, Ovid, and Web of Science. The conduct and reporting of this overview followed the Preferred Reporting Items for Overviews of Reviews guidelines. Eligible reviews included quantitative, qualitative, and mixed-methods studies examining wellbeing or mental health among AYPLHIV aged 10–24 years in SSA. Review quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Data were synthesised thematically, mapped onto Keyes Social Wellbeing framework, and study selection presented with a PRISMA flow diagram. RESULTS : Sixteen medium-to-high quality reviews were included. South Africa (n = 15) and Uganda (n = 14) were the most represented countries. Most reviews focused on adolescents aged 10–19 years (n = 11). Our analysis identified five recurring themes central to the social wellbeing of AYPLHIV: social support, acceptance and belonging, self-acceptance, aspirations and goals, and coping. These themes aligned with Keyes’ Social Wellbeing model, with social support and acceptance and belonging reflecting social integration, and aspirations and goals reflecting social contribution. Key psychological wellbeing constructs identified included positive relationships, self-acceptance, purpose in life, and environmental mastery. CONCLUSIONS : These domains reflect both personal experiences and structural realities yet remain underrepresented in commonly used wellbeing measures. This is a critical limitation, as economic evaluations often rely on generic instruments that fail to capture what matters most to AYPLHIV in SSA. Future research should develop a wellbeing scale that incorporates these domains, is sensitive to socioeconomic context, and can be collected alongside socioeconomic status indicators. Embedding such a measure into evaluation systems would improve the accuracy, equity, and policy relevance of economic evaluations and ensure that investments reflect AYPLHIV’s lived realities.
Virological failure and risk factors among people living with HIV taking second-line ART in Addis Ababa, Ethiopia
Feyissa, Bekelech Bayou; Sisay, Abay; Davids, Eugene Lee; Yalew, Anteneh; Setswe, Geoffrey (Public Library of Science, 2026-02)
BACKGROUND : Virological failure (VF) presents significant challenges in the emergence of drug resistance, and elevated risk of transmission, higher mortality rates, and a diminished quality of life. Various factors contribute to VF, but documented information on this issue is lacking in Ethiopia. Therefore, this study aimed to assess the prevalence of VF and identify the risk factors among people living with HIV who are on second-line antiretroviral treatment (ART). METHODS : A concurrent mixed-method study using quantitative and qualitative data was conducted at selected hospitals in Addis Ababa, Ethiopia. The analysis was conducted using SPSS version 28, Stata version 18.5, and R for quantitative data and thematic analysis with Atlas.ti version 24 software was used for qualitative data. RESULT : Among 369 adults living with HIV taking second-line ART enrolled in the study, 191 (52%) were male with a median age of 44 years. The prevalence of VF was 55 (14.9%, 95% CI: 11, 19), with an incidence density of 27.2 per 10,000 person months (95% CI 21.1, 35.5). Lost to follow-up significantly increased VF risk [AHR: 2.52 (95% CI: 1.35, 4.69, p-value: 0.004)]. Patients transferred from other health facilities were two times at higher risk of VF compared to those receiving ART at the same facility [AHR: 1.97 (95% CI: 1.07, 3-64, p-value: 0.029)]. Likewise, clients with a history of regimen change were at a higher risk of VF [AHR = 2.05, (95% CI: 1.08, 3.88, p-value = 0.027)]. The qualitative data also supported these findings. CONCLUSION : This study underscores the need for improved ART adherence and consistent care to reduce virological failure in PLHIV to improve the quality of life.
The lived experiences of individuals with Tourette syndrome following anterior-medial globus pallidus internus deep brain stimulation : an interpretive phenomenological analysis
Cassimjee, Nafisa; Muller, Jacomien; Van Coller, Riaan (Taylor and Francis, 2026)
PURPOSE : Tourette syndrome is a debilitating neurodevelopmental disorder. Despite the recent increase in the use of deep brain stimulation for the treatment of refractory Tourette syndrome, few qualitative studies have explored the post-surgical experiences of individuals. This research aimed to explore the lived experience of individuals who underwent deep brain stimulation for Tourette syndrome. METHOD : This qualitative study was informed by the phenomenological design. Semi-structured interviews were conducted with the first cohort of five individuals to have undergone anterior-medial globus pallidus internus deep brain stimulation in South Africa. Interpretative phenomenological analysis was utilised to analyse the data. RESULTS : Four key themes were identified: (1) Battle with Tourette syndrome; (2) Temporal journey with deep brain stimulation; (3) Transformation: (Re)constructing the self in context after deep brain stimulation; and (4) Fusion: brain, technology and me. CONCLUSION: Living with Tourette syndrome was described by the participants as a fight for control, with symptoms having profound effects on family and social relationships. Identity reconstruction following surgery was complex, but treatment led to a change in social interactions and personal growth. Improvement was not immediate but rather a gradual process to find optimal settings. Most participants managed to integrate the device successfully into their identity. IMPLICATIONS FOR REHABILITATION • Tourette syndrome is a complex disorder impacting physical, psychological and social functioning. • Deep brain stimulation is a neurotherapeutic treatment option for refractory Tourette syndrome, yet limited research is available on the lived experiences of individuals following deep brain stimulation. • Clinicians should provide comprehensive pre-operative counselling and neuropsychoeducation to patients and their families regarding the expectations, risks and psychosocial implications of deep brain stimulation. • They should provide continuous multidisciplinary patient management and psychological support to address adjustment challenges, optimise outcomes and monitor psychosocial well-being after surgery. • In addition, they need to adopt an integrated and individualised rehabilitation approach informed by multidisciplinary perspectives.
The lived experiences of biological mothers parenting with a history of complex trauma in the Govan Mbeki Local Municipality, South Africa
Shube, Sekelo Atalia; Davids, Eugene Lee (Sage, 2026)
Complex trauma is experiencing a traumatic event, in the form of abuse, which is chronic, interpersonal, and begins in childhood. Limited knowledge exists regarding the impact of complex trauma on parenting. The current study, therefore, aimed to explore the lived experiences of biological mothers parenting with a history of complex trauma in the Govan Mbeki Local Municipality, South Africa. Using purposive sampling, the study included 10 biological mothers. Data were collected using semi-structured interviews and analysed using Interpretative Phenomenological Analysis. The data tell the story of how mothers with a history of complex trauma prioritise the well-being of their children while neglecting their own needs. In addition, their experiences of complex trauma result in protecting their children from potential traumas, leading to overprotective parenting. The findings highlight the role of complex trauma on parenting, particularly among biological mothers in South Africa, and provide recommendations for society, practice, and research.
Subcultural webs of (health)care in kinked communities of gay fist-fuckers
Martin, Jarred H. (Routledge, 2026)
Existing research on kink-identified people’s healthcare experiences has focused largely on encounters with mainstream systems, where disclosing kink practices can invite stigma, misunderstanding, or denial of care. Far less attention has been given to the alternative forms of (health)care cultivated within kink subcultures themselves. This article reports findings from a qualitative study of such practices among fist-fuckers. An international sample of 20 kink-identified gay men participated in four online focus groups. Reflexive thematic analysis generated five themes: (1) skill and resource exchange; (2) emotional and psychological support; (3) placemaking care; (4) embodied and experiential knowledge; and (5) communal care and resilience. Framed through queer worldmaking, the findings show how everyday care practices among fist-fuckers form subcultural webs of health promotion and (health)care grounded in reciprocity, intimacy, and collective responsibility rather than hierarchical biomedical models. These practices are affective, emergent, and distributed through embodied knowledge and a communal ethics of care. The article argues that fist-fuckers enact queer worldmaking through the construction of health-and kink-sustaining subcultural webs that allow them to flourish in their kink. In doing so, they offer a critical rethinking of what counts as care, who provides it, where it takes place, and the ethics which organise it.
“I feel locked out the community” : the experience of community for rural-living fisters
Martin, Jarred H. (Springer, 2026)
Research has highlighted the important role that communities of kink play in the social and sexual lives of kinksters. Existing literature has not examined the experience of community for rural and remote-living kink-identified individuals, where access to communities, networks of playmates, and spaces for kink may be limited by virtue of social and geographic isolation. The aim of this study was to explore the lived experience of community among self-identified cisgender gay men who engage in fist-fucking and live in rural areas. A qualitative study was conducted with a multi-national sample of 40 fist-fuckers, each of whom participated in an online semi-structured individual interview. Guided by a interpretative phenomenological analysis of the data, six themes were developed: (1) the experience of isolation in the formative journey of self-discovery; (2) geographic, logistical, and financial burdens in accessing community; (3) feelings of (dis)connection from the community and the struggle for kink identity; (4) the absence of community networks and resources in supporting healthcare needs; (5) the opportunities and challenges of online communities and connections; and (6) the lack of communal spaces and local networks of partners in fostering sexual satisfaction. The findings revealed that participants shared lived experiences of personal isolation, sexual frustration, and social exclusion from urban-based fisting communities. For some fist-fuckers, their rural-living circumstances produced not only social and sexual dislocations from their communities but, also, a disconnectedness from their kink identity. For others, the remoteness of their living contexts forged new modes of online community building, strategies for sexual and erotic resilience, and experiences of community.
Depressive symptomatology and their correlates among caregivers of children and adolescents living with HIV in KwaZulu-Natal, South Africa
Moyo, Reuben Christopher; Davids, Eugene Lee; Nyasha, Lovemore Sigwadi; Carries, Stanley; Moyo, Audrey; Gibbs, Andrew; Shai, Nwabisa; Closson, Kalysha; Washington, Laura; Sithole, Nokwanda; Bhana, Arvin; Mwandacha, Nelly; Kaida, Angela; Govindasamy, Darshini (Taylor and Francis, 2026)
BACKGROUND : Few studies have examined factors linked to depressive symptomatology among caregivers of children and adolescents living with HIV (CALHIV). This study estimated prevalence of depressive symptoms and identified associated factors among caregivers of CALHIV in KwaZulu-Natal, South Africa. METHODS : We used baseline data from a cluster-randomised controlled trial of the impact of a cash transfer program and an economic empowerment intervention on health and well-being caregivers of CALHIV. Depressive symptoms were assessed using 10-item Centre for Epidemiologic Studies Depression Scale (CES-D-10), with score of ≥12 indicating presence depressive symptomatology. Correlates of depressive symptoms were identified using multilevel generalised linear models. RESULTS : The prevalence of depressive symptoms was 57% (95% CI: 51% – 63%). Factors associated with increased odds of depressive symptomatology were residing in peri-urban (OR = 4.80, p = 0.038), having any form of disability (OR = 8.12, p = 0.001), having existing medical condition (OR = 3.27, p = 0.009), experiencing physical abuse in the past 12 months (OR = 3.53, p = 0.020), and low social support (OR = 3.94, p = 0.005). CONCLUSION : The prevalence of depressive symptoms was high among Caregivers of CALHIV. These findings highlight the need for targeted, context-specific interventions that include mental health screening for caregivers to support their mental health and well-being.
Conspiracy theory mentality, injustice and tolerance of ambiguity
Furnham, Adrian; Cuppello, Stephen; Semmelink, David Sanele (Wiley, 2025-12)
This study examines demographic, ideology, and work personality correlates of the endorsement of Conspiracy Theories (CTs). In all, 253 English-speaking adults from various countries completed a shortened version of Bruder et al.'s Conspiracy Theory measure including beliefs about Cover-Ups, which was found to be an internally valid and reliable measure of conspiracy mentality. Participant sex, age, religious beliefs, and a sense of Injustice in the World correlated significantly with the CT score along with three traits (Adjustment, Tolerance of Ambiguity, and Competitiveness). A regression indicated that 3 of the 14 variables examined were significant and accounted for a fifth of the variance. More religious participants, who believed the world was unjust and had lower Tolerance of Ambiguity scores, tended to have higher CT scores. Implications and limitations of the study are acknowledged.
The good, the bad, and the bizarre : guiding beliefs about climate change in a post-truth society
Wagner, Claire (GESIS, 2025)
This paper begins with Levy's (2023) premise that our epistemic environment is central to solving the problem of bad and bizarre beliefs, especially about climate change, in a post-truth society. It presents some of the reasons for people holding untrue beliefs and examines two conspiracies about climate change and the harmful consequences thereof. Actions are suggested to counter bad and bizarre beliefs, including interventions to strengthen trust and confidence in credible sources, presenting material that disputes false information in a timely and easy-to-process fashion, addressing people's feelings towards the news they encounter and fostering their sense of agency in evaluating its credibility, and building an open society. This is followed by a discussion of epistemic positions in the field of environmental psychology and how non-epistemic values (typically those of powerful and wealthy nations [Cologna 2023]) could be contested. Ways in which (a critical) environmental psychology can guide epistemic action - how people gather and share information - in a post-truth society are suggested. All members of society who participate in generating knowledge are encouraged to reflect on the epistemic community to which they belong and the extent of trust they may place in it.
Developing adaptability : becoming a 4IR ambidextrous engineer in South Africa
Liccardo, Luigi; Liccardo, Sabrina; Gobind, Jenika (Taylor and Francis, 2025-11-25)
Adaptability is key to coping with the disruptions brought about by the Fourth Industrial Revolution (4IR) and COVID-19. According to the World Economic Forum’s Future of Jobs Survey, analytical thinking, resilience, flexibility and agility are the most sought-after core skills in 2025. Although researchers emphasise the central role of adaptability in coping with 4IR disruptions, little guidance is provided on how to become adaptable, particularly within engineering. Given this research gap, the article aims to: (1) examine if 3IR engineers are adaptable when faced with 4IR disruptions; (2) determine the kind of engineer that will be well-suited to cope and adapt to any disruptions faced during 4IR; and (3) investigate whether higher education institutions should modify engineering curricula to teach adaptability. The study adopted a qualitative design approach using online semi-structured interviews with 12 engineers currently working or teaching in the engineering industry. The interviews were analysed using thematic analysis. To explain the mechanisms involved in being a 4IR Ambidextrous Engineer, we propose the framework of the Adaptability Machine, which consists of the self-awareness central gear, intrapersonal gear, interpersonal gear and environmental gear. Drawing on the themes within this framework, we discuss the skills and environments conducive to coping with and adapting to any disruptions faced during 4IR. We conclude with a discussion of how higher education institutions could modify engineering curricula to assist engineering students in becoming 4IR ambidextrous engineers.
Intensive parenting behaviour scale : exploring its factor structure among South African mothers
Muller, Jacomien; Maree, David J.F.; Visser, Maretha (AOSIS, 2025-11-05)
Intensive parenting practices are increasingly studied, but validated measures for diverse African contexts are limited. The Intensive Parenting Behaviour (IPB) Scale requires psychometric validation within South Africa. This study explored the factor structure and construct validity of the IPB among South African mothers of children in middle childhood (aged 6–10 years). Data were collected via an online survey completed by 507 South African mothers, with N = 382 having complete IPB data. Exploratory factor analysis was used to examine the underlying structure of the IPB. Exploratory factor analysis revealed a multidimensional model comprising seven first-order factors (engagement, behavioural control, autonomy support, autonomy restriction, proactive protection, talent stimulation and child-centredness) loading onto two distinct second-order factors. Engagement, behavioural control and autonomy support formed an ‘Adaptive Intensive Parenting Behaviours’ dimension. Autonomy restriction, proactive protection, talent stimulation and child-centredness formed an ‘Overinvolved Intensive Parenting Behaviours’ dimension. The scale demonstrated good internal consistency and construct validity. Results support the reliability and validity of the IPB in the South African context, revealing a robust seven-factor first-order structure underpinned by two higher-order dimensions differentiating adaptive and potentially overinvolved IPB. The IPB shows promise for assessing intensive parenting constructs among South African mothers of children in middle childhood. Consistent with prior studies on intensive parenting, the IPB yielded a number of factors, suggesting multidimensionality for the construct. CONTRIBUTION : This is the first study to examine the psychometric properties of the IPB Scale in South Africa, demonstrating good reliability and validity among South African mothers.
Does it matter where you know them from? Race-ethnicity and the impact of social domain on intergroup contact
Kelly, Monique D.A.; Arendse, Danille Elize (Sage, 2025-12)
Previous research generally suggests that increased racial-ethnic intergroup contact can reduce prejudice. Most studies, however, have examined the effects of contact within one social domain, that is, the specific context in which contact occurs. Thus, the question of how the social domain shapes the strength and direction of the contact–prejudice relationship remains underexplored. Utilizing data from a self-administered online survey (N = 637), this exploratory study examines the effects of intergroup contact on neighbor acceptance across different social domains (family, friends, work, social media, school, neighborhood, community), paying particular attention to differences by respondent and hypothetical neighbor race-ethnicity. Findings reveal that not all domains of intergroup contact are significantly associated with neighbor acceptance and that the positive effects of intergroup contact vary by racial-ethnic group. We also find evidence that intergroup contact can reduce neighbor acceptance for same race-ethnic individuals among minority respondents. This study nuances conceptualizations of context in assessing the effectiveness of contact in reducing prejudice.
Whiteness at the abyss : reflections on a scene of attack
Hook, Derek (Springer, 2025-03)
This paper focusses on a series of online attacks that the author was subjected to after comments he had made in a closed lecture on the topic of ‘white anxiety’ were cut from the zoom recording and distributed widely online with the clear intent of causing outrage. The analysis of the material, which combines thematic, discourse analytic and personal reflections, yielded a series of core themes: 1) the role of the messages in consolidating an identity, 2) performative offensiveness, 3) perverse intimidations, 4) accusations/denials/expressions of racism, 5) the race-traitor as ideological dilemma, 6) antisemitism and 7) aggressive cordiality. The paper closes with a few reflections on the author’s enunciative position in respect of the attacks.
Fanon's humanism : an interview with Nigel Gibson
Gibson, Nigel C.; Hook, Derek; Laubscher, Leswin (Sage, 2025)
Humanism is obviously a crucial facet of a humanistic psychology, and a new—or decolonial—humanism is likewise crucial for Frantz Fanon’s work, but these two areas of scholarship and practice have seldom been put into a sustained dialogue. As a way of beginning such a dialogue, Nigel Gibson, one of the foremost experts on the work of Frantz Fanon, speaks with Derek Hook and Leswin Laubscher about Fanon’s ideas of a new humanism, agency, action, and liberatory practice in the context of colonial oppression and dehumanization. Key conceptualizations from Fanon’s pioneering books—Black Skin, White Masks, The Wretched of the Earth, and A Dying Colonialism—are discussed and clarified. Gibson also refers to sections of Fanon’s recently translated psychiatric writings. Drawing on several of Gibson’s books on Fanon—including Combat Breathing (2025)—this far-ranging discussion explores topics such as Fanon’s notion of combined action (psychotherapeutic and political action), self-actualization, socio-therapy, African Humanism, and Fanon’s views on violence.
The proactive personality: bright-side trait correlates
Furnham, Adrian; Cuppello, Stephen; Semmelink, David Sanele (Springer, 2025-10)
This study set out to establish to what extent demographic, ideological, self-esteem and work-related personality traits are correlated with the Proactive Personality (PP)? In all, 389 working adults completed a number of questionnaires including the well-established PP measure and a work-related, six trait measure. They also indicated whether they were junior, middle, senior or non-managers. Correlations and regressions showed that neither demography (sex, age, education) nor ideology (political and religious beliefs) were related to PP while many of the traits were strong correlates (Conscientiousness, Curiosity, Courage, Competitiveness). In all the traits accounted for 45% incremental variance over demography, ideology, self-ratings of optimism and self-esteem. The results highlight two traits hitherto not examined in this literature namely Tolerance of Ambiguity and Risk Approach (Courage) both related to PP. With Management Level as criterion variable, PP added only 1% variance above age and education, but the six traits added 11%. This suggests established personality traits are better predictors of Management Level compared to the PP measure. Implications and limitations, particularly sample diversity, are discussed.
The prevalence and correlates of common mental disorders among adolescents and young adults in rural South Africa : analysis of household survey data informed by lived experience experts
Moyo, Audrey; Sigwadhi, Lovemore Nyasha; Carries, Stanley; Sithole, Nokwanda; Moyo, Reuben Christopher; Bhana, Arvin; Nyasulu, Peter Suwirakwenda; Davids, Eugene Lee; Munyombwe, Theresa; Maposa, Innocent; Govindasamy, Darshini (BioMed Central, 2025-08-22)
BACKGROUND : Depression and anxiety are among the most common mental disorders (CMDs) affecting adolescents and young adults (AYA). CMDs often emerge during adolescence and young adulthood, yet are frequently diagnosed in adulthood. Understanding the burden and correlates of CMDs is essential for informing public mental health interventions. However, limited research incorporates the perspectives of AYA with lived experience of mental health conditions. This study aimed to determine the prevalence and factors associated with CMDs among AYA aged 15–24 years in South Africa, incorporating insights from those with lived experience. METHODS : First wave South African Population Research Infrastructure Network (SAPRIN) mental health data, collected between March 2021 and April 2022 in three rural areas, were used. AYA with complete mental health information were included. CMDs were the primary outcome, defined as the presence of either depressive symptoms (Patient Health Questionnaire-2 [PHQ-2] score ≥ 3), anxiety symptoms (Generalised Anxiety Disorder-2 [GAD-2] score ≥ 3), or both. Participatory workshops with 17 AYA aged 18–30 years with lived experience of mental health conditions informed the secondary data analysis and interpretation. Exposure variables included age, sex, living with both parents, relationship to the household head, school attendance, and occupation. Multivariable logistic regression was used to examined correlates of CMDs, accounting for clustering by surveillance site. RESULTS : Among n = 11,346 AYA, CMD prevalence was 9.0% (n = 1026). Increased odds of CMDs were associated with having children (adjusted odds ratio [aOR] = 1.27; 95% confidence interval [CI]: 1.04–1.54, p = 0.016), being the head of household, a spouse, or a sibling of the household head (aOR = 1.56; 95% CI: 1.29–1.89; p < 0.001), and being an extended family member of the household head (aOR = 1.26; 95% CI: 1.08–1.46; p = 0.002). CONCLUSION : CMD prevalence among rural AYA in South Africa was 9.0%, with early parenthood and not being the child of the household head identified as key correlates of increased CMD risk. These findings suggest that early parenthood and family structure may contribute to CMDs. Future research should explore the long-term impacts of these correlates using longitudinal datasets, while considering broader contextual factors. KEY MESSAGE : A significant proportion of rural AYA report experiencing CMDs, with early parenthood and not being the child of the household head identified as key risk factors. These findings underscore the need for community-and-school-based social support interventions, alongside economic empowerment initiatives, to address the mental health needs of this population.
Trauma exposure as a predictor of general health outcomes and trauma-related beliefs among older adults living in an adverse environment
Matamela, Nyambeni A.; Wyatt, Gail; Johnson, Cameron Dale (Routledge, 2025)
OBJECTIVES : Older adults living in adverse environments such as crime-heavy areas within South African townships are often exposed to potentially traumatic and violent circumstances. Research has not sufficiently explored the relationship between trauma exposure and general health outcomes or trauma-related beliefs among older adults living in adverse environments. This study addresses this gap in literature. METHOD : This study used a quantitative approach with a cross-sectional design. 195 participants completed the Life Adversities Screener (LADS), the General Health Questionnaire-28 (GHQ-28), and the Trauma Belief Inventory (TBI). RESULTS : Explorative analyses showed that anxiety and insomnia were associated with female sex, discrimination, injury, family violence, and interpersonal violence. Moreover, four of the five trauma types were associated with self-perception, worth, and mistrust. CONCLUSION : In later life and in circumstances where trauma exposure is common, trauma remains associated with detrimental health effects, self-perception, mistrust, and a negative worldview. These findings argue for the prevention and treatment of trauma-related pathologies across the lifespan.

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