African
Journals Online
Southern African Journal of Child and Adolescent Mental Health
Volume 13, Number 1, 2001
Abstracts
The Psychosocial Adjustment Of Children Orphaned By AIDS
Lauren Wild
Department of Psychiatry and Mental Health
University of Cape Town
Groote Schuur Hospital
Observatory
7925
Email: [email protected]
Tel. (021) 406 6565
Fax. (021) 448 8158
Abstract
This paper reviews the current state of knowledge regarding the psychosocial adjustment of AIDS orphans - the uninfected children whose mothers and/or fathers die of AIDS. It draws on published and unpublished research and clinical reports from the USA and Africa involving children and adolescents who have a parent who is HIV-seropositive, has AIDS, or has died of the disease. The review begins by identifying the stressors which commonly face AIDS orphans both before and after the death of their parent, and the likely psychological impact of these adversities. It then proceeds to examine empirical evidence that more directly addresses the question of whether AIDS orphans are at risk for experiencing psychosocial adjustment difficulties, and discusses factors that might mediate or moderate children's adjustment to the AIDS-related death of their parent. Finally, it makes recommendations for future research.
The Adolescent With Cystic Fibrosis : A Psychosocial Perspective
L.D. CAREW
Department of Psychiatry and Mental Health
University of Cape Town
Groote Schuur Hospital
Observatory 7925
ABSTRACT:
Objective: to provide an overview of the literature pertaining to the mental health of adolescents with Cystic Fibrosis (CF), a chronic physical disorder.
Method: a Medline search and aditional hand searches were performed to identify key articles relating to the psychosocial impact of CF and other chronic disorders in adolescence.
Results: Interest in the field of chronic disorders is reflected in the increased volume of research published in recent years. Epidemiological surveys have established that children and adolescents with chronic disorders are at a two- to threefold increased risk of developing a psychiatric disorder. Clinic-based studies have either adopted a broad perspective and studied chronic disorders as a whole or narrowed the focus to a single disorder. There are relatively few studies focusing on adolescent adjustment and Cystic Fibrosis. Mediating factors in individual and family adjustment have been identified in children and adolescents with chronic physical disorders.
Conclusions: First, the majority of adolescents with CF and other chronic disorders have no diagnosable psychiatric disorder nor do they report significant impairment in social adaptation. It is however suggested that significant levels of emotional disturbance go undetected in conventional studies which utilise measures of social adaptation to comment on psychosocial functioning. The psychological effects of CF and other chronic disorders warrants further exploration. Second, Intervention programmes which facilitate normative adolescent development and enhance the mental health of this group are needed. Health professionals should be sensitive to the distress of individuals and families and refer for specialised intervention when necessary
Prevalence And Detection Of Psychiatric Disorders Among Children And Adolescents Attending A Primary Health Care Clinic
B.A. Robertson
Department of Psychiatry
Groote Schuur Hospital
Observatory 7925
[email protected]
K. Ensink
Anna Freud Centre
London
C.D.H Parry
Alcohol and Drug Abuse Research Group
Medical Research Council
Cape Town
D. Chalton
Department of Statistics
University of the Western Cape
Cape Town
ABSTRACT
Objectives: To investigate (1) the prevalence of psychiatric disorders among children and adolescents attending a PHC clinic (2) the ability of PHC doctors to identify disorders (3) the performance of the Diagnostic Interview Schedule for Children, Version 2.3 (DISC-2.3)
Design: A cross-sectional study of a clinical population
Setting and subjects: 391 children and adolescents aged 6-16 years attending the Guguletu Day Hospital were screened using the WHO Reporting Questionnaire for Children (RQC)
Outcome measures: Doctors, blind to the results of the RQC, completed the WHO Health Staff Rating form (HSR). The DISC-2.3 was administered at home in all screen positive cases, and in every third screen negative case (n=300)
Results: 46 (13,3%) of the 300 subjects met the DISC-2.3 criteria for psychiatric disorder with impairment. PHC doctors correctly identified only 10.8% of subjects with a disorder.
Conclusions: A low rate of detection of psychiatric disorders by PHC doctors was found. The DISC-2.3 was long but was otherwise a useful diagnostic instrument.
Mother-Infant Attachment, Culture And Research: A Pilot Study
Mark Tomlinson.
Child Guidance Clinic
University of Cape Town
Chapel Road
Rosebank 7700
Email: [email protected]
ABSTRACT
The Strange Situation was developed in the United States in the 1970's as a measure of mother infant attachment. Since then there has been increased interest in its cross cultural applicability. This paper reports on a pilot mother-infant intervention study conducted in Hanover Park, Cape Town. Its focus is on the attachment component of this study and its cross cultural relevance, highlights common shortcomings in the research and makes a number of suggestions about how to provide the data that will ensure meaningful attachment data in the South African context.
Rethinking School-Based HIV/AIDS Interventions In South Africa
Wanjirû Mukoma
Department of Psychiatry and Mental Health
University of Cape Town
Groote Schuur Hospital
Observatory 7925, South Africa
Tel. (021) 4042164
Fax (021) 448 8158
Email: [email protected]
Abstract
Changing behaviour, even that of adolescents who are just beginning to experience and experiment with their sexuality is perhaps the biggest challenge facing HIV/AIDS prevention. In South Africa, youth aged 15-24 years have the highest rates of HIV transmission, and preventive behaviour such as condom use is lax amongst this age group. Increased prevention efforts are required for adolescents and youth, but also efforts to promote health and healthy lifestyle choices within supportive environments. The majority of South African youth attend school, making it an ideal setting in which many HIV/AIDS interventions have been implemented. In keeping with international developments, South African schools are transforming to become health promoting settings. This paper looks at how HIV/AIDS interventions can benefit from the development of the health promoting schools approach. It examines the strategies through which health promotion can be translated into action for HIV prevention and health promotion for South African adolescents.
Case Study: Narrative Of A Psychotherapeutic Treatment Of Dissociative Identity Disorder In An Adolescent
Kathleen Hanley
Department of Psychiatry
Groote Schuur Hospital
Private Bag
Observatory 7925
Email: [email protected]
Abstract
Over the last three decades, significant developments have been made in the areas of dissociative disorders research and clinical practice. Dissociative Identity Disorder (DID) (formerly Multiple Personality Disorder) is generally regarded as the most controversial of the dissociative disorder diagnoses, and yet is considered by those working with the disorder to be fundamental to the dissociation paradigm. Countering its image as a bizarre and intractable disorder, clinicians have built up a substantial body of literature which indicates that it is in fact eminently understandable and treatable. Specific theoretical principles and techniques have been developed for psychotherapeutic treatment of this group of patients with integration as the ultimate - but not exclusive - goal. The dual purpose of this case study is to describe patient symptoms and dynamics, and to illustrate the progression of an individual psychotherapeutic treatment of DID in an adolescent over a 14-month period in both inpatient and outpatient settings. The primary orientation of this case study is accordingly descriptive rather than analytic.
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