Academic literature on the topic 'Borderline personality disorder – South Africa'

BackgroundSeveral studies have suggested that immigrants have higher rates of psychiatric emergency service use and a higher risk of mental disorders such as schizophrenia than indigenous populations.AimsTo compare the likelihood that immigrants (immigrant group) v. indigenous population (indigenous group) will be diagnosed with borderline personality disorder in a psychiatric emergency service and to determine differences according to area of origin.MethodA total of 11 578 consecutive admissions over a 4-year period at a tertiary psychiatric emergency service were reviewed. The collected data included socio-demographic and clinical variables and the Severity of Psychiatric Illness rating score. Psychiatric diagnosis was limited to information available in the emergency room given that a structured interview is not usually feasible in this setting. The diagnosis of borderline personality disorder was based on DSM–IV criteria. Immigrants were divided into five groups according to region of origin: North Africa, sub-Saharan Africa, South America, Asia and Western countries.ResultsMultivariate statistical logistic regression analysis showed that all subgroups of immigrants had a lower likelihood of being diagnosed with borderline personality disorder than the indigenous population independently of age and gender. Furthermore, the rates of borderline personality disorder diagnosis were considerably lower in Asian and sub-Saharan subgroups than in South American, North African, Western or native subgroups.ConclusionsOur results showed that in the psychiatric emergency service borderline personality disorder was diagnosed less frequently in the immigrant group v. the indigenous group. Our results do not support the concept of migration as a risk factor for borderline personality disorder.

In Africa, data on the prevalence and predictors of death and suicidal ideation is lacking. In this study, a cross-sectional design was used to investigate the prevalence and risk factors for death and suicidal ideation in a cohort of 239 psychiatric patients receiving outpatient treatment at nine sites in the Durban area (South Africa) in 2015. Prevalence rates for death and suicidal ideation were high, with 35 (16%) patients reporting death ideation and 95 (40%) reporting suicidal ideation. Both death and suicidal ideation were significantly associated with unemployment (ORs = 2.61 and 2.34, respectively) and a primary diagnosis of depressive disorder (ORs = 4.72 and 6.54, respectively). Factors that uniquely predicted death ideation were: not being in an intimate relationship (OR = 6.45), ethnicity (being Indian South African: OR = 3.28) and a primary diagnosis of bipolar disorder (OR = 4.61), with suicidal ideation being uniquely predicted by a lower level of educational attainment (OR 2.86), ethnicity (being Black South African: OR = 3.36) and a primary diagnosis of borderline personality disorder (OR = 7.14). Study findings are discussed in terms of their implications for practice and future research.

<p><strong>List of abstracts and authors:</strong></p><p><strong>1. Antipsychotics in anxiety disorders</strong></p><p>Christer Allgulander</p><p><strong>2. Anxiety in somatic disorders</strong></p><p>Christer Allgulander</p><p><strong>3. Community rehabilitation of the schizophrenic patient</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera</p><p><strong>4. Dual diagnosis: A theory-driven multidisciplinary approach for integrative care</strong></p><p>David Blackbeard</p><p><strong>5. The emotional language of the gut - when 'psyche' meets 'soma'</strong></p><p>Helen Clark</p><p><strong>6. The Psychotherapy of bipolar disorder</strong></p><p>Franco Colin</p><p><strong>7. The Psychotherapy of bipolar disorder</strong></p><p>Franco Colin</p><p><strong>8. Developing and adopting mental health policies and plans in Africa: Lessons from South Africa, Uganda and Zambia</strong></p><p>Sara Cooper, Sharon Kleintjes, Cynthia Isaacs, Fred Kigozi, Sheila Ndyanabangi, Augustus Kapungwe, John Mayeya, Michelle Funk, Natalie Drew, Crick Lund</p><p><strong>9. The importance of relapse prevention in schizophrenia</strong></p><p>Robin Emsley</p><p><strong>10. Mental Health care act: Fact or fiction?</strong></p><p>Helmut Erlacher, M Nagdee</p><p><strong>11. Does a dedicated 72-hour observation facility in a district hospital reduce the need for involuntary admissions to a psychiatric hospital?</strong></p><p>Lennart Eriksson</p><p><strong>12. The incidence and risk factors for dementia in the Ibadan study of ageing</strong></p><p>Oye Gureje, Lola Kola, Adesola Ogunniyi, Taiwo Abiona</p><p><strong>13. Is depression a disease of inflammation?</strong></p><p><strong></strong>Angelos Halaris</p><p><strong>14. Paediatric bipolar disorder: More heat than light?</strong></p><p>Sue Hawkridge</p><p><strong>15. EBM: Anova Conundrum</strong></p><p>Elizabeth L (Hoepie) Howell</p><p><strong>16. Tracking the legal status of a cohort of inpatients on discharge from a 72-hour assessment unit</strong></p><p>Bernard Janse van Rensburg</p><p><strong>17. Dual diagnosis units in psychiatric facilities: Opportunities and challenges</strong></p><p>Yasmien Jeenah</p><p><strong>18. Alcohol-induced psychotic disorder: A comparative study on the clinical characteristics of patients with alcohol dependence and schizophrenia</strong></p><p>Gerhard Jordaan, D G Nel, R Hewlett, R Emsley</p><p><strong>19. Anxiety disorders: the first evidence for a role in preventive psychiatry</strong></p><p>Andre F Joubert</p><p><strong>20. The end of risk assessment and the beginning of start</strong></p><p>Sean Kaliski</p><p><strong>21. Psychiatric disorders abd psychosocial correlates of high HIV risk sexual behaviour in war-effected Eatern Uganda</strong></p><p>E Kinyada, H A Weiss, M Mungherera, P Onyango Mangen, E Ngabirano, R Kajungu, J Kagugube, W Muhwezi, J Muron, V Patel</p><p><strong>22. One year of Forensic Psychiatric assessment in the Northern Cape: A comparison with an established assessment service in the Eastern Cape</strong></p><p>N K Kirimi, C Visser</p><p><strong>23. Mental Health service user priorities for service delivery in South Africa</strong></p><p>Sharon Kleintjes, Crick Lund, Leslie Swartz, Alan Flisher and MHaPP Research Programme Consortium</p><p><strong>24. The nature and extent of over-the-counter and prescription drug abuse in cape town</strong></p><p>Liezl Kramer</p><p><strong>25. Physical health issues in long-term psychiatric inpatients: An audit of nursing statistics and clinical files at Weskoppies Hospital</strong></p><p>Christa Kruger</p><p><strong>26. Suicide risk in Schizophrenia - 20 Years later, a cohort study</strong></p><p>Gian Lippi, Ean Smit, Joyce Jordaan, Louw Roos</p><p><strong>27.Developing mental health information systems in South Africa: Lessons from pilot projects in Northern Cape and KwaZulu-Natal</strong></p><p>Crick Lund, S Skeen, N Mapena, C Isaacs, T Mirozev and the Mental Health and Poverty Research Programme Consortium Institution</p><p><strong>28. Mental health aspects of South African emigration</strong></p><p>Maria Marchetti-Mercer</p><p><strong>29. What services SADAG can offer your patients</strong></p><p>Elizabeth Matare</p><p><strong>30. Culture and language in psychiatry</strong></p><p>Dan Mkize</p><p><strong>31. Latest psychotic episode</strong></p><p>Povl Munk-Jorgensen</p><p><strong>32. The Forensic profile of female offenders</strong></p><p>Mo Nagdee, Helmut Fletcher</p><p><strong>33. The intra-personal emotional impact of practising psychiatry</strong></p><p>Margaret Nair</p><p><strong>34. Highly sensitive persons (HSPs) and implications for treatment</strong></p><p>Margaret Nair</p><p><strong>35. Task shifting in mental health - The Kenyan experience</strong></p><p>David M Ndetei</p><p><strong>36. Bridging the gap between traditional healers and mental health in todya's modern psychiatry</strong></p><p>David M Ndetei</p><p><strong>37. Integrating to achieve modern psychiatry</strong></p><p>David M Ndetei</p><p><strong>38. Non-medical prescribing: Outcomes from a pharmacist-led post-traumatic stress disorder clinic</strong></p><p>A Parkinson</p><p><strong>39. Is there a causal relationship between alcohol and HIV? Implications for policy, practice and future research</strong></p><p>Charles Parry</p><p><strong>40. Global mental health - A new global health discipline comes of age</strong></p><p>Vikram Patel</p><p><strong>41. Integrating mental health into primary health care: Lessons from pilot District demonstration sites in Uganda and South Africa</strong></p><p>Inge Petersen, Arvin Bhana, K Baillie and MhaPP Research Programme Consortium</p><p><strong>42. Personality disorders -The orphan child in axis I - Axis II Dichotomy</strong></p><p><strong></strong>Willie Pienaar</p><p><strong>43. Case Studies in Psychiatric Ethics</strong></p><p>Willie Pienaar</p><p><strong>44. Coronary artery disease and depression: Insights into pathogenesis and clinical implications</strong></p><p>Janus Pretorius</p><p><strong>45. Impact of the Mental Health Care Act No. 17 of 2002 on designated hospitals in KwaZulu-Natal: Triumphs and trials</strong></p><p>Suvira Ramlall, Jennifer Chipps</p><p><strong>46. Biological basis of addication</strong></p><p>Solomon Rataemane</p><p><strong>47. Genetics of Schizophrenia</strong></p><p>Louw Roos</p><p><strong>48. Management of delirium - Recent advances</strong></p><p>Shaquir Salduker</p><p><strong>49. Social neuroscience: Brain research on social issues</strong></p><p>Manfred Spitzer</p><p><strong>50. Experiments on the unconscious</strong></p><p>Manfred Spitzer</p><p><strong>51. The Psychology and neuroscience of music</strong></p><p>Manfred Spitzer</p><p><strong>52. Mental disorders in DSM-V</strong></p><p>Dan Stein</p><p><strong>53. Personality, trauma exposure, PTSD and depression in a cohort of SA Metro policemen: A longitudinal study</strong></p><p>Ugashvaree Subramaney</p><p><strong>54. Eating disorders: An African perspective</strong></p><p>Christopher Szabo</p><p><strong>55. An evaluation of the WHO African Regional strategy for mental health 2001-2010</strong></p><p>Thandi van Heyningen, M Majavu, C Lund</p><p><strong>56. A unitary model for the motor origin of bipolar mood disorders and schizophrenia</strong></p><p>Jacques J M van Hoof</p><p><strong>57. The origin of mentalisation and the treatment of personality disorders</strong></p><p>Jacques J M Hoof</p><p><strong>58. How to account practically for 'The Cause' in psychiatric diagnostic classification</strong></p><p>C W (Werdie) van Staden</p><p><strong>POSTER PRESENTATIONS</strong></p><p><strong>59. Problem drinking and physical and sexual abuse at WSU Faculty of Health Sciences, Mthatha, 2009</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz</p><p><strong>60. Prevalence of alcohol drinking problems and other substances at WSU Faculty of Health Sciences, Mthatha, 2009</strong></p><p>Orlando Alonso Betancourt, Maricela Morales Herrera, E, N Kwizera, J L Bernal Munoz</p><p><strong>61. Lessons learnt from a modified assertive community-based treatment programme in a developing country</strong></p><p>Ulla Botha, Liezl Koen, John Joska, Linda Hering, Piet Ooosthuizen</p><p><strong>62. Perceptions of psychologists regarding the use of religion and spirituality in therapy</strong></p><p>Ottilia Brown, Diane Elkonin</p><p><strong>63. Resilience in families where a member is living with schizophreni</strong></p><p>Ottilia Brown, Jason Haddad, Greg Howcroft</p><p><strong>64. Fusion and grandiosity - The mastersonian approach to the narcissistic disorder of the self</strong></p><p>William Griffiths, D Macklin, Loray Daws</p><p><strong>65. Not being allowed to exist - The mastersonian approach to the Schizoid disorder of the self</strong></p><p>William Griffiths, D Macklin, Loray Daws</p><p><strong>66. Risky drug-injecting behaviours in Cape Town and the need for a needle exchange programme</strong></p><p>Volker Hitzeroth</p><p><strong>67. Neuroleptic malignant syndrome in adolescents in the Western Cape: A case series</strong></p><p>Terri Henderson</p><p><strong>68. Experience and view of local academic psychiatrists on the role of spirituality in South African specialist psychiatry, compared with a qualitative analysis of the medical literature</strong></p><p>Bernard Janse van Rensburg</p><p><strong>69. The role of defined spirituality in local specialist psychiatric practice and training: A model and operational guidelines for South African clinical care scenarios</strong></p><p>Bernard Janse van Rensburg</p><p><strong>70. Handedness in schizophrenia and schizoaffective disorder in an Afrikaner founder population</strong></p><p>Marinda Joubert, J L Roos, J Jordaan</p><p><strong>71. A role for structural equation modelling in subtyping schizophrenia in an African population</strong></p><p>Liezl Koen, Dana Niehaus, Esme Jordaan, Robin Emsley</p><p><strong>72. Caregivers of disabled elderly persons in Nigeria</strong></p><p>Lola Kola, Oye Gureje, Adesola Ogunniyi, Dapo Olley</p><p><strong>73. HIV Seropositivity in recently admitted and long-term psychiatric inpatients: Prevalence and diagnostic profile</strong></p><p>Christina Kruger, M P Henning, L Fletcher</p><p><strong>74. Syphilis seropisitivity in recently admitted longterm psychiatry inpatients: Prevalence and diagnostic profile</strong></p><p>Christina Kruger, M P Henning, L Fletcher</p><p><strong>75. 'The Great Suppression'</strong></p><p>Sarah Lamont, Joel Shapiro, Thandi Groves, Lindsey Bowes</p><p><strong>76. Not being allowed to grow up - The Mastersonian approach to the borderline personality</strong></p><p>Daleen Macklin, W Griffiths</p><p><strong>77. Exploring the internal confirguration of the cycloid personality: A Rorschach comprehensive system study</strong></p><p>Daleen Macklin, Loray Daws, M Aronstam</p><p><strong>78. A survey to determine the level of HIV related knowledge among adult psychiatric patients admitted to Weskoppies Hospital</strong></p><p><strong></strong> T G Magagula, M M Mamabolo, C Kruger, L Fletcher</p><p><strong>79. A survey of risk behaviour for contracting HIV among adult psychiatric patients admitted to Weskoppies Hospital</strong></p><p>M M Mamabolo, T G Magagula, C Kruger, L Fletcher</p><p><strong>80. A retrospective review of state sector outpatients (Tara Hospital) prescribed Olanzapine: Adherence to metabolic and cardiovascular screening and monitoring guidelines</strong></p><p>Carina Marsay, C P Szabo</p><p><strong>81. Reported rapes at a hospital rape centre: Demographic and clinical profiles</strong></p><p>Lindi Martin, Kees Lammers, Donavan Andrews, Soraya Seedat</p><p><strong>82. Exit examination in Final-Year medical students: Measurement validity of oral examinations in psychiatry</strong></p><p>Mpogisheng Mashile, D J H Niehaus, L Koen, E Jordaan</p><p><strong>83. Trends of suicide in the Transkei region of South Africa</strong></p><p>Banwari Meel</p><p><strong>84. Functional neuro-imaging in survivors of torture</strong></p><p>Thriya Ramasar, U Subramaney, M D T H W Vangu, N S Perumal</p><p><strong>85. Newly diagnosed HIV+ in South Africa: Do men and women enroll in care?</strong></p><p>Dinesh Singh, S Hoffman, E A Kelvin, K Blanchard, N Lince, J E Mantell, G Ramjee, T M Exner</p><p><strong>86. Diagnostic utitlity of the International HIC Dementia scale for Asymptomatic HIV-Associated neurocognitive impairment and HIV-Associated neurocognitive disorder in South Africa</strong></p><p>Dinesh Singh, K Goodkin, D J Hardy, E Lopez, G Morales</p><p><strong>87. The Psychological sequelae of first trimester termination of pregnancy (TOP): The impact of resilience</strong></p><p>Ugashvaree Subramaney</p><p><strong>88. Drugs and other therapies under investigation for PTSD: An international database</strong></p><p>Sharain Suliman, Soraya Seedat</p><p><strong>89. Frequency and correlates of HIV Testing in patients with severe mental illness</strong></p><p>Hendrik Temmingh, Leanne Parasram, John Joska, Tania Timmermans, Pete Milligan, Helen van der Plas, Henk Temmingh</p><p><strong>90. A proposed mental health service and personnel organogram for the Elizabeth Donkin psychiatric Hospital</strong></p><p>Stephan van Wyk, Zukiswa Zingela</p><p><strong>91. A brief report on the current state of mental health care services in the Eastern Cape</strong></p><p>Stephan van Wyk, Zukiswa Zingela, Kiran Sukeri, Heloise Uys, Mo Nagdee, Maricela Morales, Helmut Erlacher, Orlando Alonso</p><p><strong>92. An integrated mental health care service model for the Nelson Mandela Bay Metro</strong></p><p>Stephan van Wyk, Zukiswa Zingela, Kiran Sukeri</p><p><strong>93. Traditional and alternative healers: Prevalence of use in psychiatric patients</strong></p><p>Zukiswa Zingela, S van Wyk, W Esterhuysen, E Carr, L Gaauche</p>

<p><strong>Background.</strong> Police officers are predisposed to trauma exposure. The development of depression and post-traumatic stress disorder (PTSD) may be influenced by personality style, prior exposure to traumatic events and prior depression.</p><p><strong> Objectives.</strong> To describe the personality profiles of new Metropolitan Police Service (MPS) officers, and to determine the association between personality profiles, trauma exposure and depressive symptoms.</p><p><strong> Methods.</strong> We performed a cross-sectional analysis of 139 new recruits at two MPS academies in South Africa. A questionnaire elucidating traumatic life events and personality profiles was developed using the Millon Clinical Multiaxial Inventory-III (MCMI-III). Depressive symptoms were measured using the Hamilton Depression Rating Scale (HAMD).</p><p><strong>Results.</strong> Almost all subjects (99.3%) had previous trauma exposure, most commonly the unexpected death of a loved one and motor vehicle accidents. Prevalence of clinical depression was low (mean HAMD 3.57; standard deviation ±3.37). Personality characteristics revealed a high prevalence of anxiety (64.7%; 95% CI 56.8 - 72.6), depressive clinical patterns (34.5%; 95% CI 26.6 - 42.2), paranoia (33.1 %; 95% CI 26.6 - 42.2) and major depression (10.3%; 95% CI 5.1 - 15.1). There were no significant associations between any of the traumatic events and depressive symptoms, nor were there any significant associations between any of the personality variables and HAMD score (p&gt;0.05).</p><p><strong>Conclusion.</strong> The presence of depressive symptoms among MPS officers was low, with no significant associations between traumatic events, personality variables and depressive symptoms.</p>

Assessments are regularly used among clinicians within psychology, yet many are deemed too time-consuming and expensive. The Personality Inventory for— Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5)—Brief Form (PID-5-BF) was developed to measure maladaptive personality traits ( negative affect, detachment, antagonism, disinhibition, and psychoticism), based on the “hybrid model” for personality disorders included in DSM- 5 Section III. Literature indicates that reliability and validity for the PID-5-BF has been established in other countries. We explored these psychometric properties within a South African population using the NEO Personality Inventory Revised and Mini International Neuropsychiatric Interview’s (MINI) Subscale K: psychotic disorders and mood disorder with psychotic features, as measures for comparison. Our results indicated support for the PID-5-BF with sufficient reliability, convergent, and discriminant validity. More research is needed on the PID-5-BF, especially in South Africa, but our findings indicate it to be a promising assessment tool that could greatly benefit clinicians in the mental health sector.

AbstractThis manuscript summarizes the presentations of an international panel of experts, representing France, Hungary, India, South Africa, and the United States, on obsessive-compulsive disorder (OCD). OCD is culturally universal but probably heterogeneous. New data presented concern a follow-up study from a joint Yale-Brown clinical project; a prevalence study in Hungary; a molecular genetics study from South Africa; a comorbidity study from India; a clinical study from Paris comparing OCD with subclinical OCD; a discussion of compulsive buying as a cross-cultural phenomenon; and survey results showing the impact of OCD on quality of life and economic variables. A roundtable discussion led to a consensus that researchers must continue to: (1) investigate the prevalence of OCD in non Western samples and in less developed countries; (2) collect clinical data on OCD in child and adolescent samples, as well as in off-spring of adults with OCD; (3) refine the concept of age of onset; (4) study the impact of OCD on quality of life and the economy; (5) investigate the validity of the obsessive-compulsive spectrum in epidemiologic and clinical samples and develop appropriate instruments for its assessment; (6) study personality disorder and how it affects treatment response, and examine its prevalence in epidemiologic samples; (7) explore the concept of OCD heterogeneity, which may reflect differing etiologies but may also suggest differential treatment strategies; (8) conduct follow-up studies, particularly now that effective treatments may alter course of illness; and, finally, (9) investigate treatment response and whether certain subtypes demand unique approaches.

Objective: This article discusses Transference-Focused Psychotherapy, a contemporary evidence-based and manualised form of psychoanalytic psychotherapy for borderline personality disorder. Transference focused psychotherapy has evolved from decades of research in the object-relations approach developed by Professor Otto Kernberg and his collaborators. It is being adopted increasingly throughout North and South America and Europe, and this article explores the role its adoption might play in psychiatric training as well as public and private service provision contexts in Australia. Conclusions: Transference focused psychotherapy is readily applicable in a range of training, research and public and private service provision contexts in Australia. A numbers of aspects of current Australian psychiatric training and practice, such as the Royal Australian and New Zealand College of Psychiatrists advanced training certificate, and the Australian medicare schedule, make it especially relevant for this purpose.

This research aims to open up for critical discussion the effects of the discourses employed by mental health professionals in relation to the diagnosis of BPO, with a view of questioning the discursive practices available within a South African context. This discussion will situate identified discourses in relation to the subjects and objects to which it refers in an attempt to identify and interrogate dominant discourses which circulate to oppress and discriminate against female 'others' within the mental health setting. This discussion will serve to challenge mainstream, traditional psychology by questioning the utility of deploying these concepts within a South African context as well as the effects this deployment may have. A discourse analytic methodology is employed to identify the constructions of BPO by five mental health professionals working within a government setting. The analysis aims at interrogating the broader role of the identified discourses in supporting institutions, preserving power relations and transmitting ideological practices. Ultimately the aim of the research is to open up for critical debate, through the example of psychology and psychiatry's treatment of BPO; constituted as 'other', the possibility that there may be deleterious consequences for the wholesale acceptance of traditional psychological understandings by mental health professionals working within a South African context.
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M.A.
The relatively rapid development of biological approaches to various psychological conditions, has prompted clinicians and researchers to investigate Borderline Personality Disorder more thoroughly. Research has evidenced the uniqueness of Borderline Personality Disorder in terms of description, aetiology and treatment. Of the various aetiologies proposed, the neuropsychological deficit approach is one which is still in its infancy and which may have promise for new treatment strategies. Latest developments delineate neuropsychological deficits in the areas of memory, perception and visuospatial ability. These factors are important for psychotherapeutic purposes. The purpose of this study was to further existing knowledge as regards the aetiology of Borderline Personality Disorder in order to initiate new treatment modalities and management strategies. The study examined whether a battery of neuropsychological tests could detect organic dysfunction in the areas of construction, orientation and attention, memory, perception and concept formation and reasoning in twenty inpatients diagnosed according to DSM-IV criteria, with Borderline Personality Disorder. Two control groups were used, one comprising twenty inpatients diagnosed according to DSM-IV criteria with Personality Disorders from Axis II, Clusters A or C; and the other comprising twenty normal volunteers. Neuropsychological functioning assessed, included measures of attention, construction, visual and auditory-verbal memory, perception, and concept-formation and reasoning. Measurement instruments used in this study included the Digit Symbol subtest of the WAIS-R; Rey Complex Figure; Logical Memory subtest of the WMS-R, Gottschaldt Embedded Figures Test; and the Wisconsin Card Sorting Test. (v) Analysis of variance, multivariate analysis of variance and post hoc tests revealed significant deficits in neuropsychological performance among the borderline personality disorder group and the control group of other personality disorders but not the normal volunteer group. Dysfunction was particularly significant in the areas of attention, visuospatial ability, perceptual organization, and ability to maintain cognitive set. These deficits do not appear to have been attributable to attention deficit disorder, attention deficit hyperactivity disorder, temporal lobe epilepsy, head injury, a concurrent Axis I diagnosis such as major depressive disorder, or current drug and/or alcohol abuse. The observed deficits suggest new ways of understanding the development and maintenance of Borderline Personality Disorder, and provide indications for treatment. In conclusion, it is recommended that full use be made of the measurement instruments used in this study as diagnostic aids to enhance the effectiveness of treatment modalities. It is further recommended that research in this topic be repeated and extended using a larger sample and matched controls.

M.A. (Clinical Psychology)
The relatively rapidly development of cognitive-behavioural approaches to various psychological conditions, has prompted clinicians and researchers to investigate the borderline personality disorder more thoroughly. Research has evidenced the uniqueness of the borderline personality disorder in terms of description, etiology and therefore treatment. of the various treatments proposed, the cognitive-behavioural approaches appear to be most effective. Latest developments in this area emphasize cognitive factors such as content-specitic cognitions and Early Maladaptive Schemas. These factors are important tor psychotherapeutic purposes. A hypothesis was formulated which stated broadly that cognitive-behavioural approaches would result in equal treatment efficacy, whether process(schema) or content based, and investigated in the context of a pilot clinical trial with tour subjects. Apart from measures for depression and cognitive processes in the BPD, a depth-of-processing task and a schema questionnaire were utilized in investigation or the hypothesis. These measures, in addition to CB interventions, were applied to a small group or carefully selected BPD's, with a secondary diagnosis or depression. Findings supported the basic hypothesis of the study, and demonstrated that cognitive-behavioural approaches of either content or process typos are equally etricacious in treatment of the borderline porsonality disorder.

Clients diagnosed with Borderline Personality Disorder (BPD) interact with healthcare professionals in compelling ways. By virtue of the symptoms that define BPD, it is likely that the client will challenge the therapist with regards to their theoretical approach or therapeutic style. In addition, clients with BPD are likely to project their need for a therapeutic interaction that is both genuine, empathic and at the same time, flexible. In light of this, it is not uncommon for healthcare practitioners to consider clients with BPD as “difficult” in some way or the other. This study explores how clinical psychologists in Gauteng conceptualise and manage a “difficult” client presenting with Borderline Personality Disorder. Further, coping strategies of the clinician will also be explored. The qualitative study, couched in a social constructionist paradigm, involved interviewing seven clinical psychologists practicing in Gauteng, South Africa. The transcripts of the semi-structured interviews were thematically analysed. The findings of the current study indicated that the difficulties experienced are reflective of the general criteria of the disorder. The picture of the difficult client is painted by personal experience, as well as stereotypes gained from interactions with colleagues and other healthcare professionals. It was further found that management of these patients were viewed and implemented based on the nature of the disorder. In addition, management by the clinician often included supervision and leisure activities.
Psychology
M.A. (Clinical Psychology)

The experience of complex childhood trauma produces a ripple-effect that psychologically impacts trauma survivors’ functioning in multiple areas. The aim of the current study was to investigate and describe the interplay between complex trauma, subsequent personality development and later psychopathology by means of the multiple case study method of six female psychiatric patients attending treatment at a tertiary psychiatric hospital within Gauteng, South Africa. This was accomplished by assessing and qualitatively analysing the results of a carefully selected battery of personality and other psychometric assessments presented to study participants. The results indicated that the experience of complex childhood trauma impacted the study participants’ personality in predictable ways, which further influenced the psychopathology they displayed as psychiatric patients. These findings aid in describing the psychological impact of complex trauma on the research participants, and also offers support for reconnecting past traumas to the current psychopathologies of psychiatric patients.
Psychology
M.A. (Clinical Psychology)

M.A.
Szasz (1961), in a book entitled, "The Myth of Mental Illness", argues about the age-old debate, whether the diagnosis of mental illness is culturally related or not. In today's multicultural milieu, clinicians are confronted with this same problem. For the purpose of the present qualitative study, Ancestral Possession (AP) and Multiple Personality Disorder (MPD), will be considered. The initial purpose of the study was to explore the fields of Ancestral Possession (AP) and Multiple Personality Disorder (MPD) amongst black subjects, and to explore how these two phenomena are understood within a cultural context. Due to practical problems encountered in finding a black subject diagnosed as suffering from MPD, the subject focus had to be slightly altered. The aim of the study was changed to investigating MPD, as a Western culture diagnosis, and AP, as an African culture diagnosis, and comparing these two phenomena. The phenomenological approach was used as a theoretical basis for the study. It was assumed that since this study focuses on subjective experiences, the phenomenological approach would be more applicable. Two case studies (MPD and AP) comprise the data of this study. A video tape, consisting of interviews of the two case studies, is part of the data, including a literature study on both phenomena. The data analysis focused on comparing the personal background of the two case studies and the manifestation and treatment of both phenomena within their cultural contexts. The differences and similarities that emerge, are discussed. It was found that there are some similarities and also some differences between the two phenomena. Similarities are found, for instance, in the symptom profile of the two phenomena. The core personality in MPD usually presents with a fragile appearance (physical and psychological) and will report losing time (having time that is unaccounted for, because other personalities had taken over). The same thing happens with isiguli (literally, patient), a person who is being called by the ancestors. She looks sick, she will find herself in places without knowing how she got there. In both phenomena the subjects appear tormented before integration. The two conditions are also alike in terms of their effect on the central personality. The ancestral spirits and the alter personalities seem to play the same role of enabling the core personality to be well-functioning. In terms of the differences found between the two phenomena, ancestral possession is socially approved in the African culture whereas multiple personality disorder is considered an illness from the Western perspective. The role of socio-cultural factors seems to complicate matters. As enculturation continues and white South Africans are becoming traditional healers, it would be interesting to see how many black South Africans will in future, be diagnosed as suffering from MPD as there are very few, if any, at present. In terms of etiological factors, MPD is usually a result of trauma whereas ancestral possession is a religious experience. The results were inconclusive in that some aspects, for instance, physiological manifestation of AP could not be clearly explained. This is due to the fact that there has not been any laboratory research done to examine the chemical and physiological changes of traditional healers when under the influence of ancestral spirits. As opposed to that, MPD subjects have been reported to have alter personalities that would indicate different EEGs and some other physiological differences.

Thesis (M.A.)--University of the Witwatersrand, Faculty of Humanities, 2012
The primary aim of this study was to investigate the relationship between binge eating disorder and personality traits. Studying personality characteristics may eventually enable us to identify individuals at heightened risk for developing binge eating, and to use this information to design more effective prevention and early intervention strategies. 138 females and 42 males participated in this study. Questionnaires using the EDI, EAT-26 and 16PF as well as an interview schedule were adopted for the study. Results revealed that there appeared to be a significant positive relationship between the EAT-26 and factor O (apprehension-self assured) and factor Q 4(tension-relaxed). There appears to be a significant positive relationship between the EDI and factor I (sensitive versus tough minded), factor L (suspicious versus accepting), factor O (insecure versus complacent) and factor Q4 (tense versus relaxed and easy going). Factor O (apprehension-self assured) appears to predict the scores obtained on the EAT-26 and the propensity to develop binge eating disorder. Factor O (insecure versus complacent) and Q4 (tense versus relaxed) were able to predict the scores on the EDI and the propensity to develop binge eating disorder. Secondary aims of the study revealed that there appears to be a relationship between body image disturbance and the total EAT-26 and EDI scores respectively. This means that participants scoring high on the body dissatisfaction subscale of the EDI will also score higher on the EAT-26 total. There appeared to be a positive relationship between gender of the participants and the total scores of the EAT-26 and EDI respectively. There were 2 interviews carried and the results of the interviews reinforced the quantitative data and previous research on binge eating disorder (Belangee et al, 2003) that personality traits are link to the development of binge eating disorder.

M.A.
The present study was undertaken in an attempt to understand and ascertain the relation between personality traits and posttraumatic stress (PTSD) in the South African Police Service (SAPD) leading to chronic illness and work-related dysfunctions. The specific hypothesis for this study will show that by means of the Comrey Personality Scales (CPS) a statistic significant distinction between police officers with PTSD and police officers without PTSD exists. The testing of the hypothesis entailed a group of 120 functional police officers that consists of white, male nonofficers. They worked in the Pretoria area of the SAPD. The PTSD status of the subjects was assessed by means of the PTDS Interview Guide of Watson, Juba, Manifold, Kucala and Anderson (1991). Police officers that met the criteria for PTSD by means of the PTSD Interview Guide were place in one group (PTSD-group, n = 414. Police officers that did not meet the criteria were placed in another group (Non-PTSD-group, n = 79). Personality traits were measured by means of the CPS. There was a significant difference between the personality traits of the PTSDgroup in comparison with the Non-PTSD-group. The PTSD-group appears to be more compulsive and ordered, more introspective, more neurotic, more sensitive and more defensive in comparison with the Non-PTSD-group. It is postulated that these personality traits can possibly cause policemen to be more susceptible for the development of PTSD.

This thesis includes four studies investigating the experiences of abused women. According to ecological approaches different systems should be considered when conducting research into abused women and their experiences. The first study involved women who successfully left an abusive relationship. An ecological approach was used to investigate the experiences of the women in the different phases of their relationship, including the initial attraction to the partner, the development and sustaining of the abuse and her attempts to leave until her final decision to leave permanently. An important finding was the importance of considering and investigating all systems and levels when dealing with abused women, including those who have left and those who are contemplating leaving this relationship. The second study found that women who experienced physical abuse were often hurt in anatomical locations that were indicative of impulsive violence. The abuser used any object in the heat of the moment to attack the victim and no premeditated planning was evident in the type of injuries sustained. The women further reported that medical practitioners did not investigate the causes of injuries and that they were not referred to social services or organisations dealing with abused women, although they were recognised as suffering from abuse. The intersection of abuse of women and HIV was the topic of focus of the third study. A review of the records of abused women revealed that many abused women were subjected to risk factors for contracting HIV, with counsellors focussing only on abuse issues. Longitudinal case studies, of women exposed to both conditions, revealed that they lacked social support and were often secondarily victimised by the social welfare systems. An environmental scan found that social and health care services were not accessible to these women. The final study investigated intervention strategies to combat burnout in workers at an organisation dealing with abused women. The importance and effectiveness of creative exercises and art sessions were determined in combination with debriefing and supervision sessions. The studies all considered systems that are important in service delivery to abused women. A holistic and systemic investigation and treatment of abused women is shown to be essential, as is the importance of grass roots research.
Psychology
D. Phil. (Psychology)

Text in English
This study was designed to determine whether a relationship exists between self-reported mindfulness, self-consciousness, adjustment and academic performance in first-year university students. Additionally, the study aimed to assess the predictive quality of mindfulness and self-consciousness towards emotional adjustment (adjustment disorder symptoms, depression and anxiety) and academic performance, and to further determine the contribution of mindfulness and self-consciousness on adjustment to the predictability of academic performance. First-year students (N = 290) at the Tshwane University of Technology (TUT) at the Pretoria West and Ga-Rankuwa campuses completed the selfreported mindfulness measure, Mindfulness Attention and Awareness Scale (MAAS) (Brown & Ryan, 2003), the Self Consciousness Scale- Revised (SCS-R) (Scheier & Carver, 1985), the Beck Depression Scale (BDI) (Beck et al., 1961) the Beck Anxiety Scale (BAI) Beck & Steer,1993) and the adjustment disorder checklist; based on DSM V, (Sadock, Sadock & Ruiz, 2014). Students’ year-end results for the first year of study were used to operationalize academic performance. Results of correlation analyses indicated a significant negative correlation between mindfulness and students’ emotional adjustment (adjustment disorder symptoms, depression and anxiety), a significant positive correlation between selfconsciousness and students’ emotional adjustment (adjustment disorder symptoms, depression and anxiety) as well as a significant negative correlation between adjustment disorder symptoms and academic performance. Multiple linear regression analysis was used to test whether mindfulness and self-consciousness significantly predicted students’ depression, anxiety and adjustment disorder symptoms. The results of the regression analysis indicated the two predictors explained 16% of the variance (F (1, 1773) = 29.66, P< 0.0001) (depression), 14% of the variance (F (1, 985) = 24.14, p < 0.0001) (anxiety) and 14% of variance (F (2, 292) = 23.87, p <0.001) (adjustment disorder symptoms). Furthermore, mediation analysis provided information regarding the impact of mindfulness and selfconsciousness on students’ academic performance. The impact of mindfulness and selfconsciousness on students’ academic performance (students’ marks) was found to be mediated by adjustment disorder symptoms. However, the Sobel test indicated a significant effect (0.03) for mindfulness and an insignificant effect (0.09) for self-consciousness.
Psychology
Ph. D. (Psychology)