Dissertations / Theses on the topic 'Depression in women - Research - Namibia'

Bibliography : leaves 122-145.
Investigations into the causes of postnatal depression are, with few exceptions, quantitative in nature. Although there are psychological, interpersonal and sociocultural perspectives on postnatal depression, the medical one dominates in terms of academic, professional and lay understandings of aetiology. The medical model has produced a plethora of investigations into the causes of postnatal depression but has paid little attention to the insights of women who have experienced the condition. This study sought to redress this by exploring the causes of post-natal depression from a women-centred perspective. A feminist approach to postnatal depression was adopted. This approach has evolved largely as a critique of the medical model and is grounded in a more qualitative tradition. Semi-structured, in-depth interviews were conducted with twenty women who had recovered from postnatal depression. Transcribed data from the interviews were thematically analysed to uncover the participants' attributed causes for their post-natal depression. A number of common themes emerged and could be broadly grouped under ""interpersonal factors"" (such as the impact of the woman's relationship with her own mother); ""psychological factors"" (such as the impact of unresolved issues and feelings of loss on the new mother) and ""biological factors"" (such as hormonal factors). The dominant theme that emerged from this study was that of ""motherhood"". Included under this heading were all those factors specifically associated with being a mother that were regarded by the women as being the cause of their postnatal depression (such as the experience of childbirth, breastfeeding and lack of sleep). At the core of this theme lay the realisation that motherhood was not what they had expected it to be. Their disappointment in not meeting their own expectations of motherhood contributed significantly to their postnatal depression. An interesting finding was that while many of the respondents located feelings of failure to live up to the ""ideal image"" of motherhood as a cause of their depression, few questioned the validity of the social construction of this ideal. This paper also examined the extent to which women's aetiological explanations resonate with existing models of post-natal depression. Their explanations were found to reflect some of the existing aetiological models of postnatal depression but no single model of explanation could be identified as the cause of their postnatal depression. Rather, women's attributions of cause were multi-layered and complex. They all attributed their depression following childbirth to a number of factors and they differed markedly from one another in their attributions. According to this research, postnatal depression results from a myriad of inter-related factors which interact with one another in different ways to produce a largely different picture for each and every woman. The limitations and contributions of this study are discussed.

Objective: Social support and religious commitment were examined in relation to antenatal and postpartum depressive symptoms in a prospective, longitudinal study to determine whether religious commitment explained variance in depression scores beyond that accounted for by social support. Background: Social support and religiosity are positively related to good mental/physical health, and depression is related to poor health outcomes in pregnancy and postpartum. It was hypothesised that social support and religious commitment would be inversely related to depressive symptoms, and that religious commitment would predict variance in depression scores over and above social support. Methods: In 106 mostly low SES Appalachian pregnant women, social support and religious commitment were measured during the first trimester. First and third trimester (Center for Epidemiological Studies Depression Scale – 10 item version), and 6 weeks and 6 months postpartum (Edinburgh Postnatal Depression Scale) depression symptoms were measured. Hierarchical regression examined relative contributions of social support (Prenatal Psychosocial Profile) and religious commitment (Religious Surrender and Attendance Scale – 3 Item Version) to depressive symptoms at each time point while controlling for education and marital status. Results: Regression results indicated that social support and religious commitment explained 10–18% and 0–3% of the variability in depression scores, respectively. Conclusion: Both social support (all time points) and religious commitment (only at 6 months postpartum) were inversely related to depression. Pregnant women low in social support and postpartum women low in social support or religious commitment may be at increased risk for depression.

Introduction: Postpartum Depression and postpartum depressive symptoms have been found to have a strong association with breastfeeding duration in a significant portion of women across a variety of geographical locations. The aim of this study was to explore the correlation between postpartum depressive symptoms at 6 months postpartum and total duration of breastfeeding measured at 15 months postpartum in Appalachian women. Methods: A longitudinal study was conducted in which 1,063 mostly low socioeconomic status women were recruited across 6 prenatal practices in Appalachia. At 6 weeks, 6 months, and 15 months postpartum, depressive symptoms were measured using the Edinburgh Postnatal Depression Scale (EPDS). From the original sample, 134 completed a self-report measure of breastfeeding initiation and duration at 15 months postpartum. Results: EPDS score did not predict whether or not women breastfed, only their duration of breastfeeding. Women who scored in the clinically significant range (13 or higher) on the EPDS at 6 months postpartum breastfed a significantly shorter length of time (Mean = 1.75 months, SD = 2.70) than women who scored below 13 on the EPDS (Mean = 4.48 months, SD 5.22; t(133) = 3.61, p = .001). Conclusion: Clinically significant Edinburgh Postnatal Depression Scale scores were predictive of shorter duration of breastfeeding.

Stress has emerged as one of the most important factors to consider in psychiatric diagnoses and has become a common reason for long-term sick leave (LTSL). Roughly 50% of LTSL due to psychiatric diseases are thought to be associated with work-related stress. The demarcation towards major depression is disputed, and no international consensus exists for how to diagnose and rehabilitate these individuals. The Swedish National Board of Health has suggested the term “exhaustion syndrome” to integrate these individuals into stress-related disorders. Prominent features of this syndrome are fatigue, sleeping disorders, and cognitive dysfunction. The cognitive dysfunction may be due to an interaction between personality features, environmental factors, the biological effects of stress hormones, and dysfunction in key brain areas, notably the hippocampus and prefrontal cortex. A consistent feature of chronic stress is activation of the cortisol, or hypothalamic-pituitary-adrenal, axis, which may be linked to cognitive dysfunction. Increased glucocorticoid levels, mainly cortisol in humans, are known to impair memory performance. The aim of this thesis was to investigate whether patients with exhaustion syndrome exhibit specific alterations in an extensive set of biological, psychological and immunological variables. Patients in Study 1 had significant cognitive impairment for specific tasks assumed to tap frontal lobe functioning. In Study 2 anxiety prone, worrying, pessimistic individuals with low executive drive and a persistent personality type were more likely to develop exhaustion syndrome. Decreased reactivity was found on the pituitary level after corticotropin releasing hormone (CRH) in exhaustion syndrome patients. The cortisol/adrenocorticotropic hormone response to CRH was slightly higher in patients compared to controls, indicating increased sensitivity at the adrenal cortex level. No differences were found in hippocampal volume. In Study 3, functional imaging revealed a different pattern of brain activation in working memory tests in patients with exhaustion syndrome compared to healthy individuals and patients with depression. In summary, our data suggests an intimate link between personality and wellbeing, cognitive performance and neuroendocrine dysfunction, in exhaustion syndrome. We thus find similarities with major depression but also distinct differences between the exhaustion syndrome and major depression.

M.Cur.
The problems women in our community are faced with are multi-dimensional and there is absolutely no community that can be declared problem-free. Many women face the pressure of having a number of responsibilities namely working, being a wife and mother, taking care of their families and perhaps caring for aging parents. Sometimes the pressure can be too overwhelming to manage. As a result, many women become depressed. The genuine life events that most often appear in connection with depression are various, but there is one distinguishing feature that appears in many cases, over and over: loss of self-esteem, of empowerment, of self confidence accompanied by feelings of worthlessness. In general, any life change, often caused by events beyond one's control, will damage the structure that gave life meaning. The likelihood of becoming depressed is increased by the lack of supportive, confiding relationship with a partner, spouse, friend, stressful life events and poor communication patterns within relationships. Studies on depression among Black-African women could not be traced. Despite the fact that considerable research on the women and depression has been done in other parts of the world, no studies have been done on similar subjects in Namibia. It was therefore considered necessary to find out how women suffering from depression from this part of the world tell their life stories. The purposes of the study were two-fold. Firstly, to explore and describe the life stories of adult depressed women in perk urban Namibia. Secondly, to use the information obtained to describe guidelines for the compilation of a health education support program for psychiatric nurses working with these patients at psychiatric outpatient clinic as well as in the community. The research questions that were generated are: how do adult depressed women tell their life stories, and then how can the information be utilised to describe guidelines to support psychiatric nurses to assist depressed women in their quest for mental health? The researcher used an exploratory, descriptive, contextual and phenomenological qualitative design to answer these research questions. Phenomenological interviews were conducted with ten (10) respondents who have been purposively selected. This was done after obtaining the necessary permission from the Ministry of Health and Social Services and informed consent from the research participants. The interviews were conducted by the researcher in Oshiwambo and English. Steps were taken throughout the course of the study to ensure trustworthiness. All the interviews were transcribed verbatim. Data was analysed following Tesch's method and the service of an independent coder was obtained. The results indicate that impaired interpersonal interactions and stressful life events have a negative influence on the daily life of women leading to the development of depressive symptoms. Guidelines intended to support psychiatric nurses were drawn up based on the themes that emerged from the raw data. These guidelines are strategies to be used by psychiatric nurses working with depressed women to assist them in managing their own depression. Possibilities for the application of the results in nursing education, nursing practice, nursing research are discussed. It is concluded that women suffering from depression need support from the psychiatric nurses in order to facilitate the promotion, maintenance and restoration of their mental health, which is an integral part of health.

Seamfulness is a narrative-based and arts-informed inquiry into young women's "depression" as pedagogy. Unfolding in rural Nova Scotia, this research is rooted in my experience of depression as the most transformative event in my life story. While memoirists tell me I am not alone, there is currently a lack of research on personal understandings of depression, particularly for young adult women. Through storytelling sessions and self-publishing workshops, I explored four young Nova Scotian women's depression as a productive site for growth. Participants include four young women, including myself, who experienced depression in their early 20s, and have not had a major depressive episode for at least three years. Aged 29 to 40, we claim Métis, Scottish, Acadian, and British ancestries, and were raised and lived in rural Nova Scotian communities during this time. At the seams of adult education, disability studies, and art, I ask: How do young women narrate experiences of "depression" as education? How do handmade, self-published booklets (or “zines”) allow for exploring this topic as embodied, emotional and critical transformative learning? To address these questions, I employ arts-informed strategies and feminist, adult education, mental health, and disability studies literatures to investigate the critical and transformative learning accomplished by young women who experience depression. Through a feminist poststructuralist lens and using qualitative and arts-informed methods, I situate depression as valuable learning, labour, and gift on behalf of the societies and communities in which women live. I argue that just as zines are powerful forms for third space pedagogy, depression itself is a third space subjectivity that gives rise to the "disorienting dilemma" at the heart of transformative learning. I close with "Loose Ends," an exploration of depression as an unanswered question. This thesis engages visual and verbal strategies to disrupt epistemic and aesethetic conventions for academic texts. By foregrounding participant zines and stories, I privilege participant voices as the basis for framing their experience, rather than as material to reinforce or contest academic theories.

Text in English
The purpose of this study is to tell the story around the roles of relationships in the world of depressed women. The epistemological framework of this study is constructivism. This study involved a series of in-depth interviews with three depressed women who had young children. Hermeneutics was the method used to analyse the data. The stories of the participants were recounted through the researcher's lens in the form of themes that emerged. The specific ways each participant tried to cope, and the emerging processes from the researcher's perspective as to what she believed was helpful or unhelpful to the participants, in addition to what the participants themselves regarded as helpful, was discussed. Recurring themes evident in the stories of all three participants were elucidated in the story of the stories. The information gained could serve as guidelines to those working with depressed people from a Western and an African context.
Psychology
M.A. (Psychology)

Women’s lived experiences of abuse and depression are examined within the context of gendered and racialized pathways to incarceration among 403 women randomly selected from a diagnostic unit in a state prison. This study utilizes feminist action research and community psychological methods to understand what factors predict incarcerated women’s placement on the mental health caseload and provides quantitative support for the pathways theoretical framework. Findings indicate that, among the sample, the prevalence of abuse experiences prior to incarceration exceeded 90%, prevalence of mental health problems exceeded 70%, and less than 35% were receiving mental health care. Being Caucasian, experiencing depression and suicidal ideation, and serving time for certain types of (non-violent, non-property, and non-drug related) crime (e.g., cruelty to children, prostitution, public order, “technicals,” and others) predicted the placement of women on the mental health caseload. Implications for trauma-informed, anti-racist, gender-responsive policies and interventions are discussed.

Postpartum depression is an illness that is frequently unreported and undetected for a variety of reasons and may be potentially devastating for the mother affected as well as her family. Routine screening of postpartum women enables health practitioners to detect symptoms of PPD early and provides an opportunity for early intervention which may improve the outcome and increase the mother’s chances of an earlier recovery. It is therefore important that reliable and convenient screening tools are available to health practitioners who have contact with postpartum women. The primary objective of this research was to make an Afrikaans version of an existing screening scale available – the Postpartum Depression Screening Scale (PDSS), designed specifically to encompass the multifaceted phenomenon of PPD. In accordance with this objective, the validity and reliability of the PDSS and its Afrikaans version was investigated in English- and Afrikaans-speaking South African mothers. A further objective of this study was to compare the performance of the PDSS with the Edinburgh Postnatal Depression Scale (EPDS) and the Quick Inventory of Depressive Symptomatology (QIDS-SR16). Various factors have been reported to be associated with the development of PPD. The final objective of this study was to explore the relationship between known risk factors for PPD and high scores on the PDSS amongst women in South African. A total of 365 South African mothers, between 4 and 16 weeks postpartum participated in this study. English-speaking mothers (n = 187) completed the PDSS, EPDS, QIDS, and a demographic and psychosocial questionnaire, while Afrikaans speaking mothers (n = 178) completed the respective Afrikaans versions of these questionnaires. A multiple translation method – Brislin’s back-translation method and the committee approach – was used to translate the PDSS and the QIDS into Afrikaans. An item response theory (IRT), Rasch analysis, was used to examine dimensionality, item difficulty, differential item functioning, and category functioning of the PDSS and the Afrikaans PDSS. Results reveal excellent person reliability estimates for the Afrikaans PDSS as well as for the PDSS in a South African sample. Both language versions performed reasonably well and the majority of items in the PDSS dimensions and the Afrikaans PDSS dimensions demonstrated fit statistics that supported the underlying constructs of each dimension. Some items were identified as problematic, namely Item 2, Item 25, Item 28, and Item 30. The item person construct maps show reasonably good spread of items. There were, however, persons that scored higher than the items could measure and an overrepresentation of items at the mean level. The Likert response categories proved to be effective for all the Afrikaans PDSS items and almost all the PDSS items. Results indicate that 49.7% of mothers screened positive for major PPD using the PDSS. A further 17.3% of mothers obtained scores indicating the presence of significant symptoms of PPD. Statistically significant correlations were obtained between total scores on the PDSS, the EPDS, and the QIDS-SR16. Stepwise multiple regression analysis identified 11 variables that were significantly associated with a high PDSS total score. These were a history of psychiatric illness, postpartum blues, feeling negative or ambivalent about expecting this baby, fearful of childbirth, infant temperament, antenatal depression in recent pregnancy, lack of support from the baby’s father, concern about health related issues regarding the infant, lack of support from friends, difficulty conceiving, and life stress.
Thesis (PhD)--University of Pretoria, 2012.
Psychology
unrestricted

This practice/thesis documents a search for hope and meaning in the experiences of young women who have faced feelings of depression and disordered eating. This portrait of a process guided by the principles of qualitative, holistic, feminist, reflexive and participatory inquiry reflects the journey of reflexive feminist praxis. My hope is to evoke a sense of the importance and value of feminist theory, the relevance of its application in understanding women's experiences of distress and the vitality of new thought and inquiry arising out of feminist research. This is what I mean by reflexive feminist praxis, where theory inspires action which in turn nourishes new understanding. It is also my wish to demonstrate that this process must include reflection upon the self, the narrator of the story. This is an invitation to reflect upon the meaning of what I have to say in your own story. This journey into meaning-making is therefore dialogic. Feelings of depression and disordered eating can claim the health, joy, hope, energy and passions of us all. This tale is now in your hands, awaiting the 'view from over there'.