Electronic Theses and Dissertations (PhDs)

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Browsing Electronic Theses and Dissertations (PhDs) by Department "Department of Psychology"

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    An exploratory study to understand the mental health care needs of university students
    (University of the Witwatersrand, Johannesburg, 2023-10) Mudau, Tondani; Jithoo, Vinitha; Dietrich, Janan
    Background: Despite high levels of psychological distress, university students are reluctant to seek counselling on campus. University students have easy access to data and regularly use their phones for academic and personal purposes. A mental health application (app) designed specifically for university students has the potential to address mental health challenges and promote help-seeking amongst university students. This study aimed to explore the prevalence of psychological distress amongst university students, the sources of their distress and common coping strategies. The study then investigated students’ and counsellors’ perceptions of using a mental health app as a coping mechanism for psychological distress. Finally, the study developed, tested, and evaluated a mental health app specifically designed for university students. Methods: A multiphase mixed methods research design comprising three phases was used to collect quantitative and qualitative data through surveys, in-depth interviews, and focus group discussions. Data were collected, analysed and interpreted within the technology acceptance model (TAM) and cognitive behavioural theoretical frameworks. Phase 1 collected data to determine the prevalence of psychological distress, common coping strategies and mobile phone use amongst university students. Phase 2 integrated quantitative and qualitative data from Phase 1 to determine the feasibility of a mental health app, and thereafter developed the mental health app. Phase 3 tested and evaluated the usability of a mental health app with students and counsellors. All quantitative data were collected using the web-based application, Research Electronic Data Capture, and analysed using Statistical Analytics Software Enterprise Guide 7.1. All qualitative data were analysed through thematic analysis and by using NVivo version 12 Pro. Results: Overall, 1 221 students and nine counsellors were enrolled in the study. Phase 1 enrolled 1 100 students in an exploratory survey, 62 in focus group discussions, and six counsellors for in-depth interviews. Socio-demographic data Phase 1: A majority of participants (72.72%) were female, within the 18–20 age group (64.6%), and in their first-year level of study (46.2%). A vast majority (94.1%) were enrolled at the University of the Witwatersrand, with many enrolled in the faculty of humanities (36.1%). Most participants were South African citizens (95.6%) and from an urban location (61%), and 20.09% had been previously diagnosed with a mental health challenge. Prevalence of psychological distress: The Kessler-10 and student stress inventory were used to determine the prevalence of psychological distress. The results show that most participants (60.5%) reported very high levels of psychological distress, while 53% reported moderate levels of stress. Male students were more likely than female students to have very high levels of psychological distress (71.4%) and mild stress (63.3%). Third-year students were more likely than first- and second-year students to have high levels of psychological distress (65%) and moderate stress (59%). Coping strategies: The Brief-COPE-28 was used to determine common coping strategies amongst students. The results show that students with moderate or severe stress used emotion-focused (mean: 30.6 [SD = 5.71] vs 28.8 [SD = 6.21]; p < .0001) and avoidance coping styles (mean: 16.3 [SD = 3.82] vs 13.2 [SD = 3.51]; p < .0001) more than those with mild stress. A larger proportion of female than male students used denial (mean: 3.50 [SD = 1.77] vs 1.54 [SD = 3.13]; p = 0.001), emotional support (mean: 5.03 [SD = 1.96] vs 4.50 [SD = 1.82]; p = 0.0001), informational support (mean: 2.00 vs 1.88, p = 0.0001), behavioural disengagement, (mean: 3.63 [SD = 1.63] vs 3.82 [SD = 1.52]; p = 0.001), and religion (mean: 5.53 [2.24] vs 4.63 [2.17]; p = 0.001) as coping strategies. Students within the 18–20 age group had higher scores for religion as a coping strategy (mean: 5.53 [SD =2.2 2] vs 4.93 [SD = 2.23]; p = 0.0003). First-years were more likely to use problem-solving coping styles than postgraduate students (mean: 22.5 [SD = 5.86] vs 22.5 [SD = 5.29] p = 0.0165). Mobile phone use: Results from a sociodemographic questionnaire show that a majority of participants (98.7%) owned a smartphone and 66.9% owned a phone with Android software. Most (81%) reported having easy access to data and only a few (26.6%) had used an online health app for their health needs. Students’ and counsellors’ perceptions of psychological distress and using a mental health app to address mental health challenges: A semi-structured interview guide was used to collect qualitative data. Thematic analysis based on the TAM and cognitive behavioural theory frameworks categorised qualitative data under six main themes: (1) students’ conceptualisation of distress, (2) common mental health challenges, (3) perceptions of factors leading to distress, (4) facilitators of using a mental health app intervention, (5) barriers to using a mental health app intervention, and (6) perceived usefulness of the app. Sociodemographic data Phase 3: Three counsellors and 59 students were enrolled in the survey. Most students (64%) were female, within the 21–24 age group (63%), and in their third year of study (37%). More than half the student participants were enrolled at the University of the Witwatersrand (54%) and 29% within the humanities faculty. App testing: The app had eight categories for participants to test (information, coping strategies, take a test, seek help, journal, podcasts, videos, and settings). A majority of participants assessed coping strategies (73%) and information (69%), followed by the seek help (47%) and take a test (45%) category. Podcasts (23%) and settings (15%) were the least assessed categories. Perceived ease of use: The belief that users will require minimal effort using the technology was assessed using the Mobile Application Rating Scale (MARS). The overall MARS score showed excellent internal consistency (Cronbach alpha = 0.93) and was highly correlated to the app’s overall star rating (r = 0.72, p < 0.0001). The overall mean for the total MARS scale was 88.1. The MARS subscales were high quality and exceeded the (3.0) mean threshold: engagement (3.84), functionality (3.52), aesthetics (4.25), information (4.36), and subjective quality (3.45). Conclusion: The findings reveal that psychological distress is prevalent amongst university students, suggesting a need for student-friendly mental health interventions. A mental health app has the potential to address this need. This study found that most students own smart mobile phones and have easy access to data, indicating that a mental health app is a viable intervention. The qualitative findings demonstrate students’ willingness to use a mental health app for psychological distress. Barriers to using the app included a lack of face-to-face therapy, over-reliance on the app, fear of misdiagnosis, and lack of accessibility and affordability. Facilitators to using the app included previous experience with apps, convenience, accessibility, and confidentiality. These aspects were considered when designing the app, for it to be student friendly. Students and counsellors suggested that, for the app to be useful, it should provide information and coping strategies, offer support, engagement, and security. Therefore, the mental health app intervention in this study was developed based on these characteristics. The designed mental health app was evaluated by students and counsellors, who rated the app to be of high quality and easy to use. This outcome is positive and should be explored further. Future studies can longitudinally test for the app’s effectiveness with students experiencing psychological distress.
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    Gendered Affective Economies of Male Sexual Violence Against Men in South Africa
    (University of the Witwatersrand, Johannesburg, 2023-08) Chitiki, Elizabeth; Nkomo, Nkululeko; Kiguwa, Peace
    Within the South African context, sexual violence against men is an under-researched phenomenon, and abuse against men is largely characterized by silence. This study focused attention on discursive and affective dimensions of societal responses to sexual violence against men (heterosexual, gay, bisexual, and transgender men). At the pinna core of this research was the interrogation of how male victim-survivors of sexual violence are constructed within contexts that are embedded with gender, sexuality, and masculinity governing ideologies. Concerning sexual violence against men, dominant sexual constructions of men perceive men as sexually promiscuous and always ready for sex. Then, one ought to pose a question about how men's sexual agency and subjectivity are constructed when one or more of these social constructs are violated in the case of sexual violence. Using data from online radio talk podcasts and virtual ethnographies, I analyse societal responses to male sexual violence. Data were analysed using Foucauldian Discourse Analysis in tandem with Affect theory. The results of this research are presented in three chapters. The first chapter of the analysis discusses victim worthiness and empathy in social constructions of male sexual violence. The second chapter of the analysis shows the humanization of a (de)humanized subject in understanding prison rape via affective tropes. The third chapter of the analysis discusses the unmasking of institutional culpability through affective economies of shared pain and rage. Thus, the findings of the study highlighted that particular discursive constructions and affective tropes are useful in the negotiation, and surfacing of particular subjectivities in connection to male sexual violence.
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    Impact of Green Building Features and Initiatives on Individual Productivity and Organisational Performance in Office Buildings
    (University of the Witwatersrand, Johannesburg, 2023-06) Nurick, Saul David; Thatcher, Andrew
    The uptake of sustainability within the real estate sector has come to the fore in the last twenty years. More specifically this has involved the development and implementation of green certification tools within the commercial property market. There are various green building tools that are applied in the different developed markets to standardise building certification within each market. Some tools are adapted versions of another tool, for example Green Star (Australia) was used as the benchmark for the development Green Star South Africa. One of the categories within every type of green building tool is indoor environmental quality (IEQ). Building occupants tend to be more aware of their indoor environment more than any other building component that may be classified as a green building feature and initiative (GBFI). Specific GBFIs impact the following IEQ factors: ventilation, natural vs artificial light, ambient temperature, humidity levels, noise levels, and office configuration. Green building research has shown that operationally green buildings benefit both owners and tenants, which also has a positive impact on building values. Many green building advocates have stated that green buildings also result in improved individual productivity and organisational performance. There is, however, conjecture amongst academic researchers regarding the accuracy of measuring productivity of knowledge workers within an office environment. Common approaches for measuring productivity include creating a simulated office as an experimental environment and setting tasks for the participant to perform in different environmental conditions. Post occupancy evaluations (POE) and building user surveys are other instruments for gathering productivity data, however these are often in the form of self-assessment, which carries an element of bias. The purpose of this research was to develop and test a theoretical framework that connected the implementation of GBFIs, specifically enhanced IEQ, to individual productivity and organisational performance. The theoretical loop is that enhanced IEQ may positively impact both individual productivity and organisational performance, which could justify the implementation of GBFIs within an office building in an on-going basis. The research comprised four academic articles. The first article was a literature review looking at past research linking green buildings and productivity. This resulted in the proposal of the theoretical model. The second article was a scoping literature review that focused on the main methods that were applied in conducting research between green building and occupant productivity to provide support for the model. Papers three and four comprised empirical research that separately analysed individual productivity and organisational performance. The paper that qualitatively analysed individual productivity indicated that location and amenities, specifically those that focused on safety and reliable building services, positively contributed to individual productivity. The second empirical paper quantitively focused on organisational performance specifically focused on financial services companies (FSCs) and the average green return ratio (AGRRi) within the context green and non-green buildings and IEQ scores. Three funds (low, moderate and high risk) were analysed for each FSC to determine if there was a statistically significant relationship between annualised returns and IEQ, which was only apparent for the South African (SA) equity fund. It was established when comparing the sample of FSCs based in green certified buildings versus conventional (non-green) in terms of group average returns, that the FSCs based in green buildings outperformed the FSCs based in conventional buildings. The differences in annualised returns have been forecasted (compounded monthly and annually), which provides an indication that on average, clients investing in FSCs occupying green buildings will yield great overall wealth over the long-term (thirty years) than clients investing in FSCs located in conventional buildings. It was further established that there was a sweet spot for IEQ scores, which relate to annualised returns for FSCs located in green certified buildings. Based on the qualitative and quantitative findings there is potential for future research to expand the application of the theoretical model to other industries and real estate sectors. Furthermore, this research could be incorporated into environmental, social and governance (ESG) research studies, which could potentially provide justification at the executive level for further insight into unpacking the relationship between individual productivity and organisational performance arising from investing in the quality of the built infrastructure of the office.
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    Towards the development of a screening tool for Anorexia Nervosa in men
    (University of the Witwatersrand, Johannesburg, 2022) Reeves, Megan Moya; Prof. Sumaya Laher
    Anorexia Nervosa (AN) in men is still not wholly understood and is often misdiagnosed. The primary aim of this tri-phasal exploratory, mixed methods study was to propose content domains and items that may be used to inform the development of future quantitative tests to screen for AN in men. It has been reported that there is currently no quantitative instrument available, which has been specifically designed to measure anorexic symptomatology in men (Darcy et al., 2012; Murray et al., 2012). The quantitative content domains and test items developed in this study may be used in future self-report screening measures to help improve the accurate recognition of AN symptoms in men. These items will help to counter the effects of gender biases evident in current AN screening tools and biases held by clinicians and psychiatrists that are reported when screening for AN in men. These test items and content domains were developed in the third phase of this study and were derived from the findings of the first two phases. In phase one, a comprehensive thematic list of symptoms reportedly experienced by men diagnosed with AN was developed from an integrative literature review of peer-reviewed journal articles published between July 2000 to July 2013 on PsychINFO, SA ePublications, and Google Scholar. The data from phase one were supplemented by a thematic analysis of 14 interviews with South African clinical psychologists and psychiatrists, conducted under phase two, which deconstructed their beliefs regarding AN in men. Ultimately, the study’s three phases cumulatively showed how the symptoms reportedly experienced by men differed to those of women, deconstructed the beliefs held by a sample of South African clinical psychologists and psychiatrists, recommended a gender sensitive and identity based conceptualisation of AN that served to explicate theory, and finally proposed original test items that may be used in future research to develop a test to more validly and reliably screen for AN symptomatology in men.