4. Electronic Theses and Dissertations (ETDs) - Faculties submissions
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Item Family Change and Child Maintenance Effect on Men’s Mental Health Outcomes in South Africa(University of the Witwatersrand, Johannesburg, 2023-10) Muchemwa, Marifa; Odimegwu, CliffordBackground: Mental health problems are increasing among men in South Africa, yet they remain inadequately studied, particularly within the context of observed family change in the country. National studies have identified the changes taking place in the family system such as increasing rates of divorce, cohabiting, non-marital childbearing, living alone, and delays in family formation. This has resulted in most children growing up in single-parent families, giving rise to child maintenance issues. The changing family situations together with complexities surrounding child maintenance may be pertinent to men’s mental health outcomes, hence the need to examine the nexus. This is important considering that men’s mental health has not been examined in the context of family change and child maintenance in the country. A lack of investigation in this area raises the following question: Do family change and child maintenance complexities contribute to men’s mental health outcomes? Methodology: An explanatory sequential mixed method was conducted to examine family change and child maintenance effects on men’s mental health outcomes in South Africa. The two mental health outcomes which were examined are depressive symptoms and Psychiatric or psychological disorders. The quantitative part of the research used longitudinal secondary data from the National Income Dynamics Study (NIDS) Waves 1-5 (2008-2017) with a sample size of 30 381 men aged 18 and older. The family change examined included a man’s transition from another marital status to being married, living with a partner, divorced, and multiple changes. It also encompassed men who transitioned from living with others to living alone. To analyse the data, the multilevel mixed-effects logistic regression and the General Estimating Equations (GEE) models were used. In the qualitative research, 30 men residing in Johannesburg were recruited using purposive and snowballing sampling methods. The men were interviewed using semi-structured in-depth interviews. The data were analysed using thematic analysis. Key Findings: Quantitative findings indicate that men who changed to cohabiting had an increased likelihood of experiencing depressive symptoms compared to those who did not go through a family change. Men who changed to live alone had an increased likelihood of experiencing both mental health outcomes compared to men who remained living with others. Men who became married had a lower likelihood of experiencing depressive symptoms than men who did not go through any family change. The qualitative findings show that it is not only family change, but its consequences linked to child maintenance complexities that is more stressful affecting men’s mental well-being. The consequences include being denied access and custody of the children. Trying to adjust to living away from their children and being excluded from the children’s lives by their ex-partners left men distressed. Quantitative findings show that men who paid child maintenance were less likely to experience psychiatric or psychological disorders than men who were not paying. However, from the qualitative findings, men who were paying child maintenance complained of how their partners gave them limited access to the children and only sought money from them making it appear as if it is the only role they can do for their children. Yet they wanted to be part of their children’s lives. Some of the men cried as they explained how being excluded from the lives of their children affected their health. Conclusions: The findings indicate that changing to live alone is a risk factor for both mental health outcomes. Men who changed to live with a partner (cohabiting) had an increased risk of experiencing depressive symptoms. Those who transitioned to be married across the five waves had a reduced likelihood of experiencing depressive symptoms. Child maintenance complexities that men encounter also affect their mental health. The complexities include undermining the fatherhood role through the exclusion in decision-making, denial of access to the children, and child custody. Policy recommendations: The findings imply that the changing nature of the family in South Africa characterised by increasing cohabitation and living alone affects men’s mental health. Men living alone and cohabiting require mental health support. Counselling should be done simultaneously with interventions that help men who are denied access to their children. Community programs that address mental health needs of men undergoing family change should be done. Including educational campaigns that raise awareness about mental health implications of family change and the importance of seeking help. Child access denial should be addressed, existing laws should ensure that both parents have equal access to the children. Crying in men should be normalized through public awareness campaigns that challenge traditional notions of masculinity. Interventions to assist men experiencing challenges to have access to their children should be carried out simultaneously with counselling as the findings highlight that men live with the pain of being denied access and custody of their children. Frontiers for Further Research: The findings showed that men were weak and powerless on matters to do with child access and custody for their children from previous relationships. Studies should be conducted which explore how the hegemonic masculinities are affected in the context of child maintenance and investigate how men feel when they experience challenges as fathers documenting their experiences regarding the various health problems, they have developed. There is a need to study gender differences in the context of family change and mental health in South Africa considering an increase in mental health problems and the changing nature of the family. The study findings show that depressive symptoms are concentrated more among young men than the elderly. Further research can be done that focus on male adolescents’ mental health.Item Exploring the pandemic: COVID-19 lockdown response levels as predictor of working memory performance and associated emotional responses(University of the Witwatersrand, Johannesburg, 2023-11) Oyejide, Aderemi Oyewunmi; Brooks, Samantha; Besharati, SahbaThe unprecedented outbreak of the COVID-19 pandemic has altered the course of many lives, resulting in multiple health and social challenges. Due to the speed with which this andemic spread, various public health ‘lockdown’ measures were introduced to mitigate its spread. The outcome of adherence to these measures has revealed the possible influence on ndividuals varying cognitive abilities. Therefore, this study aimed at exploring the predicting relationship between lockdown responses to COVID-19 restrictions and working memory performance and associated emotional responses, while looking at the socio-demographic influences of age, gender, and level of education. Participants were drawn from a secondary dataset of an international online survey study of 1634 individuals between 18 – 75 years across 49 countries. Participants’ demographic questionnaires, working memory measures (free memory recall and digit span forward tasks), and hospital anxiety and depression scale were employed to collect data for analysis. A 4-way MANOVA and hierarchical multiple regression were utilised to explore the mean differences and predicting relationships between the study variables respectively. Significant differences were found in general memory performance, anxiety and depression scores across lockdown groups, but with no significant difference in working memory. The regression analysis indicated socio-demographic variables as non-predictive markers between lockdown responses and memory performance, while age and gender were significant predictors between lockdown responses and anxiety. The current study provides valuable information for interventions that may improve peoples’ psychological appraisals in preparation for any new potential waves or future pandemics.Item Conjoint tobacco and alcohol use, and depressive symptoms among hiv positive patients in Sedibeng District, Gauteng(2024) Akahilem, Kenneth E.Background: Psychosocial challenges among HIV positive patients may promote substance use disorders. In this study, we explored the relationship between conjoint tobacco and alcohol use and depression symptoms among HIV positive patients in Sedibeng district, South Africa. Methods: In a cross-sectional study of 404 participants, a questionnaire collected information on socio-demography, tobacco and alcohol use, and depression symptoms. Outcome measures included the prevalence of conjoint tobacco and alcohol use, and its association with depression. Results: The mean participant age was 43.2 years. Most completed secondary school 62.9% (253/402), were black 99.0% (400/404), female 65.8% (266/404), unemployed 53.6% (216/403) and on ART for >1 year 97.8% (393/402). Current tobacco use was reported by 23.3% (94/404) participants with most smoking cigarette (73.7%) and having low nicotine dependence (75.5%). Current alcohol use was reported by 43.6% (176/404) participants, and 36.9% were categorised as harmful users. Only 7.7% (31/404) participants screened positive for depression; most of these (83.3%) previously undiagnosed. The prevalence of conjoint tobacco and alcohol use was 19.6% (79/404) and this was not associated with depression (p=0.438). Harmful alcohol users were more than five times likely to report conjoint tobacco and alcohol use (p=0.000) but women were less likely to report it (p=0.000).Item Effect of boophone disticha on the behaviour and hippocampal neuroanatomy in a BALB/c mouse model(2024) Xhakaza, Nkosiphendule KhuthazelaniDepression is one of the most common neuropsychiatric disorders and is associated with dysfunction of the neuroendocrine system and alterations in specific brain proteins. Boophone disticha (BD) is an indigenous psychoactive bulb that belongs to the Amaryllidacae family, which is widely used in Southern Africa to treat depression, with scientific evidence of potent antidepressant-like effects. The present study examined the antidepressant effects of BD and its mechanisms of action by measuring some behavioural parameters in the elevated plus maze, light dark box, open field forced swimming, brain content of corticosterone, brain derived neurotropic factor (BDNF), and neuroblast differentiation in the hippocampus of Balb/c mice exposed to the five-day repeated forced swim stress (5dRFSS) and 28 days chronic restraint stress. Male Balb/c mice were subjected to the 5dRFSS and 28 days chronic restraint protocols to induce depressivelike behaviour (decreased swimming, increased floating, decreased open arm entry, decreased time spent in the open arms and decreased head dips in the elevated plus maze test, increased time in dark box in the light dark box test, reduced frequency of rearing and increased time on the sides of the open field in the open field test), and treated with distilled water, fluoxetine and BD. Three weeks Boophone disticha treatment (10mg/kg/p.o) significantly attenuated both the 5dRFSS and chronic restraint-induced behavioural abnormalities and the elevated brain tissue corticosterone levels observed in stressed mice. Additionally, 5dRFSS exposure significantly decreased the number of neuroblasts in the hippocampus and BDNF levels in the brain of Balb/c mice, while fluoxetine and BD treatment attenuated these changes. In the chronic restraint stressed mice, similar effects of BD treatment were observed after 21 days of treatment, however, the levels of corticosterone were not different in control and stressed animals, probably due to habituation to stress. In both 5dRFSS and chronic restraint stress, the antidepressant effects of BD were comparable to those of fluoxetine, but unlike fluoxetine, BD did not show any anxiogenic effects, suggesting better pharmacological functions. It is important to note that in chronic restraint stress mice, it appeared that animals seemed to have habituated to stressful conditions, demonstrated in part by brain tissue levels of corticosterone that were not elevated in stressed animals treated with distilled water. However, BDNF levels remained significantly low in stressed animals treated with distilled water, suggesting that the effect of chronic stress in this parameter were not reversed when animals habituated. In conclusion, our study shows that BD exerted antidepressant-like effects in both 5dRFSS and chronic restraint stress mice, mediated in part by normalizing brain corticosterone and BDNF levels. Due to some degree of habituation in chronic stress model, caution should be exercised when evaluation effects of treatment in different parameters to evaluate antistress effects of tested agents, particularly levels of corticosterone. Furthermore, the persistent low levels of BDNF suggest that habituation of animals to chronic stress is due to normalising levels of corticosterone but not BDNF. The above occurrence could suggest that recovery from chronic stress without antidepressant treatment could alleviate other behavioural symptoms but not cognitive impairment which is influenced in part by BDNF levels.