A counselling line for problem and pathological gambling in South Africa: Preliminary data analysis

Abstract Objective Various countries and states have established telephone counselling lines for people with pathological or problem gambling. Data from such services may contribute to describing systematically the nature of gambling problems in a particular area. To date, however, few data have been published on such a telephone counselling line in a low or middle income country. Method Data on calls to the telephone counselling line of the National Responsible Gambling Foundation of South Africa were captured over a 6-month period. Such data include socio-demographic variables, the primary reason for calling, the source of the referral, preferred method of gambling, impairment as a consequence of gambling, and history of treatment for psychiatric disorders, comorbid alcohol abuse and illicit drug use. Results Calls were received from a broad range of people; the mean age of callers was 37 years, the majority were male (62%) and many were married (45%). Primary reasons for calling included the feeling of being unable to stop gambling without the help of a professional (41%), financial concerns (32%), legal problems (13%), pressure from family (10%), and suicidal thoughts (2%). The majority of callers contacted the counselling line after having heard about it by word of mouth (70%). The most common forms of gambling were slot machines (51%) and casino games (21%). Fourteen percent of callers reported having received help for other psychiatric disorders, 11% reported alcohol use disorders and 6% illicit drug use. Conclusion These data from South Africa are consistent with prior research indicating that pathological and problem gambling are seen in a range of socio-demographic groups, and that such behaviour is associated with significant morbidity and comorbidity. More work is needed locally to inform younger gamblers, gamblers using the informal gambling sector, and unemployed gamblers of the existing telephone counselling lines

Predictors of consent to cell line creation and immortalisation in a South African schizophrenia genomics study

Background Cell line immortalisation is a growing component of African genomics research and biobanking. However, little is known about the factors influencing consent to cell line creation and immortalisation in African research settings. We contribute to addressing this gap by exploring three questions in a sample of Xhosa participants recruited for a South African psychiatric genomics study: First, what proportion of participants consented to cell line storage? Second, what were predictors of this consent? Third, what questions were raised by participants during this consent process? Methods 760 Xhose people with schizophrenia and 760 controls were matched to sex, age, level of education and recruitment region. We used descriptive statistics to determine the proportion of participants who consented to cell line creation and immortalization. Logistic regression methods were used to examine the predictors of consent. Reflections from study recruiters were elicited and discussed to identify key questions raised by participants about consent. Results Approximately 40% of participants consented to cell line storage. The recruiter who sought consent was a strong predictor of participant’s consent. Participants recruited from the South African Eastern Cape (as opposed to the Western Cape), and older participants (aged between 40 and 59 years), were more likely to consent; both these groups were more likely to hold traditional Xhosa values. Neither illness (schizophrenia vs control) nor education (primary vs secondary school) were significant predictors of consent. Key questions raised by participants included two broad themes: clarification of what cell immortalisation means, and issues around individual and community benefit. Conclusions These findings provide guidance on the proportion of participants likely to consent to cell line immortalisation in genomics research in Africa, and reinforce the important and influential role that study recruiters play during seeking of this consent. Our results reinforce the cultural and contextual factors underpinning consent choices, particularly around sharing and reciprocity. Finally, these results provide support for the growing literature challenging the stigmatizing perception that people with severe mental illness are overly vulnerable as a target group for heath research and specifically genomics studies

Adaptation and validation of a computerized neurocognitive battery in the Xhosa of South Africa

Objective: Large-scale studies have revolutionized biomedical research, and neurocognitive tests can help elucidate the biological basis of neuropsychiatric diseases. However, studies have predominantly been conducted in Western settings. We describe the development and validation of a computerized battery (PennCNB) with the Xhosa population of South Africa. Method: Individuals with schizophrenia (n = 525) and a normative comparison group (n = 744) were balanced on age, sex, education, and region. Participants provided blood samples, were assessed psychiatrically, and were administered a PennCNB translation to isiXhosa, including measures of executive functions, episodic memory, complex cognition, social cognition, and sensorimotor speed. Feasibility was examined with test completion rates and input from administrators, and psychometric structural validity and associations with clinical and demographic characteristics were examined. Results: Tests were well tolerated by participants, as >87% had one (or fewer) test missing. Results suggested a similar factor structure to prior PennCNB studies in Western contexts, and expected age and sex effects were apparent. Furthermore, a similar profile of schizophrenia was observed, with neurocognitive deficits most pronounced for executive functions, especially attention, as well as memory, social cognition, and motor speed relative to complex cognition and sensorimotor speed. Conclusions: Results support the feasibility of implementing a culturally adapted computerized neurocognitive battery in sub-Saharan African settings and provide evidence supporting the concurrent validity of the translated instrument. Thus, the PennCNB is implementable on a large scale in non-Western contexts, shows expected factor structure, and can detect cognitive deficits associated with neuropsychiatric disorders. Obtaining valid measures of cognition by nonspecialized proctors is especially suitable in resource-limited settings, where traditional testing is prohibitive. Future work should establish normative standards, test–retest reliability, and sensitivity to treatment

Psychological Distress Among Ethnically Diverse Participants From Eastern and Southern Africa

IMPORTANCE: Psychological distress is characterized by anxiety and depressive symptoms. Although prior research has investigated the occurrence and factors associated with psychological distress in low- and middle-income countries, including those in Africa, these studies' findings are not very generalizable and have focused on different kinds of population groups. OBJECTIVE: To investigate the prevalence and characteristics (sociodemographic, psychosocial, and clinical) associated with psychological distress among African participants. DESIGN, SETTING, AND PARTICIPANTS: This case-control study analyzed data of participants in the Neuropsychiatric Genetics in African Populations-Psychosis (NeuroGAP-Psychosis) study, which recruited from general outpatient clinics in Eastern (Uganda, Kenya, and Ethiopia) and Southern (South Africa) Africa. Individuals who participated in the control group of NeuroGAP-Psychosis from 2018 to 2023 were analyzed as part of this study. Data were analyzed from May 2023 to January 2024. MAIN OUTCOMES AND MEASURES: The prevalence of psychological distress was determined using the Kessler Psychological Distress Scale (K10), which measures distress on a scale of 10 to 50, with higher scores indicating more distress. Participants from the NeuroGAP-Psychosis study were categorized into cases as mild (score of 20-24), moderate (score of 25-29), and severe (score of 30-50), and participants with scores less than 20 were considered controls. Factors that were associated with psychological distress were examined using binomial logistic regression. RESULTS: From the data on 21 308 participants, the mean (SD) age was 36.5 (11.8) years, and 12 096 participants (56.8%) were male. The majority of the participants were married or cohabiting (10 279 participants [48.2%]), most had attained secondary education as their highest form of learning (9133 participants [42.9%]), and most lived with their families (17 231 participants [80.9%]). The prevalence of mild, moderate, and severe psychological distress was 4.2% (869 participants), 1.5% (308 participants), and 0.8% (170 participants), respectively. There were 19 961 participants (93.7%) who served as controls. Binomial logistic regression analyses indicated that the independent associations of psychological distress were experience of traumatic events, substance use (alcohol, tobacco, or cannabis), the physical comorbidity of arthritis, chronic neck or back pain, and frequent or severe headaches. CONCLUSIONS AND RELEVANCE: In this case-control study among ethnically diverse African participants, psychological distress was associated with traumatic stress, substance use, and physical symptoms. These findings were observed to be consistent with previous research that emphasizes the importance of traumatic events as a factor associated with risk for psychopathology and notes the frequent co-occurrence of conditions such as physical symptoms, depression, and anxiety

The intention of South Africans to engage in collaborative consumption : the case of Uber

ORIENTATION : The idea of collaborative consumption is developing among consumers, where under-utilised or excess resources, skills and money are shared among peers for compensation. Collaborative consumption involves sharing, and as such, Uber, an app-based transport service enables those with spare vehicle capacity to provide a fee-based transport solution. RESEARCH PURPOSE : This study investigates the intention to use this service in a South African context, specifically through the Technology Acceptance Model (TAM) and Theory of Planned Behaviour (TPB) because of the suitability of these models in this context. Differences between regular and seldom users are also examined. MOTIVATION FOR THE STUDY : With the widespread use of Uber in South Africa, understanding the factors contributing to the intention to use Uber requires examination. RESEARCH DESIGN, APPROACH AND METHOD : Data were collected using a quantitative survey among panel respondents of South Africans, using electronic data collection. The research instrument comprised pre-existing items measured on a 6-point Likert scale. A total of 367 usable responses were received. Data analysis included testing for differences in means (t-test, Satterthwaite-Welch t-test, Anova F-test, Welch F-test) as well as regression analysis (by means of multiple regressions and two-stage least squares). MAIN FINDINGS : The findings indicate that South Africans intend to use the service largely due to their positive attitude towards the service, the perceived usefulness (PU) of the app and perceived behavioural (PB) control associated with the service. The value of the app has been highlighted in this research, and the importance of its functioning is evident. PRACTICAL/MANAGERIAL IMPLICATIONS : The importance of providing a positive service experience impacts the intention to use the service in the future. This emphasises the importance of the service itself and the functioning of the app. CONTRIBUTION/VALUE-ADD : Understanding the intention to use this service enables further development of this app and associated services.http://www.actacommercii.co.zaam2022Gordon Institute of Business Science (GIBS

The relationship between cardiovascular risk factors and knowledge of cardiovascular disease in African men in the North-West Province

Background: South Africa has an established high prevalence of cardiovascular disease (CVD), particularly amongst urban African communities. However, it was unknown whether African men's CVD knowledge was associated with their CV health profiles. Objective: To investigate the possible relationships between CV risk factors and CVD knowledge in a group of African men. Method: Questionnaires were completed by 118 African men from the North-West Province, South Africa, and health screening, including anthropometry, blood pressure, fasting blood sugar and cholesterol measurements, were done. Results: The mean CVD knowledge score was 75%. Participants' mean BP was 146/92 mmHg, falling within hypertensive ranges. Their mean fasting blood glucose of 5.8 ± 2.0 mmol/L exceeded the normal cut-off value of 5.6 mmol/L. There was a lack of association between CV risk factors and CVD knowledge, except for a borderline significant association between triglycerides and CVD knowledge (r = 0.167; p = 0.071), implying that men with higher CVD knowledge had higher levels of triglycerides. Conclusion: Despite African men's high CV risk and a relatively good understanding of CVD risk factors, there was no significant correlation between their CV risk factors and CVD knowledge

Mid-morning Break and Poster Sessions: Clinical Profile and Psychiatric Co-Morbidity of Treatment-Seeking Individuals With Pathological Gambling

Background: Pathological gambling is a prevalent and disabling mental illness, which is frequently associated with mood, anxiety, and substance use disorders. However, there is relatively little data on comorbidity in pathological gambling from low and middle income countries such as South Africa