Factores de riesgo y protectores en la salud mental de adolascentes con VIH en Namibia

Tesis inédita de la Universidad Complutense de Madrid, Facultad de Psicología, Departamento de Personalidad, Evaluación y Tratamiento Psicológico I (Personalidad, Evaluación y Psicología Clínica), leída el 18-01-2016"Introducción": A pesar de que el 90% de los adolescentes con VIH en el mundo viven en África subsahariana, pocos estudios han examinado el impacto que tiene el hecho de estar infectados por VIH sobre su salud mental en este región. Además, los adolescentes con VIH en contextos de escasos recursos se enfrentan con factores de riesgo adicionales, como la pobreza, la falta de apoyo social y el estigma relacionado con el VIH. Este estudio examina la salud mental de los adolescentes que viven con el VIH en Namibia, un país con una de las prevalencias de VIH más altas del mundo. El estudio examina si estos adolescentes muestran mayores problemas de salud mental respecto a un grupo de comparación de la comunidad. Asimismo, el estudio evalúa los factores que predicen problemas de salud mental con el fin de identificar las potenciales áreas de intervención que permitan mejorar dichos problemas. Métodos: En una fase piloto, se organizan grupos de discusión con 34 adolescentes y entrevistas con ocho informantes clave para explorar las percepciones locales sobre los problemas de salud mental, así como sus factores de riesgo y factores de proteccion. Dado que las propiedades psicométricas del instrumento seleccionado para medir salud mental, el cuestionario Strengths and Difficulties Questionnaire/ Cuestionario de Capacidades y Dificultades (SDQ), nunca habían sido exploradas antes en Namibia, se decidió administrarlo a 236 participantes con edades comprendidas entre 12 y 18 años en una fase piloto cuantitativa..."Background": Despite the fact that 90% of the world‘s HIV-positive adolescents live in sub- Saharan Africa, little research in this region has examined the impact of HIV status on their mental health. Furthermore, HIV-positive adolescents in resource poor contexts face additional risk factors, such as poverty, poor social support and HIV-related stigma. This study examines the mental health of adolescents living with HIV in Namibia, a country with one of the highest HIV prevalence in the world. The study examines whether these adolescents show increased mental health problems when compared to a community comparison group and assesses which factors predict negative mental health outcomes in order to identify potential areas of intervention for improving mental health. Methods: Group discussions with 34 adolescents and interviews with eight key informants explored local perceptions of mental health problems as well as risk and protective factors for mental health problems in a pilot phase. As the psychometric properties of the mental health instrument, the Strengths and Difficulties Questionnaire (SDQ), had never been explored in Namibia, it was administered to 236 participants between the ages of 12 and 18 prior to administration to the study sample. For the main study, 99 fully disclosed HIV-positive adolescents between the ages of 12 and 18 were interviewed at a State Hospital in Windhoek between July 2013 and March 2014, using a standardised questionnaire and compared to a randomly selected matched community comparison group (n=159). Interviews assessed emotional and behavioural symptoms of distress, using the SDQ, and risk factors including poverty, social support, orphan status and HIV-related stigma. Data were analysed with t-tests, chi-squares, ANOVAs and regression analysis...Depto. de Personalidad, Evaluación y Psicología ClínicaFac. de PsicologíaTRUEunpu

The application of psychological expertise in post-apartheid South Africa : a tracer study of masters graduates from the University of KwaZulu-Natal.

Thesis (M.Soc.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2006.Nikolas Rose, heavily influenced by Foucault's concept of "governmentality", has proposed that psychological expertise has come to play an important role in governing conduct in liberal democracies. This study was an empirical attempt to explore these theoretical arguments in South Africa, a developing democracy. Recent debates on the practice of psychology in South Africa, occurring amidst socio/political initiatives of reconstruction and development, have focused on the relevance of the discipline given its involvement in the apartheid context. The current study reflected on some of the changes in application that have resulted from calls for relevance. The participants of the study were Masters Graduates from the University ofKwaZulu-Natal, previously University of Natal and University of Durban-Westville, in the period from 19932003. Influenced by Rose's theoretical ideas advocating a history of problematizations, the data collection focussed on understanding the practical problems psychologists deal with in their work contexts and the practices used to solve these problems. Results suggest a growing application towards socially relevant problems, which include socio/economic and public health issues. Furthermore psychological expertise predominantly intervenes with individualized technologies of the self, encouraging "self-government". The governmentality framework exposes some limitations of the application of psychology in the developing world context

Factors affecting resilience in Namibian children exposed to parental divorce: a Q-Methodology study

IntroductionDivorce is a contributor to family instability within sub-Saharan Africa, and specifically within Namibia, an increasing number of children are exposed to its impact. However, not all children react uniformly to the impact of parental divorce, and many children may be resilient. Understanding what promotes resilience in children post-divorce in African contexts is vital, given the unique socio-cultural context. Therefore, this study aimed to understand how some children are capable of resilience despite exposure to parental divorce in Namibia.MethodsA multiple case study design was employed to assess the lived experiences of children aged 9–12 post-parental divorce in Windhoek. Using the Child and Youth Resilience Measurement (CYRM-12) scale, 24 children exposed to parental divorce were screened for resiliency. The Q-Methodology, with visual material, was utilized with a sub-sample of 12 children who scored high on the CYRM (50% girls, mean age = 11) to eliminate some of the challenges associated with gathering qualitative data from younger children. The PQ Method 2.35 software program was used for data analysis.ResultsBy-person factor analysis identified four statistically significant profiles. A third (33%) of participants loaded on a factor emphasizing “quality parent-child relationships” and a further 33% emphasizing “effective parent conflict resolution.” The final two factors emphasized “healthy school attachment” (17%) and “strong community attachment” (17%). All children emphasized a stable, loving familial environment, and frequent visitation with the non-custodial father.DiscussionOur findings suggest that multiple social ecologies nurture resilience in children exposed to parental divorce in Namibia. Support should be extended beyond the perimeters of the nuclear family, and relationships with extended family members, peer groups, school, and the wider community can play an important role in children's adjustment. The study highlights the importance of contextually grounded resilience as some factors that are emphasized for children from more Western communities do not reflect as strongly in the results of this study. Other factors, including a stronger reliance on community and factors such as the school, peers, and extended family members, may play a bigger role in child resilience post-divorce in Namibia