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This paper expands on the continuing understanding of the Ububele Baby Mat Project — a community-based parent–infant mental health intervention now offered at six primary healthcare clinics in Alexandra, Johannesburg. This paper describes the influence of cultural diversity and the complex layers of meaning-making involved in the Baby Mat intervention. Meaning-making is a collaborative process between the caregiver–infant dyad’s cultural beliefs and experiences, the Baby Mat couple’s relationship, knowledge and skills, and the additional minds of the multicultural supervision group. This paper aims to clarify these three layers of co-constructed meaning-making involved in the Baby Mat intervention. Three central themes are thus presented to discuss the impact of multi-cultural, multi-racial and multi-lingual therapeutic dyads on the process of the Baby Mat intervention. These core themes are the verbal and non-verbal meanings of presenting problems brought by caregiver–infant dyads; the value and obstacles involved within a cross-cultural baby mat couple; and the significance of a reflective group supervision space. Case extracts are used to illustrate these processes of multiple minds at play during a Baby Mat session. [ABSTRACT FROM PUBLISHER]

Mental health problems in childhood and adolescence pose a major threat to public health. Epidemiological studies in high, middle and low income countries indicate that approximately one in five children and adolescents suffer from a mental disorder. In many instances these persist into adulthood. In South Africa, HIV infection, substance use, and exposure to violence increase vulnerability to mental disorders. Child and adolescent mental health services play a key role in reducing the burden of mental disorders in childhood and later in adulthood. This paper focuses on service needs for children and adolescents in South Africa. It commences with a discussion of the prevalence of child and adolescent psychiatric disorders after which the legal and policy context of child and adolescent psychiatric services is described. A framework for child and adolescent mental health service provision is presented, following which steps for reducing the extent of unmet service need are considered. The paper concludes with a call to scale up child and adolescent mental health services in South Africa, based on the stark realities of unmet need and the constitutional rights of children and adolescents to appropriate mental health care. [ABSTRACT FROM PUBLISHER]

This paper takes the form of an account of the emergence of the field of psychoanalytically informed parent-infant/child psychotherapy in South Africa. It traces the origins and the development of the South African field by locating local practice within the international field. The influential links between international approaches and local practice and services are described. The historical account is based on a review of published parent-infant/child literature, including South African authored texts. Interviews with key local stakeholders and practitioners supplement the literature review. This paper endeavours to locate parent-infant/child psychotherapy more clearly on the map of mental health work in South Africa, and in so doing to promote the work as both a relevant and valuable intervention. [ABSTRACT FROM PUBLISHER]

This commentary will provide a general overview of the public health considerations of maternal mental illness, both from a global perspective as well as from the South African context. The paper will outline the consequences of maternal mental illness for mothers as well as their offspring, through the life stages from pregnancy until adulthood. The paper then describes the Perinatal Mental Health Project (PMHP), an intervention that addresses maternal mental health in Cape Town, South Africa. The evidence emerging from this example contributes to the case for integrating maternal mental health into the mainstream health environment. [ABSTRACT FROM AUTHOR]

The United Nations estimates that 79% of teenage girls trafficked globally every year are forced into involuntary prostitution. About 247 000 South African children work in exploitative conditions; about 40 000 South African female teenagers work as prostitutes. This paper investigates lifestyles and routine activities of teenagers at risk of being trafficked for involuntary prostitution. The key concepts involuntary prostitution, intergenerational sex and exploitative conditions are defined in relation to the lifestyles and routine activities of South African female teenagers. Human trafficking for involuntary prostitution is described, based on a literature review. Lifestyle exposure and routine activities theories help to explain the potential victimisation of these teenagers in human trafficking for involuntary prostitution. Actual lifestyle and routine activities of South African teenagers and risky behaviours (substance abuse, intergenerational sex and child prostitution) are discussed as factors that make teens vulnerable to such trafficking. This paper recommends that human trafficking prevention efforts (awareness programmes and information campaigns) be directed at places frequented by human traffickers and teenagers in the absence of a capable guardian to reduce victimisation, as traffickers analyse the lifestyles and routine activities of their targets. South Africa should also interrogate entrenched practices such as intergenerational sex. [ABSTRACT FROM AUTHOR]

Objective:This paper examines maternal knowledge regarding perinatal and infant mental health amongst mothers in Alexandra township, Johannesburg. The applicability and utility of these Western-derived concepts in a low socio-economic South African setting is examined. Method:A concurrent mixed methods approach was used. Descriptive statistical analysis was conducted on the responses of 255 mothers on a structured questionnaire, designed to elicit levels of knowledge about the relational needs and awareness of infants and the psychosocial needs of mothers, to determine trends in mothers’ knowledge. A thematic content analysis was also conducted on the responses to determine themes and understandings within the mothers’ responses. Results:Maternal knowledge in Alexandra regarding perinatal and infant mental health correlates with maternal education levels. Cultural, contextual and psychological factors appear to influence maternal understandings of infant sentience and maternal ambivalence. Conclusions:Further research is required to determine possible contributions of the denial of negative maternal affect post-birth to elevated levels of post-natal depression found amongst South African mothers parenting in adverse circumstances. There is a need for education regarding key messages from the neuroscience of development, to give these parents opportunities to raise their children in a way that supports healthy cognitive and emotional development. [ABSTRACT FROM PUBLISHER]

This paper examines the correlates of inconsistent condom use with most recent sexual partner among sexually experienced youth (N= 2 138) in South Africa. A cross-sectional population based survey with youth aged 18 to 24 years was conducted in 4 provinces (Eastern Cape, Gauteng, KwaZulu-Natal and Mpumalanga). More women than men (57.7% vs. 25.8%) reported inconsistent condom use with their most recent partner. Multivariate analysis indicated that for males, not having talked with a partner about condoms in the past 12 months, having 2 or more sexual partners in the past 12 months, having ever had a transactional sex partner and alcohol use before sex in the past 3 months were associated with inconsistent condom use with their most recent sexual partner. In females multivariate analysis showed that lack of self-efficacy, not having talked with a partner about condoms in the past 12 months, having ever had or been subjected to forced sex and hazardous or harmful alcohol use were found to be associated with inconsistent condom use with their most recent sexual partner in multivariate analysis. [ABSTRACT FROM PUBLISHER]

With the anticipated publication of the DSM-5 in May 2013, much reflection and work has been done on reviewing existing psychiatric nomenclature including, but not limited to the field of traumatic exposure. Traditionally, understanding of the psychiatric and psychological effects of trauma have been developed from studies with adults and then applied to trauma-exposed children with some modifications. While this is an important step to understanding the sequelae of trauma in children and adolescents, the adverse developmental effects of traumatic exposures on the rapidly evolving neurological, physical, social and psychological capacities of children calls for a developmentally sensitive framework for understanding, assessing and treating trauma-exposed children. The importance of early attachment relationships in infancy and childhood means that severely disrupted early caregiving relationships may have far-reaching and lifelong developmental consequences and can therefore be considered traumatic. Given the high rates of violence and trauma exposure of South African children and adolescents, the need for a developmentally based understanding of the effects of trauma on child and adolescent mental health becomes even more pronounced. In this paper, we draw on theoretical perspectives to provide a practical, clinically driven approach to the management of developmental trauma. [ABSTRACT FROM PUBLISHER]

BackgroundThe question of choice and individual decision making in groups where a strong ideology exists has been repeatedly studied and debated. The objective of this paper is to highlight the aspects of influence pertaining to initiation in the life world of the Xhosa boy. The amaXhosa are speakers of Bantu languages traditionally living in south-east South-Africa, and in the last two centuries throughout the southern and central-southern parts of the country. MethodTo substantiate the literature study, a survey in the form of a questionnaire was done to establish the attitudes of Xhosa people regarding traditional male initiation. To gather in-depth information from persons who had personal contact with initiates, interviews were conducted with two selected people in helping professions. DiscussionThe author argues that the traditional custom of male initiation among the amaXhosa rests on an ideology that tolerates no dissent or critique and that deprives individuals of their decision-making power. It is further argued that the implication of not undergoing the ritual is so severe for Xhosa boys that the choice they are thought to have may not be a choice in practice. ConclusionsQuestions were raised regarding the role of children and women in general in a patriarchal society. As an example of culture and religion as influencing factors in a group's reality, Xhosa male initiation was discussed. These arguments call for the raising of questions and identifying themes and discourse in the area of children's right to choice. ResultsThe results indicate that, regardless of physical and psychological implications, the custom in its traditional form is still preferred by most respondents. [ABSTRACT FROM PUBLISHER]

Purpose:There is little research on prevalence of depressive symptoms and associated factors among youth in sub-Saharan Africa. This paper explores factors associated with depressive symptomatology in South Africa. Methods:A cross-sectional analysis of interviews with 1 415 women and 1 368 men aged 15–26 was undertaken. The Centre for Epidemiological Studies on Depression Scale (CESD Scale) was used to establish depressive symptomatology. Results:The prevalence of depressive symptoms was 20.5% in women and 13.5% in men. For women, depressive symptoms were associated with increased childhood adversity (aOR 1.34 95% CI 1.116, 1.55); drug use (aOR 1.98 CI 1.17, 3.35); experience of intimate partner violence (aOR 2.21 CI 1.16, 3.00); sexual violence before the age of 18 years (aOR 1.45 CI 1.02, 2.02) and lower perceptions of community cohesion (aOR 1.23 CI 1.07, 1.40). For men, depressive symptoms were associated with a mother's death (aOR 2.24 CI 1.25, 4.00); childhood adversity (aOR 1.61 CI 1.38, 1.88); alcohol abuse (aOR 1.63 CI 1.13, 2.35), sexual coercion by a woman (aOR 2.36 CI 1.47, 3.80) and relationship conflict (aOR 1.07 CI 1.01, 1.12). Conclusions:Depressive symptoms were more highly prevalent in women than in men. Depressed mood was associated with childhood adversity, sexual violence and substance misuse in both women and men. This study further suggests gender differences in that for women, depressive symptoms were associated with intimate partner violence and lower perceptions of community cohesion, while for men the associations were with a mother's death and relationship conflict. [ABSTRACT FROM PUBLISHER]

This paper describes the development and preliminary validation of the Developmental Trauma Inventory (DTI), which is a 36-item, retrospective, self-administered screen for interpersonal childhood trauma experiences developed specifically for the South African context. Preliminary validation of the inventory was conducted using a sample of 720 school-going adolescents attending a high school in the Durban Metropolitan area (South Africa). Factor analysis produced the best fit for a 10-factor model (emotional abuse, community assault, domestic assault, poverty, witnessing community violence, witnessing domestic violence, indecent assault, domestic neglect, rape, and domestic injury). Contrary to expectations, items relating to loss and separation (e.g. death of a parent) did not produce a clear factor structure. Identified scales had good internal consistency (0.70 to 0.81), low factor inter-correlations, and high concurrent criterion-related validity in the sense that all scales were significantly correlated with scores on clinical measures of post-traumatic stress disorder (PTSD) and/or complex PTSD. These findings provide preliminary support for the utility of DTI in the South African context. [ABSTRACT FROM PUBLISHER]

Objective: The interaction between teachers, classroom strategies and learners experiencing emotional and behavioural barriers to learning and development in a system of inclusive education results in multiple dynamics on different levels. Many teachers in mainstream education lack training to deal with learners experiencing emotional and behavioural barriers. Resistance towards inclusive education is therefore evident. This paper describes the process of developing an in-service training programme for teachers who deal with learners with emotional and behavioural barriers in their classrooms. Method: A process of action research was used to allow the researcher, in collaboration with 47 teachers from 2 primary schools, to develop a training programme to address the specific needs of teachers in dealing with learners experiencing emotional and behavioural barriers in their classes. Qualitative feedback from teachers and observations by the researcher and external observers were used to evaluate the appropriateness of the training. Findings: Teachers experienced that appropriate classroom management strategies made a significant difference in the behaviour of learners experiencing emotional and behavioural barriers. The training affected teachers’ attitudes, teacher–learner interaction, learner behaviour and school organisation. Conclusion: In-service training for teachers can affect the effective implementation of inclusive education. This programme can be adapted to address the needs of teachers in other areas. [ABSTRACT FROM PUBLISHER]

Objective: In this paper, the author explores how adolescent boys negotiate multiple voices of masculinity in Alexandra Township, a historically working-class and black community in Gauteng, South Africa. Method: Thirty adolescent boys were recruited and provided with disposable cameras to take 27 photos under the theme 'my life as a boy' in the new South Africa. Arrangements were made for photos to be collected and processed. In the follow-up interviews, boys were asked to give a description of each photo and why and how they had decided to take that photo to represent aspects of their masculinity. Results Some of the photos taken depict books, cars, boys smoking, gambling, fighting and reading books at school. Conclusion: This study reveals that being a boy is not a homogeneous phenomenon. All the participants agreed that there are different ways of being a boy and that some boys are more popular than others, which often depends on the context in which the boys find themselves. The interviews revealed recurring allusions to different 'types' of boys at schools in Alexandra Township - namely, tsotsi boys and academic boys. However, it is important to note that boys do not fit neatly into each of these categories. The findings of the study reveal some interesting complexities on how adolescent boys simultaneously accept and reject certain practices of township masculinity in their daily lives, depending on the time and space in which they find themselves. Some positions are more dominant than others and this reveals how adolescent boys 'police' each other as part of a process of conforming to idealised norms of township masculinity as lived out in the township context of Alexandra. [ABSTRACT FROM AUTHOR]

Objectives: Over the last few years, researchers have made a significant effort to address the need for more reliable and valid assessment measures for South Africa. The objective of this study was to acquire empirical data regarding the use and application of the Griffiths Mental Development Scales with Black South African infants. Methods: Specifically, the study aimed to make a preliminary cross-cultural comparison of the performance of Black South African infants and the British normative sample of the Griffiths Scales (Huntley 1996). The South African sample consisted of 40 infants aged between 13 and 16 months, with approximately equal numbers of boys and girls. Results: The finding was that the South African sample performed significantly better than the British norm group on the Eye-Hand Co-ordination Scale (Scale D) and the Performance Scale (Scale E), while the norm group scored significantly higher on the Personal-Social Scale (Scale B). Conclusion: The implications of these results are discussed in the paper. [ABSTRACT FROM AUTHOR]

This paper presents a review of theoretical and empirical research on risk factors for: 1) the development of violent and other antisocial behaviour; 2) international interventions targeting antisocial, including violent youths; and 3) outcome evaluations and meta-analyses of interventions targeting antisocial, including violent youths. Taken together, the international literature indicates that interventions which effectively reduce violent and other antisocial behaviours are informed by a number of generic principles which should guide the development and implementation of South African violence-prevention programmes. Common characteristics of interventions which effectively reduce youth violence are presented, with the aim of informing the design and delivery of local interventions. In light of the alarmingly high levels of violence in South Africa, there is an urgent need to develop intensive, multi-modal, evidence-based, structured, cognitive-behavioural programmes for violent adolescents and young adults. Furthermore, it is imperative that efforts are directed at developing a reliable local evidence base of 'what works' for young offenders generally, and violent young offenders specifically. [ABSTRACT FROM AUTHOR]