South African Journal of Psychology

South Africa has one of the highest prevalence rates globally for fetal alcohol spectrum disorders. Despite this, few interventions are routinely available for countering the adverse effects of perinatal drinking. The current study used the ADAPT-ITT framework to guide the development of a behavioral intervention with remote alcohol use monitoring and provision of financial incentives contingent on alcohol abstinence for people who are pregnant and postpartum. The study aims to maximize the intervention’s relevance, acceptance, and effectiveness in reducing alcohol use during pregnancy and lactation, ultimately improving maternal and infant health outcomes in South Africa. Thirty-two in-depth interviews with people who were pregnant and 16 key-informant interviews with clinic and community members were conducted to help inform the intervention. The adapted intervention was pretested with 20 people who were pregnant or breastfeeding, and additional feedback was obtained from the community collaborative board. While there was widespread support for the intervention elements, some concerns were raised, including perceived high street value of a monitoring device, access to mobile phones to use such a device, frequency of monitoring, cheating when using a remote monitoring device, devices being lost or stolen, and the sustainability of long-term monitoring. The adapted intervention combines alcohol monitoring-based contingency management with text-based health promotion and information on where to access services tailored to maternal populations ready for testing in feasibility and efficacy trials.

We tested the role of sense of coherence, social support, satisfaction with life, and resilience, as resources in the association between fear of COVID-19, perceived vulnerability to disease, and depression. Data from 804 students were collected at three South African universities in 2022 and 2023 by means of an electronic survey and analysed using structural equation modelling. We found that higher levels of fear of COVID-19 and hopelessness were associated with depression among the sample. Satisfaction with life, sense of coherence, and perceived social support had significant negative relationships with depression, indicating that these represent potential protective resources. Perceived vulnerability to disease had a positive relationship with perceived social support. While fear of COVID-19 significantly impacted depression, it did not show a significant relationship with other mental well-being measures, such as satisfaction with life, sense of coherence, resilience, or social support. Hopelessness showed a strong negative correlation, not only with resilience but also with satisfaction with life, sense of coherence, and perceived social support, making it a critical factor in mental well-being. Perceived social support acted as a mediator between both hopelessness and perceived vulnerability to disease and depression. Satisfaction with life mediated the relationship between hopelessness and depression, and sense of coherence mediated the relationship between perceived vulnerability to disease and depression. While higher levels of fear related to COVID-19 and pervasive feelings of hopelessness were robust predictors of depressive symptoms, factors such as satisfaction with life, sense of coherence, and perceived social support emerged as protective resources.

Emerging adulthood is synonymous with high levels of stress and uncertainty, often resulting in anxiety and depression, which negatively impact mental health and well-being. Exploring the experiences of anxiety and depression symptomology in decisional situations enhances our understanding of their role in emerging adult mental health and well-being. This study examined whether decision-making styles predict anxiety and depression symptomology among emerging adults in South Africa. The cross-sectional study collected data using a secure, online platform. All data were analysed using R for descriptive and inferential statistics. Partial least squares structural equation modelling was performed using R seminr package. The sample consisted of 1411 emerging adults with a mean age of 21.81 years, who engaged in both adaptive and maladaptive decision-making. Among the participants, 74.2% were at risk of a clinical diagnosis for an anxiety disorder, and 37.3% for depression/mood disorder. Structural equation modelling indicated that adaptive decision-making led to a reduction in anxiety and depression symptomology, while maladaptive decision-making had the opposite effect. The findings highlight implications for emerging adult mental health, particularly how understanding the connections with decision-making can enhance intervention outcomes and improve mental health and mental health literacy among emerging adults in South Africa.

Youth in structurally violent environments emphasise hope when explaining their resilience. Even so, the multisystemic resources that enable hope (also over time) are relatively underreported for African young people. In response to this gap, we report a qualitative study that identified the hope-enabling resources that contributed to the resilience of two samples of African youth aged 15–24 and living in the township of eMbalenhle, South Africa. Using Draw-Write-Talk methodology, the 2017 sample (n = 30; M_age = 18.6; 56% male youth) and 2018 sample (n = 7; M_age = 18.4; 85% female youth) generated visual and narrative data of their experiences of hope enablers. A thematic analysis showed that a multisystemic mix of contextually relevant resources typically explained youth capacity for hope in the face of structural violence. Four resources informed this mix: personal strengths, faith-based beliefs, positive personal relationships, and tangible sources of inspiration. This contextually relevant mix, and its putative durability over time, has implications for how psychologists and policymakers support youth in structurally violent contexts to be hopefully resilient.

The transition from adolescence to young adulthood is a critical period in the development of an individual’s long-term health behaviour. Health literacy is a critical factor in promoting and maintaining health-enhancing behaviours and preventing non-communicable diseases. Undergraduate students often have limited health literacy, regardless of their educational experience. This quantitative study compared the health literacy of a sample of undergraduate students enrolled in degree programmes in the Faculty of Health Sciences with a similar sample from the Faculty of Humanities at a South African university. The Health Literacy Questionnaire was used to measure health literacy across nine subscales. The sample included 77 participants (n = 77). An independent samples t-test and Mann–Whitney U test were employed to compare the health literacy of students from the two faculties. The study found that students enrolled in the Faculty of Health Sciences generally demonstrated higher health literacy levels across several subscales compared to those from the Faculty of Humanities. This research contributes to understanding the disparities in health literacy among undergraduate students across distinct academic disciplines, underscoring the importance of implementing interventions to enhance health-related knowledge within specific academic domains.

This study focused on identifying adolescent learners’ social support profiles based on their self-reports regarding three sources of social support (parental, teacher, and close friend support) and associations of such profiles with their well-being. A biographical questionnaire, the Social Support Scale for Children, and the Mental Health Continuum – Short Form were administered to 770 Grades 10 and 11 learners from previously disadvantaged schools in South Africa. Five social support profiles were identified using latent profile analyses of parental, teacher, and close friend support: weakly supported, adult-supported, peer-supported, moderately supported, and integrated support. Social support profiles were associated with well-being. Flourishing, the most desirable well-being outcome, was associated with the integrated support profile (high parent, teacher, and close friend support). In contrast, the lowest level of well-being was observed in the weakly supported profile (low parent, teacher, and close friend support). The results confirmed that support from parents, teachers, and close friends was vital for adolescent learners’ well-being.

The category of registered counsellor was created to service the mental health care needs of the South African population at primary health care level. However, a lack of employment opportunities for registered counsellors within primary health care settings resulted in many opting to work within private practice. In this study, we explored barriers and facilitators to the delivery of mental health care by registered counsellors. We employed purposive and snowball sampling to recruit 15 participants, who were registered counsellors in private practice throughout South Africa, and registered with the Health Professions Council of South Africa. Semi-structured interviews were conducted online via Skype. The interviews were audio-recorded, transcribed, and analysed using thematic analysis. We used the Capability, Opportunity, Motivation model of behaviour and the Theoretical Domains Framework as conceptual frameworks in the study. We identified facilitators and barriers that registered counsellors experienced in their attempts to provide mental health care at a primary care level. We identified three themes and named them as follows: (1) registered counsellors feeling competent, capable, and motivated to engage in community work, (2) the registered counsellor as an unacknowledged mental health professional, and (3) limited alternatives to private practice. We regarded the first theme as a facilitator, and the other two as barriers to the provision of mental health care by registered counsellors in private practice. These findings suggest that registered counsellors felt motivated and capable of providing mental health care, but that structural barriers prevent them from doing so.

Masculinities are organised hierarchically, and how a man sees himself is often informed by his positioning within this hierarchy. The context within which men are located determines which factors or markers of masculinity become more salient at different times, and so do the social situations and spaces men are interacting within, and with whom they are interacting. Their socio-cultural, political, and economic positioning inform not only how they construct their gendered identities, but also where they are located within social hierarchies of masculinity. This article examines constructions of masculinities among economically marginalised men who seek work on the side of the road in Cape Town, South Africa. In-depth qualitative interviews were conducted with 10 Black African men and the findings suggest that economic provision remains a central feature in participants’ constructions of masculinity. Men’s experiences of precarious work not only impact how they see themselves but also their ability to establish and maintain romantic relationships which, as argued in this study, serve an important role in validating and affirming participants’ masculinity. This study shows that when some men are not able to provide, their romantic relationships fail, which adversely impacts their self-esteem. In response, some of the participants in this study turned towards alcohol abuse, and neglecting/abandoning their homes and families as a way to avoid the shame and humiliation they experience as ‘men who cannot provide’.

Optimal intergenerational relationships make important social contributions to age-inclusive communities and societies. Intergenerational relationships involve different cohorts of people across the life course. Existing theories look at intergenerational relationships from an intrapsychic experience, socio-cultural perspective, and/or in terms of outcomes, but do not adequately explain what occurs between interacting generational members to yield the experiences and outcomes. We identified Rogers’ person-centred approach (PCA) as a useful framework for creating optimal relationships and accordingly this article aims to identify the constructs of the PCA in the context in which Rogers developed them and we applied them to intergenerational relationships in sub-Saharan Africa. We conducted a scoping review and sampled Rogers’ original publications between January 1951 and December 1997 and obtained 1200 documents. After removing duplicates (n = 567) and applying exclusion criteria, 67 records were analysed thematically. The following PCA constructs emerged: congruence, warmth, empathy, unconditional positive regard, and locus of control, as well as two outcomes of the optimal manifestation of PCA constructs: confirmation and differentiation. We also present two PCA relational dynamics to explain optimal relationships: circularity and reciprocity. Interpreting intergenerational relationships through the lens of the PCA not only identifies the constructs of optimal relationships but also offers recommendations for transforming intergenerational relationships towards new levels of interpersonal cohesion.

Persistent power cuts, known as loadshedding, have become a disruptive fixture in South African daily life, affecting routines and economic stability. In this commentary, we argue that much attention has been given to the economic impact and political ramifications linked to loadshedding, but its psychological toll on the population has been largely overlooked. Access to electricity must be regarded as a basic human right as it is closely linked with the enjoyment of various rights like human dignity, proper housing, water, and healthcare. The lack of comprehensive research on the mental health impacts of loadshedding needs to be addressed more so against the background of the socio-psychological impact of COVID-19. Preliminary research findings indicate that ongoing loadshedding disrupts daily routines, potentially leading to safety concerns, stress, anxiety, mental strain, and isolation. The lack of safety, exacerbated by power cuts, increases vulnerability to crime and strains societal cohesion. Taken together, this may heighten the likelihood of the development of continuous traumatic stress (CTS). Despite the National Mental Health Policy framework acknowledging threats to mental health, loadshedding is omitted, highlighting a need for recognition of its impact. Acknowledging loadshedding’s silent impact is crucial, especially considering its exacerbation of safety concerns and vulnerability to CTS. A shift in perspective is needed, moving mental health from a luxury to a necessity. Psychologists are urged to advocate for mental health services and community-based solutions, emphasising collective responsibility in addressing the mental health crisis compounded by ongoing loadshedding.