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Research Interests: Psychology, Cognitive Science, Treatment Outcome, Medicine, Humans, and 15 morePlacebo, Posttraumatic stress disorder, Chronic Disease, Female, Male, Benzodiazepines, Follow-up studies, Middle Aged, Olanzapine, Adult, Analysis of Variance, Randomized Controlled Trial, Weight Gain, Antipsychotic agents, and Pharmacology and pharmaceutical sciences
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Bibliography: leaves 87-101.The present study compares the use of standardised diagnostic clinical interviews, self-report scales, and unstructured interviews, to determine if these different methods of assessment elicit the same or... more
Bibliography: leaves 87-101.The present study compares the use of standardised diagnostic clinical interviews, self-report scales, and unstructured interviews, to determine if these different methods of assessment elicit the same or similar information with regards to trauma exposure, post-traumatic stress disorder, and depression in adolescents. A sample of Grade ll learners was drawn from two schools in the Northern Suburbs of Cape T own. The total sample comprised of 58 learners between the ages of 16 and 18 years. Each participant was administered a demographic questionnaire, a clinical diagnostic interview, two self-report scales, and an unstructured interview. The diagnostic interview used was the Schedule for Affective Disorders and Schizophrenia for School-Aged Children - Present and Lifetime version (K-SADS-PL), and the self- report scales used were the Child and Adolescent Trauma Survey (CATS) and the Children's Depression Inventory (CD1). The demographic questionnaire and qualitative interview were devised for the study. The McNemar Chi-Square statistic was used to determine differences between the interview and self-report methods of assessment, and a content analysis of the qualitative interview was conducted. Additionally, a Receiver Operating Characteristic analysis was used to establish a CATS score, indicating a high risk of PTSD, that was more sensitive to the sample. The results indicate that even though clinical interviews and self-report scales appear to produce different information, if appropriate cut-off points are used, self-report scales can be used as a screening device to reduce the number of clinical interviews required, thus contributing to a more efficient use of resources. They also indicate that unstructured qualitative interviews can elicit useful information about post- traumatic responses that is not captured by the DSM IV criteria
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Glucocorticoids and inflammatory markers can influence cognitive function. Hair cortisol concentrations (HCC) reflect longer-term hypothalamic pituitary adrenal (HPA) axis function and combined with immune markers can provide insights... more
Glucocorticoids and inflammatory markers can influence cognitive function. Hair cortisol concentrations (HCC) reflect longer-term hypothalamic pituitary adrenal (HPA) axis function and combined with immune markers can provide insights into how HPA-axis and immune pathways interact to influence cognition. We examined the association between HCC and high sensitivity c-reactive protein (hsCRP) levels, as well as the interaction between HCC and hsCRP, and cognitive function in a sample of 153 females, aged between 18 and 79 years, from a cross-sectional case-control study (SHARED ROOTS), conducted in Cape Town, South Africa from May 2014 until June 2017. We examined whether HCC and hsCRP levels were associated with performance on neurocognitive tests in both unadjusted and adjusted linear regression models. HCC demonstrated a significant inverse association with verbal working memory in both unadjusted (p = 0.010) and adjusted (p = 0.016) analyses. There were significant interactions between HCC and hsCRP on verbal intelligence (p = 0.016), language (p = 0.023) and executive function (p = 0.008) scores, such that at low HCC hsCRP levels were positively associated with language (p = 0.020) and executive function (p = 0.006) scores and at high HCC hsCRP levels were inversely associated with verbal intelligence (p = 0.034) scores. Though the results did not survive correction for multiple comparisons, they suggest stress-related neuroendocrine effects on working memory impairment. Furthermore, under physiological conditions and low long-term HCC, there may be positive effects of peripheral inflammatory markers on cognitive performance, whereas there may be detrimental effects when the HPA-axis is dysregulated as reflected by high long-term cortisol output.
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Research Interests: Cognitive Science, Medicine, Comorbidity, Humans, Chronic Disease, and 15 moreFemale, Male, Checklist, Mental Disorders, Health Status, Clinical Sciences, Prevalence, Middle Aged, Adult, Health surveys, Prevalence of Mental Disorders, Cost of Illness, Disabled Persons, Psychiatric Status Rating Scales, and Disability Evaluation
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Research Interests: Psychology, Depression, Medicine, Anxiety, Humans, and 15 morePlacebo, Posttraumatic stress disorder, Female, Male, Acute Stress Disorder, Randomised Controlled Trial, Clinical Sciences, Adult, Analysis of Variance, Randomized Controlled Trial, ANXIETY, Citalopram, Pilot Projects, Escitalopram, and Psychiatric Status Rating Scales
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Research Interests: Psychology, Clinical Psychology, Psychiatry, Psychopathology, Adolescent, and 15 moreMedicine, South Africa, Humans, Female, Male, Depressive Disorder, Clinical Sciences, Aged, Middle Aged, Questionnaires, Adult, Hiv seropositivity, Life Change Events, Socioeconomic Factors, and Neuropsychological Tests
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The DSM-IV diagnosis of acute stress disorder (ASD) describes a posttraumatic reaction that occurs two to twenty-eight days following a trauma and involves symptoms of intrusion, avoidance, hyper-arousal and dissociation. A better... more
The DSM-IV diagnosis of acute stress disorder (ASD) describes a posttraumatic reaction that occurs two to twenty-eight days following a trauma and involves symptoms of intrusion, avoidance, hyper-arousal and dissociation. A better understanding of ASD and its pathogenesis could lead to improved post-trauma health care interventions. The aim of this study was to determine prospectively whether a combination of clinical, cognitive and demographic variables were predictive of ASD severity in an acutely traumatized sample. We assessed demographic (e.g. age, gender, education), clinical (e.g. sleep quality, trait anxiety, previous psychiatric diagnoses), and cognitive (e.g. negative cognitions following trauma) variables in a sample of 125 adult motor vehicle accident survivors (age: 32.26±9.99; gender: 56.6% male) approximately 10 days after the accident. Univariate analyes and stepwise linear regression were performed to identify variables predictive of ASD severity. Although a number of factors were individually associated with ASD severity, in a regression model only 3 factors, trait anxiety, suicide risk and post-traumatic cognitions, emerged as predictive of the severity of the disorder. The cross-sectional nature of the study and use of self-report measures are important to bear in mind. Higher levels of trait anxiety, risk for suicide and negative appraisals of the traumatic event were predictive of ASD severity. As these factors may help to identify those who may be at risk of more severe responses after a traumatic event, and who may benefit from secondary prevention strategies, they should be assessed for in acute trauma survivors.
Research Interests: Psychology, Clinical Psychology, Cognition, Suicide, Medicine, and 15 moreAnxiety, Humans, Affective Disorders, Female, Male, Acute Stress Disorder, Middle Aged, Longitudinal Studies, Adult, ANXIETY, Self report, Cross Sectional Studies, Psychology and Cognitive Sciences, Medical and Health Sciences, and Accidents Traffic
Please help populate SUNScholar with the full text of SU research output. Also - should you need this item urgently, please send us the details and we will try to get hold of the full text as quick possible. E-mail to scholar@sun.ac.za.... more
Please help populate SUNScholar with the full text of SU research output. Also - should you need this item urgently, please send us the details and we will try to get hold of the full text as quick possible. E-mail to scholar@sun.ac.za. Thank you.Geneeskunde en GesondheidswetenskappePsigiatri
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Please help us populate SUNScholar with the post print version of this article. It can be e-mailed to: scholar@sun.ac.zaGesondheidswetenskappePsigiatri
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Geneeskunde en GesondheidswetenskappePsigiatriePlease help us populate SUNScholar with the post print version of this article. It can be e-mailed to: scholar@sun.ac.z
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Research Interests: Clinical Psychology, Neuropsychology, Psychiatry, Medicine, Anxiety, and 15 moreNeurocognitive, Prospective studies, Humans, Posttraumatic stress disorder, Female, Male, Psychological Intervention, Clinical Sciences, Longitudinal Studies, Adult, Risk Factors, ANXIETY, Predictive value of tests, Neuropsychological Tests, and Accidents Traffic
The burden of post-traumatic stress disorder (PTSD) in low- and middle-income countries (LMIC) is high. In addition to trauma type and sociodemographic correlates, cultural and social drivers of the disorder are critical to consider in... more
The burden of post-traumatic stress disorder (PTSD) in low- and middle-income countries (LMIC) is high. In addition to trauma type and sociodemographic correlates, cultural and social drivers of the disorder are critical to consider in diagnosis and treatment provision. Sociocultural factors may underpin the cognitive and affective neural mechanisms of PTSD and its phenotypic presentation. Although steps have been taken to evaluate and disseminate empirically supported interventions for PTSD in LMIC that are feasible, affordable, and potentially sustainable despite the limited resources that exist in these countries, well-designed quantitative and qualitative randomized controlled trials are needed in order to gain a more nuanced understanding of the cultural expressions of PTSD.
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IntroductionMetabolic syndrome (MetS) parameters are: elevated waist circumference (WC), triglycerides (TG), fasting glucose (FBG) and blood pressure (BP) and reduced high-density lipoprotein cholesterol (HDL). MetS parameters are... more
IntroductionMetabolic syndrome (MetS) parameters are: elevated waist circumference (WC), triglycerides (TG), fasting glucose (FBG) and blood pressure (BP) and reduced high-density lipoprotein cholesterol (HDL). MetS parameters are associated with poor cognition and this association should be studied in the context of other factors. In particular, factors that are involved in maintaining poor lifestyle choices – MetS is largely a lifestyle illness. One factor important to consider is cognitive insight – an individual's ability to be flexible in how you think about yourself and others and to question your own thoughts.ObjectivesTo conduct an exploratory cross-sectional study investigating the influence of cognitive insight on the relationship between MetS parameters and cognition in non-psychiatric individuals.AimsTo explore the nature of the relationship between cognition and MetS parameters and test whether cognitive insight moderates the association.MethodsOur sample consisted of n = 156 participants with mixed-ancestry. Correlations between MetS parameters and cognition were tested. ANOVA was used to test interaction effects and logistic regression was done to test the predictive power of selected factors.ResultsBP correlated with attention, delayed memory, and RBANS total scale score. The BCIS self-certainty subscale moderated the relationship between BP and immediate memory and attention. Age and BCIS self-certainty were the only predictors of elevated BP.ConclusionsGood cognitive insight act as protective factor and reduce the impact of elevated BP on cognition. Cognitive insight may be a predictor of elevated BP.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Please help populate SUNScholar with the full text of SU research output. Also - should you need this item urgently, please send us the details and we will try to get hold of the full text as quick possible. E-mail to scholar@sun.ac.za.... more
Please help populate SUNScholar with the full text of SU research output. Also - should you need this item urgently, please send us the details and we will try to get hold of the full text as quick possible. E-mail to scholar@sun.ac.za. Thank you.Geneeskunde en GesondheidswetenskappePsigiatri
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Geneeskunde en GesondheidswetenskappePsigiatriePlease help us populate SUNScholar with the post print version of this article. It can be e-mailed to: scholar@sun.ac.z
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Geneeskunde en GesondheidswetenskappePsigiatriePlease help us populate SUNScholar with the post print version of this article. It can be e-mailed to: scholar@sun.ac.z
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This paper reviews: (i) trauma and posttraumatic stress disorder (PTSD) assessment instruments currently in use and (ii) trauma and PTSD studies in South African children and adolescents. Rates of trauma exposure in South African children... more
This paper reviews: (i) trauma and posttraumatic stress disorder (PTSD) assessment instruments currently in use and (ii) trauma and PTSD studies in South African children and adolescents. Rates of trauma exposure in South African children and adolescents range from 40% to 100% and rates of PTSD range from 6% to 22%. Although many reliable and valid assessment instruments are available in the trauma field, comparison across trauma studies is made difficult by the differing methodologies and assessment techniques.
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Reliable and valid neurocognitive (NC) test batteries that assess multiple domains of cognitive functioning are vital tools in the early detection of HIV-associated NC impairment. The HIV Neurobehavioral Research Center’s International... more
Reliable and valid neurocognitive (NC) test batteries that assess multiple domains of cognitive functioning are vital tools in the early detection of HIV-associated NC impairment. The HIV Neurobehavioral Research Center’s International Neurobehavioral Battery (HNRC Battery) is one such diagnostic tool and has shown cultural validity in several international neuroHIV studies. However, no published norms are currently available for the full HNRC Battery in South Africa. To accurately interpret NC test results, appropriate reference norms are required. In light of this challenge, data were collected from 500 healthy, HIV-uninfected participants to develop demographically corrected South African norms. When demographically corrected United States of America (U.S.) norms were applied to the performance scores of our neurologically intact, HIV-negative sample, an impairment rate of 62.2% was observed compared to a 15.0% impairment rate when the newly generated South African norms were app...
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Background Accurate perception of body weight is necessary for individuals with a high body mass index (BMI) to initiate strategies to improve their health status. Furthermore, identifying factors that influence accurate body weight... more
Background Accurate perception of body weight is necessary for individuals with a high body mass index (BMI) to initiate strategies to improve their health status. Furthermore, identifying factors that influence accurate body weight perception can assist in designing appropriate educational and weight management programs. We therefore aimed to investigate whether levels of cognitive functioning and insight influence the ability to correctly judge body weight. Methods One hundred and eighty four overweight and obese adults who participated in a cross- sectional case-control study and were controls in the aforementioned study were included. The study was conducted in Cape Town, South Africa. Demographic, weight-related, neuropsychiatric, neurocognitive and cognitive insight measures were administered. Regression analysis was conducted to determine the factors associated with correct weight perception. Results The final regression model explained 52.3% of variation in accurate percepti...
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Risk of bias (ROB) assessment. (PDF 50 kb)
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Eligibility form. (PDF 47 kb)
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To the Editor: Rape and HIV/AIDS are two scourges of epidemic proportion in South Africa which is known for high levels of sexual violence and one of the fastest-growing HIV epidemics in the world. While the link between rape and... more
To the Editor: Rape and HIV/AIDS are two scourges of epidemic proportion in South Africa which is known for high levels of sexual violence and one of the fastest-growing HIV epidemics in the world. While the link between rape and long-term physical and mental health problems is well established the vast majority of rapes go unreported and only a small proportion of women attend health care services after rape with many believing that their actions will not lead to punishment for the perpetrator. Another factor that may worsen matters even further is the latest version of the original bill on sexual offences (Criminal Law (Sexual Offences) Amendment Bill) passed in 2003. The latest version of the Bill states that the provision of post-exposure prophylaxis (PEP) is dependent on the victim laying a charge. This is likely to have a major negative impact on rape survivors receiving PEP within 72 hours and may impede the ability of medical and police officials to obtain medical evidence t...
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Geneeskunde en GesondheidswetenskappePsigiatriePlease help us populate SUNScholar with the post print version of this article. It can be e-mailed to: scholar@sun.ac.z