Kerry Gibson

Adjustment of Black Students at a Historically White South African University.

The adjustment of black African students to what, under apartheid, were white universities has long been a concern for South African educators. Dimensions of adjustment to university were examined for 339 African black and white freshmen attending a historically white South African university, using the Student Adaptation to College Questionnaire. No significant differences were found between black African and white participants on academic adjustment or institutional commitment. However, black African participants reported significantly poorer levels of social adjustment, and somewhat poorer levels of personal-emotional adjustment. Further investigations found relationships between academic performance, race and additional variables hypothesised to be associated with adjustment.

Adverse emotional and interpersonal effects reported by 1829 New Zealanders while taking antidepressants

In the context of rapidly increasing antidepressant use internationally, and recent reviews raising concerns about efficacy and adverse effects, this study aimed to survey the largest sample of AD recipients to date. An online questionnaire about experiences with, and beliefs about, antidepressants was completed by 1829 adults who had been prescribed antidepressants in the last five years (53% were first prescribed them between 2000 and 2009, and 52% reported taking them for more than three years). Eight of the 20 adverse effects studied were reported by over half the participants; most frequently Sexual Difficulties (62%) and Feeling Emotionally Numb (60%). Percentages for other effects included: Feeling Not Like Myself - 52%, Reduction In Positive Feelings - 42%, Caring Less About Others - 39%, Suicidality - 39% and Withdrawal Effects - 55%. Total Adverse Effect scores were related to younger age, lower education and income, and type of antidepressant, but not to level of depression prior to taking antidepressants. The adverse effects of antidepressants may be more frequent than previously reported, and include emotional and interpersonal effects.

State Violence in South Africa and the Development of a Progressive Psychology

Over the past few years, South African psychology has been portrayed as, on the whole, unresponsive to its political context.1 Questions have been raised both about the ability of local psychology to understand the phenomena of discrimination, political violence and state repression, and about the adequacy of local clinical practice in ameliorating the effects of these phenomena. These questions have been raised against the backdrop of rapid growth in overt state violence as well as of the recent proliferation of groups and organizations of mental health workers attempting, among others aims, to provide clinical services to victims of repression and violence. It is probably true to say that at present there are more local psychologists coming into regular contact with people affected by political violence, and more psychologists consciously grappling at the level of clinical practice with issues concerning political alignment, than ever before.2

Long-term antidepressant use: patient perspectives of benefits and adverse effects

Long-term antidepressant treatment has increased and there is evidence of adverse effects; however, little is known about patients’ experiences and views of this form of treatment. This study used mixed methods to examine patients’ views and experiences of long-term antidepressant treatment, including benefits and concerns. Data from 180 patients, who were long-term users of antidepressants (3–15 years), were extracted from an anonymous online survey of patients’ experiences of antidepressants in New Zealand. Participants had completed rating scales about the effectiveness of antidepressants, levels of depression before and during antidepressant use, quality of life, and perceived adverse effects. Two open-ended questions allowed participants to comment on personal experiences. The majority (89.4%) reported that antidepressants had improved their depression although 30% reported moderate-to-severe depression on antidepressants. Common adverse effects included withdrawal effects (73.5%), sexual problems (71.8%), and weight gain (65.3%). Adverse emotional effects, such as feeling emotionally numb (64.5%) and addicted (43%), were also common. While the majority of patients were pleased with the benefits of antidepressant treatment, many were concerned about these adverse effects. Some expressed a need for more information about long-term risks and increased information and support to discontinue.

Beliefs of people taking antidepressants about the causes of their own depression

BACKGROUND The beliefs of people receiving treatment about the causes of their own mental health problems are researched less often than the causal beliefs of the public, but have important implications for relationships with prescribers, treatment choices and recovery. METHOD An online survey on a range of beliefs about depression, and experiences with antidepressants, was completed by 1829 New Zealand adults prescribed anti-depressants in the preceding five years, 97.4% of whom proceeded to take antidepressants. RESULTS Six of 17 beliefs about the causes of their own depression were endorsed by more than half the sample: chemical imbalance, family stress, work stress, heredity, relationship problems and distressing events in childhood. There were some marked differences in content, structure and level of conviction of beliefs about one׳s own depression and the sample׳s previously published beliefs about depression in general. There were also significant differences between the beliefs of demographic groupings. Regression analyses revealed that self-reported effectiveness of the antidepressants was positively associated with bio-genetic causal beliefs. The quality of the relationship with the prescribing doctor was positively related to a belief in chemical imbalance as a cause and negatively related to a belief in unemployment as a cause. LIMITATIONS The convenience sample may have been biased towards a favourable view of bio-genetic explanations, since 83% reported that the medication reduced their depression. CONCLUSIONS People experiencing depression hold complex, multifactorial and idiosyncratic sets of beliefs about the causes of their own depression, apparently based at least in part on their own life experiences and circumstances. Exploring those beliefs may enhance the doctor-patient relationship and selection of appropriate treatment modality.

Understanding the non-pharmacological correlates of self-reported efficacy of antidepressants

To explore the non‐pharmacological correlates of the perceived effectiveness of antidepressants (ADs), thereby enhancing understanding of the mechanisms involved in recovery from depression while taking ADs.

Politics and emotion: Working with disadvantaged children in South Africa

This paper discusses the experience of consulting to organizations involved in the provision of care to disadvantaged groups of children in South Africa. It draws particular attention to the impact of South Africas painful political history on the emotional life of these organizations. This has created an additional burden for organizational staff who often work under difficult conditions with very troubled groups of children. The paper highlights the common experiences of deprivation and loss, fears around the abuse of power and problems with acknowledging differences between people, which are a part of South Africas political legacy. These kinds of issues were found to have a powerful impact on the functioning of organizations and also on the quality of the consultancy relationship itself. We argue that it is important to recognize the emotional demands of child-care work generally, but also that it is equally necessary work, through our political experiences, to achieve some kind of understanding of these. Lack of containment for these experiences will impact on the quality of care organizations are able to offer to children in our context.

‘In my life antidepressants have been…’: a qualitative analysis of users’ diverse experiences with antidepressants

BackgroundWhile mental health professionals have focused on concerns about whether antidepressants work on a neurochemical level it is important to understand the meaning this medication holds in the lives of people who use it. This study explores diversity in the experience of antidepressant users.MethodsOne thousand seven hundred forty-seven New Zealand antidepressant users responded to an open-ended question about their experience of antidepressants. This was analysed using content and thematic analysis.ResultsThere was considerable diversity in participants’ responses including positive (54 %), negative (16 %) and mixed (28 %) experiences with antidepressants. Those with positive experiences saw antidepressants as a necessary treatment for a ‘disease’, a life saver, a way of meeting social obligations, dealing with difficult circumstances or a stepping stone to further help. Negative themes described antidepressants as being ineffective, having unbearable side effects, undermining emotional authenticity, masking real problems and reducing the experience of control. Mixed experience themes showed how participants weighed up the unpleasant side effects against the benefits, felt calmer but less like themselves, struggled to find the one or dosage and felt stuck with continuing on antidepressants when they wished to stop.ConclusionsMental health professions need to recognize that antidepressants are not a ‘one size fits all’ solution.

Are older people prescribed antidepressants on the basis of fewer symptoms of depression, and for longer periods of time? A survey of 1825 New Zealanders.

To determine whether older people are prescribed antidepressants at lower levels of depression and with fewer symptoms, and whether they are more likely to engage in chronic usage than younger adults.

Narrative Research on Child Sexual Abuse: Addressing Perennial Problems in Quantitative Research

Narrative research can offer insights into perennial methodological problems facing quantitative researchers in the field of child sexual abuse. Using research data from a retrospective, narrative study of 29 adult participants who had spent their childhood in a New Zealand commune in which child sexual abuse was known to have occurred, this article explores four key methodological issues in the field of child sexual abuse research. These include problems surrounding the definition and reporting of child sexual abuse; the relationship between sexual abuse and other adverse experiences; the link between abuse and its variable psychological effects; and finally, the ethics of conducting research into child sexual abuse. Recommendations are made for future directions in child sexual abuse research.