South African Journal of Psychology, Ahead of Print.
We examined the extent to which neuroticism, health anxiety, social anxiety, and social support predicted well-being in a sample of online users engaging in health-seeking behaviour. We used a cross-sectional online survey to recruit participants who engaged in online health-seeking behaviour. The study included 350 participants who were recruited online using social media platforms such as Reddit and Twitter. A multiple regression was conducted to examine the relationships between neuroticism, health anxiety, social anxiety, social support, and well-being. Participants completed a battery of measures on Survey Monkey consisting of a demographic questionnaire, International Personality Item Pool Big Five Markers, Leibowitz Social Anxiety scale, Short Health Anxiety Inventory, World Health Organisation Five Well-Being Index, and the Multidimensional Scale of Perceived Social Support. We found significant negative correlations between the indicated psychological variables and well-being, indicating that higher levels of neuroticism, social anxiety, and health anxiety were related to lower levels of well-being. We also found significant, positive correlations between the social support variables and well-being, indicating that more social support was correlated with better well-being. The results of the multiple regression demonstrate that neuroticism, health anxiety, family support, and friend support were significant predictors of well-being.

South African Journal of Psychology, Ahead of Print.
Individuals diagnosed with type 2 diabetes mellitus may experience death anxiety and experiential avoidance, which may impact negatively on health-related quality of life. Meaning in life is a positive psychological resource that protects against negative psychosocial outcomes. Although a direct relationship between these variables exists, to our knowledge, previous research has not explored their interaction effect. The present study examined whether meaning in life moderates the relationship between (1) the multidimensional death anxiety and health-related quality of life, and (2) experiential avoidance and health-related quality of life among type 2 diabetes mellitus patients. The pool of participants consisted of 311 type 2 diabetes outpatients drawn from a tertiary health care institution in South-East Nigeria. The participants completed several self-report measures, such as the short form of the Diabetes Quality of Life Questionnaire, Death Anxiety Inventory–Revised, Acceptance and Action Questionnaire, and the Presence of Meaning in life subscale of Meaning in Life Questionnaire. The results of a regression analysis showed that death anxiety in terms of death acceptance, death finality, and thoughts about death were independently associated with poor health-related quality of life at low, but not at average and high levels of meaning in life. Externally generated death anxiety was associated with poor health-related quality of life at low and average, but not at high levels of meaning in life. Finally, experiential avoidance was associated with poor health-related quality of life at low and average, but not at high levels of meaning in life. We concluded that psychological interventions geared towards promoting health-related quality of life of type 2 diabetes mellitus patients should consider integrating meaning in life for its protective nature in improving positive health outcomes and recovery.

South African Journal of Psychology, Volume 53, Issue 3, Page 438-451, September 2023.
The present study drew from the career construction theory of career adaptation and assessed the extent to which career agility and psychological capital (as psychological states of adaptive readiness) activated employees’ career adaptability resources and fostered their career resilience and career satisfaction (as modes of career adaptedness). A sample of (N = 412; mean age = 38.79 years) Black African employees in the public services participated in the study. Correlational statistics showed positive associations between the study variables. Mediation effects highlighted technological adaptivity, agile learning, optimism, and hope as activators of career concern, career control, and career curiosity, which in turn boosted self-reliance, personal resilience, and work resilience. Psychological states of career agility and psychological capital had also direct effects on the career adaptedness modes of career resilience and career satisfaction. The findings enriched career adaptation theory and have utility for organisational career development practice in the public services.

South African Journal of Psychology, Ahead of Print.
Numerous studies have been conducted among survivors of the genocide against the Tutsi on the prevalence of depression and post-traumatic stress disorder. However, thus far, no studies provide information on the frequency of comorbidity of these disorders, the prevalence of the new trauma-related diagnostic disorder known as complex post-traumatic stress disorder, and the role of social determinants, such as age, sex, marital status, employment category, education, and location, in the occurrence of these disorders. The present study was conducted to address these gaps. Genocide survivors (N = 261 participants; M = 46.30, SD = 11.95, females = 52.9%) took part in the study. They completed the International Trauma Questionnaire, the Public Health Depression Questionnaire, and the Harvard Trauma Questionnaire. Descriptive statistical analyses, bivariate analyses with two-tailed chi-square tests, and logistic regression were used to determine the prevalence of the above-mentioned disorders, comorbidity, and the associations between the social determinants and the assessed psychopathologies. Of the total sample, 47.1% presented with at least one of the assessed probable mental health disorders: 15.3% (n = 40) met the criteria for probable post-traumatic stress disorder, 15.3% (n = 40) for probable complex post-traumatic stress disorder, and 38.7% (n = 101) for probable depression. Of the participants with probable post-traumatic stress disorder and complex post-traumatic stress disorder, nearly half met the criteria for probable depression. Being married but not living with the partner was associated with probable complex post-traumatic stress disorder, and unemployment was associated with probable depression. Our findings suggest clinicians and policymakers that they should consider comorbidity and social determinants in their interventions.

South African Journal of Psychology, Ahead of Print.
Children exposed to alcohol in utero may suffer from cognitive and physical sequelae. The most impactful damage in terms of daily functioning is to higher order cognitive functions involved in planning and goal-directed behaviour, referred to as executive functions. Cognitive training interventions are used as a remedial tool for executive function deficits but require implementation by professionals. For the South African context, where resources are limited, a tablet computer-based cognitive training game was developed. This study aimed to establish the feasibility of implementing and evaluating this intervention in South Africa for children exposed to alcohol prenatally. This was a three-arm feasibility randomised control trial comparing an alcohol exposed intervention arm, to an alcohol exposed control arm, and a non-exposed normative arm. Arm allocation was based on self-reported maternal alcohol use during a structured interview. To assess feasibility, we evaluated participant recruitment and barriers to implementation. Executive functions were measured at baseline and following intervention to evaluate the preliminary impact of the intervention. No significant differences were found between the three arms on the post-intervention assessments. The retention rate was acceptable for a randomised control trial; however, there was significant variance in the length of time spent playing the game overall. The majority of participants learned to play the game quickly and progressed through the difficulty levels. In conclusion, a full randomised control trial using the recruitment, randomisation and implementation method would be suitable in the South African context. The statistical outcomes of this trial do not support a full-scale randomised control trial of this intervention.

South African Journal of Psychology, Ahead of Print.
Adult mental health challenges frequently stem from undiagnosed poor mental health earlier in life. With increasing levels of poor adolescent mental health and insufficient health care resources in low- and middle-income countries, mobile mental health may offer expanded service access. Little is known about mobile mental health interventions for adolescents in low- and middle-income countries. Our aim was to review the literature on mobile mental health intervention, development and use for low- and middle-income country adolescents. We searched APA PsycInfo, Web of Science, Psychiatry online, and Ebscohost databases using keywords and phrases. Screening of the 6953 retrieved articles, generated 6 articles that met the inclusion criteria. Arksey and O’Malley’s adapted framework was followed using rigorous inclusion criteria and screening by two reviewers. Studies showed high heterogeneity. Two studies used short message service text messaging platforms, one used phone call reminders, two used smartphone applications (WhatsApp or game-based), and one study compared different short message service, web-based and smartphone app offerings. Generally, adolescents had a positive perception of mobile mental health interventions. Helpline messages, peer group sessions, access to a counsellor and games set in real-life environments were some of the preferred contents of mobile mental health interventions. Noted barriers include low personal mobile phone ownership, leading to lack of confidentiality, data costs and limited internet access. While adolescents in low- and middle-income countries find mobile mental health interventions acceptable and supportive, challenges remain. Mobile mental health interventions can potentially overcome barriers associated with face-to-face care, such as high cost and stigma. However, more research is needed to overcome these challenges and build the evidence-base in low- and middle-income countries for this field to grow.

South African Journal of Psychology, Volume 53, Issue 3, Page 366-376, September 2023.
This study explored the training needs of substance use disorder (SUD) treatment practitioners in relation to their readiness in treating queer clients. We conducted a series of semi-structured interviews (N = 7) based in the Western Cape of South Africa. A thematic analysis identified themes related to treatment structures developed for a binary perception of gender, the burden of discrimination borne by queer clients that may impede treatment, and practitioner interest in further training and development. Our findings suggest that SUD treatment practitioners do not feel fully prepared to treat queer clients and are aware of a need for gender-sensitive training in this area. Improvements to practitioner training and readiness could yield benefits for both clients and practitioners within the treatment space.

South African Journal of Psychology, Volume 53, Issue 3, Page 341-353, September 2023.
In recent years, photo-narrative methods have gained popularity as a feminist decolonial research approach. Located within the broader category of participatory action research, photovoice is committed to the democratisation of the research process. It aims to centre previously excluded knowledges and problematises what is considered ‘legitimate’ ways of knowing within the social sciences. As such, photovoice has been utilised across a wide range of studies that are aligned with a social justice agenda. Arising are questions around the burden of representation that is placed on participants; what it means for stories of marginalisation to be put ‘on display’; and the risk involved in disclosing personal experiences when there is a power differential between storyteller and audience. By highlighting complications encountered when conducting a photo-narrative project with transgender young persons in Cape Town, South Africa, this methodologically reflexive article contributes to this conversation. We explore the nuances and complexities that arose when using a methodology that relies heavily on visual data, on a community that experiences intense visual scrutiny daily. As a result, the research focused on participants’ narratives of invisibility and hypervisibility as presented in the data, thus bringing a reflexive stance and interrogation to assumptions of the approach often taken for granted.

South African Journal of Psychology, Volume 53, Issue 3, Page 327-340, September 2023.
The practice of neuropsychological assessment in South Africa is complicated by the lack of norms that are representative of clients’ educational and linguistic experiences. In an attempt to address this challenge, we argue that Crawford and Howell’s Single-Case Methodology in Neuropsychology is a good option for the neuropsychological investigation of cases that are not well represented by the available norms. This research design and inferential statistical method compares the scores of one case to the performance of a carefully matched sample of modest size. In order that practitioners and researchers might use this methodology, we provide a set of norms for South Africans with specific demographic profiles on a range of well-researched and commonly used neuropsychological tests. We provide an illustrative case study to demonstrate the application of Crawford and Howell’s Single-Case Methodology, which shows how the selection of an appropriately matched norm (control) group is an effective way to reduce test biases for individuals who are not represented by the original test norms.

South African Journal of Psychology, Volume 53, Issue 3, Page 429-437, September 2023.
Health interventions, including those directed at ameliorating symptoms of mental disorders, can contribute significantly to realising the goal of sustainable development. The Strategic Development Goal of ensuring healthy lives and well-being for all, at all ages, pertains all health conditions, including those affecting mental health. Considering the low ratio of researchers to the population of many low- and middle-income countries, there is a specific need to build capacity for research so as to ensure good quality data so that social policies can be data-informed. This article outlines four considerations for trial investigators assessing the effectiveness of mental health interventions in low- and middle-income countries, namely, task sharing, scaling up, structural barriers, and the transformation imperative. Task sharing is an arrangement in which non-specialist health workers receive training and supervision to screen for and diagnose mental disorders and intervene with persons affected by them. Scaling up a proof of concept is appropriate when trials yield positive results showing effectiveness of the intervention. Structural barriers such as transport difficulties, long waiting times in clinics, food insecurity, competing demands on people’s time, childcare concerns, and poor health literacy play an important role in driving health behaviours and should be considered in intervention design. Transformation of the cadre of researchers to include those from oppressed and marginalised groups will yield investigators who are able to frame research questions and develop methodologies that reflect the lived realities of these communities.