Vigour as a marker of positive mental health among social media respondents.

Background: Quantitative research on vigour as a therapeutically responsive marker of positive mental health, has become possible by virtue of the validation of the Vigour Assessment Scale (VAS). Considering that its validation and therapeutic responsiveness were examined in an avolitional schizophrenia population, using the VAS outside these constraints requires that its psychometric properties be investigated in a more general non-clinical population.

Method: Social media respondents (n = 787) were recruited on social media through snowball sampling and data were obtained for statistical analyses through an online questionnaire comprising the VAS and measures of work-place vigour, active involvement in personal growth, behavioural activation, procrastination, and fatigue.

Agentive steadfastness as trait marker in relation to temperament and character.

Background: Agentive steadfastness was identified as a potential trait marker with which to anticipate prognostically that a patient will persevere steadfastly and take congruent action in facing the demands of living. Taken as an enduring expression of personality, this study investigated agentive steadfastness among adult social media respondents (n = 511) in relation to temperament and character as captured in Cloninger's psychobiological model of personality.

Methods: Participants recruited though snowball sampling on social media platforms, applied the 27-item Agentive Steadfastness Index (ASI) and the 240-item Temperament and Character Inventory (TCI-R-240).

Human cloning as reproductive means in future: a qualitative thematic study of underpinning values.

Background And Objective: The possibility of using human cloning to reproduce has been met with unease, shock, and prohibition in many countries, as well as the International Committee for Monitoring Assisted Reproductive Technology and the World Health Organization. Exploring the value judgments that underpin these and other responses to reproductive human cloning (RHC) was the objective of this study.

Methods: In a qualitative design, this study explored values in their variety underpinning responses to RHC by conducting individual semi-structured in-depth interviews among nine scholars who were purposively sampled for contributing various perspectives.

Validity and reliability of the agentive steadfastness index.

Agentive steadfastness is a hitherto unarticulated and unmeasured construct, although clinicians may have drawn intuitively on it in anticipating clients' prognosis and anticipated responsiveness to adverse events. Following the conceptualisation and articulation of the agentive steadfastness construct and a measure thereof, the current study examined the validity and reliability of the agentive steadfastness index (ASI) among responding adult social media users (n = 511). Results confirmed convergent validity between agentive steadfastness and closest related psychological constructs, which were resilience (r = .

The validity of a therapeutic invigoration task in avolitional schizophrenia outpatients.

Background And Objectives: Avolition is associated with much morbidity and functional impairment in schizophrenia patients. Vigor may be taken as, in part, the inverse of avolition, but it has not been investigated as a therapeutic pursuit before. To this end, a therapeutic invigoration task was developed drawing on cognitive-behavioral and guided imagery therapies.

Patients' voices from music therapy at a South African psychiatric hospital.

Background: In the Life Esidimeni tragedy, crucial voices of mental healthcare users and practitioners were silenced, captured in the Ombud's report as a 'failure to listen'. Working against this kind of failure, various therapeutic interventions listen deliberately and uncover the voice of the patient, that is, what matters from his or her subjective perspective in his or her particular circumstances. Amongst these interventions, music therapy provides for this sensitive listening by expanding the scope and means of expression from the verbal to the musical.

Algorithmic Assessments in Deciding on Voluntary, Assisted or Involuntary Psychiatric Treatment.

The challenges in assessing whether psychiatric treatment should be provided on voluntary, assisted or involuntary legal bases prompted the development of an assessment algorithm that may aid clinicians. It comprises a part that assesses the incapacity to provide informed consent to treatment, care or rehabilitation. It also captures the patient’s willingness to receive these treatments, the risk posed to the patient’s health or safety, financial interests or reputation and risks of serious harm to self or others.

Primary caregivers' perspectives of the disruptive behaviour of their children attending Weskoppies Psychiatric Hospital, South Africa.

While practitioners might engage caregivers on their understandings of the disruptive behavioural disorders of their children, their perspectives are yet to be examined in a qualitative study. This study explored perspectives of primary caregivers on the disruptive behaviour of children who attended the child unit of Weskoppies Psychiatric Hospital, in South Africa. Qualitative methods were used in a case study design.

Validity and Reliability of the Staden Schizophrenia Anxiety Rating Scale.

In schizophrenia, none of the standard anxiety measures exhibit strong psychometric properties, and all performed poorly against quality assessment criteria. Developed for the schizophrenia population, this study examined the validity and reliability of the Staden Schizophrenia Anxiety Rating Scale (S-SARS) that measures both specified and undifferentiated anxiety. Among 353 schizophrenia patients, strong correlations with anxiety parameters supported the S-SARS's convergent validity.

Validity and reliability of the Vigour Assessment Scale in avolitional schizophrenia outpatients.

A few items of existing schizophrenia scales measure avolition, but no research has been reported on vigour in schizophrenia, including whether avolition would be more or less the inverse of vigour. Such research requires a valid and reliable measure of vigour. In the absence of this, this study developed and examined the validity and the reliability of the Vigour Assessment Scale (VAS) among 242 avolitional schizophrenia outpatients in relation to measures of workplace vigour, behavioral inhibition and activation, procrastination, fatigue, anxiety, depressive features, and active involvement in personal growth.

Inequitable access to healthcare in Africa: reconceptualising the "accountability for reasonableness framework" to reflect indigenous principles.

Background: The "Accountability for Reasonableness" (A4R) framework has been widely adopted in working towards equity in health for sub-Saharan Africa (SAA). Its suitability for equitable health policy in Africa hinges, at least in part, on its considerable successes in the United States and it being among the most comprehensive ethical approaches in addressing inequitable access to healthcare. Yet, the conceptual match is yet to be examined between A4R and communal responsibility as a common fundamental ethic in SAA.

The Core Cultural Formulation Interview in Yielding Religious Content Among Patients Suffering from a Current Major Depressive Episode.

Taken up in the DSM-5, the Cultural Formulation Interview (CFI) is a guide for assessing cultural context of an individual's mental health problem. Unreported before, the extent to which the cultural focus of the CFI yields religious content was explored qualitatively among patients with a current major depressive episode. Qualitative data were generated by applying the standard version of the CFI first and then reapplied it by phrasing its items in religious terms.

Discerning undifferentiated anxiety from syndromal anxiety in acute-phase schizophrenia.

Background: Literature on anxiety in schizophrenia is confined to well-established diagnostic syndromes and the diagnostic category of unspecified anxiety disorder has not been quantitatively verified in this population. This study examined whether anxiety that is not differentiated into the well-established syndromes is empirically discernible from syndromal anxiety and no anxiety in acute-phase schizophrenia.

Methods: After sampling 111 acute-phase schizophrenia patients, they were stratified into three groups: syndromal anxiety; undifferentiated anxiety; and without anxiety disorder.

Patient Reflections on Individual Music Therapy for a Major Depressive Disorder or Acute Phase Schizophrenia Spectrum Disorder.

Reflections of patients have not been studied qualitatively after a completed course of individual music therapy for a major depressive disorder (MDD) or an acute phase of a schizophrenia spectrum disorder (SSD). Our interpretivist study explored patient reflections through individual interviews with 15 hospitalized patients after a completed course of eight individual music therapy sessions that were flexibly structured in blended fashion utilizing a set of active and receptive music therapy methods. Our analyses yielded 8 themes, supported by 23 subthemes.

Psychological Resilience and Vulnerability as Mediators Between Adverse Life Events and Fatigue, Motor Dysfunction, and Paresthesia in Multiple Sclerosis.

Objective: Adverse life events have been associated with exacerbating multiple sclerosis (MS) symptoms, but results have been variable, raising the question on the role of other psychological factors. This study examined the role of psychological resilience and vulnerability as mediators between adverse life events on MS symptoms.

Methods: Participants with MS (N = 1239) were aged 18 to 81 years (mean [SD] = 45.

The professionalism of psychiatry registrars as perceived by patients and various health practitioners at Weskoppies Psychiatric Hospital, Pretoria.

Objectives: Amidst calls for improved professionalism, this study examined the professionalism of psychiatry registrars at Weskoppies Hospital as evaluated by their patients, themselves, their consultants and other health practitioners. The second objective was to examine the perceived importance of aspects of professionalism and compare these descriptively among the various health practitioners and patients.

Method: Participants completed the Professionalism Mini-Evaluation Exercise Questionnaire in evaluating the professionalism of the registrar.

Debate: The concept of culture has outlived its usefulness for psychiatry.

This paper presents a debate in which the authors participated at the World Psychiatric Association conference in Cape Town, South Africa in November 2016. Professor van Staden acted as chair and here, as at the debate, provides a rationale for debating a topic that many of those involved in mental health believe to be decided. The discussion that ensued demonstrated, however, that while the arguments have moved on they have not ceased.

Risperidone-associated adverse drug reactions and CYP2D6 polymorphisms in a South African cohort.

Background: Contradictory information exists regarding the influence of CYP2D6 polymorphisms on adverse drug reactions (ADRs) (extrapyramidal symptoms (EPS) and weight gain) related to risperidone treatment. This prompted us to evaluate the influence of CYP2D6 genetic variation in a cohort of South African patients who presented with marked movement disorders and/or weight gain while on risperidone treatment.

Methods: Patients who were experiencing marked risperidone ADRs were recruited from Weskoppies Public Psychiatric Hospital.

Severity of psychotic episodes in predicting concurrent depressive and anxiety features in acute phase schizophrenia.

Background: Considering that depressive and anxiety symptoms are common in schizophrenia, this study investigated whether the severity of a psychotic episode in an acute phase schizophrenia cohort is predictive of concurrent depressive and anxiety features.

Method: Fifty one recently hospitalised patients suffering from acute phase schizophrenia participated prospectively in a cross-sectional study. The severity of the psychotic episode, the depressive features and the anxiety features were measured by the Structured Clinical Interview for Positive and Negative Syndrome Scale (SCI-PANSS), the Calgary Depression Scale for Schizophrenia (CDSS), the Hamilton Anxiety Rating Scale (HAM-A) and the Staden Schizophrenia Anxiety Rating Scale (S-SARS).

Conceptual relations between loneliness and culture.

Purpose Of Review: To clarify ways in which loneliness and culture are connected conceptually.

Recent Findings: Loneliness may be distinguished from being alone or social isolation by a common property of loneliness across cultures - that is, an undesired absence of reciprocal empathic understanding. Cultural meanings shape the experience of loneliness in that they create expectations of the nature and the extent of closeness in relationships as well as social connectedness.

Acceptance and insight: incapacity to give informed consent.

Purpose Of Review: To highlight areas for potential refinement in assessments of capacity to give informed consent.

Recent Findings: The clinical assessment of the patient's capacity to give informed consent may be informed and guided by sophisticated criteria or assessment instruments. The approach of most assessment instruments and the literature on (in)capacity departs from the abilities that underpin giving informed consent.

Conceptual issues in undifferentiated somatoform disorder and chronic fatigue syndrome.

Purpose Of Review: To review the conceptual problems in distinguishing between undifferentiated somatoform disorder and chronic fatigue syndrome, for both may present with fatigue as the main symptom.

Recent Findings: The differences and/or similarities between undifferentiated somatoform disorder and chronic fatigue syndrome have not been studied, conceptually or empirically. The literature fails to present discriminant validity of chronic fatigue syndrome in relation to undifferentiated somatoform disorder.