Adolescent mental health in the context of adversity : evidence from a longitudinal intervention study in Khayelitsha, South Africa

Date
2023-12
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Stellenbosch : Stellenbosch University
Abstract
ENGLISH SUMMARY: The World Health Organization defines adolescents as individuals between the ages of 10 and 19 years, undergoing transition from childhood to adulthood [1, 2]. Adolescence is a rapid developmental phase during which an individual undergoes major physical and psychological changes [1]. The changes that occur during this period create a vulnerability that is accentuated by exposure to risk factors such as poverty, community violence, and lack of access to basic services [1-5]. Mental health conditions most commonly appear during adolescence [1]. Experiencing mental health conditions during this period can have lasting effects on an individual's health, as it can increase the risk of substance use, violence victimisation and perpetration, and suicidal ideation [6-8]. There is a critical gap in the exploration of mental health conditions among adolescents in low- and middle-income countries, particularly in sub-Saharan African countries, where most adolescents live in the context of widespread poverty [9]. Most of the research on adolescent mental health is conducted in high-income countries, despite nearly 90% of the world's adolescent population living in low- and middle-income countries [9, 10]. There is an urgent need to assess potential risk and protective factors, as well as interventions, to address the mental health of adolescents in these contexts. To design effective preventative initiatives that aim to protect adolescents from the adverse consequences of mental health conditions, it is crucial to understand risk and protective factors at various stages throughout the life course. In addition, a comprehensive understanding of support structures and interventions that can aid in the prevention of mental health conditions and the promotion of positive mental health among adolescents is crucial. This thesis is based on research reported on four articles. The first two articles report on predictors of mental health problems, exploring both early childhood and current environmental factors. The second two articles in this thesis report on potential interventions for adolescent mental health.
AFRIKAANSE OPSOMMING: Die Wereldgesondheidsorganisasie definieer "adolessente" as individue tussen die ouderdomme van 10 en 19 jaar en dit beskryf die tydperk in die lewe wanneer 'n individu oorgaan van kinderjare na volwassenheid [1, 2]. Dit is 'n vinnige ontwikkelingsfase waartydens 'n individu groot fisieke en psigologiese veranderinge ondergaan [1]. Die verandering wat gedurende hierdie tydperk plaasvind, skep 'n kwesbaarheid wat deur armoede geaksentueer word [1-5]. Geestesversteurings kom meestal eers tydens adolessensie voor [1]. Om geestesgesondheidstoestande gedurende hierdie tydperk te ervaar kan blywende uitwerking op 'n individu se gesondheid he, aangesien dit die risiko van dwelmgebruik, geweldviktimisering en -mishandeling, en selfmoordgedagtes kan verhoog [6-8]. Daar is 'n kritieke gaping in die navorsing van geestesgesondheidstoestande onder adolessente in lae- en middelinkomstelande, veral in Afrika-lande suid van die Sahara, waar die meeste adolessente in die konteks van wydverspreide armoede leef [9]. Die meeste van die navorsing oor adolessente geestesgesondheid word in hoe-inkomstelande gedoen, ten spyte daarvan dat byna 90% van die wereld se adolessente bevolking in lae- en middelinkomstelande woon [9, 10]. Daar is 'n dringende behoefte om potensiele risiko- en beskermende faktore, sowel as intervensies, te bestudeer om die geestesgesondheid van adolessente in hierdie kontekste aan te spreek. Om effektiewe voorkomende inisiatiewe te ontwikkel, wat daarop gemik is om adolessente teen die nadelige gevolge van geestesgesondheidstoestande te beskerm, is dit van uiterse belang om risiko- en beskermende faktore op verskeie stadiums deur die loop van die lewe te verstaan. Daarby is 'n omvattende begrip van ondersteuningstrukture en intervensies wat kan help met die voorkoming van geestesgesondheidstoestande en die bevordering van positiewe geestesgesondheid onder adolessente noodsaaklik. Hierdie tesis is gebaseer op navorsing wat oor vier artikels gerapporteer word. Die eerste twee artikels rapporteer op aanwysers van geestesgesondheidsprobleme, wat beide vroee kinderjare en huidige omgewingsfaktore ondersoek. Die tweede twee artikels in hierdie tesis rapporteer op potensiele intervensies vir adolessente geestesgesondheid.
Description
Thesis (PhD)--Stellenbosch University, 2023.
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