Doctoral Degrees (Psychiatry)

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Browsing Doctoral Degrees (Psychiatry) by Author "Adams, Amy S."

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    An investigation of the relationship between PTSD, reflective functioning and caregiving sensitivity amongst mothers misusing substances
    (Stellenbosch : Stellenbosch University, 2020-03) Adams, Amy S.; Berg, Astrid; Suchman, Nancy; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry.
    ENGLISH SUMMARY : Substance use has increased significantly in South Africa and has been associated with several risk factors for both maternal and infant mental health including dysfunctional parenting practices. Trauma has been shown to impact an individual’s ability to form stable attachments with early caregivers as well as on relationships formed later in life. Reflective functioning is postulated to moderate several different individual risk factors including the effects of trauma. However, the relationship between these factors has not been explored in the South African setting. Moreover, mothers misusing substances serve as a unique population within which to explore this interaction. The current study therefore represents a distinctive research endeavour. The primary aim of this study was to explore the relationship between PTSD, reflective functioning (RF) and caregiving sensitivity amongst mothers misusing substances. The objectives deriving from this were to (a) evaluate the levels of reflective functioning of mothers in both the exposed group and the non-exposed group (b) assess the caregiving sensitivity of mothers in both the exposed group and the non-exposed group and (c) compare the levels of reflective functioning and caregiving sensitivity in the exposed group with those found in the non-exposed group. The total sample consisted of 72 mother/child dyads and were recruited from those who had previously participated in the Safe Passage Study (SPS). Participants who presented with PTSD were assigned to an exposed group (PTSD group) and those who did not meet full diagnostic criteria for PTSD were assigned to a non-exposed group (No PTSD group). Thereby controlling for the effects of PTSD on outcome variables in an attempt to assess associations between these variables. Trauma exposure was assessed using the Life Events Checklist (LEC) and the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) was used to assess PTSD. Parental reflective functioning was assessed with the shortened version of the Parental Development Interview (PDI-S). Caregiving sensitivity was assessed with the use of the Coding Interactive Behaviour system (CIB) which was used to rate a video-recorded mother-child interactive play session termed the curiosity box paradigm. Findings of the present study revealed that only 20.8% of participants in the total sample presented with adequate RF and 79.2% presented with poor RF with no statistically significant difference between the exposed and non-exposed group. The level of caregiving sensitivity between the exposed and non-exposed group were mostly similar. Small-medium effect sizes suggested that mothers in the No PTSD group presented with a poorer quality of maternal behaviour with their child than those in the PTSD group. Little evidence of correlation between RF and caregiving sensitivity was found. No significant difference was found between mothers with higher levels of PTSD and lower levels of RF and their caregiving sensitivity. No statistically significant results were found suggesting a moderating effect of RF on PTSD and the outcome variable caregiving sensitivity. Overall, the findings confirmed the concerning extent of substance use and PTSD pathology in the given setting. It also revealed largely poor levels of reflective functioning and caregiving sensitivity in this specific population and highlighted the need for ongoing research and intervention.