Adaptation and validation of a computerized neurocognitive battery in the Xhosa of South Africa
- Authors: Cobb, Scott J , Moore, Tyler M , Stein, Dan J , Pretorius, Adele , Zingela, Zukiswa , Nagdee, Mohammed , Ngqengelele, Linda , Campbell, Megan M , Sibeko, Goodman , King, Mary C , McClellan, Jon M , Port, Allison M , Jackson, Chad , Ruparel, Kosha , Susser, Ezra , Gur, Ruben C
- Date: 2021
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/302439 , vital:58196 , xlink:href="https://doi.org/10.1037/neu0000742"
- Description: Objective: Large-scale studies have revolutionized biomedical research, and neurocognitive tests can help elucidate the biological basis of neuropsychiatric diseases. However, studies have predominantly been conducted in Western settings. We describe the development and validation of a computerized battery (PennCNB) with the Xhosa population of South Africa. Method: Individuals with schizophrenia (n = 525) and a normative comparison group (n = 744) were balanced on age, sex, education, and region. Participants provided blood samples, were assessed psychiatrically, and were administered a PennCNB translation to isiXhosa, including measures of executive functions, episodic memory, complex cognition, social cognition, and sensorimotor speed. Feasibility was examined with test completion rates and input from administrators, and psychometric structural validity and associations with clinical and demographic characteristics were examined. Results: Tests were well tolerated by participants, as >87% had one (or fewer) test missing. Results suggested a similar factor structure to prior PennCNB studies in Western contexts, and expected age and sex effects were apparent. Furthermore, a similar profile of schizophrenia was observed, with neurocognitive deficits most pronounced for executive functions, especially attention, as well as memory, social cognition, and motor speed relative to complex cognition and sensorimotor speed. Conclusions: Results support the feasibility of implementing a culturally adapted computerized neurocognitive battery in sub-Saharan African settings and provide evidence supporting the concurrent validity of the translated instrument. Thus, the PennCNB is implementable on a large scale in non-Western contexts, shows expected factor structure, and can detect cognitive deficits associated with neuropsychiatric disorders. Obtaining valid measures of cognition by nonspecialized proctors is especially suitable in resource-limited settings, where traditional testing is prohibitive. Future work should establish normative standards, test–retest reliability, and sensitivity to treatment.
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- Date Issued: 2021
Evaluating Community Engagement Strategies to Manage Stigma in Two African Genomics Studies Involving People Living with Schizophrenia or Rheumatic Heart Disease
- Authors: Campbell, Megan M , Matshabane, Olivia P , Mqulwana, Sibonile , Mndini, Michael , Nagdee, Mohammed , Stein, Dan J , de Vries, Jantina
- Date: 2021
- Subjects: To be catalogued
- Language: English
- Type: text , article
- Identifier: http://hdl.handle.net/10962/302475 , vital:58199 , xlink:href="https://doi.org/10.1155/2021/9926495"
- Description: In global health research and genomics research specifically, community engagement has gained prominence in enhancing ethical conduct, particularly in managing the risk of stigmatization, but there is minimal scientific evidence on how to do this effectively. This article reports on community engagement evaluation strategies in two African genomics studies: the Stigma in African Genomics Research study and the Genomics of Schizophrenia in South African Xhosa People (SAX) study. Within the Stigma in African Genomics Research study, a self-report rating scale and open-ended questions were used to track participant responses to an experiential theatre workshop. The workshop focused on participant experiences of living with schizophrenia or rheumatic heart disease (RHD). While the schizophrenia group reported more alienation and less stigma resistance than the RHD group, both groups demonstrated increased stigma resistance over time, after participating in the workshops. Hearing from others living with and managing the same illness normalised participants’ own experiences and encouraged them. Within the SAX study, a short rating scale and qualitative feedback methods were used to evaluate a Mental Health Literacy Day targeting mental health stigma. Information talks about (i) the symptoms of schizophrenia and treatment options and (ii) the illness experiences of a patient in recovery were rated as the most helpful on the day. Audience members reported that these talks challenged negative perceptions about severe mental illness. Three important learnings emerged from these evaluations: firstly, integration of evaluation strategies at the research study planning phase is likely to promote more effective community engagement. Secondly, a combination of quantitative and qualitative methods that draw on simple descriptive statistics and thematic analysis can provide nuanced perspectives about the value of community engagement. Thirdly, such evidence is necessary in establishing and promoting the science of community engagement in genomics research and health research more broadly.
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- Date Issued: 2021
The forensic mental health profile of women offenders in the Eastern Cape, South Africa
- Authors: Nagdee, Mohammed
- Date: 2020
- Subjects: Female offenders -- Mental health , Female offenders -- South Africa -- Psychology , Female offenders -- South Africa -- Mental health , People with mental disabilities and crime , Women murderers -- South Africa , Forensic psychology -- South Africa , Fort England Psychiatric Hospital
- Language: English
- Type: text , Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10962/167109 , vital:41438
- Description: Introduction There is a dearth of research on mental health issues in women offenders in South Africa, especially regarding their socio-demographic backgrounds, offence characteristics, and forensic mental health profiles. Objectives This study examined the psychosocial and forensic mental health profile of women offenders referred by eastern Cape courts for forensic evaluation. A range of socio-demographic, criminological, clinical and forensic mental health variables were systematically explored. Methods A bi-phasic, mixed methods study design was adopted. The clinical and forensic records of all women referred for forensic evaluation to Fort England forensic psychiatric hospital in the Eastern Cape, South Africa were retrospectively reviewed, comprising 173 individual cases in the study period of 1993-2017. Inferential statistical analyses (chi-squared and multivariate logistic regression) were applied to explore relationships between variables and offending outcomes of nterest. Detailed semi-structured interviews were subsequently conducted with a sub-sample of 8 women with mental disorder and violent offending ackgrounds. Interview transcripts thematically analysed. Results Most women came from impoverished and disadvantaged backgrounds. Whilst the majority were first offenders, a high proportion had violent index offences, with murder, attempted murder and assault with intent to do grievous bodily harm accounting for over half of cases. The majority of victims of violence were well known to the perpetrator, especially as biological children, intimate male partners or close family members. Biological children in their first year of life were particularly vulnerable to being victims of homicidal violence. Disproportionately high rates of pre-offence mental illness, alcohol misuse, HIV infection and prior abuse of the offender (especially by intimate male partners) were present. High rates of severe mental disorders (especially psychiatric comorbidity and psychotic-spectrum disorders), and relatively low rates of personality disorders and substance disorders were diagnosed. The majority of women were declared to lack trial competence and criminal capacity, respectively, following forensic evaluation. Women who had backgrounds of prior abuse themselves had over three mes the odds of subsequent violent offending in general, and almost six times the odds of homicidal offending in particular. Homicidal offences were significantly more commonly committed by women with no prior psychiatric history and no psychiatric comorbidity. Women who committed homicide had over eleven times of killing children as opposed to adults. Women over the age of 30 years, and those without psychiatric comorbidity, were significantly less likely to have killed children. Thematic analysis of interviews emphasized the important roles played by gender, self-image, and mental health in violent offending pathways. Conclusions A complex array of socio-demographic, criminological, clinical and forensic variables interact in women offenders of the Eastern Cape referred by courts for forensic evaluation. Exploration of these factors improves understanding of the broader psychosocial context of female offending, and of the personal experiences of the women themselves. This in turn provides an enhanced gender-focus to guide the progressive changes required in policy, legislative, clinical and research endeavours in this field.
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- Date Issued: 2020