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Background: By 2008, 12 million children in sub-Saharan Africa were orphaned by AIDS. Cross-sectional studies show psychological problems for AIDS-orphaned children, but until now no longitudinal study has explored enduring psychological effects of AIDS-orphanhood in the developing world. Methods: A 4-year longitudinal follow-up of AIDS-orphaned children with control groups of other-orphans and non-orphans. 1021 children (M = 13.4 years, 50% female, 98% isiXhosa-speaking) were interviewed in 2005 and followed up in 2009 with 71% retention (49% female, M = 16.9 years), in poor urban South African settlements. Children were interviewed using sociodemographic questionnaires and well-validated standardised scales for assessing depression, anxiety, and post-traumatic stress. Data were analysed using mixed-design ANOVA and backward-stepping regression. Results: AIDS-orphaned children showed higher depression, anxiety, and post-traumatic stress disorder (PTSD) scores in both 2005 and 2009 when compared with other-orphans and non-orphans. Backward-stepping regression, controlling for baseline mental health, and sociodemographic cofactors such as age, gender, and type of bereavement, revealed that being AIDS-orphaned in 2005 was associated with depression, anxiety, and PTSD scores in 2009. This was not the case for other-orphaned or non-orphaned children. Age interacted with orphan status, such that there was a steep rise in psychological distress in the AIDS-orphaned group, but no rise with age amongst other-orphans and non-orphans. Conclusions: Negative mental health outcomes amongst AIDS-orphaned children are maintained and worsen over a 4-year period. It is important that psychosocial support programmes are sustained, and focus on youth as well as young children.

Poor readers have lower academic achievement and increased anxiety, including reading anxiety, which may perpetuate lower academic achievement. We explored reading anxiety in university students, investigating whether the association between reading ability and academic achievement is mediated by reading anxiety (independent of general anxiety). Participants were students (n = 169, 69% female, age = 20.70) at an Australian university who completed an online reading assessment (decoding skills, phonological awareness, orthographical knowledge and comprehension), and a survey examining reading anxiety, trait anxiety and self‐reported reading history. Academic achievement was based on university grades. Two reading anxiety factors (social and non‐social) were identified; both factors were distinct from trait anxiety. Reading ability was negatively correlated with reading anxiety and positively correlated with academic achievement. Reading anxiety was not correlated with academic achievement and it did not mediate the relationship between reading ability and academic achievement as expected. As this was the first study to explore reading anxiety in adults, further research is required to determine the impact reading anxiety may have on university students beyond academic achievement. [ABSTRACT FROM AUTHOR]

Although declining in all other age groups, AIDS-related deaths among adolescents are increasing. In the context of HIV, mental health problems are associated with negative health outcomes, including non-adherence to life-saving ART. For effective programming it is essential to identify factors associated with psychological outcomes in this population. Adopting a socioecological perspective, we aimed to identify correlates of internalising and externalising symptoms in a large, representative sample of South African adolescents living with HIV. HIV-positive adolescents (n = 1060), who received care in public health facilities in South Africa's Eastern Cape, completed measures of internalising and externalising symptoms. Hypothesised correlates included HIV and health-related factors (physical health, mode of infection, medication sideeffects, disclosure, stigma), health-service related factors (negative interactions with clinic staff, clinic support group), interpersonal factors (abuse, bullying victimisation, social support), parenting-related factors (orphanhood, positive parenting, parental monitoring, parent communication), as well as individual and demographic-related factors (self-efficacy, age, gender, urban/rural location, poverty). Correlates operating across a variety of contexts were identified. Bullying victimisation, self-efficacy, and positive parenting may be particularly salient intervention targets as they were associated with better outcomes on most or all mental health measures, can be addressed without directly targeting adolescents living with HIV (reducing the chances of accidental exposure and stigma), and are associated with better adolescent mental health in South Africa more generally. [ABSTRACT FROM AUTHOR]

Background Individual differences in emotional reactivity and perseveration have recently been demonstrated to account for independent variance in trait positive and negative affect. We extend this research and investigate: 1) if individual differences in the tendency to experience intense emotions (emotional intensity) represent an additional dimension of trait positive and negative affect, and 2) if emotional reactivity, intensity, and perseveration are differentially associated with psychological distress and symptoms of depression, anxiety, and stress. Method Undergraduate students ( n = 472) completed the Positive and Negative Affect Schedule (PANAS), the Emotional Reactivity Intensity and Perseveration Scale (ERIPS, adapted from the PANAS), the Kessler Psychological Distress Scale (K10), and the Depression Anxiety and Stress scales (DASS). Results Psychometric analyses confirmed the hypothesised structure of the ERIPS, with all subscales demonstrating excellent internal consistency. Correlations with the K10 established criterion validity. Emotional reactivity, intensity and perseveration accounted for unique variance in trait positive and negative affect scores and were differentially associated with psychological distress, depression, anxiety and stress scores. Conclusion Findings provide a preliminary validation of the ERIPS and suggest emotional reactivity, intensity, and perseveration represent independent dimensions of trait affect. Future research investigating these dimensions could enhance understanding of normal emotional responding and emotional vulnerability. [ABSTRACT FROM AUTHOR]

HIV stigma--both "self-stigma" toward positive individuals and "stigma by association" toward their families--is linked with adverse mental health. This study examined how stigma was associated with the mental health of parents and children in South Africa. Parent-child dyads (n = 2,477 dyads) in South Africa participated in a cross-sectional survey. For both parents and children, greater stigma was associated with their own reports of greater anxious and depressive symptoms. Parents' reports of stigma were associated with children's greater anxious and depressive symptoms. Children's reports of stigma were related to parents' greater anxious and depressive symptoms. There was a significant interaction, such that the association between parent stigma and depression was stronger when children also reported high levels of stigma. Findings provided support the effect of HIV stigma on the mental health of families and illustrate the importance of taking a family-based approach to stigma-reduction interventions to alleviate mental health problems. [ABSTRACT FROM AUTHOR]

Background Theoretically, two types of emotional responding could underlie individual differences in trait affect: 1) a disposition reflecting increased probability of experiencing positive or negative emotions (emotional reactivity), and 2) a disposition to experience prolonged emotional reactions once elicited (emotional perseveration). We developed a measure of these dimensions and investigated whether emotional reactivity and perseveration 1) account for unique variance in trait affect, and 2) are differentially associated with symptoms of psychological distress. Method In Study 1, participants (T1: n = 90; T2: n = 51) completed the Positive and Negative Affect Schedule (PANAS) and the Emotional Reactivity and Perseveration Scale (ERPS, adapted from the PANAS). In study 2, participants ( n = 228) completed the PANAS, ERPS, and Depression Anxiety Stress Scales. Results Study 1 established the basic psychometric properties of the ERPS and demonstrated that emotional reactivity and perseveration accounted for unique variance in trait positive and negative effect. Study 2 confirmed these findings and established that emotional reactivity and perseveration are differentially associated with depression, anxiety, and stress scores. Conclusion Emotional reactivity and perseveration represent independent dimensions of trait affect. Considering these dimension in future research could further the understanding of both normal emotional responding and emotional vulnerability. [ABSTRACT FROM AUTHOR]

The Revised Children's Manifest Anxiety Scale (RCMAS) is regularly used with South African children, although its performance in this context has yet to be empirically evaluated. This study assessed the basic psychometric properties of the RCMAS using data collected in a large study examining the mental health of children and adolescents living in poor urban communities around Cape Town. Reliability of the full-scale was good, and the predicted relationships between anxiety, depression, PTSD, delinquency, age, sex, and somaticism scores offered evidence of construct validity. However, the reliabilities for the physiological, worry/oversensitivity, and concentration subscales were low, and confirmatory factor analysis revealed the hypothesized three-factor model did not adequately fit the data. Exploratory analyses suggested a four-factor solution consisting of social evaluation, worry, affective responses, and physiological symptoms/sleep disturbance factors. Further confirmatory research examining this four-factor structure is needed. Given the continued use of the RCMAS in South Africa, these findings provide an important first step in establishing its reliability and validity for use with South African youth; however, scores obtained on the three subscales should be interpreted with caution and further detailed psychometric evaluation of the RCMAS in South African samples is clearly required. [ABSTRACT FROM AUTHOR]

Objective: The current study assessed the basic psychometric properties of the Child PTSD Checklist and examined the structure of symptoms of posttraumatic stress disorder (PTSD) in a large sample of South African youth. Methodology: The checklist was completed by 1025 (540 male; 485 female) South African youth (aged between 10 and 19 years). The factor structure of the scale was assessed with a combination of confirmatory and exploratory techniques. Internal consistencies for the full scale and all subscales were evaluated with Cronbach's alpha and McDonald's omega. Validity was assessed by comparing PTSD scores obtained by children who had and had not experienced a traumatic event, and by examining associations between total PTSD scores and known correlates of PTSD. Results: Scores on the Child PTSD Checklist clearly discriminated between youth who had experienced a traumatic event and those who had not. Internal consistencies for the full scale (and all subscales) were acceptable to good and hypothesized correlations between PTSD, depression, anxiety, somatic symptoms, and age were observed. Two of the reported fit statistics for the tripartite DSM-IV-TR model of PTSD did not meet traditional criteria and further exploratory analyses revealed a four-factor structure (broadly consistent with Simms and colleagues' Dysphoria Model of PTSD symptoms) which provided a better fit to the observed data. Conclusion: Given the continued use of the Child PTSD Checklist in South Africa, findings offer an important first step in establishing the reliability and validity of the checklist for use with South African youth. However, further evaluation of the checklist in South African samples is clearly required before conclusions regarding its use as diagnostic tool in this context can be made. [ABSTRACT FROM AUTHOR]

Background: By 2008, 12 million children in sub-Saharan Africa were orphaned by AIDS. Cross-sectional studies show psychological problems for AIDS-orphaned children, but until now no longitudinal study has explored enduring psychological effects of AIDS-orphanhood in the developing world. Methods: A 4-year longitudinal follow-up of AIDS-orphaned children with control groups of other-orphans and non-orphans. 1021 children ( M = 13.4 years, 50% female, 98% isiXhosa-speaking) were interviewed in 2005 and followed up in 2009 with 71% retention (49% female, M = 16.9 years), in poor urban South African settlements. Children were interviewed using sociodemographic questionnaires and well-validated standardised scales for assessing depression, anxiety, and post-traumatic stress. Data were analysed using mixed-design ANOVA and backward-stepping regression. Results: AIDS-orphaned children showed higher depression, anxiety, and post-traumatic stress disorder (PTSD) scores in both 2005 and 2009 when compared with other-orphans and non-orphans. Backward-stepping regression, controlling for baseline mental health, and sociodemographic cofactors such as age, gender, and type of bereavement, revealed that being AIDS-orphaned in 2005 was associated with depression, anxiety, and PTSD scores in 2009. This was not the case for other-orphaned or non-orphaned children. Age interacted with orphan status, such that there was a steep rise in psychological distress in the AIDS-orphaned group, but no rise with age amongst other-orphans and non-orphans. Conclusions: Negative mental health outcomes amongst AIDS-orphaned children are maintained and worsen over a 4-year period. It is important that psychosocial support programmes are sustained, and focus on youth as well as young children. [ABSTRACT FROM AUTHOR]

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