Psychological well-being and biological correlates in African women

Abstract

The aim of this study was to explore, from different perspectives, whether obesity related variables are associated with facets of psychological well-being, with a vision to future enhancement of health and the quality of life of people in the African context. This study was undertaken from the perspective of positive psychology and focused on the metabolic syndrome and obesity as biological facets. This research was conducted as part of the multidisciplinary POWIRS (Profiles of Obese Women with Insulin Resistance Syndrome) project. African (n=102) and Caucasian (1 15) women took part in a cross-sectional design. The thesis consists of 3 articles: I) Childhood relationships and bio-psycho-.gocia1 well-being in African women, 2) Psychological well-being and rhe metabolic syndrome in African and Caucasian women, and 3) Psychological well-being and (the absence of obesity in African and Caucasian women. In this study psychological well-being was conceptualized and operationalized by means of the General Health Questionnaire (GHQ); Sense of Coherence Scale (SOC-29); Affectometer 2 (AFM) (short form); Fortitude Questionnaire (FORQ); Cognitive Appraisa1 Questionnaire (CAQ); Psychological Well-being Scales (SPWB); Quality of Childhood Relationship Questionnaire (QCR); Satisfaction with Life Scale (SWLS) and the Jarel Spiritual Well-Being Scale (SWS-H). These scales were chosen to include hedonic as well as eudaimonic psychological well-being facets, but also an index of psychological symptoms. As far as possible, scales with acceptable psychometric properties as described in international as well as South African context were selected. The first article focused on whether African women with a recalled higher level of quality of childhood relationships mould differ significantly with regard to biological, psychological and social well-being from women with a recalled lower level of quality of childhood relationships. Body mass index (BMI) was used as objective measure of obesity to operationalize physical health. Findings were that the recalled quality of childhood relationships is linked with obesity and psycho-social well-being in this group of African women. The second article focused on psychological well-being and (the absence of) the metabolic syndrome (MS). It explored the possible association between comprehensive psychological well-being and MS in different cultural contexts, and explored whether African and Caucasian women without MS markers and those with MS differ on specific indices of psychological well-being. The criteria of the NCEP ATPIII mere implemented to determine markers of MS, and the absence of markers of MS was used as measure of physical health. Findings were that an association is found in Caucasian women between comprehensive psychological well-being and the absence of the metabolic syndrome, but not in the case of African women. Caucasian women without metabolic syndrome markers had significantly higher levels of psycho-social well-being than women with the metabolic syndrome. but a less apparent pattern of differences emerged for African women. MS markers for African women should be further explored. The third article explored facets of psychological well-being as predictors for (the absence of) obesity (measured by BMI and WHR) in African and Caucasian women, and whether similar or different psychological well-being facets will emerge as predictors of obesity in different cultural contexts. Obesity was operationalized in terms of waist-hip-ratio (WHR) and body-mass-index (BMI). The finding was that clusters of psychological well-being facets are practical significant predictors of obesity (measured by BMI and WHR) and that these clusters differ in some respects for African and Caucasian women. It was concluded that, firstly. findings support holistic conceptualizations of health such as proposed by the WHO (1999). Secondly, it may be worthwhile to include facets of psychological well-being in already existing intervention programmes. The development of strengths that focus on life skills and behaviours related to positive interpersonal relationships, optimistic cognitive attributional styles, finding a sense of purpose and meaningfulness in life, may be particularly beneficial. Sensitivity for cultural contexts is indicated. In view of the increase in the occurrence of obesity in childhood and adolescence it is recommended that educational training programmes should be implemented early in life in order to facilitate protective strengths and to promote bio-psycho-social health in individuals and communities. Advocacy for more attention to psycho-social and protective factors in public health is needed.