Obtaining informed consent for HIV antibody testing: the decision making process

All patients referring themselves for HIV antibody testing must receive pre-test counselling and must give their informed consent before testing can proceed. All patients being referred by their doctors for HIV antibody testing must also receive pre-test counselling and must give their informed consent before testing can proceed, except in very unusual circumstances. This paper is written primarily for medical and nursing staff who are considering referring a patient for testing and it is particularly relevant to those staff working in the field of mental health. This paper draws on professional guidelines and suggests that staff use a two-part decision making process. In the first part die referrer decides whether there are substantial clinical grounds for needing the test result immediately. If there are, the referral is made for pre-test counselling and testing, for example at the local Genito-Urinary Medicine (GU) clinic. In the second part experienced AIDS counsellors try to enable the patient to decide whether or not to proceed. If the patient is not able to understand or make a decision the AIDS counsellors, in consultation with other staff, will decide whether to proceed. Whatever the decision, it should be respected by professional staff.     

Understanding and taking stock of positive emotion disturbance

The prevailing view on positive emotions is that they correlate with and confer psychological health benefits for the individual, including improved social, physical and cognitive functioning. Yet an emerging wave of scientific work suggests that positive emotions are also related to a range of suboptimal psychological health outcomes, especially when the intensity, duration, or context do not optimize the individual's goals or meet current environmental demands. This paper provides an overview of the “other side” of positive emotion, by describing and reviewing evidence supporting the emerging field of positive emotion disturbance (PED). We review relevant emotion processes and key themes of PED and apply this framework to example emotional disorders, and discuss implications for psychological change and future research agendas.     

The researcher goes to school

Educational research in the naturalistic setting is challenging and rewarding for the researcher, but it places new demands upon teachers and administrators. School personnel may view the researcher as an intruder, a fact which researchers must understand from the school's point of view. Research needs and goals must be understood by school personnel prior to the onset of data collection. Research can be successfully implemented in the naturalistic setting if emphathetic researchers work closely with school personnel to facilitate mutual understanding.     

Evaluating evidence of psychological adaptation: how do we know one when we see one?

Evolutionary psychologists argue that human nature contains many discrete psychological adaptations. Each adaptation is theorized to have been functional in humans' ancestral past, and empirical evidence that an attribute is an adaptation can come from showing it possesses complexity, efficiency, universality, and other features of special design. In this article, we present a tutorial review of the evidentiary forms that evolutionary psychologists commonly use to document the existence of human adaptations. We also present a heuristic framework for integrating and evaluating cross-disciplinary evidence of adaptation. Pregnancy sickness, incest avoidance, men's desires for multiple sex partners, and an easily learned fear of snakes are evaluated as possible human adaptations using this framework. We conclude that future research and teaching in evolutionary psychology would benefit from more fully utilizing cross-disciplinary frameworks to evaluate evidence of human adaptation.     

Genetic Cancer Risk Assessment and Counseling: Recommendations of the National Society of Genetic Counselors

These cancer genetic counseling recommendations describe the medical, psychosocial, and ethical ramifications of identifying at-risk individuals through cancer risk assessment with or without genetic testing. They were developed by members of the Practice Issues Subcommittee of the National Society of Genetic Counselors Cancer Genetic Counseling Special Interest Group. The information contained in this document is derived from extensive review of the current literature on cancer genetic risk assessment and counseling as well as the personal expertise of genetic counselors specializing in cancer genetics. The recommendations are intended to provide information about the process of genetic counseling and risk assessment for hereditary cancer disorders rather than specific information about individual syndromes. Key components include the intake (medical and family histories), psychosocial assessment (assessment of risk perception), cancer risk assessment (determination and communication of risk), molecular testing for hereditary cancer syndromes (regulations, informed consent, and counseling process), and follow-up considerations. These recommendations should not be construed as dictating an exclusive course of management, nor does use of such recommendations guarantee a particular outcome. These recommendations do not displace a health care provider's professional judgment based on the clinical circumstances of a client.     

Feeling stuck in the present? Mania proneness and history associated with present-oriented time perspective

Humans have the ability to mentally time travel through past, present, and future. But can a disruption in emotion characteristic of emotional disorders cause this ability to unwind, leaving people "stuck" in the present emotional moment? Two studies are presented that examine emotional time-perspective in a disorder (mania) characterized by present-oriented tendencies, including impulsivity and emotion dysregulation. In Study 1, associations were reported between mania proneness and emotion time-perspective (n = 509), and Study 2 compared emotion time-perspective between individuals with a clinical history of mania (n = 32), and controls (n = 30). We show that mania is associated with increased present and decreased future focus. These findings suggest that emotional disorders can be understood, at least in part, by examining how people understand and use time to guide their behavior and feelings.     

A test of the bidirectional association between sleep and mood in bipolar disorder and insomnia

The present study investigates sleep, mood, and the proposed bidirectional relationship between the two in psychiatric disorders. Participants with interepisode bipolar disorder (n = 49), insomnia (n = 34), and no psychiatric history (n = 52) completed seven consecutive days of sleep diaries and mood measures. The interepisode bipolar and insomnia participants exhibited greater sleep disturbance than the healthy control individuals. Negative mood was equally heightened in both interepisode bipolar disorder and insomnia, and there were no differences between the three groups in positive mood. Total wake time was associated with next morning negative mood in bipolar disorder, whereas evening negative mood was associated with subsequent total wake time in both bipolar disorder and insomnia. Additionally, positive mood was associated with subsequent total wake time for the insomnia group. Results support the theory that disruptions in nighttime sleep and daytime mood may be mutually maintaining and suggest the potential importance of transdiagnostic or universal processes.     

A discrete emotions approach to positive emotion disturbance in depression

Converging findings suggest that depressed individuals exhibit disturbances in positive emotion. No study, however, has ascertained which specific positive emotions are implicated in depression. We report two studies that compare how depressive symptoms relate to distinct positive emotions at both trait and state levels of assessment. In Study 1 (N=185), we examined associations between depressive symptoms and three trait positive emotions (pride, happy, amusement). Study 2 compared experiential and autonomic reactivity to pride, happy, and amusement film stimuli between depressive (n=24; DS) and non-depressive (n=31; NDS) symptom groups. Results indicate that symptoms of depression were most strongly associated with decreased trait pride and decreased positive emotion experience to pride-eliciting films. Discussion focuses on the implications these findings have for understanding emotion deficits in depression as well as for the general study of positive emotion.