Category: Health & Medical

Does EMDR lend to better treatment outcomes for major
depressive disorder compared to treatment as usual (pharmacotherapy,
psychotherapy, etc)?

Instruction
For this assignment, please choose your topic by reviewing Assignment 3: Power Point Presentation Topics. Choose one topic of your choice to complete Assignment 3.
Assignment requirements and rubric are attached as a PDF with this assignment.
Your Power Point Presentation should:
Be 10-15 slides in length, not including a title slide and reference slide. The title slide should list the topic, the date, and your name.
Presentation should include a photo of you that is professional in nature.
Describe the information technology topic and related questions thoroughly.
Incorporate a minimum of five scholarly research articles into the presentation.
Contain a summary slide that wraps up the presentation.
Follow APA guidelines.
Be professional and visually appealing. Select appropriate background, coloring, and fonts. Please include pictures, charts, or other visuals as appropriate for a professional presentation.
Presentation should be submitted in a .pptx file
NOTE: Please review Power Point Presentation Best Practices under the library module or click on the link below.
https://libguides.hccfl.edu/powerpoint
If you are not familiar with how to create a Power Point Presentation, click on the link below.
https://support.microsoft.com/en-us/office/basic-tasks-for-creating-a-powerpoint-presentation-efbbc1cd-c5f1-4264-b48e-c8a7b0334e36?ui=en-us&rs=en-us&ad=us

Does EMDR lend to better treatment outcomes for major
depressive disorder compared to treatment as usual (pharmacotherapy,
psychotherapy, etc)?

Instruction
For this assignment, please choose your topic by reviewing Assignment 3: Power Point Presentation Topics. Choose one topic of your choice to complete Assignment 3.
Assignment requirements and rubric are attached as a PDF with this assignment.
Your Power Point Presentation should:
Be 10-15 slides in length, not including a title slide and reference slide. The title slide should list the topic, the date, and your name.
Presentation should include a photo of you that is professional in nature.
Describe the information technology topic and related questions thoroughly.
Incorporate a minimum of five scholarly research articles into the presentation.
Contain a summary slide that wraps up the presentation.
Follow APA guidelines.
Be professional and visually appealing. Select appropriate background, coloring, and fonts. Please include pictures, charts, or other visuals as appropriate for a professional presentation.
Presentation should be submitted in a .pptx file
NOTE: Please review Power Point Presentation Best Practices under the library module or click on the link below.
https://libguides.hccfl.edu/powerpoint
If you are not familiar with how to create a Power Point Presentation, click on the link below.
https://support.microsoft.com/en-us/office/basic-tasks-for-creating-a-powerpoint-presentation-efbbc1cd-c5f1-4264-b48e-c8a7b0334e36?ui=en-us&rs=en-us&ad=us

Does EMDR lend to better treatment outcomes for major
depressive disorder compared to treatment as usual (pharmacotherapy,
psychotherapy, etc)?

A physical therapist receives a phone call from a woman demanding to know when her daughter-in-law’s next appointment is. The therapist tells the woman that she cannot disclose any information, and the woman becomes very angry and abusive, threatening to make a complaint. After the phone call, the therapist logs into the electronic medical record system to make a note about the conversation. However, since the two women share the same last name, the therapist accidentally accesses the woman’s record instead of the daughter-in-law’s record. The therapist realizes the mistake, but not before spotting that the woman suffers from a serious mental health disorder, which might explain her behavior on the phone. The therapist mentions to her supervisor the possibility of a complaint being brought and also mentions that the woman has a history of mental health problems. Do you feel that there has been a breach of confidentiality? Why or why not? How should the supervisor handle this situation? Should the patient be notified?

6.Now you are going to write a one paragraph summary of the article you read where you describe the following elements:
a) the design the authors used for their project,
b) identify the independent and dependent variables,
c) talk about how the authors carried out their study (the methods; including the participants, how they manipulated the iv, how they measured the dv, and how they controlled for confounding variables in the study),
d) summarize the results.
But here’s the catch: I want you to write a bad paper. Yup, you read that right, I want you to write a bad paper. I want you to write an example of what a paper should NOT be.
You may be wondering, “what do you mean by a bad paper?” Well, here’s where you can get creative. In your paper you should:
Incorrectly describe two of the above-mentioned required aspects of the paragraph (items a through d)
Include at least 4 grammatical errors.
You will be sharing this paper with your peers this week, so be prepared to swap papers with one of your group members during the discussion assignment! The goal is to give your peers lots of elements to fix, so don’t be afraid to be tricky!
a. Write no more than 10 sentences, the max word count is 250.
b. In-text citation and direct quotes are not needed (we will learn how to do that next week!).
c. You cannot directly copy and paste the sentences/phrases from the original article. You must use your own words (paraphrase) to summarize. Each student’s writing should and must be different.
d. Font: Times New Roman; Font size: 12.
Don’t forget to save a copy of your response to this question before you submit your assignment! You’ll need it for the discussion assignment this week!
Article
Short Report
Enhancing the Pace of Recovery
Self-Distanced Analysis of Negative Experiences Reduces
Blood Pressure Reactivity
O ̈ zlem Ayduk1 and Ethan Kross2
1 University of California, Berkeley, and 2 Columbia University
Recent work suggests that rumination plays a key role in medi-
ating the relationship between stress and cardiovascular disease
(Brosschot, Gerin, & Thayer, 2006). People engage in rumina-
tion because they believe that understanding their feelings will
improve their mood. However, these attempts often backfire,
instead maintaining negative affect (Nolen-Hoeksema, 1991)
and delaying physiological recovery from negative events
(Glynn, Christenfeld, & Gerin, 2002)—a key risk factor for
cardiovascular disease (McEwen, 1998).
At first glance, these findings suggest that people should avoid
focusing on their negative feelings. However, this prescription
contradicts an alternative literature indicating that emotional
processing facilitates coping (e.g., Pennebaker & Chung, 2007).
Thus, a key question emerges: How can people analyze negative
experiences without enhancing their vulnerability to cardiovas-
cular disease?
According to a recent proposal (Kross, Ayduk, & Mischel,
2005), whether people’s attempts to understand their negative
feelings are adaptive depends on the type of self-perspective
they adopt. Research results supported the prediction that analyz-
ing feelings surrounding a negative experience from a self-
distanced perspective (from an observer’s vantage point) leads
people to display lower levels of negative affect and rumination
than does analyzing such feelings from a self-immersed perspec-
tive (from one’s own vantage point; Kross et al., 2005; also see
Kross & Ayduk, in press).
The current study extends these findings to cardiovascular
reactivity. We predicted that participants who adopted a self-
distanced perspective, compared with those who adopted a self-
immersed perspective, would demonstrate smaller increases in
blood pressure reactivity both when analyzing their feelings dur-
ing the experiment and during a recovery period after the
experiment was over.
METHOD
Ninety undergraduates (54.55% women; mean age 5 20.71,
SD 5 4.24) from diverse ethnic backgrounds were recruited for a
study on mental imagery and physiological responses. They
completed the study on a computer, which provided both written
and oral instructions. Participants first sat quietly for 5 min for
baseline measurements of blood pressure (i.e., baseline phase).
Next, they were cued to recall an experience when they were
angry and indicated that they had recalled an appropriate ex-
perience by pressing the space bar (i.e., recall phase); the
computer recorded their recall times. Then they were told, ‘‘Go
back to the time and place of the conflict and see the scene in
your mind’s eye.’’ They were then randomly assigned to one of
two perspective conditions. In the self-immersed condition,
participants were told,
Relive the situation as if it were happening to you all over again . . .
Reexperience the interaction as it progresses in your mind’s eye.
In the self-distanced condition, participants were told,
Take a few steps back . . . . Move away from the situation to a point
where you can now watch the conflict from a distance . . . . Watch the
conflict unfold as if it were happening all over again to the distant
you. Replay the interaction as it progresses in your mind’s eye.
Participants were given as much time as they needed to adopt
these perspectives and indicated they had done this successfully
by pressing the space bar; the computer recorded this time.
Next, they were directed to analyze their feelings for 60 s from
the perspective they adopted:
As you continue to relive this conflict, try to understand the
emotions that you [your distant self ] experienced as the conflict
unfolded. Why did you [he/she] have those feelings? What were
the underlying causes and reasons?
The perspective-taking and analysis instructions together con-
stituted the manipulation phase of the study.
Address correspondence to O ̈ zlem Ayduk, Department of Psycholo-
gy, 3210 Tolman Hall, University of California, Berkeley, CA 94720,
e-mail: ayduk@berkeley.edu, or to Ethan Kross, e-mail: ekross@
psych.columbia.edu.
PS YC HOLOGICA L SC IENCE
Volume 19—Number 3 229Copyright r 2008 Association for Psychological Science
Finally, participants completed a series of questionnaires that
included assessments of the study’s dependent variables and
covariates and then sat quietly for a 5-min recovery period.
Blood pressure was recorded throughout the experiment.
Dependent Variables
Participants’ ratings of the extent to which and the intensity with
which they reexperienced their original feelings during the ex-
periment were averaged to form an emotional-reactivity index
(r 5 .76, p < .001; scale: 1–7, M 5 3.44, SD 5 1.44). Blood pressure was recorded using a Medwave continual blood pressure machine (St. Paul, MN). Mean arterial blood pressure (MAP) was used as the main dependent variable. Covariates Because participants varied in how quickly they recalled an experience of anger (recall time), adopted a particular perspec- tive (perspective time), and completed the questionnaires (questionnaire time), we included these response times as covariates. Because imagery vividness—the composite of self- reported imagination ability and vividness of the recalled memory, r(88) 5 .50, p < .001—and the self-reported resolution status of the recalled experience (69% resolved vs. 31% unre- solved) might have affected reactivity during the experiment, we also controlled for these variables. We observed no group differences in any covariate except for perspective time (self- distanced: M 5 59.07 s, SD 5 20.51; self-immersed: M 5 45.94 s, SD 5 22.95), t(88) 5 2.84, p < .01, d 5 0.60. None of the covariates moderated the results reported in this article. Exclusions Six participants were excluded because they did not follow in- structions. Additionally, six extreme or biologically implausible blood pressure reactivity scores were excluded from analyses. Exclusions were not related to experimental condition, w2 (1, N 5 90) 5 0.14, p 5 .71. Some data could not be scored because of faulty sensors or noisy signals, so sample sizes for blood pressure indices vary. RESULTS Baseline MAP did not differ significantly between the two con- ditions, t(74) 5 1.40, p 5 .17. We therefore computed change scores by subtracting baseline MAP values from MAP values for each study phase (i.e., recall, manipulation, recovery). Separate one-way analyses of covariance (ANCOVAs) were conducted on emotional reactivity and MAP reactivity scores from each study phase. Condition was the between-subjects predictor, and rel- evant covariates were included. The ANCOVA revealed that participants in the self-distanced group reported lower levels of emotional reactivity than partic- ipants in the self-immersed group. Because recall of the anger experience preceded the experimental manipulation, we ex- pected and found no difference between the two groups in MAP reactivity during recall (F < 1). In contrast, participants in the self-distanced group showed lower MAP reactivity than those in the self-immersed group during both the manipulation and the recovery phases of the experiment (see Table 1 for significant results). DISCUSSION A hallmark feature of rumination is that it delays physiological recovery (Gerin, Davidson, Christenfeld, Goyal, & Schwartz, 2006), which may increase the risk of cardiovascular disease (McEwen, 1998). Thus, the fact that analyzing experiences of anger from a self-distanced rather than a self-immersed per- spective led to lower reactivity may have important protective benefits for physical health. This study, to our knowledge, is the first to examine how the negative physiological consequences associated with rumination can be reduced without relying on distraction. Our finding on distancing as an alternative strategy is important because dis- traction, although effective at reducing short-term arousal, may be less useful for long-term coping (Kross & Ayduk, in press). A key challenge for future research will be to identify the boundary conditions that determine when distanced analysis is adaptive and when it is not. It is possible that under certain circumstances, alternative coping strategies (e.g., avoidance in the case of uncontrollable situations; emotional flooding and habituation in coping with fear and trauma) are more helpful than distancing. Acknowledgments—This research was supported by grants from the National Institute of Mental Health (MH0697043, MH039349) and by a National Research Service Award. We would like to thank the research assistants who scored the phys- TABLE 1 Effect of Experimental Condition on the Dependent Variables Variable Experimental condition Difference between conditionsSelf-immersed Self-distanced F dM SE n M SE n Emotional reactivity 4.01 0.20 42 3.05 0.21 39 9.20nn 0.70 MAP: manipulation 4.85 1.01 37 0.81 1.04 35 6.98nn 0.65 MAP: recovery 4.72 1.03 36 1.39 1.08 33 4.37n 0.53 Note. Mean arterial blood pressure (MAP) was scored as the difference from baseline. All analyses controlled for imagery vividness (scale: 1–7, M 5 5.14, SD 5 1.17), resolution status (31% unresolved), recall time (M 5 66.48 s, SD 5 13.90 s), and perspective time (M 5 51.46 s, SD 5 21.30 s). Time to complete the questionnaire (M 5 22.41 min, SD 5 7.18 min) was included as an additional covariate in analyzing MAP during recovery. np < .05. nnp .01. 230 Volume 19—Number 3 Distanced Analysis Versus Immersed Analysis iological data and Liz Page Gould, Anett Gyurak, Basil Mar- golis, and Wendy Berry Mendes for consultation on the analyses and interpretation of the physiological data. REFERENCES Brosschot, J.F., Gerin, W., & Thayer, J.F. (2006). The perseverative cognition hypothesis: A review of worry, prolonged stress-related physiological activation, and health. Journal of Psychosomatic Research, 60, 113–124. Gerin, W., Davidson, K.W., Christenfeld, N.J.S., Goyal, T., & Schwartz, J.E. (2006). The role of angry rumination and distraction in blood pressure recovery from emotional arousal. Psychosomatic Medi- cine, 68, 64–72. Glynn, L.M., Christenfeld, N., & Gerin, W. (2002). The role of rumi- nation in recovery from reactivity: Cardiovascular consequences of emotional states. Psychosomatic Medicine, 64, 714–726. Kross, E., & Ayduk, O ̈ . (in press). Facilitating adaptive emotional anal- ysis: Short-term and long-term outcomes distinguishing dis- tanced-analysis of depressive experiences from immersed-anal- ysis and distraction. Personality and Social Psychology Bulletin. Kross, E., Ayduk, O., & Mischel, W. (2005). When asking ‘‘why’’ does not hurt: Distinguishing rumination from reflective processing of negative emotions. Psychological Science, 16, 709–715. McEwen, B.S. (1998). Protective and damaging effects of stress me- diators. New England Journal of Medicine, 338, 171–179. Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psy- chology, 100, 569–582. Pennebaker, J.W., & Chung, C.K. (2007). Expressive writing, emo- tional upheavals, and health. In H. Friedman & R. Silver (Eds.), Handbook of health psychology (pp. 263–284). New York: Oxford University Press. (R ECEIVED 5/17/07; REVISION ACCEPTED 9/20/07) Volume 19—Number 3 231

A physical therapist receives a phone call from a woman demanding to know when her daughter-in-law’s next appointment is. The therapist tells the woman that she cannot disclose any information, and the woman becomes very angry and abusive, threatening to make a complaint. After the phone call, the therapist logs into the electronic medical record system to make a note about the conversation. However, since the two women share the same last name, the therapist accidentally accesses the woman’s record instead of the daughter-in-law’s record. The therapist realizes the mistake, but not before spotting that the woman suffers from a serious mental health disorder, which might explain her behavior on the phone. The therapist mentions to her supervisor the possibility of a complaint being brought and also mentions that the woman has a history of mental health problems. Do you feel that there has been a breach of confidentiality? Why or why not? How should the supervisor handle this situation? Should the patient be notified?

6.Now you are going to write a one paragraph summary of the article you read where you describe the following elements:
a) the design the authors used for their project,
b) identify the independent and dependent variables,
c) talk about how the authors carried out their study (the methods; including the participants, how they manipulated the iv, how they measured the dv, and how they controlled for confounding variables in the study),
d) summarize the results.
But here’s the catch: I want you to write a bad paper. Yup, you read that right, I want you to write a bad paper. I want you to write an example of what a paper should NOT be.
You may be wondering, “what do you mean by a bad paper?” Well, here’s where you can get creative. In your paper you should:
Incorrectly describe two of the above-mentioned required aspects of the paragraph (items a through d)
Include at least 4 grammatical errors.
You will be sharing this paper with your peers this week, so be prepared to swap papers with one of your group members during the discussion assignment! The goal is to give your peers lots of elements to fix, so don’t be afraid to be tricky!
a. Write no more than 10 sentences, the max word count is 250.
b. In-text citation and direct quotes are not needed (we will learn how to do that next week!).
c. You cannot directly copy and paste the sentences/phrases from the original article. You must use your own words (paraphrase) to summarize. Each student’s writing should and must be different.
d. Font: Times New Roman; Font size: 12.
Don’t forget to save a copy of your response to this question before you submit your assignment! You’ll need it for the discussion assignment this week!
Article
Short Report
Enhancing the Pace of Recovery
Self-Distanced Analysis of Negative Experiences Reduces
Blood Pressure Reactivity
O ̈ zlem Ayduk1 and Ethan Kross2
1 University of California, Berkeley, and 2 Columbia University
Recent work suggests that rumination plays a key role in medi-
ating the relationship between stress and cardiovascular disease
(Brosschot, Gerin, & Thayer, 2006). People engage in rumina-
tion because they believe that understanding their feelings will
improve their mood. However, these attempts often backfire,
instead maintaining negative affect (Nolen-Hoeksema, 1991)
and delaying physiological recovery from negative events
(Glynn, Christenfeld, & Gerin, 2002)—a key risk factor for
cardiovascular disease (McEwen, 1998).
At first glance, these findings suggest that people should avoid
focusing on their negative feelings. However, this prescription
contradicts an alternative literature indicating that emotional
processing facilitates coping (e.g., Pennebaker & Chung, 2007).
Thus, a key question emerges: How can people analyze negative
experiences without enhancing their vulnerability to cardiovas-
cular disease?
According to a recent proposal (Kross, Ayduk, & Mischel,
2005), whether people’s attempts to understand their negative
feelings are adaptive depends on the type of self-perspective
they adopt. Research results supported the prediction that analyz-
ing feelings surrounding a negative experience from a self-
distanced perspective (from an observer’s vantage point) leads
people to display lower levels of negative affect and rumination
than does analyzing such feelings from a self-immersed perspec-
tive (from one’s own vantage point; Kross et al., 2005; also see
Kross & Ayduk, in press).
The current study extends these findings to cardiovascular
reactivity. We predicted that participants who adopted a self-
distanced perspective, compared with those who adopted a self-
immersed perspective, would demonstrate smaller increases in
blood pressure reactivity both when analyzing their feelings dur-
ing the experiment and during a recovery period after the
experiment was over.
METHOD
Ninety undergraduates (54.55% women; mean age 5 20.71,
SD 5 4.24) from diverse ethnic backgrounds were recruited for a
study on mental imagery and physiological responses. They
completed the study on a computer, which provided both written
and oral instructions. Participants first sat quietly for 5 min for
baseline measurements of blood pressure (i.e., baseline phase).
Next, they were cued to recall an experience when they were
angry and indicated that they had recalled an appropriate ex-
perience by pressing the space bar (i.e., recall phase); the
computer recorded their recall times. Then they were told, ‘‘Go
back to the time and place of the conflict and see the scene in
your mind’s eye.’’ They were then randomly assigned to one of
two perspective conditions. In the self-immersed condition,
participants were told,
Relive the situation as if it were happening to you all over again . . .
Reexperience the interaction as it progresses in your mind’s eye.
In the self-distanced condition, participants were told,
Take a few steps back . . . . Move away from the situation to a point
where you can now watch the conflict from a distance . . . . Watch the
conflict unfold as if it were happening all over again to the distant
you. Replay the interaction as it progresses in your mind’s eye.
Participants were given as much time as they needed to adopt
these perspectives and indicated they had done this successfully
by pressing the space bar; the computer recorded this time.
Next, they were directed to analyze their feelings for 60 s from
the perspective they adopted:
As you continue to relive this conflict, try to understand the
emotions that you [your distant self ] experienced as the conflict
unfolded. Why did you [he/she] have those feelings? What were
the underlying causes and reasons?
The perspective-taking and analysis instructions together con-
stituted the manipulation phase of the study.
Address correspondence to O ̈ zlem Ayduk, Department of Psycholo-
gy, 3210 Tolman Hall, University of California, Berkeley, CA 94720,
e-mail: ayduk@berkeley.edu, or to Ethan Kross, e-mail: ekross@
psych.columbia.edu.
PS YC HOLOGICA L SC IENCE
Volume 19—Number 3 229Copyright r 2008 Association for Psychological Science
Finally, participants completed a series of questionnaires that
included assessments of the study’s dependent variables and
covariates and then sat quietly for a 5-min recovery period.
Blood pressure was recorded throughout the experiment.
Dependent Variables
Participants’ ratings of the extent to which and the intensity with
which they reexperienced their original feelings during the ex-
periment were averaged to form an emotional-reactivity index
(r 5 .76, p < .001; scale: 1–7, M 5 3.44, SD 5 1.44). Blood pressure was recorded using a Medwave continual blood pressure machine (St. Paul, MN). Mean arterial blood pressure (MAP) was used as the main dependent variable. Covariates Because participants varied in how quickly they recalled an experience of anger (recall time), adopted a particular perspec- tive (perspective time), and completed the questionnaires (questionnaire time), we included these response times as covariates. Because imagery vividness—the composite of self- reported imagination ability and vividness of the recalled memory, r(88) 5 .50, p < .001—and the self-reported resolution status of the recalled experience (69% resolved vs. 31% unre- solved) might have affected reactivity during the experiment, we also controlled for these variables. We observed no group differences in any covariate except for perspective time (self- distanced: M 5 59.07 s, SD 5 20.51; self-immersed: M 5 45.94 s, SD 5 22.95), t(88) 5 2.84, p < .01, d 5 0.60. None of the covariates moderated the results reported in this article. Exclusions Six participants were excluded because they did not follow in- structions. Additionally, six extreme or biologically implausible blood pressure reactivity scores were excluded from analyses. Exclusions were not related to experimental condition, w2 (1, N 5 90) 5 0.14, p 5 .71. Some data could not be scored because of faulty sensors or noisy signals, so sample sizes for blood pressure indices vary. RESULTS Baseline MAP did not differ significantly between the two con- ditions, t(74) 5 1.40, p 5 .17. We therefore computed change scores by subtracting baseline MAP values from MAP values for each study phase (i.e., recall, manipulation, recovery). Separate one-way analyses of covariance (ANCOVAs) were conducted on emotional reactivity and MAP reactivity scores from each study phase. Condition was the between-subjects predictor, and rel- evant covariates were included. The ANCOVA revealed that participants in the self-distanced group reported lower levels of emotional reactivity than partic- ipants in the self-immersed group. Because recall of the anger experience preceded the experimental manipulation, we ex- pected and found no difference between the two groups in MAP reactivity during recall (F < 1). In contrast, participants in the self-distanced group showed lower MAP reactivity than those in the self-immersed group during both the manipulation and the recovery phases of the experiment (see Table 1 for significant results). DISCUSSION A hallmark feature of rumination is that it delays physiological recovery (Gerin, Davidson, Christenfeld, Goyal, & Schwartz, 2006), which may increase the risk of cardiovascular disease (McEwen, 1998). Thus, the fact that analyzing experiences of anger from a self-distanced rather than a self-immersed per- spective led to lower reactivity may have important protective benefits for physical health. This study, to our knowledge, is the first to examine how the negative physiological consequences associated with rumination can be reduced without relying on distraction. Our finding on distancing as an alternative strategy is important because dis- traction, although effective at reducing short-term arousal, may be less useful for long-term coping (Kross & Ayduk, in press). A key challenge for future research will be to identify the boundary conditions that determine when distanced analysis is adaptive and when it is not. It is possible that under certain circumstances, alternative coping strategies (e.g., avoidance in the case of uncontrollable situations; emotional flooding and habituation in coping with fear and trauma) are more helpful than distancing. Acknowledgments—This research was supported by grants from the National Institute of Mental Health (MH0697043, MH039349) and by a National Research Service Award. We would like to thank the research assistants who scored the phys- TABLE 1 Effect of Experimental Condition on the Dependent Variables Variable Experimental condition Difference between conditionsSelf-immersed Self-distanced F dM SE n M SE n Emotional reactivity 4.01 0.20 42 3.05 0.21 39 9.20nn 0.70 MAP: manipulation 4.85 1.01 37 0.81 1.04 35 6.98nn 0.65 MAP: recovery 4.72 1.03 36 1.39 1.08 33 4.37n 0.53 Note. Mean arterial blood pressure (MAP) was scored as the difference from baseline. All analyses controlled for imagery vividness (scale: 1–7, M 5 5.14, SD 5 1.17), resolution status (31% unresolved), recall time (M 5 66.48 s, SD 5 13.90 s), and perspective time (M 5 51.46 s, SD 5 21.30 s). Time to complete the questionnaire (M 5 22.41 min, SD 5 7.18 min) was included as an additional covariate in analyzing MAP during recovery. np < .05. nnp .01. 230 Volume 19—Number 3 Distanced Analysis Versus Immersed Analysis iological data and Liz Page Gould, Anett Gyurak, Basil Mar- golis, and Wendy Berry Mendes for consultation on the analyses and interpretation of the physiological data. REFERENCES Brosschot, J.F., Gerin, W., & Thayer, J.F. (2006). The perseverative cognition hypothesis: A review of worry, prolonged stress-related physiological activation, and health. Journal of Psychosomatic Research, 60, 113–124. Gerin, W., Davidson, K.W., Christenfeld, N.J.S., Goyal, T., & Schwartz, J.E. (2006). The role of angry rumination and distraction in blood pressure recovery from emotional arousal. Psychosomatic Medi- cine, 68, 64–72. Glynn, L.M., Christenfeld, N., & Gerin, W. (2002). The role of rumi- nation in recovery from reactivity: Cardiovascular consequences of emotional states. Psychosomatic Medicine, 64, 714–726. Kross, E., & Ayduk, O ̈ . (in press). Facilitating adaptive emotional anal- ysis: Short-term and long-term outcomes distinguishing dis- tanced-analysis of depressive experiences from immersed-anal- ysis and distraction. Personality and Social Psychology Bulletin. Kross, E., Ayduk, O., & Mischel, W. (2005). When asking ‘‘why’’ does not hurt: Distinguishing rumination from reflective processing of negative emotions. Psychological Science, 16, 709–715. McEwen, B.S. (1998). Protective and damaging effects of stress me- diators. New England Journal of Medicine, 338, 171–179. Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psy- chology, 100, 569–582. Pennebaker, J.W., & Chung, C.K. (2007). Expressive writing, emo- tional upheavals, and health. In H. Friedman & R. Silver (Eds.), Handbook of health psychology (pp. 263–284). New York: Oxford University Press. (R ECEIVED 5/17/07; REVISION ACCEPTED 9/20/07) Volume 19—Number 3 231

A physical therapist receives a phone call from a woman demanding to know when her daughter-in-law’s next appointment is. The therapist tells the woman that she cannot disclose any information, and the woman becomes very angry and abusive, threatening to make a complaint. After the phone call, the therapist logs into the electronic medical record system to make a note about the conversation. However, since the two women share the same last name, the therapist accidentally accesses the woman’s record instead of the daughter-in-law’s record. The therapist realizes the mistake, but not before spotting that the woman suffers from a serious mental health disorder, which might explain her behavior on the phone. The therapist mentions to her supervisor the possibility of a complaint being brought and also mentions that the woman has a history of mental health problems. Do you feel that there has been a breach of confidentiality? Why or why not? How should the supervisor handle this situation? Should the patient be notified?