The Mindful Couple

Couples who request conjoint treatment often demonstrate relationship problems that are exacerbated by emotional reactivity. Neurobiology research has clarified the process of emotional dysregulation, and the benefit of mindful interventions in managing and preventing hyperarousal. This paper examines the mechanics of emotional dysregulation and presents a case example that demonstrates how breathing and staying in the moment were used to help de-escalate an agitated couple. Mindful interventions can be used to help couples tolerate, understand, and manage emotional states that can otherwise become destructive. These techniques are particularly useful with volatile couples, and can be used in conjunction with other therapeutic interventions.     

Large Contests

We consider contests with many, possibly heterogeneous, players and prizes, and show that the equilibrium outcomes of such contests are approximated by the outcomes of mechanisms that implement the assortative allocation in an environment with a single agent that has a continuum of possible types. This makes it possible to easily approximate the equilibria of contests whose exact equilibrium characterization is complicated, as well as the equilibria of contests for which there is no existing equilibrium characterization.     

Developing expert systems for management applications

The Alvey Report has resulted in a growing interest in the UK in ‘expert systems’. It is fairly generally accepted, at least in the UK, that such systems function in a particular type of way, i.e. they arrive at decisions through a process of rule based inference. It is suggested that it may be more fruitful to regard rule based inference as one approach to the construction of expert systems, and that proven techniques of operational research may well be more useful in constructing other types of expert system. Alternative applications of expert systems are derived on the basis of a broader definition of an expert system in terms of what it does rather than how it does it. A parallel is drawn between these applications and some typical concerns of business research. It is suggested that a useful aid in identifying promising business applications of expert systems is to set up four ‘dimensions’ along which different types of system differ. Examples are given of where other techniques might conceivably be useful in applications of expert systems.     

The Role of Affect Regulation in a Case of Attempted Maternal-Filicide Suicide: Commentary on an Act of Despair

A case of attempted maternal-filial suicide is discussed from the perspective of trauma, emotional regulation and defense mechanisms. Case details which include childhood sexual abuse, observed parental violence and emotional neglect allow for an illustration of the impact of childhood family experiences on adult intimacy and coping patterns. Domestic violence and the perception of protection are also explored. Emotional regulation in the experience of despair is approached from an object relations perspective. Based on this, implications for prevention and treatment are presented.

Reasons for the adoption of celibacy among older men and women living with HIV/AIDS

The reasons for becoming celibate following diagnosis with HIV/AIDS were examined using focused interviews with 63 infected older adults (ages 50 ‐ 68). Forty‐eight percent reported they were currently celibate or had been celibate following diagnosis with HIV/AIDS. Women reported celibacy (78%) more than men (36%). Although men and women reported some similar reasons for celibacy, most notably fear of infecting others and fear of reinfection, we also found gender differences in the reasons for celibacy. Additional reasons offered by women included loss of interest in sex, anger and distrust of men, and desire to focus on themselves rather than men. Other reasons offered by men included fear of rejection or stigma‐tization, difficulty with sexual performance, and negative body image. The prevalence of celibacy and the finding that many reasons for celibacy are related to fear, anger, and distrust suggests that older adults may have difficulty resuming healthy sexual relationships following diagnosis with HIV/AIDS.     

Improving homeless persons' utilisation of primary care: lessons to be learned from an outreach programme in The Netherlands

Elissen AMJ, Van Raak AJA, Derckx EWCC, Vrijhoef HJM. Improving homeless persons' utilisation of primary care: lessons to be learned from an outreach programme in The Netherlands Faced with rising homelessness, countries around the world are in need of innovative approaches to caring for those without shelter, who, more often than not, suffer from severe health problems. We conducted a case study of an innovative Dutch Primary Care for the Homeless (PCH) programme to gain insight into clients' demographic characteristics, health problems and service use, and to develop an explanation for its success in increasing the latter. Our analyses are based on a combination of quantitative and qualitative data. The results of the study suggest that the success of the PCH programme can be explained by the providers' pragmatism and will to adapt their mode of care provision to the behavioural patterns and needs of their homeless clients.     

Letters to the Editor

Quantitative graphics have been central to the development of science, and statistical graphics date from the earliest attempts to analyze data. Many familiar forms, including bivariate plots, statistical maps, bar charts, and coordinate paper, were used in the 18th century. Statistical graphics developed through attention to four problems: spatial organization (17th and 18th centuries), discrete comparison (18th and early 19th centuries), continuous distribution (19th century), and multivariate distribution and correlation (late 19th and early 20th centuries). Today, statistical graphics appear to be reemerging as an important analytic tool, with recent innovations exploiting computer graphics and related technologies.