Examining the Relationship Between PTSD Symptom Clusters and Drinking to Cope Motives on Drinking Outcomes

Examining the Relationship Between PTSD Symptom Clusters and Drinking to Cope Motives on Drinking Outcomes Fatima Tariq, Dept. of Psychology, with Dr. Christina Sheerin, Dept. of Psychology and Virginia Institute for Psychiatric and Behavioral Genetics Posttraumatic stress disorder (PTSD) is prevalent among combat veterans, and its symptoms are categorized (in DSM-IV) in clusters of: reexperiencing, avoidance, and hyperarousal. Alcohol use disorder (AUD), often preceded by risky drinking behaviors such as binge drinking, and PTSD comorbidity is especially common in veteran populations. One theory underlying this comorbidity is that individuals use alcohol to self-medicatePTSD symptoms. Extant literature more often examines the relation on PTSD symptom severity as a unitary construct rather than on individual symptom clusters,a gap the present study attempts to fill.The aims of this study were to examine whether PTSD total symptom severity and each symptom cluster had significant main effects on a range of alcohol use outcomes (total frequency, binge drinking, and risky drinking) and determine whether self-reported drinking to cope motives moderate the relationship between PTSD symptoms and alcohol use outcomes. It was hypothesized that a) the hyperarousal symptom cluster would most strongly predict alcohol outcomes, as compared to other clusters, and b) drinking to cope would moderate the relationship between PTSD symptoms on alcohol use outcomes, such that those who reported greater drinking to cope motives would endorse higher severity of alcohol use. The present sample (N = 211) consists of a combat trauma-exposed subsample of individuals from a larger study of OIF/OEF veterans (90.5% male, 70.1% white, 70.1%) assessed for PTSD, determined through clinical interview with the Clinician-Administered PTSD Scale for DSM-IV. Participants also completed the drinking to cope subscale from the Drinking Motives Questionnaire (DMQ-Cope) and the Timeline Folllowback measure (TLFB; with outcome measures including total number of drinks per month, risky drinking status, and total number of binge days). Analyses consisted of a series of separate hierarchical regression models, with PTSD severity scores (total and symptom cluster) entered in Step 1, DMQ-Cope entered in Step 2, and their interaction entered in Step 3. Linear regressions were conducted for the continuous number of drinks per month, a logistic regression was conducted for risky drinker status, and a negative binomial regression was conducted for number of binge drinking days. In the linear regressions examining whether total PTSD symptom severity and each symptom clusters had significant main effects on total number of drinks per month, while all PTSD severity scores were initially associated in Step 1 with total alcohol use (all ps \u3c0.02), when DMQ-Cope was added to the model (Step 2), they were no longer significant. In the final step (Step 3), DMQ-Cope showed main effects (all ps \u3c 0.001), but there were no significant interaction effects found (all ps \u3e 0.15). The pattern for both risky drinking status and number of binge drinking days was the same. PTSD total and cluster scores were not associated with either outcome in any of the Steps (all ps \u3e 0.35), DMQ-Cope showed a main effect in all models (all ps \u3c 0.003), and no interaction effects were found (all ps \u3e 0.107). The current findings show that across all alcohol use outcomes, drinking to cope is a strong predictor of alcohol use outcomes, over and above the impact of PTSD symptoms in this sample. Drinking to cope has been independently associated with both PTSD and alcohol misuse and the current study’s findings add to the existing literature. Contrary to hypotheses, however, hyperarousal symptoms were not associated with alcohol use outcomes and no moderations were found. Limitations include limited diversity within the sample and future research would benefit from examination in civilian populations, extension to different types of traumas, and examination of other alcohol use outcomes, such as risky drinking behaviors and problems.https://scholarscompass.vcu.edu/uresposters/1351/thumbnail.jp

A Pragma-Stylistic Analysis of the Blind Man’s Garden by Nadeem Aslam

This paper aims at describing Pragma-stylistic Analysis used in the Novel “Blind Man’s Garden” published in 2013 by British Pakistani author Nadeem Aslam. The study is intended to investigate the role of speech act theory (SAT) in understanding dramatic texts through using pragma-stylistic approach. It is also an attempt to examine the pragma-stylistic effects of using speech acts (SAs) and their implication in conveying the theme of the play and the intentions of the characters. The researcher explores the application of speech act theory proposed by J.L. Austin and John Searle. This study was conducted using textual analysis and descriptive qualitative method. Based on the data analysis the eight extracts are selected from Nadeem’s novel and they are Locutionary, Perlocutionary, Illocutionary, Representatives, Declaratives, Commissive, Expressive and Directives. The analysis reveals that the interaction between stylistics and pragmatics is a vital tool for analyzing dramatic texts in terms of (SAT). SAs are grouped into systematic combination depending on the purpose of the speaker or the play wright. By using Pragma-stylistic Analysis the writer able to catch reader’s attention to focus on the content of the novel. Keywords: Stylistics, Pragmatics, Pragma-stylistic and Speech Acts

Diagnostic Framework for Electricity Losses in Pakistan Using Data Visualization Techniques

To obtain the best results and leads to accuracy, data visualization techniques allows the big data and unprocessed data in a structured format. There are a lot of techniques that provides the best results for both high and low dimensional data preprocessing. Electricity crisis are becoming the part of day to day life and increasing rapidly. There are a lot of factors that affects the distribution and transmission losses of electricity. PEPCO, GENCO and other distribution companies are responsible for electricity distribution .There are 10-12% electricity losses during the distribution from main to other. At different sectors electricity production and installation from different resources of energy needs a proper monitoring system .Except of system losses a lot of electricity lost due to non-technical factors which leads to the shortage of electricity in a Country. .Grid stations should be planted according to the population of the province .Diagnostic framework includes the previous and present data comparison which predicts and forecasts the future consumption that helps to overcome losses by time series analysis algorithm (ARIMA

Micro load balancing with delayed queue lengths

DRILL is a micro load balancing algorithm designed to efficiently utilize the path redundancy in modern data centers. It uses egress port queue lengths to make fast packet routing decisions to reduce upstream congestion and queueing delays. However, high performance switches with multiple forwarding engines making routing decisions in parallel, do not have direct access to these queue lengths. We explore and evaluate different ways of obtaining this information in data center settings, specifically using incoming traffic and specially generated update packets to piggyback this information. We find that staleness of this data does not have a huge impact on flow completion times compared to DRILL (6% increase) and still achieves a considerable advantage over ECMP (28% decrease)

Eggerthella lenta bacteraemia in endometrial adenocarcinoma - A case report from Pakistan

We report a case of Eggerthella lenta bacteraemia. An elderly lady with metastasised endometrial adenocarcinoma presented with complaints of fever nausea vomiting and abdominal pain. CT scan of the abdomen showed enlarged liver with multiple metastatic lesions raising suspicion of small-bowel obstruction. Due to multiple comorbid conditions, surgery was contraindicated and she was treated empirically with meropenem and vancomycin. Blood culture received on admission grew Eggerthela lenta

Breast imaging chameleon: Pseudoangiomatous stromal hyperplasia presenting as breast malignancy

Pseudoangiomatous stromal hyperplasia (PASH) is a benign mesenchymal proliferative lesion of the breast, often an incidental finding on breast biopsy specimens and rarely presents as a palpable lump. The case being reported is interesting as a lactating female presented with gross left breast enlargement due to a huge firm mass with skin thickening and palpable left axillary lymph nodes. A provisional diagnosis of left breast malignancy was made and the patient extensively worked up with ultrasound, CT scan, bone scan and core biopsy. The histopathology, however, revealed PASH of the breast. There was no invasive or in situ malignancy. The patient was successfully managed conservatively

Tetralogy of Fallot with absent pulmonary valve syndrome; appropriate surgical strategies

Abstract OBJECTIVE: To evaluate patients presenting with Tetralogy of Fallot with absent pulmonary valve syndrome to a tertiary care hospital and their surgical management. METHODS: The retrospective study was conducted at Congenital Cardiac Services, Aga Khan University Hospital, Karachi, Pakistan, and comprised data of Tetralogy of Fallot patients between April 2007 and June 2012. Data was analysed together with follow-up echocardiography. Variables assessed included demographics, imaging, operative technique, complications, post-operative recovery and follow-up echocardiography. SPSS 17 was used for statistical analysis. RESULTS: Of the 204 patients, 6 (3%) had undergone surgical correction for Tetralogy of Fallot with absent pulmonary valve syndrome. All 6(100%) patients underwent complete repair. Median age for surgery was 8.5 years (range: 0.5-29 years). Of the different surgical strategies used, Contegra and Bioprosthetic valve placement had satisfactory outcome with minimal gradient at Right Ventricular Outflow Tract, good ventricular function and mild valvular regurgitation. One (16.6%) patient with Trans Annular Patch developed post-operative Right Ventricle Outflow Tract gradient of 80mmHg with moderate pulmonary regurgitation. One (16.6%) patient with monocusp valve developed free pulmonary regurgitation at 6 months. The other 4(66.6%) patients are currently free from any complications or re-intervention. CONCLUSIONS: Early surgery is preferred in symptomatic patients. The repair depends upon achieving integrity of pulmonary circulation which is best achieved by using right ventricle to pulmonary artery conduit or inserting a pulmonary valve

Outcome of non-malignant papillary lesions of the breast on core biopsy: An experience from a tertiary care center in Pakistan

Background: Papillary lesions of the breast constitute a heterogeneous group ranging from non-malignant papillomas to papillary carcinoma. While surgical excision is recommended for atypical papilloma or papillary DCIS/ carcinoma on core biopsy, controversy persists in the management of benign papillomas which are diagnosed with core needle biopsy (CNB) since there are variable reported rates for tumor upgrade. The purpose of this study was to determine the outcome of papillary lesions of the breast diagnosed at image-guided CNB, after surgical excision or follow-up, and to identify potential predictors of high-risk lesions/malignancy on imaging.Materials and methods: We retrospectively identified 52 non-malignant papillary lesions on core biopsy between January 2012 and June 2018. The outcome of surgical excision, as well as clinical and imaging features of these lesions, were assessed. The final histologic upgrade was recorded, and variables were compared between benign and atypical lesions on core biopsy as well as between upgraded and non-upgraded lesions after surgical excision. Results: Thirty-six lesions out of 52 lesions were benign papillomas on core biopsy, while 16 were papillary lesions with ADH/DCIS. All of these lesions except four benign papillomas were excised. Of the 32 benign papillomas excised, 7 were upgraded to papilloma with ADH/DCIS and one to DCIS with the focus of invasion. Among the 16 atypical lesions excised, one was upgraded to papillary DCIS with a final upgrade rate of 17.3%. There was no statistically significant clinical or imaging feature among those that were upgraded on excision from those that were not upgraded. Conclusion: Non-malignant papillary lesions have a significant upgrade rate. There are no reliable clinical or imaging features that can pre-surgically predict upgrade. Therefore, surgical excision of all papillary lesions is recommended for definitive diagnosis

Training Counselors Using Virtual Reality

Virtual reality (VR) has the potential to expand experiential learning opportunities in counselor education. This article discusses how semi- and immersive VR can provide students a diverse range of experiences to increase both counseling skill and empathy development for clients with a myriad of identities, diagnoses, and presenting counseling issues. Suggestions and implications for counselor education are discussed