text:
Author's note: This story originally appeared in Scientific American, April 2009. As the suggestion of U.S. Army medical student Petulant Skeptic (see below), I am re-publishing it here, open access, because the return of veterans of the Iraq and Afghanistan wars renews the importance of examining our ideas about how most soldiers react to combat. As noted in Petulant Skeptic's preface below, the U.S. press and populace seems all too ready to attribute every trouble suffered or made by combat veterans a sign of searing trauma. We can do better. – David Dobbs
Preface by Petulant Skeptic, U.S. Army.
As America rushes to understand SSgt Robert Bales' alleged murder of 16 Afghan civilians there will be, and already is (see: here, here, and here), a renewed interest in Post Traumatic Stress Disorder (PTSD) and Traumatic Brain Injury (TBI) among those who have served in Afghanistan and Iraq. While the media have been more restrained in blaming Bales' purported PTSD or TBI than they were with Benjamin Barnes—the Mt. Rainier Shooter three months ago (see here for a recap)—there continues to be precious little examination of PTSD's prevalence and persistence among veterans. As a soldier, a medical student, and someone interested in these "invisible" injuries of war I find myself often paraphrasing David's article in order to elucidate the confusing nomenclatures, conflated diagnoses and backwards incentives of how the Department of Veteran's Affairs handles PTSD. Rather than rush to understand Bales, let's use this time to let the facts of that case settle and resolve — and take this as an opportunity to reexamine a broken system for the good of those who suffer below the radar of national calamity.
The Post-Traumatic Stress Trap
by David Dobbs
In 2006, soon after returning from military service in Ramadi, Iraq, during the bloodiest period of the war, Captain Matt Stevens of the Vermont National Guard began to have a problem with PTSD, or post-traumatic stress disorder. Stevens's problem was not that he had PTSD. It was that he began to have doubts about PTSD: The condition was real, he knew, but as a diagnosis he saw it being dangerously overemphasized.
Stevens led the medics tending an armored brigade of 800 soldiers, and his team patched together GIs and Iraqi citizens almost every day. He saw horrific things. Once home, he had his share, he says, of "nights where I'd wake up and it would be clear I wasn't going to sleep again."
He was not surprised: "I would expect people to have nightmares for a while when they came back." But as he kept track of his unit in the U.S., he saw troops greeted by both a larger culture and a medical culture, especially in the Department of Veterans Affairs (VA), that seemed reflexively to view bad memories, nightmares and any other sign of distress as an indicator of PTSD.
"Clinicians aren't separating the few who really have PTSD from those who are experiencing things like depression or anxiety or social and reintegration problems, or who are just taking some time getting over it," says Stevens. He worries that many of these men and women are being pulled into a treatment and disability regime that will mire them in a self-fulfilling vision of a brain rewired, a psyche permanently haunted.
Stevens, now a major, and still on reserve duty while he works as a physician's assistant, is far from alone in worrying about the reach of PTSD. Over the last five years or so, a long-simmering academic debate over PTSD's conceptual basis and rate of occurrence has begun to boil over into the practice of trauma psychology and to roil military culture as well. Critiques, originally raised by military historians and a few psychologists, are now being advanced by a broad array of experts, including giants of psychology, psychiatry, diagnosis, and epidemiology such as Columbia's Robert Spitzer and Michael First, who oversaw the last two editions of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, the DSM-III and DSM-IV; Paul McHugh, the longtime chair of Johns Hopkins University's psychiatry department; Michigan State University epidemiologist Naomi Breslau; and Harvard University psychologist Richard McNally, a leading authority in the dynamics of memory and trauma, and perhaps the most forceful of the critics. The diagnostic criteria for PTSD, they assert, represent a faulty, outdated construct that has been badly overextended so that it routinely mistakes depression, anxiety, or even normal adjustment for a unique and particularly stubborn ailment.
This quest to scale back the definition of PTSD and its application stands to affect the expenditure of billions of dollars, the diagnostic framework of psychiatry, the effectiveness of a huge treatment and disability infrastructure, and, most important, the mental health and future lives of hundreds of thousands of U.S. combat veterans and other PTSD patients. Standing in the way of reform is conventional wisdom, deep cultural resistance and foundational concepts of trauma psychology. Nevertheless it is time, as Spitzer recently argued, to "save PTSD from itself."
Casting a Wide Net
The overdiagnosis of PTSD, critics say, shows in the numbers, starting with the seminal study of PTSD prevalence, the 1990 National Vietnam Veterans Readjustment Survey. The NVVRS covered more than 1,000 Vietnam veterans in 1988 and reported that 15.4 percent of them had PTSD at that time and 31 percent had suffered it at some point since the war. That 31 percent has been the standard estimate of PTSD incidence among veterans ever since.
In 2006, however, Columbia University epidemiologist Bruce Dohrenwend, hoping to resolve nagging questions about the study, reworked the numbers. When he had culled the poorly documented diagnoses, he found that the 1988 rate was 9 percent, and the lifetime rate just 18 percent.
McNally shares the general admiration for Dohrenwend's careful work. Soon after it was published, however, McNally asserted that Dohrenwend's numbers were still too high because he counted as PTSD cases those veterans with only mild, subdiagnostic symptoms, people rated as "generally functioning pretty well." If you included only those suffering "clinically significant impairment" — the level generally required for diagnosis and insurance compensation in most mental illness — the rates fell yet further, to 5.4 percent at the time of the survey and 11 percent lifetime. It was not 1 in 3 veterans that eventually got PTSD, but 1 in 9 — and only 1 in 18 had it at any given time. The NVVRS, in other words, appears to have overstated PTSD rates in Vietnam vets by almost 300 percent.
"PTSD is a real thing, without a doubt," says McNally. "But as a diagnosis, PTSD has become so flabby and overstretched, so much a part of the culture, that we are almost certainly mistaking other problems for PTSD, and thus mistreating them."
The idea that PTSD is overdiagnosed seems to contradict reports of resistance in the military and the VA to recognizing PTSD — denials of PTSD diagnoses and disability benefits, military clinicians discharging soldiers instead of treating them, and a disturbing increase in suicides among veterans of the Middle East wars. Yet the two trends are consistent. The VA's PTSD caseload has more than doubled since 2000, mostly owing to newly diagnosed Vietnam veterans. The poor and erratic response to current soldiers and recent vets, with some being pulled in quickly to PTSD treatments and others discouraged or denied, may be the panicked stumbling of an overloaded system.
Overhauling both the diagnosis and the VA's care system, say critics, will ensure better care for genuine PTSD patients as well as those being misdiagnosed. But the would-be reformers face fierce opposition. "This argument," McNally notes, "tends to really piss some people off." Veterans send him threatening emails. Colleagues accuse him of dishonoring veterans, dismissing suffering, discounting the costs of war. Dean Kilpatrick, a University of South Carolina traumatologist who is president of the International Society for Traumatic Stress Studies (ISTSS), once essentially called McNally a liar.
A Problematic Diagnosis
The most recent Diagnostic and Statistical Manual (DSM-IV) defines PTSD as the presence of three symptom clusters — reexperiencing via nightmares or flashbacks; numbing or withdrawal; and hyperarousal, evident in irritability, insomnia, aggression, or poor concentration — that arise in response to a life-threatening event.
Both halves of this definition are suspect. To start with, the link to a traumatic event, which makes PTSD almost unique among complex psychiatric diagnoses in being defined by an external cause, also makes it uniquely problematic, for the tie is really to the memory of an event. When PTSD was first added to the DSM-III in 1980, traumatic memories were considered reasonably faithful recordings of actual events. But as research since then has repeatedly shown, memory is spectacularly unreliable and extraordinarily malleable. We routinely add or subtract people, details, settings, and actions to our memories. We conflate, invent, and edit.
In one study by Washington University memory researcher Elizabeth Loftus, one out of four adults who were told they were lost in a shopping mall as children came to believe it. Some insisted the event happened even after the ruse was exposed. Bounteous research since then has confirmed that such false memories are common. (See, "Creating False Memories" by Elizabeth Loftus, Scientific American, Sept 1997.)
Soldiers enjoy no immunity from this tendency. A 1990s study at the New Haven, Connecticut VA hospital asked 59 Gulf War veterans about their war experiences a month after their return and again two years later. The researchers asked about 19 specific types of potentially traumatic events, such as witnessing deaths, losing friends, and seeing people disfigured. Two years out, 70 percent of the veterans reported at least one traumatic event they had not mentioned a month after returning, and 24 percent reported at least three such events for the first time. And the veterans recounting the most "new memories" also reported the most PTSD symptoms.
To McNally, such results suggest that some veterans experiencing "late-onset" PTSD may be attributing symptoms of depression, anxiety, or other subtle disorders to a memory that has been elaborated and given new significance — or even unconsciously (and innocently) fabricated.
"This has nothing to do with gaming or working the system or consciously looking for sympathy," he says. "We all do this: We cast our lives in terms of narratives that help us understand them. A vet who's having a difficult life may remember a trauma, which may or may not have actually traumatized him, and everything makes sense."
To make PTSD diagnosis more rigorous, some have suggested that blood chemistry, brain imaging or other tests might be able to detect physiological signatures of PTSD. Studies of stress hormones in groups of PTSD patients show differences from normal subjects, but the overlap between the normal and the PTSD groups is huge, making individual profiles useless for diagnostics. Brain imaging has similar limitations, with the abnormal dynamics in PTSD heavily overlapping those of depression and anxiety.
With memory unreliable and biological markers elusive, diagnosis depends on clinical symptoms. But as a 2007 study showed starkly, PTSD's symptom profile is as slippery as the would-be biomarkers. Alexander Bodkin, a psychiatrist at Harvard's McLean Hospital, screened 90 clinically depressed patients separately for PTSD symptoms and for trauma, then compared the results. First he and a colleague used a standardized PTSD screening interview to assess PTSD symptoms. Then two other PTSD diagnosticians, ignorant of the symptom reports, used a standard interview to see which patients had ever experienced trauma fitting DSM-IV criteria.
If PTSD arose from trauma, the patients with PTSD symptoms should have histories of trauma, and those with trauma should show more PTSD. It was not so. While the symptom screens rated 70 of the 90 patients PTSD-positive, the trauma screens found only 54 who had suffered trauma; the diagnosed PTSD "cases" outnumbered those who had experienced traumatic events. Things got worse when Bodkin compared the diagnoses one-on-one. If PTSD required trauma, then the 54 trauma-exposed patients should account for most of the 70 PTSD-positive patients. But the PTSD-symptomatic patients –were equally distributed among the trauma-positive and the trauma-negative groups. The PTSD rate had zero relation to the trauma rate. It was, Bodkin observed, "a scientifically unacceptable situation."
More practically, as McNally points out, "To give the best treatment, you have to have the right diagnosis."
The most effective treatment for patients whose symptoms arose from trauma is exposure-based cognitive behavioral therapy (CBT), which concentrates on altering the response to a specific traumatic memory by repeated, controlled exposure to it. "And it works," says McNally. "If someone with genuine PTSD goes to the people who do this really well, they have a good chance of getting better." CBT for depression, in contrast, teaches the patient to recognize dysfunctional loops of thought and emotion and develop new responses to normal, present-day events. "If a depressed person takes on a PTSD interpretation of their troubles and gets exposure-based CBT, you're going to miss the boat," says McNally. "You're going to spend your time chasing this memory down instead of dealing with the way the patient misinterprets present events."
To complicate the matter, recent studies showing that traumatic brain injuries from bomb blasts, common among solders in Iraq, produce symptoms almost indistinguishable from PTSD. One more overlapping symptom set.
"The overlap issue worries me tremendously," says Gerald Rosen, a University of Washington psychiatrist who has worked extensively with PTSD patients. "We have to ask how we got here. We have to ask ourselves, 'What do we gain by having this diagnosis?'"
Disabling Conditions
Rosen is thinking of clinicians when he asks about gain. But what does a veteran gain with a PTSD diagnosis? One would hope, of course, that it grants access to effective treatment and support. This is not happening. In civilian populations, two-thirds of PTSD patients respond to treatment. But as psychologist Chris Frueh, who researched and treated PTSD for the VA from the early 1990s until 2006, notes, "In the two largest VA studies of combat veterans, neither showed a treatment effect. Vets getting PTSD treatment from the VA are no more likely to get better than they would on their own."
The reason, says Frueh, is the collision of the PTSD construct's vagaries with the VA's disability system, in which every benefit seems structured to discourage recovery.
The first benefit is healthcare. PTSD is by far the easiest mental health diagnosis to have declared "service-connected," a designation that often means the difference between little or no care and broad, lasting health coverage. Service connection also makes a vet eligible for monthly disability payments of up to $4,000. That link may explain why most veterans getting PTSD treatment from the VA report worsening symptoms until they are designated 100 percent disabled — at which point their use of VA mental health services drops by 82 percent. It may also help to explain why, although the risk of PTSD from a traumatic event drops as time passes, the number of Vietnam veterans applying for PTSD disability almost doubled between 1999 and 2004, driving total PTSD disability payments to more than $4 billion annually. Perhaps most disastrously, these payments continue only if you're sick. For unlike a vet who has lost a leg, a vet with PTSD loses disability benefits as soon as he recovers or starts working. The entire system seems designed to encourage chronic disability.
"In the several years I spent in VA PTSD clinics," says Frueh, "I can't think of a single PTSD patient who left treatment because he got better. But the problem is not the veterans. The problem is that the VA's disability system, which is 60 years old now, ignores all the intervening research we have on resilience, on the power of expectancy and the effects of incentives and disincentives. Sometimes I think they should just blow it up and start over." But with what?
Richard Bryant, an Australian PTSD researcher and clinician, suggests a disability system more like that Down Under. An Australian soldier injured in combat receives a lifelong "noneconomic" disability payment of $300 to $1,200 monthly. If the injury keeps her from working, she also gets an "incapacity" payment, as well as job training and help finding work. Finally — a crucial feature — she retains all these benefits for two years once she goes back to work. After that, her incapacity payments taper to zero over five years. But her noneconomic payments — a sort of financial Purple Heart — continue forever. And like all Australians, she gets free lifetime health care.
Australian vets come home to an utterly different support system from ours: Theirs is a scaffold they can climb. Ours is a low-hanging "safety net" liable to trap anyone who falls in.
Two Ways to Carry a Rifle
When a soldier comes home, he must try to reconcile his war experience with the person he was beforehand and the society and family he returns to. He must engage in what psychologist Rachel Yehuda, who researches PTSD at the Bronx VA hospital, calls "recontextualization" — the process of integrating trauma into normal experience. It is what we all do, on a smaller scale, when we suffer breakups, job losses, the deaths of loved ones. Initially the event seems an impossible aberration. Then slowly we accept the trauma as part of the complex context that is life.
Matt Stevens recognizes this can take time. Even after a year home, the war still occupies his dreams. Sometimes, for instance, he dreams that he is doing something completely normal — while carrying his combat rifle.
"One night I dreamt I was birdwatching with my wife. When we saw a bird, she would lift her binoculars, and I would lift my rifle and watch the bird through the scope. No thought of shooting it. Just how I looked at the birds."
It would be easy to read Stevens's dream as a symptom of PTSD, expressing fear, hypervigilance, and avoidance. Yet the dream can also be seen as demonstrating his success in recontextualizing his experience. He is reconciling the man who once used a gun with the man who no longer does.
Saving PTSD from itself, say Spitzer, McNally, Frueh, and other critics, will require a similar shift —seeing most post-combat distress not as a disorder but as part of normal, if painful, healing. This will involve, for starters, revising the PTSD diagnosis construct — presently under review for the new DSM-V due to be published in 2012 — so it accounts for the unreliability of memory and better distinguishes depression, anxiety, and phobia from true PTSD. Mental-health evaluations need similar revisions so they can detect genuine cases without leading patients to impose trauma narratives on other mental-health problems. Finally, Congress should replace the VA's disability regime with an evidence-based system that removes disincentives to recovery — and even go the extra mile and give all combat veterans, injured or not, lifetime healthcare.
These changes will be hard to sell in a culture that resists any suggestion that PTSD is not a common, even inevitable, consequence of combat. Mistaking its horror for its prevalence, people assume PTSD is epidemic, ignoring all evidence to the contrary.
The biggest longitudinal study of soldiers returning from Iraq and Afghanistan, led by VA researcher Charles Milliken and published in 2007, seemed to confirm that we should expect a high incidence of PTSD. It surveyed combat troops immediately on return from deployment and again about 6 months later and found around 20 percent symptomatically "at risk" of PTSD. But of those reporting symptoms in the first survey, half had improved by the second survey, and many who first claimed few or no symptoms later reported serious symptoms. How many of the early "symptoms" were just normal adjustment? How many of the later symptoms were the imposition of a trauma narrative onto other problems? Matt Stevens, for one, is certain these screens are mistaking many going through normal adjustment as dangerously at risk of PTSD. Even he, although functioning fine at work, home, and in society, scored positive in both surveys; he is, in other words, one of the 20 percent "at risk." Finally, and weirdly, both screens missed about 75 percent of those who actually sought counseling — a finding that raises further doubts about the screens' accuracy. Yet this study received prominent media coverage emphasizing that PTSD rates were probably being badly undercounted.
A few months later, another study — the first to track large numbers of soldiers through the war — provided a clearer and more consistent picture. Led by U.S. Navy researcher Tyler Smith and published in the British Medical Journal, the study monitored mental health and combat exposure in 50,000 U.S. soldiers from 2001 to 2006. The researchers took particular care to tie symptoms to types of combat exposure and demographic factors. Among the 20,000 troops who went to Iraq, 4.3 percent developed diagnosis-level symptoms of PTSD. The rate ran about 8 percent in those with combat exposure and 2 percent in those not exposed.
These numbers are about a quarter of the rates Milliken found. But they're a close match to PTSD rates seen in British Iraq War vets and to rates McNally calculated for Vietnam veterans. The contrast to the Milliken study, along with the consistency with British rates and with McNally's NVVRS calculation, should have made the Smith study big news. Yet the media, the VA, and the trauma psychology community almost completely ignored the study. "The silence," McNally wryly noted, "was deafening."
This silence may be merely a matter of good news going unremarked. Yet it supports McNally's contention that we have a cultural obsession with trauma. The selective attention supports too the assertion by military historian and PTSD critic Ben Shephard that American society itself gained something from the creation of the PTSD diagnosis in the late 1970s: a vision of war's costs that transforms our soldiers from perpetrators to victims — and in doing so, absolves the rest of us for sending them, for we too were victimized, fooled into supporting a war we later regretted. It's good that we feel soldiers' pain. But to impose on a distressed soldier the notion that his memories are inescapable, that he lacks the strength to incorporate his past into his future, is to highlight our moral sensitivity at the soldier's expense.
PTSD exists. Where it exists we must treat it. But our cultural obsession with PTSD has magnified and replicated and institutionalized PTSD until it has finally become the thing itself — a prolonged failure to contextualize and accept our own collective aggression. It may be our own postwar neurosis.
The PTSD Trap by David Dobbs is licensed under a Creative Commons Attribution-NoDerivs 3.0 Unported License. You may freely reproduce and distribute, but only in unmodified form and only with authorship credit (David Dobbs) and a link back to this post (http://daviddobbs.net/smoothpebbles/the-ptsd-trap/). Thanks.
Image: Standing Watch, courtesy U.S. Army/flickr, via Creative Commons license.
David Dobbs writes on science, culture, and medicine for various magazines. This is his blog.
Petulant Skeptic is the pen name of third-year medical student in the U.S. Army, who tweets and blogs under a pseudonym, lest he suffer career setbacks for his expressed views.
Sources cited:
Richard McNally, "Progress and Controversy in the study of posttraumatic stress disorder," Annu. Rev. Psychol. 2003. 54:229-52 (pdf)
T.C. Smith et. al., "New onset and persistent symptoms of post-traumatic stress disorder self reported after deployment and combat exposures," BMJ, January 15, 2008
Dohrenwend et al., "The Psychological Risks of Vietnam for U.S. Veterans," Science 18 August 2006: 979-982
Richard McNally, "Psychiatric Casualties of War," Science 18 August 2006: 923-924
Richard McNally's Vietnam Veterans PTSD reanalysis, a lecture on YouTube
You can find An extensive discussion at the Scientific American site (open access)
See also:
Lisa Richardson and Christopher Frueh, Prevalence Estimates of Combat-Related Post-Traumatic Stress Disorder: Critical Review, Australian & New Zealand Journal of Psychiatry, January 2010. Excellent look at prevalence rates from different methods and countries; shows clear pattern of overdiagnosis in most US studies.
Iris Engelhard and others, Deployment-related stress and trauma in Dutch soldiers returning from Iraq, British Journal of Psychiatry, 2007. Study finding single-digit rates of PTSD in Dutch veterans of Iraq War. The study used both clinical interviews and questionnaires to separately assess the same soldiers; a key finding was that questionnaires — the method used most frequently by US studies — sharply overestimate PTSD rates.
Amy Iversen and others, The prevalence of common mental disorders and PTSD in the UK military: using data from a clinical interview-based study, BMC Psychiatry, 2009. A study using both questionnaires and clinical interviews. It found single-digit PTSD rates among UK veterans of the Iraq and Afghanistan conflicts, double-digit rates of more common problems; another sign that the US may be systematically mistaking other mental and readjustment problems for PTSD.
Nicola Fear, Simon Wessely, and others. What are the consequences of deployment to Iraq and Afghanistan on the mental health of the UK armed forces? A cohort study, The Lancet, May 2010. Large study of UK soldiers and veterans who had served in Iraq and Afghanistan. Results very close to those in Iverson's 2009 study (above).
And here's a fuller annotated list of sources that I ran on my blog in 2009 when this feature originally ran at Scientific American:
These are organized by story section, roughly in the order the relevant material appears. Quoted passages are from the article, with source material following.
– Introduction-
• Harvard psychology professor Richard J. McNally's, "Progress and Controversy in the Study of Posttraumatic Stress Disorder [pdf download]," Annual Rev Psychology 2003:229-52, As the story notes, the PTSD debate has been going on a while now — since the PTSD diagnosis' creation in the late 1970s — but was fanned into heat in 2003 by this long review essay by McNally.
"This critique, which was originally raised by military historians and a few psychologists, is now being pushed by a broad array of experts…" These have appeared in many venues, but are presented together most comprehensively in Gerald Rosen's (ed) 2004 Posttraumatic Stress Disorder: Issues and Controversies (also in a Kindle edition and in a special 2007 issue of the Journal of Anxiety Disorders.
• The 1990 National Vietnam Veterans Readjustment Survey, which surveyed over 1,000 Vietnam veterans in 1988 and found that 15.2 percent of them had PTSD then and 30.9 percent had suffered it at some point since the war, is a key document in the PTSD debate. It established the canonical rate estimates — but came under fire almost immediately for not confirming cases and for rate estimates some historians and diagnosticians thought unrealistically high. Its findings are summarized nicely hereby Jennifer Price at the VA's National Center for PTSD.
• In "The Psychological Risks of Vietnam for U.S. Veterans: A Revisit with New Data and Methods in Science in August 2006, Columbia University epidemiologist Bruce Dohrenwend and others, hoping to resolve the debate about the NVVRS, presented a reanalysis of the original NVVRS data. They found that the 1988 rate was 9.1 percent and the lifetime rate 18.7 percent — 40 percent drops from the original. Both sides claimed these findings proved their case. The PTSD establishment said the study supported the construct's basic integrity by confirming most cases and showing a dose-response relationship. Critics said it proved that this seminal 1990 study had overstated Vietnam veterans' PTSD rates.
• McNally's "Psychiatric Casualties of War," presented alongside Dohrenwend's study in Science, stressed how sharply Dohrenwend's revision cut the canonical rates established by the NVVRS — and argued that applying standard clinical defintions of impairment would cut the rates even further. Theletters section that follows these pieces online gives a good picture of the academic dispute that flared up afterwards.
It was that exchange that drew my attention to the controversy; as editor of Scientific American's Mind Matters blog, I solicited "The Costs of War,", a pair of commentaries on the controversy — one by McNally, one by William Schlenger and Charles Marmar — that ran in Mind Matters in the fall of 2007. (Apologies for the post's present formatting; it did not fare well in sciam.com's later website overhaul.)
The flap in Science also led to a special, hastily called symposium at the November 2006 annual meeting of the International Society for Traumatic Stress Studies (ISTSS), which featured presentations by Dohrenwend; Terry Keane, a leading PTSD researcher and clinician at the Boston VA; then-ISTSS president Dean Kilpatrick, who is is a PTSD researcher and clinician at the Medical University of South Carolina; and — via an 8-minute presentation delivered via DVD, as he was in Europe on a previous commitment — Richard McNally.
I am hoping to secure ISTSS's permission to place here an audio recording of the entire symposium. McNally's video presentation, however, is viewable below.
(It was this presentation that led Kilpatrick to "essentially call McNally a liar," as I said in the piece. Specifically, after McNally's presentation aired, Kilpatrick took the floor (it was his turn) and said, "What I would like to do is swear Rich McNally in under oath to tell the truth, the whole truth, and nothing but the truth. If that were done, I think you'd have seen an entirely different presentation." Kilpatrick later said he meant not that McNally lied, but that he failed to present the entire story — an odd thing to ask, as one observer noted, of an 8-minute presentation)
– A Problematic Diagnosis –
The fourth Diagnostic Statistical Manual (DSM-IV) provides the present diagnostic definition and guidelines for PTSD. This is updated somewhat from the original construct presented in the 1978 DSM-III.
On the reliability of memory: Elizabeth Loftus's "Creating False Memories," from Scientific American, Sept 1997, describes how malleable memory can be, as does Daniel Schacter's Seven Sins of Memory. McNally's book Remembering Trauma gives a fuller, more trauma-specific account of memory's foibles. The "1990 study at the West Haven VA Hospital" that explored malleability of memories in veterans of the 1990 Gulf War is by "Consistency of memory for combat-related traumatic events in veterans of Operation Desert Storm, " by Southwick and others.
On PTSD's endocrinology:Rachel Yehuda's "Biology of posttraumatic stress disorder," from 2001, is one of several studies that found evidence of neuroendocrinological pecularities in PTSD; a 2004 studyby Lindsey et alia's is one of several that did not. On the search for correlates of PTSD detectable through brain imaging, see Francati, Vermetten, and Bremner, "Functional neuroimaging studies in posttraumatic stress disorder: review of current methods and findings," 2006.
On the ties between trauma and PTSD symptoms,: see the Bodkin, Pope, and Hudson study described in the article, "Is PTSD caused by traumatic stress," which found zero correlation between PTSD diagnoses made by symptom clusters and those made by trauma histories.
"The most effective PTSD treatment is exposure-based cognitive behavioral therapy" – This is asserted by many experts and authorities, including a comprehensive review by a National Academy of Science committee, Treatment of Posttraumatic Stress Disorder: An Assessment of the Evidence (2007).
The symptom overlap between PTSD and traumatic brain injury is explored, among other places, in Hoge et alia's "Mild Traumatic Brain Injury in U.S. Soldiers Returning from Iraq," New England J of Medicine, 31 Jan 2008.
– Disabling Conditions –
"In civilian populations, two-thirds of PTSD patients respond to treatment." from, e.g, "A Multidimensional Meta-Analysis of Psychotherapy for PTSD," Am J Psychiatry 162 (Feb 2005) (Search for "Across all treatments")
"…most veterans getting PTSD treatment from the VA report worsening symptoms until they reach 100 percent disability — at which point their use of VA mental health services drops 82 percent." From VA Office of Inspector General, "Review of State Variances in VA Disability Compensation Payments" [large download] (Report VAOIG-05-00765-137), May 2005, p ix.
"… although the risk of PTSD from a traumatic event drops as time passes, the number of Vietnam veterans applying for PTSD disability almost doubled between 1999 and 2004, driving total PTSD disability payments to over $4 billion annually." from Veterans Compensation for Posttraumatic Stress Disorder, Institute of Medicine and National Research Council PTSD Compensation and Military Service, National Academics Press, 2005.
The innovative disability program used in Australia is described here.
– Two Ways to Carry a Rifle –
Finally, the conflicting studies of PTSD in US veterans of the Iraq and Afghanistan wars cited in the piece are Milliken et alia, "Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq War," JAMA 14 Nov 2007, which found rates of around 20%, and Smith et al, "New onset and persistent symptoms of post-traumatic stress disorder self reported after deployment and combat exposures: prospective population based US military cohort study," BMJ 16 Feb 2008, which found rates of under 5%.
03-22-12, 11.38 EDT: Changed "Veterans Administration" (old name for agency) to "Department of Veterans Affairs" in two spots.


text:
On October 1, 2011, California experienced a major change to its criminal justice system. After the Supreme Court ordered the state to drastically reduce its prison population, the Legislature decided to shift responsibility for a wide variety of offenders to the local level. KALW's criminal justice editor, Rina Palta has been following the developments. She joined Holly Kernan in the studio.
* * *
HOLLY KERNAN: Let's start with a quick refresher on realignment. What does it do?
RINA PALTA: Realignment basically changes the punishment for a large group of felonies. For things like drug possession, petty theft, and car theft, prison used to be an option on the table. And some counties in California were using prison quite a bit for people who committed these low-level, non-violent felonies. So when the state was told to reduce its prison population, this is one of the big groups that it identified of people who should not be in state prison. The other group was parole violators, who generally serve really short, 90-day sentences.
So as of October 1, these offenders are officially not the state's responsibility anymore. They're left to the counties to decide what to do with. And the counties can opt for a variety of punishments, like house arrest, probation, community service, mandatory drug treatment, or incarceration at the county jail.
KERNAN: So it sounds like the state has essentially given a large set of its responsibilities to the counties. How are counties paying for these new offenders?
PALTA: Well, along with this new responsibility does come some money. But not a lot. Counties were given an amount based on the number of people they generally send to prison, and that can be divided between the sheriff's department, probation, and whatever other services are needed for this new population. And the county can basically decide to divvy up the money any way it sees fit.
KERNAN: One of the issues we've talked about a lot regarding realignment is whether the new law will lead to reform in California, which is a state has that's spent so much money on prisons and has incarcerated so many people for so long. So now we are one month in – what's your sense of whether or not things are changing in California?
PALTA: Realignment has absolutely been billed as a reform measure by Governor Jerry Brown's administration. But that message was not well received in many corners of the state – mainly Los Angeles, San Bernardino, and a lot of other counties that have a lot of people to deal with now that they won't be in prison. And those counties continue to exert a whole lot of political pressure on the governor and on the California Department of Corrections and Rehabilitation. In a sort of preview of how Republicans are planning on playing this issue, the Assembly GOP released a video in October, attacking the governor. Here's a clip:
CA REPUBLICAN PARTY VIDEO: Assemblyman Nielsen says realignment is a scheme for the state to transfer some of its budget problems to cash-strapped counties and to release prisoners early without getting its hands dirty. "They are dangerous. Many have serious and violent offenses. Every citizen should be preoccupied with their personal safety and the safety of their family members."
KERNAN: That was a clip from a video being circulated by California's Republican party, attacking the governor for what they say is threatening public safety and dumping the responsibility for prison overcrowding on the counties. Rina, are Nielsen's criticisms fair? What are the public safety concerns here?
PALTA: Well there's no question that California counties don't have the space right now to house all the people currently in jail as well as the new realigned population. So counties may have to let people out of jail earlier and that may or may not cause an uptick in crime. Jails could let out some people who are awaiting trial and can't afford bail, which is really the vast majority of the jail population right now. But there is always a chance that someone in custody, even if they haven't been convicted of a crime yet, could be dangerous if they're let out.
KERNAN: And what about the other concern, that realignment will lead to more prison construction in the state that's already got a lot of prisoners?
PALTA: Sure, well at first the state said that wouldn't happen unless counties invested their own funds in building new jails, and prison secretary Matt Cate even said the state was deliberately not giving counties enough money to realignment to imprison the same number of people the state has been locking up, that since lockups are the most expensive option, counties would have a natural incentive to look into alternatives. But recently the state has announced that they're giving counties $600 million to construct new jail beds and in the reform community this is being viewed as California once again building itself out of its prison problem instead of working on alternatives to incarceration.
Here's what Emily Harris, statewide coordinator for Californians United for a Responsible Budget has to say about this development.
EMILY HARRIS: It's pretty terrifying when 35 of our 58 counties are wanting to build more jail cells. When we think about California's history, we've just been addicted to incarcerating people. And I think it's having an impact on our economy, on our neighborhoods, on our community members. And if we don't do something soon to stop it, we're going to be just continuing a legacy of mass incarceration and thinking about where California will be in five years or 10 years, we're going to be in 58 Plata-Coleman cases because we're not actually changing the conditions for people in prisons and jails.
KERNAN: Rina, how is this all playing out in the Bay Area?
PALTA: Leaders in the Bay Area right now are feeling somewhat double-shafted. In the first round of funding for realignment, they didn't get as much money as other counties because San Francisco and Alameda counties have really done a good job of keeping low-level offenders at the local level not in prison. And now, as Harris points out, the state, instead of giving more money to the kinds of things that the Bay Area has tried to invest in – you know, rehabilitation programs, drug treatment, half-way houses – the state is giving out money for jail construction and jail construction only.
As for outside of the Bay Area, it's hard to imagine why a county like San Bernardino or Los Angeles or Sacramento would take their own money and invest in alternatives if the state is offering up money to do what has long been the default mode in this state, and that's add more beds.
Follow Rina Palta's coverage of prison overcrowding in California and realignment at our criminal justice blog, The Informant.

subset: commoncrawl


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(CNN) -- BP officials have turned to a new source for help with their oil cleanup efforts: actor Kevin Costner.
The oil giant announced Monday that it had ordered 32 machines from Costner's company, the actor told CNN in an exclusive interview on "AC360."
The machines use a centrifuge mechanism to separate oil from water and recycle the crude at the same time, Costner said.
"This is the key, it's the linchpin to people going back to work. It's certainly a way to fight oil spills in the 21st century," he said. "It creates an efficiency where there are no efficiencies out there, and it's been a long time coming."
Costner said he had been working on developing the machine since 1992 or 1993 with the help of his brother, a scientist.
Each machine weighs about 4,000 pounds, he said, and will allow crews to collect more oil.
"Skimmers are picking up 90 percent water, 10 percent oil, and they throw it into a barge ... What this machine simply does, in that particular case, will give a pure payload. Suddenly a barge will be coming back to shore with 99 percent oil as opposed to the other way around," he said.
Got an idea to fix the oil disaster? Share solutions and views
Costner described the machine to a congressional committee last week.
"It may seem an unlikely scenario that I'm the one delivering this technology at this moment in time, but from where I'm sitting, it is equally inconceivable that these machines are not already in place," he said.
CNN's Anderson Cooper contributed to this report.


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If you're looking at using the full-page caching that the Zend Framework has to offer, you should read about Robert Basic's experiences with it before implementing it in your application.
When I started rewriting this blog, I knew from start that I want to use Zend Framework's full page caching, as, I think, that's the best cache for this purpose. Not much going on on the front end, much more reads than writes, no ajax or any other "dynamic" content. While implementing the cache, I ran into two issues.
His issues revolved around the feature not creating valid cache files due to a duplicate "startSession" call in his code and having the Google Analytics code included in the template (with different keys every time). You can find out more about this functionality in the Zend Framework manual.


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Rome, Italy: Europe leads the world in Assisted Reproduction Technology (ART) with most cycles initiated in the region, the 26th Annual Meeting of the European Society of Human Reproduction and Embryology heard today (Wednesday 30 June).
According to data presented by the European IVF Monitoring Group (EIM), 479,288 treatment cycles were reported in 32 European countries in 2007 . This compares globally with 142,435 cycles from the US and 56,817 cycles from Australia and New Zealand. "The number of cycles performed in many developed countries has grown by 5-10% per annum over the last 5 years," said Dr. Jacques de Mouzon, chairman of ESHRE's EIM. "The 4.5% increase we observed in Europe from 2006 to 2007 however is partly due to more clinics reporting to our database," he added.
In 28 countries where clinics reported deliveries, more than 90,000 babies were born in 2007. There were 118,667 regular IVF treatments, 246,687 intracytoplasmic sperm injection (ICSI) cycles, 74,855 frozen embryo transfer cycles (FER), 15,028 egg donor cycles (ED), 6,822 preimplantation genetic diagnosis/screening cycles (PGD/PGS) and 660 in vitro maturation cycles (IVM). "The reverse trend from IVF to ICSI continues with now 67.5% of fresh cycles using the latter technology, although the efficacy of ICSI in terms of pregnancy rates is the same as standard IVF," he added.
He pointed out that the overall rate of multiple births was very similar to the previous year with European ART twin deliveries at 20.5% and triplet deliveries at 0.8%. Most countries in Europe are now recording fewer than 1% triplet deliveries, except for Italy (2.8%), Latvia (11.1%) and Serbia (3.3%). "The good news is that since 1997, we have observed a decline from 30% to 21% in overall multiple birth rates and a fourfold reduction in triplet deliveries from 3.7% to 0.8%," he said.
Nordic countries like Denmark still have the highest availability of ART at 13,263 cycles per million of women aged 15-45. The lowest availabilities were recorded in the largest economies in Europe such as Germany (3,931), UK (3,794) and Italy (3,829). This is also mirrored in the number of infants born after ART with only 1.5% in Germany, 1.8% in the UK and 1.2% in Italy. In comparison in Denmark 4.9% of all children were born through IVF.
"In the last 11 years since the beginnings of the EIM we have seen a gradual increase of 26% to 33% of pregnancies per transfer for IVF and ICSI, from 15% to 22% for FER and from 27% to 46% for oocyte donation, and all this despite the transfer of fewer and fewer embryos," said Dr. de Mouzon.
In order to further assess the safety of ART, the EIM has initiated a major study (MART – the Morbidity in ART study), collecting data from a large series of ART children born in Scandinavia. Funded by ESHRE and the Medical Faculty of Copenhagen University, the team will analyse data from the national ART registers in Denmark, Finland, Norway and Sweden. "We estimate that we will have about 75,000 children in our database at the end. The data from Denmark and Finland are ready, the Swedish will finalise their data soon and in Norway the application to obtain these data is currently being processed," explains Prof. Anders Nyboe Andersen, past chairman of the EIM.
Due to the possibility of cross-linking ART data with data from other health registers, the researchers will be able to assess long-term morbidity in these children and compare it with appropriate control groups. "It is the long-term commitment of the EIM to expand this database to other European countries, but it will be at least a year before we can present the results to the public," Prof. Nyboe Andersen concluded.


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With Christmas over, it's time for the Suns to get back to work. The schedule makers blessed the Suns with bookend home games around the holiday, and the team was in no danger of being highlighted in a Christmas day game, so they should be fresh coming off of time off with family and friends. Hopefully they weren't getting too fat and happy while tonight's opponent, the New York Knicks, were busy getting coaled up by the Los Angeles Lakers.
When: Wednesday, December 26, 2012, 7:00 PM local time (9:00 EST)
Where: US Airways Center, Phoenix, AZ
Watch/Listen: TV: FSAZ, Radio: 620 KTAR
Last Meeting:
The Knicks won the previous meeting between the teams 106-99 at Madison Square Garden on December 2nd. New York used a 35-22 second quarter to put separation between themselves and the Suns. Phoenix closed the gap to six at 91-85 with 6:24 left, but couldn't completely recover from the disastrous second quarter. Carmelo Anthony had a game high 34 points. Marcin Gortat had 18 points and 10 rebounds for the Suns. Raymond Felton dominated the point guard matchup with 23 points and seven assists versus Goran Dragic's nine points and five assists (foreshadowing alert).
Team Bios:
New York Knicks: 20-8
Points per game: 102.6 (T-5th) Points allowed: 96.5 (T-12th)
Injuries: Marcus Camby, Raymond Felton and Steve Novak have all been, or still are, nursing injuries, but all are expected to play. Amar'e Stoudemire is not expected to play for a few more games. Rasheed Wallace is also out and Iman Shumpert is recovering from a long term injury.
The Knicks are coming off of a hard fought loss on Christmas day against the surging Lakers at the Staples Center. Carmelo Anthony, as he has done all season, led the Knicks with 34 points, but he also logged 43 minutes in the game. Four other Knicks played at least 34 minutes in the game, including Tyson Chandler who clocked in with 40.
New York is off to a sizzling start, but has tapered off recently with three losses in their last five games, including home losses to the Houston Rockets and Chicago Bulls. The team has incorporated many new pieces around its remaining core players and has seemed to do so rather seamlessly. This is not the same Knicks team that ended the 2011-12 season. The additions include Jason Kidd, Raymond Felton, Ronnie Brewer, Rasheed Wallace, Pablo Prigioni, Kurt Thomas and Marcus Camby. Amar'e Stoudemire and Iman Shumpert return, but neither has seen action this season. The only remnants from last season's roster are Carmelo Anthony, Tyson Chandler, J.R. Smith and Steve Novak. Four players. That's it.
One of those players happens to be early season MVP candidate Carmelo Anthony, which is quite an important returning piece. Melo is currently second in the NBA in scoring (28.3) and actually boasts the highest eFG% of any year of his career (.531) thanks in part to blistering shooting from three point range (.437). Did I mention he played 43 minutes yesterday? Felton and Kidd seem to be the newcomers who have been most impactful, orchestrating an offense that was stagnant all too often last season.
Phoenix Suns: 11-17
Points per game: 97.3 (12th) Points allowed: 100.9 (26th)
Injuries: None, as usual.
The Suns are coming off of a savage beating at the hands of the Los Angeles Clippers on Sunday night in what turned out to be the fourth time this season that the Suns have lost by more than 20 points. The final score of 103-77 wasn't really indicative of the Suns play, because it wasn't really that close. The Suns seemed more concerned with complaining about the officiating than competing in the game and the Clippers smelled blood.
The Suns look to recompose themselves in the getaway game before a daunting three game road trip to close out the year. The near future holds grave implications for the Suns, as they will either reverse their current trajectory and fight for a playoff spot or find themselves hopelessly out of the race in the next two to three weeks. It's already gut check time for the Suns. Unfortunately, recent indications don't adumbrate favorably.
After a stretch that provided a glimmer of hope on the defensive end, that spark is fading into the gloaming. The Suns are now mired in 29th in opponent field goal percentage (.471) and 30th in opponent three point field goal percentage (.405). The Suns are an average offensive team with no go to scorer that plays hideous defense. I think that sums it up pretty thoroughly and tersely.
What To Watch For:
Player X vs. Goran Dragic: Goran has been playing so poorly lately that I pretty much expect him to get violated on a regular basis. Dragic is now averaging 12.6 points (on 41.2% shooting) and 5.8 assists for the month of December. The Suns have played 11 games so far in the month. Dragic is supposed to be the team's best player. Flip a coin. That will tell you whether Dragic will score more than 10 points, considering he's pulled off the feat only seven times in his last 14 games. Throw in the nasty habit of picking up early fouls and it becomes alarmingly clear that he needs to get his sh$# together. Tonight sounds good to me.
Fireworks: The New York Knicks are on pace to set NBA records for three pointers made (11.5) and attempted (29.2). Despite launching bombs at such a prodigious rate the Knicks rank third in the league in three point field goal percentage. The Suns, as previously mentioned, are dead last in the league at defending the three. Tonight we will see how the matchup of best vs. worst unfurls.
Rebounding: Finally, an area where the Suns don't suck worse than their opponent. The Suns are an impressive -3.5 in rebounding differential (good for 25th in the league) while the Knicks are a lowly -4.2 (three spots below Phoenix at 28th). Both of these teams get owned on the glass on a regular basis. Maybe this could be a point of emphasis for the Suns to focus on in the game since the Knicks don't have a superfluous number of areas of weakness.
Tired Legs/Playing the Suns/Dignity: Not only did the Knicks play a fiercely contested game against the Lakers yesterday, but now they're playing the Suns. The legs might not be quite as fresh since key players logged heavy minutes. It might be hard for New York to get up for this game after the spotlight of a Christmas day matchup. The Knicks may be bummed about playing a back-to-back and missing out on holiday festivities. The Knicks may be disinterested in playing a team of the Suns caliber and overlook them. The Suns may be pissed off after the humiliating rout they suffered through last game. Any or all of these may culminate in an unexpected victory for the Suns.
Key Stat: The season high for scoring in a game by an individual Sun this season is 26. Both Dragic and Shannon Brown have hit this mark once. Carmelo Anthony has scored at least 26 points 17 times. Seventeen. I set the over/under for a Sun scoring 30 at 27 games. We are officially over. Anthony has scored at least 30 points 11 times this season. The Sun is a star, but the Suns have no star.
The Final Word(s):
I really like the dynamic coming into this game based on the way the last few days have played out for both teams. The Suns would definitely appear to have the advantage based on rest and intangibles. The only problem I see in forecasting a Phoenix victory is that the Suns just aren't very good
at all right now.
The Suns are just 3-9 against teams with winning records, as of right now, on the season. So while a victory isn't outside the realm of plausibility, I don't know that I'd give the Suns the same coin flip of having a good game that I gave Dragic earlier.
LIKE Bright Side of the Sun on Facebook!


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Monday, July 28, 2014
Benji"s House
37 comments:
Oh Edward come to our house and play, cos they run around our yard all the time and tease us.ReplyDelete
stella rose
You look like such good friends!ReplyDelete
its a tough job but someone has to do it - right?ReplyDelete
- AnonymousJuly 28, 2014 at 6:34 AM
Where is it? Hope it's not somewhere in your bed... that would be bad :o)ReplyDelete
They are tricky.ReplyDelete
No rest for us dawgs, huh? Good job on keeping your home tree rat free!ReplyDelete
I've been stalking a tree rat here too. Would you believe he has the nerve to come right up to my sliding glass door on the deck? And taunt me? I MUST figure out a way to get my revenge.ReplyDelete
; ) Katie
We think your tree rat is at our house now and brought his 40 friends with him!ReplyDelete
Lily Belle & Muffin
OMD can we come over and help you with those pesky tree rats? Have a marvellous Monday.ReplyDelete
Best wishes Molly
Benji sure is cuteReplyDelete
Retro rover
Whew....it does look pretty exhausting!!ReplyDelete
Dory, Jakey, Arty and Bilbo
Woohoo you are visiting your buddy Benji!! Have fun exploring his yard.ReplyDelete
Hugs madi your bfff
I wonder, if there really was a tree rat Lily or were you bored because the two guys didn't play with you??ReplyDelete
HI Lily & EdwardReplyDelete
Looks like you had a great time at your friend Benny's home :) Milo & Jet
I think that was a false alarm that Lily called just to see how fast you guys would come running.ReplyDelete
Thanks for being a friend
Sweet William The Scot
I have lots of tree rats. You can come chase them any time. Hope you and Benny had great fun!ReplyDelete
xoxo Marjie
I think we should all get together an hunt rabbits!ReplyDelete
Your Pals,
Murphy & Stanley
Lily, We think you were teasing the boys!ReplyDelete
Mr Bailey, Hazel & greta
OMD Benji's place was INVATED by a Tree Rat????????ReplyDelete
You did a super job of repelling it...
We agree TREE RAT Eradication is TUFF work.
Yes they are, they cheat and run up trees! Love DollyReplyDelete
Did you guys get it!?!?ReplyDelete
PS: Your new friend Benji is mighty cute!
My sister Bailie and I hunt tree rats on a daily basis and they are just downright tricky, nasty creatures! Some day I will catch one and make an example of it for the entire tree rat community!ReplyDelete
It looks exhausting!ReplyDelete
Hi there Benji, Lily and Edward, looks like we have all been having fun with our Friends, I love to chase tree rats, it looks like you had a great time running around! So much fun, what a nice day! Love and Licks from your furiend Frank XxxxxxxxXReplyDelete
Yup, tree rat huntin are hard work!ReplyDelete
Did you and Benji go back to ball playing, Lily? I wanna play too!ReplyDelete
Love ya lots♥
Tree rat hunting does take dedication!ReplyDelete
We just got NINE of your posts at the same time!!!ReplyDelete
Hope that tree rat makes a mistake and comes within range...
Looks like life at Benji's house is a whole lot of fun!!!ReplyDelete
Woos - Phantom, Ciara, and Lightning
I got tree rats tooo- at my house,,,, come on over and lets play!ReplyDelete
Looks like y'all had it all under control. Enjoy your time a Benji's.ReplyDelete
Aroo to you,
OMD!!! OMD!!! What? No tree rat?? Nuts. NUTS! That's it!!! We can lure him down the tree with NUTS!!! I'll be right overs...we gots work to do!!!ReplyDelete
Ruby ♥
Was Lily just pullin' your furs??ReplyDelete
Wally & Sammy
Save some energy for playing. Those tree rats are hard to catch.ReplyDelete
Dip and Elliot x
It is so hard to keep up with them!ReplyDelete
You get that bad tree rat! C'mon Edward, show Lilt how it's done!ReplyDelete
Love & Biscuits,
Cathy, Isis & Phoebe
Benji looks famous - like he's been on a TV show or something! I sure hope you finally found that tree rat...they have no business being in YOUR yard.ReplyDelete


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Sevendust via Facebook. Sevendust fans, rejoice! The hard rock act has announced they will release their ninth studio album, 'Black Out the Sun,' on their own 7Bros. Records label (through Warner Music Group's Independent Label Group) on March 26, 2013. The album's debut single, 'Decay,' will reach active rock airwaves and retail outlets Jan. 22, 2013. 'Black Out the Sun' was self-produced by the band — Lajon Witherspoon (vocals), Morgan Rose (drums and vocals), Clint Lowery (guitar/vocals), Vince Hornsby (bass and vocals) and John Connolly (guitar and vocals) — at The Architekt Studios in Butler, N.J., with the assistance of mixer and engineer Mike Ferretti. As for the sound of the new album, it's going to be heavy. In Loudwire's recent interview with drummer Morgan Rose , he chatted about the upcoming disc by dishing, "I know I'm gonna scream like a banshee on the next record, I don't know how many more we got left in us – from now on it's gotta be treated like it's the last one in my book. I know it's gonna be real heavy." Sevendust are also set to tour in support of 'Black Out the Sun,' which is the follow-up to 2010's 'Cold Day Memory,' and have announced a headlining U.S. tour with Lacuna Coil set for February of 2013. For a complete list of tour dates, click below: [button href="http://loudwire.com/lacuna-coil-sevendust-early-2013-u-s-tour/" title="Lacuna Coil + Sevendust 2013 U.S. Tour Dates " align="center"]
View original post here:
Sevendust Announce Release Date for New Album 'Black Out the Sun'


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Tuesday, January 27, 2009
This kid's got imagination
Here's what Max looked like when I walked in the door from work last night. I couldn't help it, I laughed and laughed, he was so adorably fab in his camo pj's, pirate's hat and shades. He wanted to sleep with the sunglasses on but I refused (and I will refrain from making a joke about that so-called song, "I Wear My Sunglasses At Night.")
Max has gotten very imaginative lately, something that's always sorta-kinda been there but has really kicked in. He walks around with a toy phone and pretends to take pictures of things. He swoops his plastic plane around and "flies" it. He loves to play monster and catch me, Dave or Sabrina. He bends over, swings an arm and makes like an elephant. He hasn't yet gotten the hang of the "hide" part of Hide and Seek (he stands in the middle of the living room and puts an arm over his eyes) but, hey, maybe he's playing the existential version of the game, what do I know.
What I can say is that imagination like this is a good sign that all sorts of wheels are spinning in his brain. Go to it, my sweet soldier-pirate-hipster boy.
16 comments:
Hello, I stumbled across your site and was compelled to leave a comment. I saw your blog on "Class of 2008" blogroll and thought \, "Hmmm, cute blog name"... then I opened my email to see my "5 min for special needs" and lo and behold, you wrote a post. So, here I am in your blog. I am the mother of three children, two boys and one precious little girl who has an extra chromosome.ReplyDelete
My daughter just turned 18 months old and I have been thinking about returning to her NICU where she spent two weeks and letting the nurses know how wonderful our lives are. They were fabulous when we were nervous and fearful. Thanks for the reminder, I will make a date on my calendar to go say "hello" and "thank you".
BTW, LOVE the pirate look. My 5 year old is a big fan of all things pirate.
I would say imagination and style! So, who did he inherit his fashion sense from?ReplyDelete
That is a fantastic outfit. Evidently Max understands the importance of sensitive handsome pirate movie star military men. Watch out-- it sounds like he's emulating those guys in romance novels. All he needs now is a billion dollars and much, much longer hair.ReplyDelete
While Connor isn't quite ready to start playing "pretend" yet, he has come up with some, um, interesting outfits when I let him choose his own clothes. I think he picks them based on texture rather than color coordination. Either that, or he got his fashion sense from his dad, who believes that shorts and tennis shoes are appropriate for any weather, even if it is 20 degrees outside and snowing.
By the way, I saw you stopped by my blog the other day and left me a message-- thanks. :)
Like the shades Max, and the hat...ReplyDelete
I used to dress like this in high school!! I think he looks really chic!!ReplyDelete
Boys and their 'Styles'....Gotta Love Them!ReplyDelete
I hope you're having a Great Day....I think of you & Max often!
Very cute indeed!! He looking at you like "What? this is a cool outfit..whats the problem!?!"ReplyDelete
Very good imagination forever...don't you love when the are doing age appropriate stuff!!
- AnonymousJanuary 27, 2009 at 1:34 PM
i love it!ReplyDelete
the pirate look is absolutely adorable. Too cute max! I just love to watch kids grow, and develop, and use their imaginations. I work at a daycare teaching preschool, and that's one of my favorite parts of the job!ReplyDelete
I love it! We have PJ day coming up at school soon and I just might steal that costume idea!ReplyDelete
Funny you say that he "has been there", because I said those words to Mike last night regarding Jude. He is only 5 months but he does things other babies do .... just delayed. Each time he complete a new task like a .......... giggle.... (last night) I exclaim that's normal!!! Right now it's like Jude is 2 months delayed so I am wondering how this will equate in months or years when he gets older. I love the pirate hat, and the shades....too cool!ReplyDelete
* Jeanette: What's a "Class of 2008" blogroll? That would make me 22 years old. I'll take that!ReplyDelete
* Sue: He clearly did not inherit his fashion sense from me. I am best described as J. Crew meets, um, J. Crew.
* Jess: Connor's dad and Dave clearly went to the same Daddy School, because Dave also likes to wear shorts in winter! And are you saying Max is the next Fabio? That could be interesting.
* Rich: Thanks for the approval!
* Lyla: I believe you still dress like this.
* Melanie and Jenn: Yeah, I love it when Max does stuff that's just every-kid stuff. Jenn, you sound exactly like I did when Max was Jude's age. There is just no way of knowing how delays in infancy translate to delays as kids get older. Honestly, I have stopped wondering what "age" Max is developmentally. I know that may seem hard for you to believe right now, but I have. I just pay attention to what he's doing, and don't worry about the age/numbers thing.
- AnonymousJanuary 27, 2009 at 10:46 PM
Too cute for words!ReplyDelete
- AnonymousJanuary 28, 2009 at 12:42 AM
It's a great look! He makes a super pirate!ReplyDelete
Imaginative play is so wonderful to watch, isn't it? Our house is often a shop. I am constantly having to pay BC for things that he takes out of the cupboard. Once of his first 3 word sentences was 'Here you go'. I guess he's picked that up from shopping!
What a handsome pirate!!!ReplyDelete
- AnonymousJanuary 28, 2009 at 7:19 PM
This is adorable! You are so right about imaginative play - It's huge! Max is such a cutie!ReplyDelete


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|Every afternoon, Elaine enjoys sitting down to a hot cup of tea, while
|Is it just me or do you think those orange stools were someone's idea of a joke! (Source unknown)
I hope you all survive April Fool's Day. If you didn't see Andie's post (Divine Theatre) - go and have a look here.
Till next time
Sharon x


text:
Pale Green Fake Cupcake. Great gift, Hand made just like a real cupcake but using Artificial Products to achieve the most realistic fake cupcake. Our Artifical Cupcakes are durable and light weight.
Fake Food Display Prop for Home Staging, Theatre Props and Movies.
Size: 3"H x 3"D
Made in America