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Where to see Oscar-nominated films in Milwaukee
Here's a guide to where, and whether, you can see this year's Oscar-nominated feature films in Milwaukee. In addition, you can see this year's nominated live-action and animated short films in separate programs starting Friday at the Oriental Theatre.
"Amour" (5 - best picture, best director for Michael Haneke, best actress for Emmanuelle Riva, original screenplay, foreign-language film): Showing at Downer. »Read Full Article
'Walking Dead' stars, producer coming to Riverside Theater
Between the unfathomably desperate conditions, an extreme distrust of others and the constant fear of death, things are plenty tough for the unlucky living enduring a cataclysmic zombie apocalypse on AMC's "The Walking Dead."
But the show itself couldn't be sitting any prettier. »Read Full Article
Mequon's Bhati Beads accessorize SI swimsuit models
Margaret Maggard of Mequon might be the only person watching Sports Illustrated Swimsuit 2013 models on "The Today Show" this morning because of what they were wearing on their wrists.
It's the seventh year that the magazine has used Maggard's Bhati Beads jewelry to accessorize its famous models. In the segment, Gomes and Henderson joined Sports Illustrated senior editor MJ Day to talk about the fit, the look and the style of swimsuits. »Read Full Article
Here's your chance to design the 2013 Jazz in the Park T-shirt
Jazz plus art equals the chance to design the official 2013 Jazz in the Park T-shirt.
The competition is open to all professional and amateur designers. Consideration will be given to designs honoring the heritage of jazz and calling to mind music ranging from New Orleans to Chicago to New York and places in between while never forgetting that this is Milwaukee. »Read Full Article
On Tap Today: A time for restraint - and John McClane
Lent begins today, a season of reflection, self-denial and restraint.
But that doesn't mean you have to give up everything. »Read Full Blog Post


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Malcolm W. Browne, Pulitzer-Prize Winning Reporter, Dies at 81Obituaries
Malcolm W. Browne, a Pulitzer Prize-winning reporter whose four-decade career included covering the Vietnam War — and taking one of the most memorable photos of the conflict — and a lively second act as a science writer who explained chemical weapons and described the rise of synthetic body parts, died on Monday in Hanover, N.H. He was 81.
The cause was complications of Parkinson's disease, said his wife, Le Lieu Browne.
Mr. Browne, who lived in Thetford Center, Vt., and Manhattan, spent most of his career writing for The New York Times, which sent him to Argentina, Vietnam, Bosnia, Pakistan and wherever else his curiosity called him after he became a science writer in the late 1970s.
"My life is terrific," Mr. Browne said in a 1993 interview. "It affords the greatest possible variety of experience. That, after all, is why I became a journalist."...
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- Voting opens soon for the leaders of the OAH in 2017
- A team of science historians are attempting to re-create recipes from sixteenth-century alchemy texts
- David Kennedy recalls his dinners with President Obama
- When Kellie Jones Wanted To Study Black Art History, The Field Didn't Exist. So She Created It Herself.
- Michael Honey: The 60's activist turned historian

subset: commoncrawl


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When Princeton University seniors Aman Sinha and Amelia Bensch-Schaus were summoned to the dean's office, they both wondered: What did they do wrong?
"It's sort of like being called down to the principal's office," Sinha said. "It's either something really good or something really bad."
It turned out to be something really, really good.
Sinha, a mechanical and aerospace engineering major, was named valedictorian of the 2013 graduating class, and Bensch-Schaus, a classics major, was salutatorian. They had not only graduated from one of the most elite institutions in the country, but emerged at the very top of the 1,300-member senior class.


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Welcome to Glock Talk
Why should YOU join our Glock forum?
- Converse with other Glock Enthusiasts
- Learn about the latest hunting products
- Becoming a member is FREE and EASY
If you consider yourself a beginner or an avid shooter, the Glock Talk community is your place to discuss self defense, concealed carry, reloading, target shooting, and all things Glock.
Anyone familiar with the New CQC-7 vs the old (1990s) Benchmade model?
Discussion in 'The Cutting Edge' started by BRabbit, May 14, 2010.
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Requests for Reprints: Gregory J. Dehmer, MD, C.V. Richardson Cardiac Catheterization Laboratory, North Carolina Memorial Hospital, Manning Drive, Second Floor, Chapel Hill, NC 27514.
Current Author Addresses: Dr. Dehmer: C.V. Richardson Cardiac Catheterization Laboratory, North Carolina Memorial Hospital, Chapel Hill, NC 27514. Dr. Popma: The University of Texas Southwestern Medical Center, Dallas, TX 75235.
Because coronary angioplasty is being increasingly used as a treatment for coronary artery disease, the proper evaluation and management of patients after the procedure are important issues. Although coronary angioplasty is a complex technical procedure, the methods routinely used to evaluate its results have many shortcomings. Although the initial results of the procedure are assessed most commonly by the visual interpretation of video images and coronary angiograms, quantitative angiography, transstenotic pressure gradients, and coronary flow reserve measurements have also been used. In the period after coronary angioplasty, success can be evaluated by patients' clinical improvement in symptoms and their stress responses to various functional tests. The management of the patient during the first 24 hours after angioplasty should focus on the prevention, detection, and, if necessary, treatment of acute vessel closure. During the subsequent 6 months, the emphasis should shift to the evaluation of recurrent symptoms and prevention of restenosis. We discuss the methods used to assess the results of coronary angioplasty and suggest guidelines for managing patients after the procedure.
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Quinten Rushton Got Wasted, Exposed Himself, Fatally Stabbed Friend, and Tried to Stab Girlfriend Before Kicking Cop in the Junk
We've all had those mornings after a night of heavy drinking where we wake up and say to ourselves "what the f**k did I do last night?"
Chances are, the answer to that age-old question isn't "pulled out my penis, fatally stabbed my friend, attempted to stab my girlfriend, and kicked a cop in the balls" -- unless your name is Quinten Samuel Rushton.
Rushton was arrested early yesterday morning after police say he fatally stabbed his friend after a night of drinking. Rushton's reason for slicing his pal: he pushed him earlier in the night.
According to court documents obtained by New Times, about 1 a.m. yesterday, police were called to the home of the 48-year-old victim at 1116 West Madero Avenue in Mesa in response to a stabbing.
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The woman who reported the stabbing to police was Venetia Waddell, Rushton's girlfriend, who witnessed the attack.
Waddell told police that she, the victim, and Rushton had been drinking at the home she and Rushton share at 1042 West Madero Avenue.
At some point in the night, the trio decided to go down the street to the victim's house and play pool.
As the three shot pool, Waddell, court docs say, pulled off her dress and started dancing in nothing but her bra and panties, which prompted Rushton to pull out his penis.
When the strip tease was over, Waddell went back to her house to check on her two kids, but then went back to the victim's house.
Shortly after she returned, Rushton, Waddell later told police, grabbed a knife from the victim's kitchen and stabbed him once in the abdomen as he was sitting on a couch in the living room.
Rushton then turned the knife on his girlfriend -- he attempted to stab her, too, but only managed to nick her. He then fled the house on foot.
Within 15 minutes of Waddell reporting the stabbing, police found Rushton nearby. He was all scraped up and had a cut under his left eye -- and he wasn't going down without a fight.
As he was being detained, Rushton kicked one of the officers in the groin in an attempt to flee police.
Following his arrest, Rushton admitted to stabbing the victim. He told police he did it because the victim pushed him earlier in the night.
Rushton, whom Waddell says has an unreported history of domestic violence, was booked into a Maricopa County jail on one count each of second-degree murder, aggravated assault with a deadly weapon, and aggravated assault of a police officer.
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Published 28 Dec 2011
Family Dentist Fountain Valley CA, TMJ Disorders & Facial Pain, Huntington Beach Dental Office http://Denti...
Family Dentist Fountain Valley CA, TMJ Disorders & Facial Pain, Huntington Beach Dental Office http://DentistFountainValleyCA.com Family Dentist Fountain Valley CA, gives us an insight on TMJ Disorders and misaligned teeth in this video interview. TMJ disorder is known to cause jaw misalignment. TMJ causes pain in the upper body. In some cases also created pain in the shoulders and neck. TMJ for the most part causes teeth grinding and jaw clenching. However it can be treated with a bite guard. The bite guard will effectible protect the teeth and will provide relief to the jaw. In some cases TMJ is treated with physical therapy or chiropractic care. For more information about TMJ disorders visit Family Dentist Fountain Valley CA, at http://DentistFountainValleyCA.com Fountain Valley Family Dentist also serves the cities of Fountain Valley, Huntington Beach, Santa Ana, Midway City, Costa Mesa, Westminster, Garden Grove.


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|Women, Girls, Men, Boys
My name is Luz Mendoza and I am originally from Spain, from the beautiful Island of Tenerife, I moved to the UK over 17 years ago and live in London with my better half a wonderful english man and my ...
My name is Luz Mendoza and I am originally from Spain, from the beautiful Island of Tenerife, I moved to the UK over 17 years ago and live in London with my better half a wonderful english man and my three children, a boy and identical twin girls. I crochet, knit, sew, cook, bake and eat, laugh, play, hug, kiss… basically I am in love with life!
I have decided to write the crochet patterns that are mostly inspired by my kids, sometimes it is what I think they need or like and sometimes it is just a plain request!, 'mummy can you make me a…' the best part is to see their faces when I gave them something that I have made, 'mummy, you made it for me?', I love it!, I hope you enjoy my patterns to. Happy Crocheting!
This listing is for the PDF PATTERN of the gloves only!, note the owl is another of my patterns, you will be able to get from my shop very soon!
As always you are welcome to sell your work from this pattern
Crochet mittens pattern, a bit longer wirst warmer on them that you might normally get for a crochet pattern, it is going to be a very cold winter so wrap up warm! this is a very easy pattern, will be making them in a couple of hours!
You will need:
150 gr of DK weight or light worsted weight
Size hook 4.5 mm
6 buttons
Tapestry needle
Please note all my patterns are written in standard american terms.
For giveaways, coupons and free patterns please visit my facebook on:
and my blog:
Thanks for visiting!
Please note:
Because of the nature of this listing I cannot take any refunds, I will try my best to help you with the instructions.
If you have any questions about this pattern or the sales conditions please convo me.
** This pattern is Copyright created and designed by Luz Patterns. This pattern may not be distributed in any form, that includes pictures text and instructions. You are welcome to sell the items that you make using the pattern, but please put a link back to my shop. Thanks.


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On this gloomy, cloudy day, I present to you "A View of Tantallon Castle" by Alexander Nasmyth (1758-1840), who is regarded as the founder of Scottish landscape painting. Nasmyth's view of the Tantallon Castle is representative of the style for which he is most well-known: Scottish landscapes in the Italian tradition.
1. Alexander Nasmyth provided several illustrations for collected editions of Sir Walter Scott's poems. The inspiration for "A View of Tantallon Castle" is thought to have come from... READ ON
Howard Rheingold gave a TED talk in 2005 discussing the nature of cooperation, and how it contrasts with classical views of competition as the driver of progress. Discussed: The Prisoner's Dilemma (and how he suggests eBay solves it), Tragedy of the Commons (and how humans create social structures to overcome it), The Ultimatum Game, Wikipedia, Bittorrent, and finally Rheingold's proposal for a Cooperation Project to embrace a cooperative form of economic progress.
This video is worth a look for... READ ON
The Amazing Fact Generator, much like me, is hungry. I can go to the kitchen and grab some leftover pizza, but The Amazing Fact Generator requires cold hard facts to sustain it.
While we're waiting for our fact-checker to verify our favorite fact from last week (I'll announce the winner tomorrow), let's get this week's contest rolling. Our topic today is outer space, so leave your (amazing) fact in the comments with your name and location. If it's both amazing and... READ ON
Big plans for Clinton-Obama III?
The two remaining Democratic candidates take the stage tonight for one final debate before the March 4th primaries. People everywhere are talking about this race "" and by 'everywhere,' I mean my barbershop, selected friends' Facebook profiles and on MSNBC. But where will tonight's contest rank historically?
Last week's Austin debate drew roughly 7.7 million viewers, while last month's showdown in Hollywood was seen by 8.3 million. These numbers understandably... READ ON
When most people go on vacation, they take pictures of their friends and family. Beautiful vistas. Old buildings. I like all that stuff as much as the next guy, but for some reason when I get out my camera, I take pictures of strangers. Strangers don't pose. They do funny things without realizing they're being watched. And when you get the pictures back, they're never around to complain about how they look.
During a semester abroad in Ireland, I began spending free afternoons on the streets,... READ ON
This article has nothing to do with the supernatural; it's about real bodies that just can't seem to rest in peace, or at least had to wait for their chance.A couple of recent cases raise the question of how much respect a dead body should be given. The mummy of King Tut was taken from his tomb in 1922 after 3,000 years. Since then, it's been robbed, dismembered, scanned, and finally displayed to the public last year. Padre Pio was canonized by Pope John Paul II in 2002. Now, the... READ ON
To recap, every day this week, I'm presenting a specific challenge. Your job: come up with the answers and hold onto them! Why? Because on Friday, you'll need those answers to solve a short puzzle. The first person to email in the correct answers and successfully show how you arrived at them (thus the title: How Did You Know?) wins a choice of any t-shirt or book from our store.
In case you missed Day 1 of this feature, check out yesterday's challenge here.
Today, after the jump,... READ ON
The greenest car in America is not the Prius. It's a Honda that runs on "compressed natural gas", which makes my inner child giggle.
Where to get the best breakfasts in America. Unfortunately, but not surprisingly, none of the 15 are in my hometown.
How to Manage Your Online Reputation. That is, if you are brave enough to find out what your online reputation is... I'm not sure that I am.
On his post-Oscar show, Jimmy Kimmel responded to Sarah Silverman's "affair" with... READ ON
Bloggers love posting pictures of signs -- we've covered misspelled signs, weird signs, and (my personal favorite) signs featuring unnecessary quotation marks. Well, in further proof that there's a blog for literally everything, I've come across a blog documenting the use of the lowercase letter L among uppercase letters.
Yes, this is real -- since 2005, blogger William Levin has been documenting signs in which the letter L is written in lowercase, while the other letters are uppercase. Each entry... READ ON
The short story represents a form of creative tinkering that can serve as a springboard to later elaborations and embellishments. Authors often revisit the material covered in their stories more comprehensively as they technically mature and become accomplished writers. Listed below are brief precis of short stories from four acclaimed American authors. Can you name the story being described? Take the quiz: Short & Sweet.
If your bookshelves aren't overflowing with short story collections, perhaps... READ ON
Every Monday, we venture into the archives of The New York Times to find the first time the paper of record covered selected topics. This week, our focus is The Oscars. If you have a suggestion for next week, leave us a comment.
September 24, 1976
At the Movies
Not long ago, United Artists teased the public by placing ads in newspapers for a sneak preview of "a film that will open in December to qualify for the Academy Awards." Moviegoers anticipating a star-studded extravaganza may have been... READ ON
In a previous gadget report, I noted that the working parts of a computer mouse are tiny, and the bulk of the tool comes from having to fit our hands. So why not use that extra space for some other useful purpose?
The Vacuum Mouse from Thanko does just that. As a computer mouse, it's a standard three-button tool. Flick a switch on the side and it turns into a vacuum cleaner! Suck up the Cheetos dust from your desktop while you're waiting for a video to buffer or downloading a large... READ ON
Dutch artist Desiree Palmen is no wallflower, but she knows a thing or two about blending into the background. That's because her latest project is literally aimed at making people disappear -- in plain sight. What we mean is... READ ON
Today I'm unveiling an episodic trivia hunt that may or may not become a periodic feature, depending on how you all react to it. The hunt works like this: every day this week, I'll be presenting a specific challenge. Your job: come up with the answers and hold onto them! Why? Because on Friday, you'll need those answers to solve a short puzzle. The first person to email in the correct answers and successfully show how you arrived at them (thus the title: How Did You Know?) wins a... READ ON
Blind people do not have a better sense of hearing or smell than you do. But they learn to use those senses more efficiently.
A real-life Indiana Jones believes he may have traced the Ark of the Covenant to Zimbabwe. But don't expect it to still be there waiting for us.
Retro Sabotage is a collection of classic arcade games with a twist. I would tell you what the twist is, but it's different for each game!
Top 10 Smart and Lazy Ways to Save Your Workday. It's not about... READ ON
Goldfish can distinguish the music of one composer from another.


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Sports Talk Florida fans, you can stay involved with every conversation and connect with us 24/7. The more you interact with us, the more we are going to want to give you free stuff just because. I mean, who doesn?t love free stuff?! Easy enough, right? Give us a ?thumbs up? on Facebook, be a follower on Twitter, or even peep our pics on Instagram. Whatever your social media addiction is, we?ve got you covered. Join the fun today and you?re that much closer to doing cool stuff for free.
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Top Definition
Tool used to desend from moutain of shit your life has become
I'll be lucky if I have a shit toboggan left after this divorce attorney is done with me!
بواسطة Intent... إبريل/نَيْسان 22, 2009
Trending Now
Can you define these popular missing words?
Something you ride through a shitstorm. Anything that helps you through a shitstorm, i.e. a difficult situation or set of circumstances.
I'm just gonna hop on the shit toboggan and ride out this hellride of a week.
بواسطة Dusty Pellegrino مايو/أيار 16, 2011


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Peter Laarman: The very wealthiest Americans, whose share of income and wealth has shot up astronomically for the past 25 years, have somehow gotten a huge number of other Americans to buy into the idea that there isn't enough money. And that therefore we should cut lifeline benefits that go to poor children and sick people and old people and veterans.
Friday Feedback: "The Role of the Middle-Class Revisited"
Friday Feedback: This week, Rosalio Munoz comments on Dr. Rodolfo Acuña's article that states, "Chicanas/os and Latinos remain political pochos because once they are out of college most do not remain politically active."
Why the Most Important Issues May Be Off the Table in the 2012 Election
Robert Reich: By continuing to push and prod we give hope to countless Americans on the verge of giving up. We give back to them the courage of their own convictions, and thereby lay the groundwork for a future progressive agenda
How Austerity Is Ushering in a Global Recession
Robert Reich: Chalk up a big part of Europe's slowdown to the politics and economics of austerity. Europe – including Britain – have turned John Maynard Keynes on his head. They've been cutting public spending just when they should be spending more to counteract slowing private spending.
Goldman Sucks
Tom Degan: It's highly unlikely that any serious reform is going to be put forward until the Republican presence on Capital Hill has been significantly diluted if not eradicated. I do not believe that it is a given that they are going to gain major ground come Election Day. In fact there is every reason to believe that they will only continue to self-destruct between now and then. They can't win without the section of the electorate who describe themselves as "moderate". The moderates are taking a good look at the train wreck that is the modern GOP and by all accounts they're becoming more and more disgusted by what they see.
It's Morning in Reagan Studies
The argument of The Reagan Revolution belies its title: according to Troy, there was no Reagan revolution. This is not to say Reagan was an inconsequential president: Troy portrays him as a man who changed the nation's political climate even if he never changed its topography.


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The sister of slain actress Sharon Tate said she's doing what she can to make sure convicted Manson Family follower Leslie Van Houten dies behind bars.
Debra Tate told NBC News she has delivered 138,700 signatures to California Gov. Jerry Brown's office asking him to deny Van Houten's parole bid after nearly 50 years in prison.
"I feel very strongly that she should remain behind bars," Tate said. "It came out at her last parole hearing that she is in communication with Charles Manson."
Van Houten said Manson did write to her, but she turned the mail over to authorities and did not write back.
Now 66, Van Houten was deemed "suitable for parole" in April by the Board of Parole Hearings. She was convicted along with other cult members of the 1969 killings of Leno and Rosemary LaBianca. She was not part of the crew that killed Tate and four others in a rented home.


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Mar 8
Mar 7
Feb 6
Jan 30
LA Release Party!
Dec 14
Sounds Like: The Black Keys, Amy Winehouse
Label: we do it ourselves, yo
Bio: Rush the Throne formed in October of 2012. Originally, the band started under the name of the lead singer but it was something all its own. As the band played more shows and began to record their debut album, they thought "damn, we really need a name." After names such as Vile Vicar and Vermiciou...See Full Bio
Che Zifandel
Mike Georgia
Watts Yoshizawa


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Snowboarding Forum - Snowboard Enthusiast Forums (http://www.snowboardingforum.com/forum.php)
- Site News, Updates and Suggestions (http://www.snowboardingforum.com/site-news-updates-suggestions/)
- - How do I change my title? (http://www.snowboardingforum.com/site-news-updates-suggestions/38364-how-do-i-change-my-title.html)
How do I change my title?
How do I change my "Lifetime Member" title? The one that Snowolf has set to "Marxist".
(Sigh. Yes, it'll probably turn out to be embarrassingly easy. Feel free to revile me)
What you going to change it too?
Hmm, how about 'Slave to BA' or 'Mrs' or something. :laugh:
Oh, i think your avatar and the kid on the frosty boy ads may very well be twins or something
There's a thread in the VIP section where you list it and Snowolf will change it for you
or pm one of the admins
you have to go to the mvd and draw a number and wait
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This book is the first in the game warden John Marlin series. I have listened to much worse, but there are too many really good mystery/thrillers out..Show More »
This book almost lost a star because of a few scenes in the book - one of which was a takeoff of a famous scene from The Godfather. There was a lot ..Show More »
No, the narrator just doesn't get the character voices right.
The book and narration was very below my interest and quality. I kept falling asleep during it, and it took me several days to get through. The voice..Show More »
The setting and the characters are great. I could identify with the local area and swear I know some of those folks
There are many reasons why a book might be unavailable.
Sometimes a book goes temporarily out of print - and sometimes no audio version has ever been recorded. Audible wants to give you the most complete selection we can and we'll keep adding series and filling in gaps as quickly as possible.
Rehder's books are always a fun ride with his large cast of crazies who never fail to entertain. Hog Heaven is no different. I almost didn't download ..Show More »
Thanks to Ben Rehder for continuing the Blanco Co mystery series. Hilarious and engaging. The narrator however ruined the story for me. He tries uns..Show More »
Got hooked on series when Jonathan Davis was the reader. The current reader, RK Ross, just does accents. Davis brought characters to life. This bo..Show More »


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Vegetarian Fruit Snacks
After my posts on easy homemade fruit snacks (jello version and natural fruit juice version), I had several people ask me about whether there was a vegetarian recipe since the ones I shared used gelatin.
In fact, I came across several vegetarian versions that used agar agar powder. I'm pretty familiar with agar agar powder as it's used in a lot of Chinese desserts. Like gelatin, it's a thickening agent, and it's also vegetarian. The desserts made with agar agar powder usually have the consistency similar to Jello. The powder is quite cheap at Asian supermarkets, so I was happy to test it out.
I tried it several times, but I could never quite get it to be as chewy as the fruit snacks I like or the ones I made with the gelatin. Some were very firm and crumbly, some were too soft, some tasted like Jello. I finally got a version that was pretty tasty, but it's more like a soft fruit snack. It's firmer than Jello, but only has the tiniest chew. It's still pretty tasty though and I know some people like their fruit snacks soft rather than chewy, so I decided to share the recipe.
I'm not going to give up though. I don't think it's possible to achieve the chewy fruit snacks with only agar, but I'm going to try another vegetarian version with pectin.
Agar Fruit Snacks
- 1 cup fruit juice
- 4 tbsp agar agar powder (not flakes)
Boil fruit juice and agar agar powder in sauce pan on low boil and stir until smooth. Remove from heat and pour into silicone molds. Place molds into fridge to set for about 15 minutes. Pop out of molds and serve. Store uneaten fruit snacks in fridge.
16 Responses to "Vegetarian Fruit Snacks"
Thanks for posting this recipe! I bought some agar agar and didn't know what to do with it. The proportions here gave it an interesting texture. I'm going to play around with some different juices and see what works best (I used a wildberry juice this time).
I just made these and I think they turned out great. I used 1 cup of all natural just tart cherry juice mixed with 1 T. of agar flakes (can't find the powder anywhere)…thanks for the recipe!!!
I love the rose shape! Where did you find the mold?
Just tried these out and I'm wondering if your measurements are a bit off? I had one cup of fruit juice (freshly juiced oranges) and the 4 tablespoons of agar powder was ridiculous. It was wayyyy past stir-able consistency. Instantly went crazy chunky. I was able to save it by slowly adding back in about 3 cups of juice while heating on the stove top. I'm wondering it maybe you meant 4 teaspoons of the powder rather than tablespoons? It may just have been my type of juice though…?
I think agar's ratio to liquid changes with more acidity
(orange juice) I remember reading that once…
The agar agar shown in the photo here (Golden Coin) is not pure agar agar. It has a lot of sugar filler, which is why the ratio seemed so off to Tanya. You could probably half the amount listed in this recipe and be ok.
Do you have the link for the silicon rose mold? It's super cute!
When to remove the liquid from the heat ? Is it just started to boil ?


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By The Hill Staff - 04/25/10 02:50 PM EDT
Former Sen. Alan Simpson (R-Wyo.) and former Clinton chief of staff Erskine Bowles said Sunday that nothing will be off the table when the bipartisan pair opens President Barack ObamaBarack ObamaSetting the record straight on Crimea Buzz builds on Becerra's future plans Green Party nominee escorted off debate premises MORE's financial commission Tuesday.
Or, as Simpson said in classic fashion, the point is to get everyone at the table, and then "we'll bleed and b---h from there."
Simpson called the task "a suicide mission," noting that he and Bowles were "jumping without a parachute."
"It's not just unsustainable," Simpson said. "It's unconscionable what's going to happen to this country."
The two appeared on "Fox News Sunday," where Bowles said that foreign borrowing was a "recipe for disaster."
"Let's make sure the American people know we have a looming crisis," Bowles said. "To do that we need a real set of numbers." He added that he would like to go after spending before getting to potential tax hikes.
When asked about President Barack Obama's vow to not raise taxes on the middle class, Bowles said, "What I feel bound by is the president looked at Sen. Simpson and I and said everything is on the table."
That includes "cutting sacred cows or raising revenue."
Simpson also acknowledged that "nothing off the table" included the just-signed healthcare bill.
And, Bowles said, that includes the controversial value-added tax.
Simpson said the important thing was looking across the board at comprehensive overhaul. "You can't do a value-added tax without dealing with the income tax," he said.


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Assessments of personality disorder (PD) and conduct disorder (CD) in a random community sample at mean age 13 were employed to predict subsequent substance abuse disorder (SUD), trajectories of symptoms of abuse or dependence on alcohol, marijuana, or other illicit substances, and hazard of initiating marijuana use over the subsequent decade. Personality disorders and conduct disorder were associated with diagnoses and symptoms of SUDs in every model and their effects were independent of correlated family risks, participant sex, and other Axis I disorders. Specific elevated PD symptoms in early adolescence were also associated with differential trajectories of already initiated SUD symptoms as well as elevated risk for future onset of SUD symptoms. For several models the greatest of these effects were shown for borderline PD and for conduct disorder, the predecessor of adult antisocial PD. Passive-aggressive PD also showed independent elevation effects on substance use symptoms for alcohol and marijuana. Analyses over 30 years suggest that Cluster B PD (borderline, histrionic, narcissistic) are independent risks for development of SUD and warrant clinical attention.
Numerous studies have examined the comorbidity of substance use disorders (SUDs) and Axis II personality disorders (PDs) in clinical and nonclinical samples of adults (Ball et al., 1997; DeJong et al., 1993; Driessen et al., 1998; Grilo, Martino, Walker, Becker, Edell, & McGlashan, 1997; Johnson et al., 1996; Morgenstern et al., 1997; Nace, Davis, & Gaspari, 1991; O'Boyle, 1993; Rounsaville et al., 1998; Trull, Waudby, & Sher, 2004; Verheul et al., 1998; Weiss et al., 1993). In addition to well-established links between antisocial PD and SUDs (Regier et al., 1990), researchers have recently documented reliable associations between borderline PD and SUDs (see Trull, Sher, Minks-Brown, Durbin, & Burr, 2000, for a review). Even after controlling for effects of antisocial PD and other co-occurring PDs, borderline PD remained significantly associated with higher rates of substance abuse in adults in an outpatient psychiatric sample (Skodol, Oldham, & Gallaher, 1999).
Borderline PD typically manifests in affective instability and mood reactivity, intense and unstable interpersonal relationships, unstable identity and self-image, and a recurrent pattern of impulsive and potentially self-destructive behavior. There are numerous ways to explain why borderline PD would be associated with increased rates of SUDs. Deficits in affect regulation and impulse control that characterize borderline PD may also predispose people to SUDs. Alternatively, early problems with drugs and alcohol in adolescence may undermine subsequent personality development. It is also possible that shared genetic factors or family risks may explain part of the co-occurrence between borderline PD and SUDs. Parental PD and substance abuse are known to increase risk for borderline PD in early adolescence (Guzder, Paris, Zelkowitz, & Feldman, 1999; Johnson, Brent et al., 1995) and the intergenerational transmission of SUDs is well documented (Luthar, Merikangas, & Rounsaville, 1993; Merikangas et al., 1998; Miles et al., 1998). For borderline PD, however, the limited genetic evidence currently available suggests that heritable influences on these personality traits are separate from those associated with alcohol abuse (Jang, Vernon, & Livesley, 2000). Thus, clarifying the developmental factors that may account for associations observed between borderline PD and SUDs is a goal of the current study.
Little is known about comorbidity between SUDs and PDs during adolescence other than well-documented links between SUDs and conduct disorder in adolescence and antisocial PD in adulthood (Hesselbrock, 1986; Robins, 1966). Previous studies of drug and alcohol abuse in adolescence have not systematically assessed PDs because little was known about the manifestation and meaning of Axis II disorders before adulthood. As evidence has documented that significant personality disturbances occur even in early adolescence (Bernstein, Cohen, Velez, Schwab-Stone, Siever, & Shinsato, 1993; Johnson, Cohen, Kasen, Skodol, & Brook, 2000; Johnson, Cohen, Skodol, Oldham, Kasen, & Brook, 1999; Kasen, Cohen, Skodol, Johnson, & Brook, 1999; Rey, Morris-Yates, Singh, Andrews, & Stewart, 1995; Rey, Singh, Morris-Yates, & Andrews, 1997), it has become increasingly important to assess comorbidity between SUDs and PDs to increase understanding of etiology and course issues.
Adolescent SUDs and co-occurring Axis II disorders have been investigated in inpatient psychiatric samples (Grilo, Becker, Walker, Levy, Edell, & McGlashan, 1995; Grilo, Martino, Walker, Becker, Edell, & McGlashan, 1997). When comparing adolescents with and without SUDs for co-occurring Axis I disorders and Axis II disorders, Grilo et al. (1995) reported that conduct disorder and borderline personality disorder were diagnosed more frequently in patients with SUDs. In a separate study, borderline PD was associated with SUD diagnoses in adolescent inpatients only when substance abuse co-occurred with conduct disorder (Grilo, et al., 1997). This finding underscores the importance of taking comorbid conduct disorder into account when assessing PD-SUD comorbidity in adolescents.
Findings based on adolescent patients may be influenced by ascertainment bias (Berkson, 1946) that overestimates general comorbidity rates in non-treatment populations. However, adolescents with borderline PD in a non-patient sample of first-year college students also were more likely than those without any PD to be heavy users of alcohol and marijuana (Johnson, Hyler, Skoldol, Bornstein, & Sherman, 1995). Although this study of non-patient adolescents was not limited by ascertainment bias, it did not control for conduct/antisocial disorder or other PDs that often co-occur with borderline PD, thus leaving it uncertain whether borderline PD is linked with SUDs above and beyond their associations with other psychiatric disorders.
Research on adolescent PDs and SUDs is mostly based on cross-sectional data. Thus very little is known about the effects of early PDs on the development and course of SUDs in later adolescence and adulthood. Much more is known about the relationship of adolescent conduct disorder with current and subsequent substance use and SUDs. Retrospectively reported data from the Epidemiologic Catchment Area Study suggest that conduct disorder symptoms in childhood predicted higher rates of SUD in adolescence (Robins & Price, 1991). Data from the National Longitudinal Study of Youth also suggest that antisocial behavior in early adolescence predicted substance use in late adolescence (Windle, 1990). Other studies using a range of assessment methods have found that conduct disorder tends to precede SUD (Boyle, Offord, Racine, Szatmari, Gleming, & Links, 1992; Gittelman, Manuzza, Shenker, & Bonagura, 1985; Kandel, Kessler, & Margulies, 1978), perhaps partly because the age of onset and of peak prevalence are younger for conduct disorder than for SUD.
Conduct disorder (CD) is a unique childhood disorder in the current diagnostic system because it is not included as an adult Axis I disorder. Rather, similar behaviors and attitudes in adulthood are considered a personality disorder (antisocial personality disorder), and thus excluded from Axis I despite the current diagnostic requirement of a history of conduct disorder. Clearly, it is reasonable to think of adolescent CD as essentially an early manifestation of PD although many adolescents meeting CD diagnostic criteria do not subsequently meet antisocial PD criteria. Nevertheless, it remains unclear whether borderline PD or any other PDs in early adolescence predict subsequent SUDs independently of conduct disorder.
To address these issues the current study employed data from a longitudinal cohort on which PD and SUD have been assessed since early adolescence to focus on how early PDs relate to prospective levels and changes in SUD symptoms over the subsequent 20 years from adolescence to mid-adulthood. In this study Axis II disorders were assessed in most of the cohort before the period when most substance abuse typically begins between ages 15 and 19 (Burke, Burke, Regier, & Rae, 1990). Thus it was also possible to determine whether the course of early onset substance abuse problems was influenced by the presence of early personality disorder and whether PD preceded onset of such problems.
These data come from a residentially-based random sample of children residing in one of two upstate New York counties who had been assessed for Axis I and II disorders first in 1983. The sample was based on an earlier study using maternal interviews to determine a range of problems of age 1 to 10 offspring potentially associated with area-specific social indicators (Kogan, Smith, & Jenkins, 1977). Sample members who could be located at follow-up in 1983 were supplemented with 54 newly sampled participants recruited from areas of urban poverty to replace those from the previous sample lost when neighborhoods were razed in connection with urban renewal. With this supplement the 1983 sample closely represented demographic characteristics of the geographic area of recruitment (see nypisys.cpmc.columbia.edu/childcom/for details on sampling and sample retention) Follow-up interviews of both mothers and youths with an expanded protocol were conducted in 1983 (T2), 1985–1986 (T3), and 1991–1994 (T4), when youths were mean (SD) ages 13.7 (2.6) years, 16.4 (2.8) years and 22.4 (2.8) years, respectively. Retention rate has been over 95% until the most recent mean age 33.2 (2.9) follow-up of 680 of the 796 surviving participants (85%). At all interviews, consent was obtained from all participants according to IRB standards, and a NIH Certificate of Confidentiality exists for these data.
Substance use disorders, conduct disorder, and all other Axis I disorders were assessed with the Diagnostic Interview Schedule for Children (DISC-I; Costello, Edelbrock, Duncan, & Kalas, 1984). Beginning in 1983 we administered the DISC-I separately to children and a parent, usually their mothers. Home interviews were carried out by two interviewers who were blind to the responses of the other respondent and to any prior data. When first assessed with the DISC-I, children ranged in age from nine to 18.
Data from parent and child were combined by computer algorithms in two ways. First, we created continuous scales for each Axis I disorder defined by Diagnostic and Statistical Manual of the American Psychiatric Association (American Psychiatric Association, 1987) by summing responses to disorder-specific questions on symptoms and associated impairment for each respondent. By and large these scales have acceptable internal consistency reliability, ranging from .6 to over .9 (Cohen & Cohen, 1996), despite the absence of concern about such reliability in the definition of these disorders. DSM-III-R diagnoses for adolescents were made based on criteria met by either youth or parent report on the DISC-I but also requiring that the sum of the mother and adolescent symptom scales for the disorder be at least one standard deviation above the sample mean. This decision to consider either respondent's symptom indication as positive is consistent with the consensus of the field that sensitivity is thereby ensured (Bird, Gould, & Staghezza, 1992), while the use of the additional criterion based on the pooled scales enhances the specificity of the diagnoses. DISC-I algorithms thus yielded diagnoses for SUDs that were used as dependent variables at mean ages 16.4 and 22.2 in our multilevel logistic analyses. As indicated below, we used conduct disorder diagnoses at mean age 13.7 as a predictor variable. We also used a dichotomous predictor indicating the presence of any other Axis I diagnoses (i.e., excluding conduct disorder and SUDs, thus primarily anxiety and depression) as a control variable.
In the adult assessments at mean age 22.4 we altered the DISC to increase its appropriateness for adult respondents and collected Axis I diagnostic information only from the offspring. At mean age 33.2 we employed the SCID-IV interview for Axis I disorders.
In 1983 no developed instruments existed for assessing PD before adulthood. We created such an instrument by adapting items from the PDQ questionnaire for adults (Hyler, Rieder, Spitzer, & Williams, 1982; Hyler, Reider, Williams, Spitzer, Hendler & Lyons, 1988) and by selecting appropriate items from other existing scales or writing age appropriate items when necessary (Bernstein et al., 1993; Bernstein, Cohen, Skodol, Bezirganian, & Brook, 1996). Although many criteria used information from both respondents, most information came from the offspring interview. Thus, when the mother was the only informant for a given assessment we have excluded those children from the analyzed sample. Some PD diagnostic criteria are intrinsically difficult to assess by self-report, and we relied on the parental respondent for these when assessing PDs at T2, T3, and T4.
For this study we used symptom scales based on offspring only reports to assess alcohol abuse/dependence and marijuana abuse/dependence consistent with DSM criteria. The use of youth reports only was chosen in keeping with evidence both from this study and from others that parents are not always aware of offspring substance use and abuse and also because these measures were not available from a parent once the participants reached adulthood. These scales were subjected to a logistic function transformation in order to normalize sufficiently for use in the employed statistical programs and a zero value indicates the total absence of such symptoms.
Parental respondents in the 1983, 1986, and 1992 interviews were asked in separate items whether the child's mother had any problems with drinking or drugs, and identical questions were asked about the child's father. These four items were used to create a simple dichotomous variable indicating the presence or absence of parental substance abuse. Because it is plausible that parental substance abuse may contribute to offspring PD and CD as well as to offspring substance abuse/dependence this variable was employed as a control variable in the analyses.
Family socioeconomic status was measured as a standardized sum of standardized parental education, occupational status, and family income. Because this variable is related to both offspring PD and CD and offspring substance use it is included as a control variable. Gender was also included as a control variable and investigated with regard to potential influence on the analyze relationships between adolescent PD and SUD diagnoses, we contrasted participants with PD diagnoses at mean age 13.7 with a comparison group (n=567) of participants without any PD.
In each of these analyses the primary predictors are the early adolescent PDs assessed in 1983 (T2) when the cohort was on average 13.7 years old. In the first set of these analyses, we used multilevel logistic regression equations to estimate the associated increase in the odds of SUD diagnoses covering assessed ages between age 9 (the youngest at T2) and age 27 (the oldest at T4), net of the effects of control variables also included in the model. The SAS GLIMMIX macro was used to fit the multilevel logistic regression models (Cohen et al., 2000; Littell et al., 1996).
The second set of analyses examined the association between the age of first marijuana use and early adolescent PD. Survival analyses were employed to calculate the average age of first time to use marijuana for youth with each PD (or conduct disorder) in comparison to those without PDs using the Kaplan-Meier method. (Age-of-onset data for alcohol use and other SUDs were not recorded and thus could not be analyzed here.) In order to exclude effects potentially attributable to common causes or correlates of PD and SUDs or SUD symptoms, all analyses include as covariates sex, race, family socioeconomic status, parental substance use, and other Axis I disorders.
The next analyses addressed developmental questions more directly by employing multilevel models to assess patterns of change in self-reported symptoms of alcohol and marijuana abuse and dependence. In aggregate these analyses tested whether there were significant differences in the trajectories of SUD symptoms between ages 12 (the youngest participants in 1986) and 38 (the oldest in 2003) associated with diagnostic criteria for each DSM-IV PD in the early adolescent (1983) assessment. The two sets of analyses used the SAS PROC MIXED program (Littell et al., 1996) and employed all covariates, including age and substance abuse/dependence symptoms in the 1983 assessment as control variables. In addition, they examine the interaction of early adolescent PD symptoms with early SUD symptoms. This test determines whether early personality disorder may alter the course-effects of early onset SUD symptoms.
In these longitudinal multilevel models participant measures repeated over time are the basic dependent variables, comparable to a single variable in ordinary regression analyses. Instead of accounting for the variance in a single dependent variable, these methods account for the variance in functions of the set of variables; here the variance in participant means, linear slopes or trajectories, and residual individual variance around their own trajectories. This set of variance indicators is considered the basic "random" data, just as in ordinary regression "random" variation of a single variable is to be accounted for. The first step in these analyses examines the between participant differences ("random effects") in mean level, and in linear and nonlinear (quadratic) age changes. For alcohol-use symptoms the dramatic normative age curve so dominated the variance that the estimates of random (between participant) variance in linear and quadratic slopes were not statistically significant. If there had been evidence of significant variance in these parameters we would have reported those random estimates in the table.
This model was then the basis for examination of the fixed (average) effects of linear and quadratic age change (the basic model), and those of the covariates (Model 1). Following this basic model, we fit a series of models for each PD diagnosis that test both main effects and interactive effects of PD on the influence of other variables on subsequent alcohol or marijuana SUD symptom means or trajectories. As noted in the following section, these analyses were carried out in two sets. The first examined the associations of early adolescent PD with the level and course of SUD symptoms from early adolescence to young adulthood. The second set of analyses attempted to enable stronger causal inferences by including early adolescent SUD symptoms as a predictor of subsequent mean and trajectory of SUD symptoms over the following 20 years.
Table 1 presents the means of each of the control variables and their correlations with early PD, SUDs, and symptoms of alcohol and marijuana use disorders. At mean age 13.7, 182 youths (24.3%) met criteria for at least one PD. Co-occurring PD diagnoses were frequent in this community sample; on average youths with PD received nearly two (1.84) diagnoses per person. As noted in earlier reports (Bernstein, et al.,1996; Johnson et al, 2000), the high PD prevalence observed in early adolescence declines linearly with age but nevertheless maintains the same rank order correlation of symptom level over time as is shown in adulthood. The most prevalent Axis II disorders were histrionic PD (6.1%), narcissistic PD (5.3%), paranoid PD (4.7%), borderline PD (4.7%), passive-aggressive PD (4.4%), and obsessive-compulsive PD (4.1%). In contrast, schizoid PD, schizotypal PD, avoidant PD, dependent PD, and conduct disorder were each reported for less than 4.0% of the participants.
Prevalence estimates for SUDs in Table 1 combine diagnoses for abuse and dependence of a given substance. In the assessment at mean age 13.7 (SD = 2.6), 6.1% of the participants reported at least one SUD (alcohol, marijuana, or other illicit drug), and 8.0% and 19.3% of the participants subsequently met criteria for a SUD at mean age 16.4 and 22.4, respectively. Of those reporting any SUD at T2, 20 out of 46 participants (43.5%) had at least one co-occurring PD. This rate is significantly higher than the 23.0% observed in the group without SUD (χ2 = 9.80, p < .01).
Table 2 summarizes estimates from multilevel logistic regression analyses of SUD that controlled for potential effects of age, sex, race, family SES, parental substance use, and Axis I disorders. In these analyses participants with schizotypal PD, borderline PD, narcissistic PD, passive-aggressive PD, or conduct disorder at mean age 13.7 had significantly elevated rates of SUD between early adolescence and young adulthood. Odds Ratios (OR) ranged from 5.82 to 12.30 for those with PDs in comparison to those without PDs or conduct disorder. Tests for the independent effects of specific PDs in these predictions were not carried out because of insufficient statistical power due to high rates of comorbidity between PDs and low rates of SUD.
Table 3 shows the association of early adolescent PD and the age of initial marijuana use from preadolescence and early adolescence to adulthood. Average age of first time to use marijuana was 18.6 for the group without PDs. Average age of first use of marijuana was significantly earlier for subjects with paranoid PD (14.9), borderline PD (16.5), and conduct disorder (13.6) than those without PD as indicated in the Kaplan-Meier estimates.
Survival analyses were carried out with Cox regression analyses in which we included statistical covariates used in the earlier analyses. In these analyses, hazard ratios are similar to ORs in logistic regression, in that they are expressions of risk in comparison to a reference group. In this case the hazard indicates the odds that marijuana use will be initiated by participants in the group who have not already initiated it at an earlier age in comparison to the corresponding odds for a reference group. Significant effects were found for those with paranoid PD, borderline PD, and conduct disorder when compared with participants without any PD or conduct disorder. At any given point over this age period, those with paranoid PD in early adolescence had 1.73 times the hazard of initiating marijuana use than adolescents without PD or conduct disorder. Borderline PD in early adolescence was associated with 2.22 times the hazard of initiating marijuana use, while adolescents with conduct disorder had 3.32 times the hazard of initiating marijuana use over this period, each in comparison with adolescents without PD or conduct disorder.
Cox regressions examining independent hazard ratios for initiating marijuana use were also carried out and included all PDs and conduct disorder in the same model. Early adolescent borderline PD and conduct disorder were independently associated with elevated hazard ratios for the onset of marijuana use. Paranoid PD did not show a significant independent effect. At any given age, adolescents with borderline PD who had not yet begun marijuana use had 1.73 times the hazard for marijuana initiation observed in the reference group and those with conduct disorder had 2.59 times the hazard of initiating marijuana use.
The next analyses used multilevel change models to test whether PD and conduct disorder at T2 were associated with age changes in SUD symptom levels over time. All analyses included the covariates noted above as well as linear and quadratic effects of age at each assessment. Analyses first tested whether groups defined by specific PD diagnoses and the comparison group without any PD showed significant differences in patterns of change in SUD symptoms over time. A second set of analyses tested the independence of each PD's associations with each SUD scale by including the other PDs in the same model.
As reported in Table 4, alcohol abuse/dependency symptoms in the group without PD (n=567) increased linearly about 0.071 average unit per year combined with a 0.004 unit deceleration in this increase after age 17 (the age around which all ages were centered). Youths diagnosed with seven out of ten PDs had statistically higher mean symptoms levels over time when compared with those without any PD. Specifically, participants with paranoid PD, schizotypal PD, borderline PD, narcissistic PD, histrionic PD, avoidant PD, passive-aggressive PD, and conduct disorder all had higher levels of alcohol abuse/dependence than those without any PD. For youth with schizotypal PD, the increase in SUD symptoms was 0.034 units per year less than that of the group without PD, indicating that the high mean level of alcohol disorder symptoms was present at an early age and did not increase as rapidly as in the reference group. Those with narcissistic PD showed a very elevated mean with decelerated increase with age in comparison with those without PD.
Table 4 also summarizes analyses that included all PDs and conduct disorder simultaneously in the same multilevel model, thereby adjusting for the effects of co-occurring PDs along with all the other controls specified above. These models identify the independent association of each separate PD with the change in symptom level over time net of other PDs and conduct disorder. As depicted in Figure 1, borderline PD, narcissistic PD, histrionic PD, passive-aggressive PD, and conduct disorder in early adolescence were all found to be independently associated with significantly elevated mean symptoms of alcohol abuse/dependency across the age range. Borderline PD was independently associated with a 0.03 unit smaller linear increase in alcohol use disorder symptoms per year in comparison with those without disorder. As shown in Figure 1, the effect of early adolescent borderline PD on these symptoms dissipated by about age 23. Aside from differences in overall alcohol symptom levels, other PDs and conduct disorder did not show a significantly different trajectory from the no disorder group over time.
For the group without PD (n=567), marijuana abuse/dependency symptoms increased linearly about 0.026 unit per year combined with a 0.001 unit deceleration in this increase (Table 5). Compared with the group without PD, statistically higher mean symptom levels were found across the age range for adolescents with schizotypal, borderline, histrionic, avoidant, and passive-aggressive PD, as well as those with conduct disorder. No significant differences in linear age change in symptoms were identified between those with PD and those without PD. However, adolescents with histrionic and avoidant PD showed decelerated age changes compared to those adolescents without PD.
The independent associations of early adolescent PDs and symptoms of marijuana abuse/dependency from early adolescence to adulthood are presented in the final model in Table 5 and depicted in Figure 2. After adjusting for the effects of all other PDs in early adolescence, borderline PD, passive-aggressive PD, and conduct disorder were each independently associated with statistically higher mean symptoms of marijuana use disorder across the age range.
For the group without PD (n=567), symptoms of illicit drug use other than marijuana increased linearly by about 0.064 unit per year combined with a 0.003 unit acceleration in this increase (Table 6). Compared with the young adolescents without PD, statistically higher mean symptom levels for illicit SUD were found across the age range for adolescents with borderline PD, narcissistic PD, histrionic PD, avoidant PD, and conduct disorder. Young adolescents with borderline PD, however showed an annual increase in symptoms that was 0.025 unit per year less than that of the reference group. No significant group differences in quadratic age change were found.
The independent associations of early adolescent PDs and symptoms of illicit drug disorders (other than marijuana) from early adolescence to adulthood are presented in the final model in Table 6 and depicted in Figure 3. When controlling for all other PDs in early adolescence, histrionic PD and conduct disorder were independently associated with higher symptom means across the age range. Conduct disorder was independently associated with a 0.02 unit decrease in the symptoms of illicit drug abuse/dependency per year when comorbid PD effects were taken into account. Thus, those with early adolescent conduct disorder had much elevated early symptoms but subsequent assessments brought their illicit drug-associated symptoms to a level roughly equivalent to that of those with a history of early histrionic PD by age 20 (see Figure 3).
The next analyses used multilevel change models to test whether PD and conduct disorder at mean age 13.7 were associated with trajectories of SUD symptom levels over the subsequent 20 years. All analyses included the covariates noted above but in addition current SUD symptoms and age at the 1983 assessment were predictors of subsequent trajectories. Analyses tested whether specific PD diagnoses showed significant effects on alcohol or marijuana use disorder symptom trajectories, including symptoms estimated at age 23 and linear and non-linear changes in symptoms from mean age 16.4 to mean age 33.2. In addition, we investigated the possibility that the influence of early SUD symptoms on the subsequent trajectory may be influenced by comorbidity with PD. These influences may take two hypothesized versions. First, the presence of comorbid PD may increase the risk associated with co-occurring SUD problems with regard to continuity or elevation of such problems over the ensuing years. Second, in the absence of co-occuring SUD symptoms, PD may be an even stronger predictor of higher future SUD symptoms. The rationale for this expectation is that family monitoring may protect many early adolescents from substance use and thus SUD symptoms. At older ages access to these substances is more self-determined and availability increases. Under these circumstances the risk associated with PD may be more readily manifest.
As reported in Table 7, alcohol abuse/dependency symptoms (AAD) in the entire sample increased linearly (about 0.0030 average unit per year combined with a 0.0006 unit deceleration in this increase after age 23 1(the age around which all ages were centered). There was significant and substantial continuity of AAD from this early period (.305 units) as well as significant associations with each of the control variables: higher average symptoms estimated at age 23 for those with parental substance use problems, lower family SES, any Axis I disorder, males, and white respondents. For subsequent models each personality disorder was assessed as a potential predictor of subsequent mean, trajectory, and interaction with current AAD in a model based on the entire sample data and including all covariates.
Participants with paranoid PD in early adolescence showed an elevated increase in AAD symptoms per year over the subsequent 20 years: (0.003 + 0.008 = 0.011) as compared to 0.003. In addition, the estimated average symptoms at age 23 was increased from 0.305 in the basic model to 0.305 + 0.381 = 0.686 in those with this disorder (Figure 4). Early schizoid, schizotypal, and borderline PD did not show significant associations with AAD trajectories that were significantly independent of current AAD, nor an influence on the effect of early adolescent AAD. However Histrionic PD was related to higher mean AAD estimated at age 23 and Narcissistic PD was related to lower mean, less decline in AAD after age 23, and a much greater continuity in AAD symptoms from early adolescence on.
The positive association of Avoidant PD with mean AAD at age 23 was of marginal statistical significance (p = .06). Dependent PD, on the other hand appears to have a protective effect, with a virtually nil continuity of symptoms from early adolescence (0.305 − 0.288 = 0.017). In contract, passive-aggressive PD, like narcissistic PD was related to a much increased continuity of AAD from early adolescence thereafter. Finally, conduct disorder had a substantial association with subsequent mean ADD symptoms but did not influence either the trajectory or the continuity of early ADD symptoms.
The basic model of the trajectory of marijuana abuse or dependency symptoms (MAD) is provided in Table 8. We see here that the trajectory of MAD in the 20 years following the early adolescent assessment was a strictly linear increase. The effect of early MAD was substantial and symptoms were higher in males and in those with an Axis I disorder other than conduct disorder. There were no significant effects of parental substance use, family SES, or race on MAD symptom means over this period net of earlier MAD.
Paranoid PD was independently related to higher subsequent mean MAD symptoms and a steeper trajectory. In addition, among those with no MAD in the early adolescent assessment the impact of paranoid PD on subsequent mean MAD was much greater. Variations on this pattern were also apparent for those with borderline and schizotypal PDs (Figure 5). In the case of schizotypal PD the effect on linear slope was not statistically significant and in the case of borderline PD the effect on linear slope was negative. Nevertheless, in all of these disorders a similar pattern of particular impact on subsequent symptoms in the absence of MAD symptoms in early adolescence is apparent.
The associations of histrionic and narcissistic PD with subsequent MAD are limited to an increase in overall mean for the first and increase in linear trajectory for the second. Avoidant PD was associated with both of these effects. However the other Cluster C PDs, dependent and obsessive compulsive showed higher continuity with early adolescent MAD symptom level or, equivalently, higher impact of these PDs on subsequent elevated MAD mean when early adolescent symptoms were elevated.
The present study is the one of the first to document associations between PD and SUDs in a random sample of adolescents from the community. Moreover, this study is the first to examine how early manifestations of PD may influence the developmental course of SUDs from adolescence to adulthood. Because this study controlled for well-known risk factors for SUDs (male gender, conduct disorder, and parental substance abuse), it documents how borderline, histrionic, and narcissistic PDs in early adolescence all represent independent risk factors for the development of SUDs in later adolescence and early adulthood. These Cluster B PDs in adolescence clearly warrant clinical attention when assessing early risks for SUDs and implementing interventions to prevent or treat those disorders.
As expected, PD at mean age 13.7 was associated with increased risk of co-occurring SUD as well as the increase in subsequent onset of marijuana use. Although early adolescent PD-SUD correlation leaves it unclear if PD precedes SUD or vice versa, separate multilevel logistic models indicated that schizotypal, borderline, narcissistic, and passive-aggressive PDs each increased the risk for subsequent substance use diagnoses, as did conduct disorder. In multilevel models, specific PDs also predicted changes in symptom trajectories across from early adolescence to early adulthood. These adolescent PDs were assessed when Axis II disorders are normally at their highest levels (Bernstein et al., 1993; Johnson et al., 2000) and before they begin a normative decline later in adolescence and early adulthood. In contrast, peak rates for the onset of substance abuse generally occur between ages 15 and 19 (Burke, Burke, Regier, & Rae, 1990). As such, the PDs used in our multilevel models showed clear associations with SUDs before, during, and after this peak period of risk for first use of alcohol, marijuana, or other illicit drugs. These analyses indicate PDs may not only predict persistence of some SUD problems over as much as the following two decades but may also represent an elevated risk for onset of SUD problems among adolescents who have not yet begun use.
Consistent with the literature on adults (Trull et al., 2000; Skodol et al., 1999), borderline PD at mean age 13.7 was associated with elevated symptoms of alcohol abuse and marijuana use in adolescence and early adulthood. This effect was observed even after taking conduct disorder, other Axis I and Axis II disorders, male gender, and parental substance abuse into account. Moreover, the observed link between borderline PD and SUDs cannot be attributed to any artifact of overlapping criterion sets in DSM-IV because we did not use any substance abuse items to assess impulsive self-destructive behavior in borderline PD or any other criterion for this Axis II disorder.
There are several ways to explain prospective associations between borderline PD and SUDs. Youths diagnosed with borderline PD in our sample began smoking marijuana at significantly younger ages than those without any PD. Early onset of substance use is noteworthy because it increases the risk for later substance abuse in adolescence and early adulthood (Anthony, & Petronis, 1995; Kandel, Davies, Karus, & Yamaguchi, 1986). Based on the available data presented in Figure 1, borderline PD and histrionic PD also may be associated with earlier onsets for alcohol use symptoms.
Although little is known about shared genetic influences that could link borderline PD and SUDs, it is known that common family risk factors are associated with both forms of disorder. Parental substance abuse is a risk factor for borderline PD and substance abuse in adolescents (Guzder et al., 1999; Johnson, Brent et al., 1995; Widiger & Trull, 1993; Luthar et al, 1993; Merikangas et al., 1998; Miles et al., 1998). Parental substance abuse also may increase risk for sexual abuse that in turn leads to increased risk for substance abuse and borderline PD in adolescents (Brown & Anderson, 1991; Sabo, 1997). Parental substance abuse may also contribute to problematic parenting that has been associated with borderline PD in adolescent offspring (Bezirganian, Cohen, & Brook, 1993). It thus could be that various environmental risk factors for borderline PD are indirectly influenced by genetic risks that are well-documented for substance abuse (e.g., Tsuang et al., 1996).
Figures 1 and and22 suggest that alcohol and marijuana symptoms around age 12 are comparably elevated for participants diagnosed with conduct disorder and borderline PD. Both disorders are characterized by impulse control problems that may increase susceptibility to substance abuse problems, perhaps especially in early adolescence. However, borderline PD is also characterized by marked affect dysregulation that is not a part of the conduct disorder syndrome. Substance abuse associated with borderline PD thus may reflect a maladaptive self-medicating strategy intended to regulate dysphoric affect (Casillas & Clark, 2002; Dulit, Fyer, Haas, Sullivan, & Frances, 1990). Substance abuse co-occurring with conduct disorder and antisocial PD, in contrast, may reflect novelty-seeking behavior that is genetically mediated (Heath, Cloninger, & Martin, 1994; Howard, Kivlahan, & Walker, 1997).
Conduct disorder almost invariably had the largest effect size as a predictor of substance abuse in models that simultaneously included PDs, age, sex, and other co-occurring Axis I disorders. Whereas the long-term trajectory for alcohol and marijuana abuse associated with borderline PD in early adolescence gradually decelerated and intersected with more normative levels around age 23, trajectories associated with conduct disorder remained at higher levels throughout adolescence and early adulthood. On average, youths with conduct disorder also appear to start smoking marijuana at a much younger age (13.6 years) than those diagnosed with borderline PD (16.5 years). Based on differences in onset, trajectory, and overall severity, borderline PD and conduct disorder each appear to have unique profiles as risk factors for SUDs.
Histrionic and narcissistic PDs also reflect elevated risk for alcohol abuse independent of risks associated with borderline PD and conduct disorder. Histrionic PD is also associated with increased risk for illicit drug use. These findings replicate findings elsewhere (Grilo et al., 1995; Skodol et al., 1999) suggesting that Cluster B PDs are more consistently associated with SUDs than Cluster A PDs (paranoid, schizoid, and schizotypal PDs) or from Cluster C PDs (avoidant, dependent, obsessive-compulsive PDs). When analyzed here as separate predictor variables, avoidant and schizotypal PDs initially appeared to be associated with subsequent SUDs. However, the effects of these Clusters A and C PDs lost significance when Cluster B PDs were simultaneously included in the model. Young people with schizotypal or avoidant PD may thus be at probable risk for SUDs based on how much they also present with borderline PD or other Cluster B disorders. In our sample seven of the 26 participants (27%) diagnosed with avoidant PD also had borderline PD, and eight of 19 participants (42%) diagnosed with schizotypal PD also had borderline PD, thereby illustrating how borderline PD frequently co-occurs with PDs from different diagnostic clusters.
People diagnosed with passive-aggressive PD, in contrast, remained significantly associated with alcohol and marijuana abuse/dependence disorders even after taking into account other PDs, conduct disorder, and all other control variables used in this study. Passive-aggressive traits, however, are observed so frequently together with other PDs that the utility of passive aggressive PD as a distinct diagnostic construct has been questioned. In this context our finding that passive-aggressive traits play a prominent role in SUDs suggests a strong effect regardless of what other PD or conduct disorder symptoms might also be present.
Can we say that personality disorder in early adolescence has an unambiguous causal impact on the probability of SUD or the level of SUD symptoms? Some PDs are certainly risk indicators for subsequent initiation, onset, or higher level symptoms of these problems. Nevertheless, as is likely the case for psychiatric disorders more generally, comorbidity may often develop out of shared biological and environmental risks. For any given pair of disorders, including substance use disorders, once either or both develops, the consequences of each may then constitute a risk for further increase or persistence of the other. When there are age-regulated disorder exposures, such as substance access, the timing of these problems will further modulate the reciprocal influences that may ensue. Thus, at least some PDs may be indicators of more basic risk for SUD without actually mediating the effect of these basic risks, despite the relationships with future onset or elevated symptoms of SUD. That is, the comorbidity reflects common causes, and the ability to express PD at a younger age than one can access problematic substances may be the source of the apparent sequence effect often attributed to causation.
When borderline PD and SUDs occur in combination, they are known to increase risk for suicidal behavior in adult patients in treatment for SUDs or Axis II disturbances (O'Boyle & Brandon, 1998; Yen et al., 2003). Other research has documented how borderline PD increases risk of violence victimization or perpetration in a sample of perinatal substance abusers (Haller & Miles, 2003). Furthermore, co-occurring Axis II and SUDs are associated with significantly worse compliance with follow-up treatment after inpatient hospitalizations (Links, et al., 1995; Ross, et al., 2003). Serious risks associated with co-occurring PD and SUD are thus well known in clinical settings for adults but they are only beginning to be documented in adolescents. The present results strongly suggest that clinicians should evaluate their patients for the presence of PDs, especially Cluster B PDs, when assessing or treating SUDs in adolescents.
Treatments are emerging to assist patients presenting with co-occurring PD and SUD. Although originally designed to treat borderline PD, Dialectical Behavioral Therapy (DBT; Linehan, 1993) has been adapted and evaluated for treatment of SUD (Dimeff, Rizvi, Brown, & Linehan, 2000) and SUD that co-occurs with borderline PD (van den Bosch, Verheul, Schippers, & van den Brink, 2002). Skills training interventions used in DBT have also been integrated with family therapy for adolescent patients with SUDs (Santisteban, Muir, Mena, & Mitrani, 2003).
Because this study assessed PDs and SUDs in a randomly selected community sample, its estimates of co-occurring psychiatric disorders are not artificially inflated by ascertainment bias. Prospective assessment of psychiatric disorders ensured that our findings were not distorted by error accompanying retrospective reports of adolescent disturbances by adult respondents. Although this study relies on measures of PD that are unique to our sample, the findings reported here are largely consistent with the available literature on co-occurring PDs and SUDs in adults and adolescents. Furthermore, our study employs rigorous controls for co-occurring psychiatric disorders and other risk factors that otherwise might account for the associations we found between Cluster B PDs in early adolescence and subsequent SUDs. Although this study indicates that PDs represent long-term risks for SUDs that are independent of conduct disorder, additional research is needed to clarify which risk aspects are unique to PDs and thereby distinguish them from risks associated with conduct disorder.
As for any study of SUD in young people, findings are likely to be somewhat conditional on the cohort being investigated, secular changes in usage patterns of psychoactive drugs being so common in young people. Nevertheless, we look to our research for findings that will generalize beyond the given research cohort. For this reason, the 10 birth-year span of this cohort is slightly advantageous in comparison to a cohort born in a single year. This cohort was born between 1965 and 1975 and thus "turned 15" across the decade of the 1980's. On the other hand, the findings must be averaged over this cohort span, and may thus be less easily compared to other cohort studies. Another limitation is the modest sample size, especially for the investigation of the stronger illicit drugs. Our self-reported data produced very few cases meeting diagnostic criteria for these drugs, and thus extreme symptom distributions requiring statistical transforms to roughly meet the criteria for the statistical analyses we carried out. Thus these analyses should be considered tentative until supported by other studies.
This study was supported by National Institute of Mental Health Grant MH-36971, MH-38916, MH-49191, DA-03188, and DA016977-01.
1Because of the transformation of the symptom measures required to improve the variable distribution conformity with the assumptions of the statistical model, the scale cannot be directly interpreted as number of symptoms. In addition the measure of early adolescent AAD was centered by subtracting its mean in order to facilitate interpretation of interaction effects.
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Can anyone tell me what the DTC P1619 - "Map Cooling Thermostat Control
Circuit Signal Low" means on my 2001 E46 330ci?
Also, can anyone tell me what could cause it?
It has been to the dealers twice and an independant once with this
fault, but neither have acted on it.
Many thanks
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Gardens open at pair of inner-city centers
Taria Miller stood under bright sunlight in the garden where she recently cleared weeds and planted vegetables.
She looked at the spots where spinach, collard greens, zucchini and about a dozen other vegetables will soon harvest.
"Tomatoes and broccoli," Taria said, when asked which ones are her favorites to eat.
The 9-year-old is enrolled in a summer camp at the Martin Luther King Center, 312 Chestnut St., which officially opened its community garden on Wednesday.
The Multicultural Community Resource Center, 554 E. 10th St., also opened a similar garden Wednesday. Both projects were funded by AmeriHealth Caritas Pennsylvania, a health-care plan that is based in Harrisburg.
"Building gardens builds healthier communities," said Leslie Demaske, community outreach specialist with AmeriHealth. "These gardens provide nutritional resources and educational opportunities."
The MLK Center garden is located across Chestnut Street on property owned by the center. Staff and children who attend youth programs there did the weeding and planting in mid-June.
"Anyone who lives in the area can harvest and take care of the garden," said James Sherrod, the center's executive director. "It allows people from within our community to plant and enjoy the vegetables of their labor."
The garden behind the MCRC building was planted by refugees age 60 and older who are clients at the center, said Carol Pifer, a social services coordinator with the agency.
"They were predominantly farmers in their home countries who end up here living in the inner city," Pifer said. "This garden gives them a chance to utilize their skills."
About $2,500 in funding for the projects was provided by AmeriHealth to support local gardening, which helps to improve health and brings people together from a wide variety of backgrounds, said Nancy Fahey, a manager with AmeriHealth.
"Going to the grocery store to buy healthy foods is expensive," Fahey added.
GERRY WEISS can be reached at 870-1884 or by e-mail. Follow him on Twitter at twitter.com/ETNweiss.


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Growing up, Greeley's Chuckie Williams never dreamt of being one of the nation's top college basketball players. He certainly never thought he would have his jersey retired and make a Hall of Fame.
However, that's exactly what Williams, 52, accomplished because of his determination to find a better life for himself.
The former All-American guard at Kansas State University, who led the Wildcats to two appearance in the Elite Eight of the NCAA tournament, was inducted into the Kansas State Hall of Fame Oct. 6.
In February, Williams had his jersey retired along with Lon Kruger and former Denver Nuggets guard Mike Evans. He was also recently one of 10 players named to the school's all-century team.
"The Hall of Fame? You can't even dream that you will be in the Hall of Fame," Williams said. "So no I never had that dream and yes, I am totally humbled by it."
Williams got into sports hoping to escape the troubled neighborhood of Columbus, Ohio where he grew up. His childhood friend Gary Owens knew how difficult it was for Williams to escape the trappings of a neighborhood where alcohol and drugs were a way of life.
"In a community infested with drugs and alcohol, to be able to go to college and all that, you had to have a spirit in you because he had all the adversities not to be successful," Owens said.
Williams wasn't about to let it swallow him up.
"I didn't want to be a product of my environment on the negative side," Williams said.
In the fourth grade, he started playing basketball and excelled in the sport almost immediately. He became a star at powerhouse Columbus East High School where he earned Parade All-American honors his senior year. Owens said that Williams developed a jump shot in junior high that made him nearly unstoppable.
"They had chained nets and he could make them sing a song when he shot his jumper," Owens said. "You thought a bird was out chirping when he came on the court because his jumper was so pretty."
He drew interest from a variety of major college basketball programs, including Indiana, Ohio State, UCLA and Louisville. He took four of his five allowed recruiting visits by the NCAA to Southwest Louisiana, Louisville, Ohio State and Indiana, but had one more visit he could take. He wasn't sure where that would be when he met Bob Gottlieb, a former player at Ohio State who was an assistant at Kansas State.
Gottlieb, who played with NBA standouts Jerry Lucas and college coaching legend Bobby Knight at Ohio State, convinced Williams to give Kansas State a try. He wanted to go to a school where he could get a quality education and compete for a championship every year and knew after his visit that KSU would give him his best chance at both.
"The most important thing that Kansas State did that no other school did for me was give me a sense of security," Williams said. "At 18, I was a long, long way from home, but when I took that visit, they made me feel like I had never left home."
As a boy from the city, life in Manhatten was a culture shock. For the first three months he was homesick. Still, it wasn't long before he knew it was where he belonged. Williams became an instant success on the court. He played alongside former Denver Nuggets guard Mike Evans to form one of the most feared backcourts in college basketball, earning them the nickname the Purple Popguns.
Williams former teammate and college roommate Darryl Winston said that Williams was a leader and mentor whose flashy style made him a big man on campus.
"Chuckie was my roommate and Chuckie was a ladies man," Winston said. "He kind of gave us a little cockiness and as a mentor for us gave us that little strut that made you successful on the court and off the court. Chuckie had a flair about him. He had a little East Coast mentality, so he dressed a little flashy and he just had an air about him that the rest of us kind of took on."
After college, Williams was a No. 1 draft pick (15th overall) of the Cleveland Cavaliers and played six years in the NBA but two ruptured discs in his back forced him into early retirement.
Still, Williams calls his NBA career a "wonderful" journey in which he played alongside the great players that helped build the NBA in what it is today.
WHO: Greeley's Chuckie Williams
SPORT: Basketball
COLLEGE: Kansas State (1973-76)
COLLEGE CAREER: Williams averaged 22.1 points as a junior and 20.9 as a senior, earning all-Big 8 both seasons. He held the single-game scoring mark for 19 years with his 47-point effort against Vanderbilt in 1975. His three-game run in the NCAA tournament in 1975 nearly got K-State to the Final Four. He scored 20 points against Pennsylvania in the first round, 32 against Boston College in the second round and 35 in an overtime loss to Syracuse in the regional final.
POST-CAREER HONORS: One of only basketball players to have his jersey retired by KSU. Named to school's All-Century team with guards Mitch Richmond, Rolando Blackman, Mike Evans, Steve Henson, Lon Kruger; forwards Ernie Barrett, Bob Boozer and Ed Nealy; and center Jack Parr. Entered KSU Hall of Fame last month.
PRO CAREER: Drafted No. 1 (15th overall) by the Cleveland Cavaliers, but career was cut short by a back injury.
FAVORITE NBA STORY: Spending time with former senator John Warner and his ex-wife, actress Elizabeth Taylor, while snowed in at a hotel in Richmond, Va. "We drank beer, we had fun and they were very nice to us."
ON WHETHER HE WATCHES THE NBA TODAY: "I'm not a big fan of today. Do I watch it? More so when it is getting close to playoffs times because I know they are really playing and earning their money."
ON PLAYING THE UNIVERSITY OF COLORADO HIS JUNIOR YEAR: "I think Mike (Evans) scored about 32 and I scored like about 37 in one game and I was like 'this is really something. This is neat.' That was one game where he (Evans) really showed me a lot. I will never forget that game, that gym and that dungeon."
Greeley's Bob and Betty Toiton were also inducted into the Kansas State University Hall of Fame Oct. 6 for their long-time support of the Wildcats program. The Greeley couple were the principal benefactors in KSU's recent 3.1 million renovation of its baseball stadium. In recognition of their contribution, the facilities names was changed to Frank Myers Field at Toiton Family Stadium.
The Toiton's are 1955 graduates of Kansas State. Both have been members of the school's President's Club since 1980. They are currently KSU Foundation trustees. Betty served on the school's alumni association's board of directors from 1982-85 and 1987. Bob received the Distinguished Service Award from the school's College of Engineering.


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[AWARDS]U.S. Soccer has announced the finalists for the 2008 "Best of U.S. Soccer" awards in 12 categories. The seventh annual series, presented by SOCCER AMERICA, gives fans the opportunity to make their selections for the best in soccer in the United States. Fans can vote once a day from now until Monday, Dec. 8, on ussoccer.com's "Best of U.S. Soccer" blog page.
The 2008 "Best of U.S. Soccer" awards will be decided entirely by online fan votes submitted over the next three weeks.
In addition to voting for the "Best of U.S. Soccer" awards, fans will also have the chance to vote daily for U.S. Soccer's prestigious Athlete of the Year awards, which will be announced later this week.
2008 "Best of U.S. Soccer" Awards Categories
Best all-access Video
Best Assist
Best Fan Photo
Best Goal (MNT)
Best Goal (WNT)
Best Goal (Academy)
Best Performance (Player)
Best Performance (Team)
Best Photo
Best Soccer Bar
Best Soccer Blog
Best Soccer Specialty Store


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How to pronounce Howard F. Mosher: MO-sher, rhymes with
Making Books into Movies: a Conversation with Jay Craven and Howard Frank Mosher
Unless otherwise stated, this interview was conducted at the time the book was first published, and is reproduced with permission of the publisher. This interview may not be reproduced or reprinted without permission in writing from the copyright holder.
Blood at the Root
"A gripping, timely, and important examination of American racism."
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