Do Coping Motives and Perceived Impaired Control Mediate the Indirect Links from Childhood Trauma Facets to Alcohol-Related Problems?

INTRODUCTION: The Self-Medication Hypothesis suggests that individuals drink to alleviate undesirable affective states. Behavioral Economics Theory states that individuals deprived of resources (i.e., physically neglected) consume more reinforcing substances when they are available than others. Childhood trauma may indirectly increase impaired control over alcohol (IC; drinking beyond one's own intentions) and thereby increase alcohol use and problems through the employment of coping-motives. METHOD: A structural equation model that included sex as a covariate examined mediated paths with 612 university students. RESULTS: Men were less likely to be emotionally abused and were more likely to use greater amounts of alcohol than women did. Physical neglect was directly linked to both more IC and alcohol use. Emotional and sexual abuse were directly linked to more coping motives. Both emotional and sexual abuse were indirectly linked to more alcohol use and its related problems through increased coping motives and IC. CONCLUSIONS: Consistent with Behavioral Economics Theory, there was a direct link between physical neglect and IC. We also found partial support for the Self-Medication Hypothesis regarding the emotional and sexual abuse trauma dimensions; they indirectly contributed to alcohol use and its related problems via the mediating mechanisms of more coping motives and IC. Our findings suggest coping motives could be a therapeutic target for intervention among those sexually or emotionally abused.

Atypical Presentation of Spontaneous Coronary Artery Dissection.

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome, more common in young women without risk factors for, or a history of, coronary artery disease and usually occurs in the peripartum period. There are two types of SCAD: atherosclerotic and nonatherosclerotic coronary artery dissection. Management options include conservative management, percutaneous coronary intervention, or surgical intervention, depending on the presentation and extent of the dissection. We present reports of two cases of SCAD (one man and one woman) presenting to the emergency department of our community hospital in February 2020 with nonspecific symptoms.