Borderline personality disorder: health service use and social functioning among a national household population
It is unclear whether Axis II psychopathology or co-morbid clinical syndromes result in the treatment-seeking behaviour and social impairment of patients with borderline personality disorder (BPD). This study examined the independent associations between social functioning and service use and Axis I...
Gespeichert in:
| Veröffentlicht in: | Psychological medicine 2009-10, Vol.39 (10), p.1721-1731 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1731 |
|---|---|
| container_issue | 10 |
| container_start_page | 1721 |
| container_title | Psychological medicine |
| container_volume | 39 |
| creator | Coid, J. Yang, M. Bebbington, P. Moran, P. Brugha, T. Jenkins, R. Farrell, M. Singleton, N. Ullrich, S. |
| description | It is unclear whether Axis II psychopathology or co-morbid clinical syndromes result in the treatment-seeking behaviour and social impairment of patients with borderline personality disorder (BPD). This study examined the independent associations between social functioning and service use and Axis I and Axis II disorders in persons with BPD in the national household population of Britain.
The study was a cross-sectional survey of adults aged 16-74 years in households (n=8397). Data included self-reported consultations with health-care professionals and behavioural problems. Diagnosis was determined by computer-assisted interviews. Analyses included logistic regression adjusting for demography, co-morbid Axis I clinical syndromes and other Axis II disorders.
Consultation in the past year was reported by 57.5% of persons with BPD but only 13.4% reported lifetime psychiatric admission. BPD was not independently associated with impaired functioning but was associated with co-morbid psychotic, depressive and anxiety disorders. Only general practitioners (GPs) were consulted for problems independently due to BPD.
Functional effects of BPD are mediated through co-morbid clinical syndromes, not Axis II psychopathology. A subgroup do not have co-morbid disorders or seek treatment, and are high functioning. |
| doi_str_mv | 10.1017/S0033291708004911 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_734043721</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><cupid>10_1017_S0033291708004911</cupid><sourcerecordid>1878122911</sourcerecordid><originalsourceid>FETCH-LOGICAL-c501t-f95d9453e0aefb49864e827d0dcf0d563129ea77fa2478dab7d16288720edbc53</originalsourceid><addsrcrecordid>eNqFkU9v1DAQxSMEokvhA3BBFhJwCoz_xTE3WtEt0kqoAs6WYztdlyRO7QTRb4_TjVoJBFxsad5vRm_mFcVzDG8xYPHuCwClRGIBNQCTGD8oNphVsqylqB8Wm0UuF_2oeJLSFQCmmJHHxRGWhAMXclOMJyFaFzs_ODS6mMKgOz_dIOvTrfAe7Z3upj1KLv7wxqE5OaQHi1IwXneonQcz-TD44RLpPiwvGvRSyeI-ZHofOovGMM7dbflp8ajVXXLP1v-4-Hb28evpebn7vP10-mFXGg54KlvJrWScOtCubZisK-ZqIixY04LlFcVEOi1EqwkTtdWNsLgidS0IONsYTo-LN4e5YwzXs0uT6n0yruv04LItJSgDRgXBmXz9T5ILCrWoxX_BPItyQWgGX_4GXoU55otkBhiTsqIsQ_gAmRhSiq5VY_S9jjcKg1riVX_Em3terIPnpnf2vmPNMwOvVkAno7s26sH4dMcRLCHvsjgsD5xPk_t5p-v4XVWCCq6q7YViF3x7dr47UZB5uprVfRO9vXT3K_3d7i_Scct0</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>204499634</pqid></control><display><type>article</type><title>Borderline personality disorder: health service use and social functioning among a national household population</title><source>MEDLINE</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><source>Cambridge University Press Journals Complete</source><creator>Coid, J. ; Yang, M. ; Bebbington, P. ; Moran, P. ; Brugha, T. ; Jenkins, R. ; Farrell, M. ; Singleton, N. ; Ullrich, S.</creator><creatorcontrib>Coid, J. ; Yang, M. ; Bebbington, P. ; Moran, P. ; Brugha, T. ; Jenkins, R. ; Farrell, M. ; Singleton, N. ; Ullrich, S.</creatorcontrib><description>It is unclear whether Axis II psychopathology or co-morbid clinical syndromes result in the treatment-seeking behaviour and social impairment of patients with borderline personality disorder (BPD). This study examined the independent associations between social functioning and service use and Axis I and Axis II disorders in persons with BPD in the national household population of Britain.
The study was a cross-sectional survey of adults aged 16-74 years in households (n=8397). Data included self-reported consultations with health-care professionals and behavioural problems. Diagnosis was determined by computer-assisted interviews. Analyses included logistic regression adjusting for demography, co-morbid Axis I clinical syndromes and other Axis II disorders.
Consultation in the past year was reported by 57.5% of persons with BPD but only 13.4% reported lifetime psychiatric admission. BPD was not independently associated with impaired functioning but was associated with co-morbid psychotic, depressive and anxiety disorders. Only general practitioners (GPs) were consulted for problems independently due to BPD.
Functional effects of BPD are mediated through co-morbid clinical syndromes, not Axis II psychopathology. A subgroup do not have co-morbid disorders or seek treatment, and are high functioning.</description><identifier>ISSN: 0033-2917</identifier><identifier>EISSN: 1469-8978</identifier><identifier>DOI: 10.1017/S0033291708004911</identifier><identifier>PMID: 19250579</identifier><identifier>CODEN: PSMDCO</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Adolescent ; Adult ; Adult and adolescent clinical studies ; Aged ; Biological and medical sciences ; Borderline personality disorder ; Borderline Personality Disorder - epidemiology ; Borderline Personality Disorder - psychology ; Borderline Personality Disorder - therapy ; Co-morbidity ; Comorbidity ; Consultation ; demography ; epidemiology ; Female ; Health services utilization ; Households ; Humans ; Male ; Medical sciences ; Mental Disorders - epidemiology ; Mental Health Services - utilization ; Middle Aged ; personality disorder (Axis I) ; Personality disorders ; Prevalence ; Psychiatric Status Rating Scales ; Psychiatry ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology ; Psychopathology. Psychiatry ; service use ; Social Adjustment ; Social functioning ; Social interaction ; Social psychology ; United Kingdom - epidemiology ; Young Adult</subject><ispartof>Psychological medicine, 2009-10, Vol.39 (10), p.1721-1731</ispartof><rights>Copyright © 2009 Cambridge University Press</rights><rights>2009 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c501t-f95d9453e0aefb49864e827d0dcf0d563129ea77fa2478dab7d16288720edbc53</citedby><cites>FETCH-LOGICAL-c501t-f95d9453e0aefb49864e827d0dcf0d563129ea77fa2478dab7d16288720edbc53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S0033291708004911/type/journal_article$$EHTML$$P50$$Gcambridge$$H</linktohtml><link.rule.ids>164,314,777,781,12827,27905,27906,30980,30981,55609</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21900873$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19250579$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Coid, J.</creatorcontrib><creatorcontrib>Yang, M.</creatorcontrib><creatorcontrib>Bebbington, P.</creatorcontrib><creatorcontrib>Moran, P.</creatorcontrib><creatorcontrib>Brugha, T.</creatorcontrib><creatorcontrib>Jenkins, R.</creatorcontrib><creatorcontrib>Farrell, M.</creatorcontrib><creatorcontrib>Singleton, N.</creatorcontrib><creatorcontrib>Ullrich, S.</creatorcontrib><title>Borderline personality disorder: health service use and social functioning among a national household population</title><title>Psychological medicine</title><addtitle>Psychol. Med</addtitle><description>It is unclear whether Axis II psychopathology or co-morbid clinical syndromes result in the treatment-seeking behaviour and social impairment of patients with borderline personality disorder (BPD). This study examined the independent associations between social functioning and service use and Axis I and Axis II disorders in persons with BPD in the national household population of Britain.
The study was a cross-sectional survey of adults aged 16-74 years in households (n=8397). Data included self-reported consultations with health-care professionals and behavioural problems. Diagnosis was determined by computer-assisted interviews. Analyses included logistic regression adjusting for demography, co-morbid Axis I clinical syndromes and other Axis II disorders.
Consultation in the past year was reported by 57.5% of persons with BPD but only 13.4% reported lifetime psychiatric admission. BPD was not independently associated with impaired functioning but was associated with co-morbid psychotic, depressive and anxiety disorders. Only general practitioners (GPs) were consulted for problems independently due to BPD.
Functional effects of BPD are mediated through co-morbid clinical syndromes, not Axis II psychopathology. A subgroup do not have co-morbid disorders or seek treatment, and are high functioning.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Borderline personality disorder</subject><subject>Borderline Personality Disorder - epidemiology</subject><subject>Borderline Personality Disorder - psychology</subject><subject>Borderline Personality Disorder - therapy</subject><subject>Co-morbidity</subject><subject>Comorbidity</subject><subject>Consultation</subject><subject>demography</subject><subject>epidemiology</subject><subject>Female</subject><subject>Health services utilization</subject><subject>Households</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Mental Disorders - epidemiology</subject><subject>Mental Health Services - utilization</subject><subject>Middle Aged</subject><subject>personality disorder (Axis I)</subject><subject>Personality disorders</subject><subject>Prevalence</subject><subject>Psychiatric Status Rating Scales</subject><subject>Psychiatry</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology</subject><subject>Psychopathology. Psychiatry</subject><subject>service use</subject><subject>Social Adjustment</subject><subject>Social functioning</subject><subject>Social interaction</subject><subject>Social psychology</subject><subject>United Kingdom - epidemiology</subject><subject>Young Adult</subject><issn>0033-2917</issn><issn>1469-8978</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkU9v1DAQxSMEokvhA3BBFhJwCoz_xTE3WtEt0kqoAs6WYztdlyRO7QTRb4_TjVoJBFxsad5vRm_mFcVzDG8xYPHuCwClRGIBNQCTGD8oNphVsqylqB8Wm0UuF_2oeJLSFQCmmJHHxRGWhAMXclOMJyFaFzs_ODS6mMKgOz_dIOvTrfAe7Z3upj1KLv7wxqE5OaQHi1IwXneonQcz-TD44RLpPiwvGvRSyeI-ZHofOovGMM7dbflp8ajVXXLP1v-4-Hb28evpebn7vP10-mFXGg54KlvJrWScOtCubZisK-ZqIixY04LlFcVEOi1EqwkTtdWNsLgidS0IONsYTo-LN4e5YwzXs0uT6n0yruv04LItJSgDRgXBmXz9T5ILCrWoxX_BPItyQWgGX_4GXoU55otkBhiTsqIsQ_gAmRhSiq5VY_S9jjcKg1riVX_Em3terIPnpnf2vmPNMwOvVkAno7s26sH4dMcRLCHvsjgsD5xPk_t5p-v4XVWCCq6q7YViF3x7dr47UZB5uprVfRO9vXT3K_3d7i_Scct0</recordid><startdate>20091001</startdate><enddate>20091001</enddate><creator>Coid, J.</creator><creator>Yang, M.</creator><creator>Bebbington, P.</creator><creator>Moran, P.</creator><creator>Brugha, T.</creator><creator>Jenkins, R.</creator><creator>Farrell, M.</creator><creator>Singleton, N.</creator><creator>Ullrich, S.</creator><general>Cambridge University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7QP</scope><scope>7QR</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2S</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20091001</creationdate><title>Borderline personality disorder: health service use and social functioning among a national household population</title><author>Coid, J. ; Yang, M. ; Bebbington, P. ; Moran, P. ; Brugha, T. ; Jenkins, R. ; Farrell, M. ; Singleton, N. ; Ullrich, S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c501t-f95d9453e0aefb49864e827d0dcf0d563129ea77fa2478dab7d16288720edbc53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Borderline personality disorder</topic><topic>Borderline Personality Disorder - epidemiology</topic><topic>Borderline Personality Disorder - psychology</topic><topic>Borderline Personality Disorder - therapy</topic><topic>Co-morbidity</topic><topic>Comorbidity</topic><topic>Consultation</topic><topic>demography</topic><topic>epidemiology</topic><topic>Female</topic><topic>Health services utilization</topic><topic>Households</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Mental Disorders - epidemiology</topic><topic>Mental Health Services - utilization</topic><topic>Middle Aged</topic><topic>personality disorder (Axis I)</topic><topic>Personality disorders</topic><topic>Prevalence</topic><topic>Psychiatric Status Rating Scales</topic><topic>Psychiatry</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology</topic><topic>Psychopathology. Psychiatry</topic><topic>service use</topic><topic>Social Adjustment</topic><topic>Social functioning</topic><topic>Social interaction</topic><topic>Social psychology</topic><topic>United Kingdom - epidemiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Coid, J.</creatorcontrib><creatorcontrib>Yang, M.</creatorcontrib><creatorcontrib>Bebbington, P.</creatorcontrib><creatorcontrib>Moran, P.</creatorcontrib><creatorcontrib>Brugha, T.</creatorcontrib><creatorcontrib>Jenkins, R.</creatorcontrib><creatorcontrib>Farrell, M.</creatorcontrib><creatorcontrib>Singleton, N.</creatorcontrib><creatorcontrib>Ullrich, S.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Sociology Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Sociology Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Psychological medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Coid, J.</au><au>Yang, M.</au><au>Bebbington, P.</au><au>Moran, P.</au><au>Brugha, T.</au><au>Jenkins, R.</au><au>Farrell, M.</au><au>Singleton, N.</au><au>Ullrich, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Borderline personality disorder: health service use and social functioning among a national household population</atitle><jtitle>Psychological medicine</jtitle><addtitle>Psychol. Med</addtitle><date>2009-10-01</date><risdate>2009</risdate><volume>39</volume><issue>10</issue><spage>1721</spage><epage>1731</epage><pages>1721-1731</pages><issn>0033-2917</issn><eissn>1469-8978</eissn><coden>PSMDCO</coden><abstract>It is unclear whether Axis II psychopathology or co-morbid clinical syndromes result in the treatment-seeking behaviour and social impairment of patients with borderline personality disorder (BPD). This study examined the independent associations between social functioning and service use and Axis I and Axis II disorders in persons with BPD in the national household population of Britain.
The study was a cross-sectional survey of adults aged 16-74 years in households (n=8397). Data included self-reported consultations with health-care professionals and behavioural problems. Diagnosis was determined by computer-assisted interviews. Analyses included logistic regression adjusting for demography, co-morbid Axis I clinical syndromes and other Axis II disorders.
Consultation in the past year was reported by 57.5% of persons with BPD but only 13.4% reported lifetime psychiatric admission. BPD was not independently associated with impaired functioning but was associated with co-morbid psychotic, depressive and anxiety disorders. Only general practitioners (GPs) were consulted for problems independently due to BPD.
Functional effects of BPD are mediated through co-morbid clinical syndromes, not Axis II psychopathology. A subgroup do not have co-morbid disorders or seek treatment, and are high functioning.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><pmid>19250579</pmid><doi>10.1017/S0033291708004911</doi><tpages>11</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0033-2917 |
| ispartof | Psychological medicine, 2009-10, Vol.39 (10), p.1721-1731 |
| issn | 0033-2917 1469-8978 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_734043721 |
| source | MEDLINE; Applied Social Sciences Index & Abstracts (ASSIA); Cambridge University Press Journals Complete |
| subjects | Adolescent Adult Adult and adolescent clinical studies Aged Biological and medical sciences Borderline personality disorder Borderline Personality Disorder - epidemiology Borderline Personality Disorder - psychology Borderline Personality Disorder - therapy Co-morbidity Comorbidity Consultation demography epidemiology Female Health services utilization Households Humans Male Medical sciences Mental Disorders - epidemiology Mental Health Services - utilization Middle Aged personality disorder (Axis I) Personality disorders Prevalence Psychiatric Status Rating Scales Psychiatry Psychology. Psychoanalysis. Psychiatry Psychopathology Psychopathology. Psychiatry service use Social Adjustment Social functioning Social interaction Social psychology United Kingdom - epidemiology Young Adult |
| title | Borderline personality disorder: health service use and social functioning among a national household population |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-18T19%3A16%3A33IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Borderline%20personality%20disorder:%20health%20service%20use%20and%20social%20functioning%20among%20a%20national%20household%20population&rft.jtitle=Psychological%20medicine&rft.au=Coid,%20J.&rft.date=2009-10-01&rft.volume=39&rft.issue=10&rft.spage=1721&rft.epage=1731&rft.pages=1721-1731&rft.issn=0033-2917&rft.eissn=1469-8978&rft.coden=PSMDCO&rft_id=info:doi/10.1017/S0033291708004911&rft_dat=%3Cproquest_cross%3E1878122911%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=204499634&rft_id=info:pmid/19250579&rft_cupid=10_1017_S0033291708004911&rfr_iscdi=true |