Comorbidity Between Reading Disability and Math Disability: Concurrent Psychopathology, Functional Impairment, and Neuropsychological Functioning

Reading disability (RD) and math disability (MD) frequently co-occur, but the etiology of this comorbidity is not well understood. Groups with RD only (N = 241), MD only (N = 183), and RD + MD (N = 188) and a control group with neither disorder (N = 411) completed a battery of measures of internaliz...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:Journal of learning disabilities 2013-11, Vol.46 (6), p.500-516
Hauptverfasser: Willcutt, Erik G., Petrill, Stephen A., Wu, Sarah, Boada, Richard, DeFries, John C., Olson, Richard K., Pennington, Bruce F.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 516
container_issue 6
container_start_page 500
container_title Journal of learning disabilities
container_volume 46
creator Willcutt, Erik G.
Petrill, Stephen A.
Wu, Sarah
Boada, Richard
DeFries, John C.
Olson, Richard K.
Pennington, Bruce F.
description Reading disability (RD) and math disability (MD) frequently co-occur, but the etiology of this comorbidity is not well understood. Groups with RD only (N = 241), MD only (N = 183), and RD + MD (N = 188) and a control group with neither disorder (N = 411) completed a battery of measures of internalizing and externalizing psychopathology, social and academic functioning, and 10 neuropsychological processes. Groups with RD only, MD only, and RD + MD were significantly impaired versus the control group on nearly all measures, and the group with RD + MD was more impaired than the groups with MD and RD alone on measures of internalizing psychopathology, academic functioning, and 7 of 10 neuropsychological constructs. Multiple regression analyses of the neuropsychological measures indicated that deficits in reading and math were associated with shared weaknesses in working memory, processing speed, and verbal comprehension. In contrast, reading difficulties were uniquely associated with weaknesses in phoneme awareness and naming speed, and math deficits were uniquely associated with weaknesses in set shifting. These results support multiple-deficit neuropsychological models of RD and MD and suggest that RD and MD are distinct but related disorders that co-occur because of shared neuropsychological weaknesses in working memory, processing speed, and verbal comprehension.
doi_str_mv 10.1177/0022219413477476
format Article
fullrecord <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3749272</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><ericid>EJ1019766</ericid><sage_id>10.1177_0022219413477476</sage_id><sourcerecordid>1443430068</sourcerecordid><originalsourceid>FETCH-LOGICAL-c395t-90d1e17a6cbae8cda14ccf4fa6c8d8e61a68597a4519cbae0ea8eca7cb421f743</originalsourceid><addsrcrecordid>eNp1kd1LwzAUxYMobn68-6IMfPGlmqRp0vgg6PxGEUSfw216u2V0rSad4n9vy3TMgU-Be3735FwOIXuMHjOm1AmlnHOmBYuFUkLJNdJnSZxGQqV0nfQ7Oer0HtkKYUIpFVzJTdLjsRBacdUnp8N6WvvM5a75Glxg84lYDZ4RcleNBpcuQObKToIqHzxCM16a7ZCNAsqAuz_vNnm9vnoZ3kYPTzd3w_OHyMY6aSJNc4ZMgbQZYGpzYMLaQhTtIM1TlAxkmmgFImG6QyhCihaUzQRnhRLxNjmb-77NsinmFqvGQ2nevJuC_zI1OPNXqdzYjOoPEyuhueKtwdGPga_fZxgaM3XBYllChfUsGCZELGJKZdqihyvopJ75qj2vo7jWMpFdIjqnrK9D8FgswjBqumLMajHtysHyEYuF3yZaYH8OoHd2IV_dM8q0kp1BNNcDjHAp1X8ffgMuY59W</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1442996564</pqid></control><display><type>article</type><title>Comorbidity Between Reading Disability and Math Disability: Concurrent Psychopathology, Functional Impairment, and Neuropsychological Functioning</title><source>MEDLINE</source><source>Applied Social Sciences Index &amp; Abstracts (ASSIA)</source><source>SAGE Complete A-Z List</source><creator>Willcutt, Erik G. ; Petrill, Stephen A. ; Wu, Sarah ; Boada, Richard ; DeFries, John C. ; Olson, Richard K. ; Pennington, Bruce F.</creator><creatorcontrib>Willcutt, Erik G. ; Petrill, Stephen A. ; Wu, Sarah ; Boada, Richard ; DeFries, John C. ; Olson, Richard K. ; Pennington, Bruce F.</creatorcontrib><description>Reading disability (RD) and math disability (MD) frequently co-occur, but the etiology of this comorbidity is not well understood. Groups with RD only (N = 241), MD only (N = 183), and RD + MD (N = 188) and a control group with neither disorder (N = 411) completed a battery of measures of internalizing and externalizing psychopathology, social and academic functioning, and 10 neuropsychological processes. Groups with RD only, MD only, and RD + MD were significantly impaired versus the control group on nearly all measures, and the group with RD + MD was more impaired than the groups with MD and RD alone on measures of internalizing psychopathology, academic functioning, and 7 of 10 neuropsychological constructs. Multiple regression analyses of the neuropsychological measures indicated that deficits in reading and math were associated with shared weaknesses in working memory, processing speed, and verbal comprehension. In contrast, reading difficulties were uniquely associated with weaknesses in phoneme awareness and naming speed, and math deficits were uniquely associated with weaknesses in set shifting. These results support multiple-deficit neuropsychological models of RD and MD and suggest that RD and MD are distinct but related disorders that co-occur because of shared neuropsychological weaknesses in working memory, processing speed, and verbal comprehension.</description><identifier>ISSN: 0022-2194</identifier><identifier>EISSN: 1538-4780</identifier><identifier>DOI: 10.1177/0022219413477476</identifier><identifier>PMID: 23449727</identifier><identifier>CODEN: JLDIAD</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Adolescent ; Behavior Disorders ; Child ; Cognition Disorders - epidemiology ; Cognition Disorders - physiopathology ; Cognitive Ability ; Colorado ; Comorbidity ; Comprehension ; Consciousness ; Control Groups ; Diagnostic Tests ; Disability ; Diseases in Twins - epidemiology ; Diseases in Twins - physiopathology ; Dyscalculia - epidemiology ; Dyscalculia - physiopathology ; Dyslexia - epidemiology ; Dyslexia - physiopathology ; Etiology ; Experimental Groups ; Female ; Functional impairment ; Humans ; Impaired control ; Internalization ; Learning disabilities ; Male ; Mathematical Aptitude ; Mathematics Achievement ; Memory ; Mental Disorders ; Multiple Disabilities ; Multiple Regression Analysis ; Naming ; Neuropsychological functioning ; Neuropsychological Tests - statistics &amp; numerical data ; Neuropsychology ; Outcome Measures ; Participant Characteristics ; Phonemes ; Physical Disabilities ; Predictor Variables ; Psychopathology ; Reading Achievement ; Reading comprehension ; Reading Difficulties ; Reading disabilities ; Regression analysis ; Screening Tests ; Short term memory ; Social Cognition ; Special education ; Stroop Color Word Test ; Twins ; Verbal memory ; Wisconsin Card Sorting Test</subject><ispartof>Journal of learning disabilities, 2013-11, Vol.46 (6), p.500-516</ispartof><rights>Hammill Institute on Disabilities 2013</rights><rights>Copyright SAGE PUBLICATIONS, INC. Nov/Dec 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c395t-90d1e17a6cbae8cda14ccf4fa6c8d8e61a68597a4519cbae0ea8eca7cb421f743</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1177/0022219413477476$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1177/0022219413477476$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>230,314,777,781,882,21800,27905,27906,30980,43602,43603</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ1019766$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23449727$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Willcutt, Erik G.</creatorcontrib><creatorcontrib>Petrill, Stephen A.</creatorcontrib><creatorcontrib>Wu, Sarah</creatorcontrib><creatorcontrib>Boada, Richard</creatorcontrib><creatorcontrib>DeFries, John C.</creatorcontrib><creatorcontrib>Olson, Richard K.</creatorcontrib><creatorcontrib>Pennington, Bruce F.</creatorcontrib><title>Comorbidity Between Reading Disability and Math Disability: Concurrent Psychopathology, Functional Impairment, and Neuropsychological Functioning</title><title>Journal of learning disabilities</title><addtitle>J Learn Disabil</addtitle><description>Reading disability (RD) and math disability (MD) frequently co-occur, but the etiology of this comorbidity is not well understood. Groups with RD only (N = 241), MD only (N = 183), and RD + MD (N = 188) and a control group with neither disorder (N = 411) completed a battery of measures of internalizing and externalizing psychopathology, social and academic functioning, and 10 neuropsychological processes. Groups with RD only, MD only, and RD + MD were significantly impaired versus the control group on nearly all measures, and the group with RD + MD was more impaired than the groups with MD and RD alone on measures of internalizing psychopathology, academic functioning, and 7 of 10 neuropsychological constructs. Multiple regression analyses of the neuropsychological measures indicated that deficits in reading and math were associated with shared weaknesses in working memory, processing speed, and verbal comprehension. In contrast, reading difficulties were uniquely associated with weaknesses in phoneme awareness and naming speed, and math deficits were uniquely associated with weaknesses in set shifting. These results support multiple-deficit neuropsychological models of RD and MD and suggest that RD and MD are distinct but related disorders that co-occur because of shared neuropsychological weaknesses in working memory, processing speed, and verbal comprehension.</description><subject>Adolescent</subject><subject>Behavior Disorders</subject><subject>Child</subject><subject>Cognition Disorders - epidemiology</subject><subject>Cognition Disorders - physiopathology</subject><subject>Cognitive Ability</subject><subject>Colorado</subject><subject>Comorbidity</subject><subject>Comprehension</subject><subject>Consciousness</subject><subject>Control Groups</subject><subject>Diagnostic Tests</subject><subject>Disability</subject><subject>Diseases in Twins - epidemiology</subject><subject>Diseases in Twins - physiopathology</subject><subject>Dyscalculia - epidemiology</subject><subject>Dyscalculia - physiopathology</subject><subject>Dyslexia - epidemiology</subject><subject>Dyslexia - physiopathology</subject><subject>Etiology</subject><subject>Experimental Groups</subject><subject>Female</subject><subject>Functional impairment</subject><subject>Humans</subject><subject>Impaired control</subject><subject>Internalization</subject><subject>Learning disabilities</subject><subject>Male</subject><subject>Mathematical Aptitude</subject><subject>Mathematics Achievement</subject><subject>Memory</subject><subject>Mental Disorders</subject><subject>Multiple Disabilities</subject><subject>Multiple Regression Analysis</subject><subject>Naming</subject><subject>Neuropsychological functioning</subject><subject>Neuropsychological Tests - statistics &amp; numerical data</subject><subject>Neuropsychology</subject><subject>Outcome Measures</subject><subject>Participant Characteristics</subject><subject>Phonemes</subject><subject>Physical Disabilities</subject><subject>Predictor Variables</subject><subject>Psychopathology</subject><subject>Reading Achievement</subject><subject>Reading comprehension</subject><subject>Reading Difficulties</subject><subject>Reading disabilities</subject><subject>Regression analysis</subject><subject>Screening Tests</subject><subject>Short term memory</subject><subject>Social Cognition</subject><subject>Special education</subject><subject>Stroop Color Word Test</subject><subject>Twins</subject><subject>Verbal memory</subject><subject>Wisconsin Card Sorting Test</subject><issn>0022-2194</issn><issn>1538-4780</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNp1kd1LwzAUxYMobn68-6IMfPGlmqRp0vgg6PxGEUSfw216u2V0rSad4n9vy3TMgU-Be3735FwOIXuMHjOm1AmlnHOmBYuFUkLJNdJnSZxGQqV0nfQ7Oer0HtkKYUIpFVzJTdLjsRBacdUnp8N6WvvM5a75Glxg84lYDZ4RcleNBpcuQObKToIqHzxCM16a7ZCNAsqAuz_vNnm9vnoZ3kYPTzd3w_OHyMY6aSJNc4ZMgbQZYGpzYMLaQhTtIM1TlAxkmmgFImG6QyhCihaUzQRnhRLxNjmb-77NsinmFqvGQ2nevJuC_zI1OPNXqdzYjOoPEyuhueKtwdGPga_fZxgaM3XBYllChfUsGCZELGJKZdqihyvopJ75qj2vo7jWMpFdIjqnrK9D8FgswjBqumLMajHtysHyEYuF3yZaYH8OoHd2IV_dM8q0kp1BNNcDjHAp1X8ffgMuY59W</recordid><startdate>20131101</startdate><enddate>20131101</enddate><creator>Willcutt, Erik G.</creator><creator>Petrill, Stephen A.</creator><creator>Wu, Sarah</creator><creator>Boada, Richard</creator><creator>DeFries, John C.</creator><creator>Olson, Richard K.</creator><creator>Pennington, Bruce F.</creator><general>SAGE Publications</general><general>SAGE Publications and Hammill Institute on Disabilities</general><general>SAGE PUBLICATIONS, INC</general><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</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>7QJ</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20131101</creationdate><title>Comorbidity Between Reading Disability and Math Disability</title><author>Willcutt, Erik G. ; Petrill, Stephen A. ; Wu, Sarah ; Boada, Richard ; DeFries, John C. ; Olson, Richard K. ; Pennington, Bruce F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c395t-90d1e17a6cbae8cda14ccf4fa6c8d8e61a68597a4519cbae0ea8eca7cb421f743</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Behavior Disorders</topic><topic>Child</topic><topic>Cognition Disorders - epidemiology</topic><topic>Cognition Disorders - physiopathology</topic><topic>Cognitive Ability</topic><topic>Colorado</topic><topic>Comorbidity</topic><topic>Comprehension</topic><topic>Consciousness</topic><topic>Control Groups</topic><topic>Diagnostic Tests</topic><topic>Disability</topic><topic>Diseases in Twins - epidemiology</topic><topic>Diseases in Twins - physiopathology</topic><topic>Dyscalculia - epidemiology</topic><topic>Dyscalculia - physiopathology</topic><topic>Dyslexia - epidemiology</topic><topic>Dyslexia - physiopathology</topic><topic>Etiology</topic><topic>Experimental Groups</topic><topic>Female</topic><topic>Functional impairment</topic><topic>Humans</topic><topic>Impaired control</topic><topic>Internalization</topic><topic>Learning disabilities</topic><topic>Male</topic><topic>Mathematical Aptitude</topic><topic>Mathematics Achievement</topic><topic>Memory</topic><topic>Mental Disorders</topic><topic>Multiple Disabilities</topic><topic>Multiple Regression Analysis</topic><topic>Naming</topic><topic>Neuropsychological functioning</topic><topic>Neuropsychological Tests - statistics &amp; numerical data</topic><topic>Neuropsychology</topic><topic>Outcome Measures</topic><topic>Participant Characteristics</topic><topic>Phonemes</topic><topic>Physical Disabilities</topic><topic>Predictor Variables</topic><topic>Psychopathology</topic><topic>Reading Achievement</topic><topic>Reading comprehension</topic><topic>Reading Difficulties</topic><topic>Reading disabilities</topic><topic>Regression analysis</topic><topic>Screening Tests</topic><topic>Short term memory</topic><topic>Social Cognition</topic><topic>Special education</topic><topic>Stroop Color Word Test</topic><topic>Twins</topic><topic>Verbal memory</topic><topic>Wisconsin Card Sorting Test</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Willcutt, Erik G.</creatorcontrib><creatorcontrib>Petrill, Stephen A.</creatorcontrib><creatorcontrib>Wu, Sarah</creatorcontrib><creatorcontrib>Boada, Richard</creatorcontrib><creatorcontrib>DeFries, John C.</creatorcontrib><creatorcontrib>Olson, Richard K.</creatorcontrib><creatorcontrib>Pennington, Bruce F.</creatorcontrib><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index &amp; Abstracts (ASSIA)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of learning disabilities</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Willcutt, Erik G.</au><au>Petrill, Stephen A.</au><au>Wu, Sarah</au><au>Boada, Richard</au><au>DeFries, John C.</au><au>Olson, Richard K.</au><au>Pennington, Bruce F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ1019766</ericid><atitle>Comorbidity Between Reading Disability and Math Disability: Concurrent Psychopathology, Functional Impairment, and Neuropsychological Functioning</atitle><jtitle>Journal of learning disabilities</jtitle><addtitle>J Learn Disabil</addtitle><date>2013-11-01</date><risdate>2013</risdate><volume>46</volume><issue>6</issue><spage>500</spage><epage>516</epage><pages>500-516</pages><issn>0022-2194</issn><eissn>1538-4780</eissn><coden>JLDIAD</coden><abstract>Reading disability (RD) and math disability (MD) frequently co-occur, but the etiology of this comorbidity is not well understood. Groups with RD only (N = 241), MD only (N = 183), and RD + MD (N = 188) and a control group with neither disorder (N = 411) completed a battery of measures of internalizing and externalizing psychopathology, social and academic functioning, and 10 neuropsychological processes. Groups with RD only, MD only, and RD + MD were significantly impaired versus the control group on nearly all measures, and the group with RD + MD was more impaired than the groups with MD and RD alone on measures of internalizing psychopathology, academic functioning, and 7 of 10 neuropsychological constructs. Multiple regression analyses of the neuropsychological measures indicated that deficits in reading and math were associated with shared weaknesses in working memory, processing speed, and verbal comprehension. In contrast, reading difficulties were uniquely associated with weaknesses in phoneme awareness and naming speed, and math deficits were uniquely associated with weaknesses in set shifting. These results support multiple-deficit neuropsychological models of RD and MD and suggest that RD and MD are distinct but related disorders that co-occur because of shared neuropsychological weaknesses in working memory, processing speed, and verbal comprehension.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>23449727</pmid><doi>10.1177/0022219413477476</doi><tpages>17</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0022-2194
ispartof Journal of learning disabilities, 2013-11, Vol.46 (6), p.500-516
issn 0022-2194
1538-4780
language eng
recordid cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3749272
source MEDLINE; Applied Social Sciences Index & Abstracts (ASSIA); SAGE Complete A-Z List
subjects Adolescent
Behavior Disorders
Child
Cognition Disorders - epidemiology
Cognition Disorders - physiopathology
Cognitive Ability
Colorado
Comorbidity
Comprehension
Consciousness
Control Groups
Diagnostic Tests
Disability
Diseases in Twins - epidemiology
Diseases in Twins - physiopathology
Dyscalculia - epidemiology
Dyscalculia - physiopathology
Dyslexia - epidemiology
Dyslexia - physiopathology
Etiology
Experimental Groups
Female
Functional impairment
Humans
Impaired control
Internalization
Learning disabilities
Male
Mathematical Aptitude
Mathematics Achievement
Memory
Mental Disorders
Multiple Disabilities
Multiple Regression Analysis
Naming
Neuropsychological functioning
Neuropsychological Tests - statistics & numerical data
Neuropsychology
Outcome Measures
Participant Characteristics
Phonemes
Physical Disabilities
Predictor Variables
Psychopathology
Reading Achievement
Reading comprehension
Reading Difficulties
Reading disabilities
Regression analysis
Screening Tests
Short term memory
Social Cognition
Special education
Stroop Color Word Test
Twins
Verbal memory
Wisconsin Card Sorting Test
title Comorbidity Between Reading Disability and Math Disability: Concurrent Psychopathology, Functional Impairment, and Neuropsychological Functioning
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-20T14%3A00%3A37IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Comorbidity%20Between%20Reading%20Disability%20and%20Math%20Disability:%20Concurrent%20Psychopathology,%20Functional%20Impairment,%20and%20Neuropsychological%20Functioning&rft.jtitle=Journal%20of%20learning%20disabilities&rft.au=Willcutt,%20Erik%20G.&rft.date=2013-11-01&rft.volume=46&rft.issue=6&rft.spage=500&rft.epage=516&rft.pages=500-516&rft.issn=0022-2194&rft.eissn=1538-4780&rft.coden=JLDIAD&rft_id=info:doi/10.1177/0022219413477476&rft_dat=%3Cproquest_pubme%3E1443430068%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1442996564&rft_id=info:pmid/23449727&rft_ericid=EJ1019766&rft_sage_id=10.1177_0022219413477476&rfr_iscdi=true