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One-session therapist-directed exposure vs. self-exposure in the treatment of spider phobia
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“To control procedural fidelity, the assessment and treatment protocol were available. In fact, specific instructions for conducting both conditions (IVE or ARE) were presented, based on the OST protocol [44,45,54].”
From In Vivo versus augmented reality exposure in the treatment of small animal phobia: A randomized controlled trial (2016) · cites this paper as [54]
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Treatment of specific phobia in adults
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“Patients are exposed to blood/injury stimuli in a graduated fashion while being instructed to tense their muscles in order to raise their blood pressure, thereby preventing fainting in the presence of blood or injections (Öst et al., 1991; Öst, Sterner, & Fellenius, 1989).”
BackgroundFear of spiders’ questionnaire
Szymanski, J., & O'Donohue, W. (1995) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/0005-7916(94)00072-t · Cited by 450
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“Even if formal diagnostic procedures for comorbid disorders were not used, consistent significant improvements on measures of depression, general anxiety, and overall phobia were obtained after the brief treatment in spider phobia (Hellstrbm & Ost, 1995; Ost et al., 1991), blood-injury phobia (Hellstrom et al.”
Self-citationBaus, O., & Bouchard, S. (2014) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2014.00112 · Cited by 260
“Behavior avoidance test (BAT) (adapted from Öst et al., 1991b) Presence Degree of belief in catastrophic thought (assessed daily on scale from Fear and avoidance scales (adapted from Marks and Mathews, 1979) Fear of spiders questionnaire (FSQ) (Szymanski and O’Donohue presence measures the level…”
National Trends in the Use of Outpatient Psychotherapy
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A comparison of two spider fear questionnaires
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Cannabinoid CB1 Receptor Mediates Fear Extinction via Habituation-Like Processes
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“Our protocol of prolonged stimulus presentations resembles the principle of exposure therapy, which is successfully used for the treatment of phobias and posttraumatic stress disorder (Wolpe, 1958; Bartling et al., 1980; Ost et al., 1991; Foa and Riggs, 1993).”
MethodNewman, M. G., Erickson, T., Przeworski, A., & Dzus, E. (2003) · Journal of Clinical Psychology · doi:10.1002/jclp.10128 · Cited by 206
“Results of this research found that SA treatments yielded significant benefits, with only a few exceptions (i.e., Girodo & Henry, 1976; Hellstrom & Öst, 1995; Öst et al., 1991).”
BackgroundMcLean, C. P., & Foa, E. B. (2011) · Expert Review of Neurotherapeutics · doi:10.1586/ern.11.94 · Cited by 199
One-Session Treatment of Specific Phobias: A Detailed Description and Review of Treatment Efficacy
Zlomke, K. R., & Davis, T. E. (2008) · Behavior Therapy · doi:10.1016/j.beth.2007.07.003 · Cited by 178
Using Augmented Reality to Treat Phobias
Juan, M. ‐., Alcañíz, M., Monserrat, C., Botella, C., Baños, R., & Guerrero, B. (2005) · IEEE Computer Graphics and Applications · doi:10.1109/mcg.2005.143 · Cited by 177
“The AR system was applied using the guidelines for “one-session treatment” from Öst-treatment [12].”
Treating Cockroach Phobia With Augmented Reality
Botella, C., Bretón-López, J., Quero, S., Baños, R., & García-Palacios, A. (2010) · Behavior Therapy · doi:10.1016/j.beth.2009.07.002 · Cited by 173
“The AR exposure therapy was applied using the “one-session treatment” guidelines developed by Öst, Salkovskis, and Hellström (1991).”
BackgroundMethodInfluentialMiloff, A., Lindner, P., Dafgård, P., Deak, S., Garke, M., Hamilton, W., Heinsoo, J., Kristoffersson, G., Rafi, J., Sindemark, K., et al. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.04.004 · Cited by 155
Effectiveness of virtual reality exposure in the treatment of arachnophobia using 3D games
Bouchard, S., Côté, S., St-Jacques, J., Robillard, G., & Renaud, P. (2006) · Technology and Health Care · doi:10.3233/thc-2006-14103 · Cited by 156
“The average improvement on the BAT reported by participants receiving one session of individual therapist-directed in vivo exposure with modeling are 50% and 62% in studies by ¨Ost [20,21].”
A meta-analytic study of self-help interventions for anxiety problems.
Hirai, M., & Clum, G. (2006) · The Behavior Therapist · doi:10.1016/j.beth.2005.05.002 · Cited by 181
One-session group treatment of spider phobia
Öst, L.-G. (1996) · Behaviour Research and Therapy · doi:10.1016/0005-7967(96)00022-8 · Cited by 97
Self-citationAugmented Reality: A Brand New Challenge for the Assessment and Treatment of Psychological Disorders
Giglioli, I. A. C., Pallavicini, F., Pedroli, E., Serino, S., & Riva, G. (2015) · Computational and Mathematical Methods in Medicine · doi:10.1155/2015/862942 · Cited by 150
“and Treatment of Psychological Disorders Irene Alice Chicchi Giglioli,1 Federica Pallavicini,1 Elisa Pedroli,1 Silvia Serino,1 and Giuseppe Riva1,2 1Applied Technology for Neuro-Psychology Lab, IRCCS Istituto Auxologico Italiano, 20145 Milan, Italy 2Department of Psychology, Catholic University of Milan, 20123 Milan,…”
MethodInfluentialOne versus five sessions of exposure in the treatment of flying phobia
Öst, L.-G., Brandberg, M., & Alm, T. (1997) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(97)00077-6 · Cited by 146
Self-citationHellström, K., & Öst, L.-G. (1995) · Behaviour Research and Therapy · doi:10.1016/0005-7967(95)00028-v · Cited by 137
Self-citationMiloff, A., Lindner, P., Hamilton, W., Reuterskiöld, L., Andersson, G., & Carlbring, P. (2016) · Trials · doi:10.1186/s13063-016-1171-1 · Cited by 141
“The BAT [35] will feature 13 steps (scored 0–12) corresponding to sequentially closer contact with the spider.”
BackgroundInfluentialJenike, M. A. (1983) · Comprehensive Psychiatry · doi:10.1016/0010-440x(83)90098-6 · Cited by 143
Phobic disorders and panic in adults: A guide to assessment and treatment.
Antony, M. M., & Swinson, R. P. (2000) · American Psychological Association eBooks · doi:10.1037/10348-000 · Cited by 143
One versus five sessions of exposure in the treatment of injection phobia
Öst, L.-G., Hellström, K., & Kåver, A. (1992) · Behavior Therapy · doi:10.1016/s0005-7894(05)80385-5 · Cited by 165
Self-citationBotella, C., Bretón-López, J., Quero, S., Baños, R., García-Palacios, A., Zaragozá, I., & Alcañíz, M. (2011) · Computers in Human Behavior · doi:10.1016/j.chb.2010.07.043 · Cited by 152
“Secondly, following Öst’s recommendation (Öst et al., 1991), participants are advised to continue confronting cockroach-related phobic situations after therapy in order to completely surmount the problem.”
BackgroundMixing realities? An application of augmented reality for the treatment of cockroach phobia
Botella, C. M., Juan, M. C., Baños, R. M., Alcañiz, M., Guillén, V., & Rey, B. (2005) · CyberPsychology & Behavior · doi:10.1089/cpb.2005.8.162 · Cited by 139
Öst, L.-G., Alm, T., Brandberg, M., & Breitholtz, E. (2001) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(99)00176-x · Cited by 138
Self-citationApplied tension, exposure in vivo, and tension-only in the treatment of blood phobia
Öst, L.-G., Fellenius, J., & Sterner, U. (1991) · Behaviour Research and Therapy · doi:10.1016/0005-7967(91)90006-o · Cited by 138
Self-citationAdvances in the psychosocial treatment of anxiety disorders. Implications for national health care.
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Phobic beliefs: Do cognitive factors play a role in specific phobias?
Thorpe, S. J., & Salkovskis, P. M. (1995) · Behaviour Research and Therapy · doi:10.1016/0005-7967(95)00022-p · Cited by 128
Self-citationComparison between one-session psychological treatment and benzodiazepine in dental phobia.
Thom, A., Sartory, G., & Jöhren, P. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.68.3.378 · Cited by 128
Botella, C., Pérez-Ara, M. Á., Bretón-López, J., Quero, S., García-Palacios, A., & Baños, R. M. (2016) · PLoS ONE · doi:10.1371/journal.pone.0148237 · Cited by 124
“The therapist’s instructions to the participants followed the recommendations of Öst, Salkovskis, and Hellström [54]: his/her role is to encourage the participant and collaborate with him/her to advance in the treatment objectives.”
MethodCounterconditioning in the treatment of spider phobia: effects on disgust, fear and valence.
de Jong, P. D., Vorage, I., & van den Hout, M. (2000) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(99)00135-7 · Cited by 114
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One versus five sessions of applied tension in the treatment of blood phobia
Hellström, K., Fellenius, J., & öst, L.-G. (1996) · Behaviour Research and Therapy · doi:10.1016/0005-7967(95)00060-7 · Cited by 117
Wells, S., Polglase, K., Andrews, H. B., Carrington, P., & Baker, A. (2003) · Journal of Clinical Psychology · doi:10.1002/jclp.10189 · Cited by 137
“…major studies in this area –– researchers used ads in local newspapers to recruit, as well as, in some cases, some physician referrals (see Bandura, 1969; Ost et al, 1991; Hellstrom & Ost, 1993; Ost, 1996; Ost et al.1997; Ost et al. 1998; Muris, Merckelbach, Holdrinet, & Sijsenaar 1998; Muris…”
BackgroundIntensive One-Session Treatment of Specific Phobias
Davis, T. E., Ollendick, T. H., & Öst, L. (2012) · Autism and child psychopathology series · doi:10.1007/978-1-4614-3253-1 · Cited by 106
“In previous research, I have developed and evaluated a specific treatment method for blood phobia called applied tension (Öst et al. 1991; Öst and Sterner 1987; Öst et al. 1989).”
BackgroundMethodSelf-citationChoking phobia: A review of the literature
McNally, R. J. (1994) · Comprehensive Psychiatry · doi:10.1016/0010-440x(94)90174-0 · Cited by 105
Andersson, G., Waara, J., Jonsson, U., Malmaeus, F., Carlbring, P., & Öst, L. (2009) · Cognitive Behaviour Therapy · doi:10.1080/16506070902931326 · Cited by 101
“On the BAT the Öst et al. (1991) patients had a pretreatment mean of 6.5, and the Hellström and Öst (1995) patients a mean of 4.2, compared with 6.3 for the current sample.”
BackgroundMethodResultInfluentialSelf-citationSuso‐Ribera, C., Fernández‐Álvarez, J., García‐Palacios, A., Hoffman, H. G., Bretón-López, J. M., Baños, R., Quero, S., & Botella, C. (2018) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2017.0672 · Cited by 97
“The behavioral avoidance test (BAT) is an objective, observational test of the patient’s behavior, to measure clinical progress in overcoming phobias through exposure to the feared object.(29) In all the studies, a sealed container containing a live cockroach or a spider was placed on a table inside a room.”
BackgroundMethodSelf-Efficacy, Anxiety, and Phobic Disorders
Williams, S. L. (1995) · The Plenum series in social/clinical psychology · doi:10.1007/978-1-4419-6868-5_3 · Cited by 99
One-session group therapy of spider phobia: direct versus indirect treatments.
Öst, L.-G., Ferebee, I., & Furmark, T. (1997) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(97)00028-4 · Cited by 96
Self-citationAn event-related potential study on exposure therapy for patients suffering from spider phobia
Leutgeb, V., Schäfer, A., & Schienle, A. (2009) · Biological Psychology · doi:10.1016/j.biopsycho.2009.09.003 · Cited by 95
“One week later, the therapy group received a single-session cognitive behavior therapy (CBT) of up to 4 h according to Öst (1989, 1996), Öst et al. (1991).”
MethodOne- vs. five-session treatment of dental phobia: A randomized controlled study
Haukebø, K., Skaret, E., Öst, L., Raadal, M., Berg, E., Sundberg, H., & Kvale, G. (2007) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/j.jbtep.2007.09.006 · Cited by 96
Self-citationHandbook of Brief Cognitive Behaviour Therapy
(2001) · International Journal of Health Care Quality Assurance · doi:10.1108/ijhcqa.2001.06214dae.012 · Cited by 90
“For example, Öst et al. (1991) found that one session of therapist-directed exposure lasting a maximum of three hours effectively reduced fear and avoidance in spider-phobic patients.”
BackgroundFear reduction in patients with dental treatment phobia
Jöhren, P., Jackowski, J., Gängler, P., Sartory, G., & Thom, A. (2000) · British Journal of Oral and Maxillofacial Surgery · doi:10.1054/bjom.2000.0531 · Cited by 82
Alliance, technology, and outcome in the treatment of anxious youth
Chu, B. C., Choudhury, M. S., Shortt, A. L., Pincus, D. B., Creed, T. A., & Kendall, P. C. (2004) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(04)80006-3 · Cited by 84
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Self-citationLindner, P., Rozental, A., Jurell, A., Reuterskiöld, L., Andersson, G., Hamilton, W., Miloff, A., & Carlbring, P. (2020) · JMIR Serious Games · doi:10.2196/17807 · Cited by 71
“Approximately 1 week later, participants completed the combined interview and posttreatment assessment (BAT and self-rating scales).”
MethodInfluentialLong-term effects of cognitive behavior therapy on brain activation in spider phobia
Schienle, A., Schäfer, A., Stark, R. M., & Vaitl, D. (2009) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2008.11.005 · Cited by 71
“Positive immediate, as well as longterm effects for cognitive behavior therapy (CBT), are well documented (Öst et al.,1991,1997; Arntz and Lavy,1993; Hellström andÖst,1995; Öst, 1996; Gotestam and Hokstad, 2002; Koch et al., 2004).”
BackgroundLindner, P., Miloff, A., Bergman, C., Andersson, G., Hamilton, W., & Carlbring, P. (2020) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.00116 · Cited by 66
“Since the previous trial did not include a control group with the same BAT procedure but without treatment, or even additional administration of self-report measures after the BAT but before the treatment session, the degree of confounding is unknown.”
BackgroundInfluentialAn experimental test of the role of control in spider fear.
Healey, A., Mansell, W., & Tai, S. (2017) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2017.03.005 · Cited by 63
Bertuzzi, V., Fratini, G., Tarquinio, C., Cannistrà, F., Granese, V., Giusti, E. M., Castelnuovo, G., & Pietrabissa, G. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.721382 · Cited by 66
Zheng, Z., Li, R., Xiao, F., He, R., Zhang, S., & Li, J. (2018) · PsyCh Journal · doi:10.1002/pchj.212 · Cited by 60
Brief Cognitive‐Behavioral Therapy: Definition and Scientific Foundations
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The assessment and treatment of specific phobias: a review
Grös, D. F., & Antony, M. M. (2006) · Current Psychiatry Reports · doi:10.1007/s11920-006-0066-3 · Cited by 55
“The results demonstrated that the therapist-directed exposure performed significantly better than the self-directed exposure at reducing fear on self-report ratings, behavioral measures, and clinician ratings [ 17 ].”
MethodResultCognitive Behavior Therapy in Clinical Social Work Practice
Ronen, T., Freeman, A., Beck, A. T., Ronen, T., MacLaren, C., Freeman, A., Thyer, B. A., Myers, L. L., Gambrill, E., Carrigan, A., et al. (2006) · Springer Publishing Company eBooks · doi:10.1891/9780826104786 · Cited by 55
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“It has been shown superior to self-directed exposure (Öst et al., 1991) and to manual directed self-exposure for spider phobia treatment (Hellström & Öst, 1995).”
BackgroundMethodPresence-Inducing Media for Mental Health Applications
Riva, G., Botella, C., Baños, R., Mantovani, F., García-Palacios, A., Quero, S., Serino, S., Triberti, S., Repetto, C., Dakanalis, A., et al. (2015) · Immersed in Media · doi:10.1007/978-3-319-10190-3_12 · Cited by 55
An augmented reality system validation for the treatment of cockroach phobia
Bretón-López, J., Quero, S., Botella, C., García-Palacios, A., Baños, R. M., & Alcañiz, M. (2010) · Cyberpsychology Behavior and Social Networking · doi:10.1089/cyber.2009.0170 · Cited by 52
“The study included an intensive treatment session for cockroach phobia following the protocol developed by O¨st et al. 22 During immersion, participants were exposed to the various elements included in the AR system; the therapist remained nearby (Figures 1 and 2).”
Ruhmland, M., & Margraf, J. (2001) · Verhaltenstherapie · doi:10.1159/000050321 · Cited by 50
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Self-citationOne-Session Treatment of Specific Phobias in Children: Recent Developments and a Systematic Review
Davis, T. E., Ollendick, T. H., & Öst, L. (2018) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-050718-095608 · Cited by 52
Self-citationActive-imaginal exposure: examination of a new behavioral treatment for cynophobia (dog phobia)
Rentz, T. O., Powers, M. B., Smits, J. A. J., Cougle, J. R., & Telch, M. J. (2003) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(03)00041-x · Cited by 47
Lipka, J., Hoffmann, M., Miltner, W., & Straube, T. (2014) · Biological Psychiatry · doi:10.1016/j.biopsych.2013.11.008 · Cited by 46
Treating small animal phobias using a projective-augmented reality system: a single-case study
Wrzesien, M., Botella, C., Bretón-López, J., del Río González, E., Burkhardt, J.-M., Alcañiz, M., & Pérez-Ara, M. Á. (2015) · Computers in Human Behavior · doi:10.1016/j.chb.2015.01.065 · Cited by 42
Prediction of outcome in the treatment of specific phobia. A cross validation study.
Hellström, K., & Öst, L.-G. (1996) · Behaviour Research and Therapy · doi:10.1016/0005-7967(96)00004-6 · Cited by 36
Self-citationTraumatic memories, eye movements, phobia, and panic: a critical note on the proliferation of EMDR.
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Opioid antagonist affects behavioral effects of exposure in vivo.
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A Woman Afraid to Deliver: How to Manage Childbirth Anxiety
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Efficacy of self-administered treatments for depression and anxiety.
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“…found no correlation between outcome and completion, comprehension, or practice of the self-help techniques (Ackerson et al., 1998; Floyd et al., 2004; Lidren et al., 1994; Öst et al., 1991), Rosen et al. (1976) and Rohen (2002) did find associations between adherence to the SAT and outcome.”
BackgroundMiragall, M., Baños, R. M., Cebolla, A., & Botella, C. (2015) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.01531 · Cited by 29
“The therapy was applied using the guidelines of “one-session treatment” recommended by Öst et al. (1991), which implied utilizing intensive exposure, and it was carried out in only one session in a maximum of 3 h.”
MethodUpdate on empirically validated therapies, II: (619622010-001)
Chambless, D. L., Baker, M. J., Baucom, D. H., Beutler, L. E., Calhoun, K. S., Crits-Christoph, P., Daiuto, A., DeRubeis, R., Detweiler, J., Haaga, D. A. F., et al. (1997) · PsycEXTRA Dataset · doi:10.1037/e619622010-001 · Cited by 1,488
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“The additional effect of using this coping skill during exposure training, however, never really was tested systematically, probably also because relaxation training was not an element in the one-session treatment of specific phobia later developed by Öst and collegues.(6,51) As a consequence, another training, applie…”
Performance-related anxiety in agoraphobia: Treatment procedures and cognitive mechanisms of change
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Treating Spider Phobics with Eye Movement Desensitization and Reprocessing: A Controlled Study
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“To date five controlled treatment trials have been conducted for adults with BII phobia (Hellström et al. 1996; Öst et al. 1984a, 1989, 1991b, 1992), all conducted by the one research group, led by Öst and colleagues from Sweden.”
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Cognitive Therapy for Anxiety Disorders: Current Status and Future Challenges
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Psychosocial treatment of phobia and panic disorders.
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Metadata
- Authors
- Öst, L.-G., Salkovskis, P. M., & Hellström, K.
- Affiliations
- Uppsala University (SE)
- Warneford Hospital (GB)
- Corresponding author
- Öst, Lars-Göran
- Venue
- Behavior Therapy
- Publisher
- Elsevier BV
- Published
- 1991
- Volume
- 22
- Issue
- 3
- Pages
- 407-422
- ISSN
- 0005-7894 (ISSN-L)
- OpenAlex
- W1992300724
- Cited by
- 220
- References
- 25
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 5 · 2023: 4 · 2022: 4 · 2021: 6 · 2020: 7 · 2019: 6 · 2018: 13 · 2017: 5 · 2016: 5 · 2015: 7 · 2014: 7 · 2013: 5 · 2012: 7
- FWCI
- 7.23
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavior Therapy (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- spider phobia, specific phobia, exposure therapy, single-session intervention, long-term follow-up
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