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Published in: Annals of Behavioral Medicine 2/2014

01-04-2014 | Original Article

Does Caregiving Cause Psychological Distress? The Case for Familial and Genetic Vulnerabilities in Female Twins

Authors: Peter P. Vitaliano, Ph.D., Eric Strachan, Ph.D., Elizabeth Dansie, Ph.D., Jack Goldberg, Ph.D., Dedra Buchwald, M.D.

Published in: Annals of Behavioral Medicine | Issue 2/2014

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Abstract

Background

Informal caregiving can be deleterious to mental health, but research results are inconsistent and may reflect an interaction between caregiving and vulnerability to stress.

Methods

We examined psychological distress among 1,228 female caregiving and non-caregiving twins. By examining monozygotic and dizygotic twin pairs discordant for caregiving, we assessed the extent to which distress is directly related to caregiving or confounded by common genes and environmental exposures.

Results

Caregiving was associated with distress as measured by mental health functioning, anxiety, perceived stress, and depression. The overall association between caregiving and distress was confounded by common genes and environment for mental health functioning, anxiety, and depression. Common environment also confounded the association of caregiving and perceived stress.

Conclusions

Vulnerability to distress is a factor in predicting caregivers' psychosocial functioning. Additional research is needed to explicate the mechanisms by which common genes and environment increase the risk of distress among informal caregivers.
Literature
1.
go back to reference National Alliance for Caregiving, AARP. Caregiving in the US. Washington, DC; 2009. National Alliance for Caregiving, AARP. Caregiving in the US. Washington, DC; 2009.
2.
go back to reference Rosalynn Carter Institute for Caregiving. Averting the caregiving crisis: Why we must act now. Americus, GA; 2010; 5-12. Rosalynn Carter Institute for Caregiving. Averting the caregiving crisis: Why we must act now. Americus, GA; 2010; 5-12.
3.
go back to reference National Alliance for Caregiving, AARP. Caregiving in the US. Washington, DC; 2004. National Alliance for Caregiving, AARP. Caregiving in the US. Washington, DC; 2004.
4.
go back to reference Marks NF, Lambert JD, Choi H. Transitions to caregiving, gender, and psychological well-being: A prospective US national study. J Marriage Fam. 2002; 64: 657-667.CrossRef Marks NF, Lambert JD, Choi H. Transitions to caregiving, gender, and psychological well-being: A prospective US national study. J Marriage Fam. 2002; 64: 657-667.CrossRef
5.
go back to reference Pearlin LI, Semple S, Turner H. Stress of AIDS caregiving: A preliminary overview of the issues. Death Stud. 1988; 12: 5-6.CrossRef Pearlin LI, Semple S, Turner H. Stress of AIDS caregiving: A preliminary overview of the issues. Death Stud. 1988; 12: 5-6.CrossRef
6.
go back to reference Shahly V, Chatterji S, Gruber M, et al. Cross-national differences in the prevalence and correlates of burden among older family caregivers in the World Health Organization World Mental Health (WMH) Surveys. Psychol Med. 2012; 9: 1-15. Shahly V, Chatterji S, Gruber M, et al. Cross-national differences in the prevalence and correlates of burden among older family caregivers in the World Health Organization World Mental Health (WMH) Surveys. Psychol Med. 2012; 9: 1-15.
7.
go back to reference Pinquart M, Sorensen S. Differences between caregivers and non-caregivers in psychological health and physical health: A meta-analysis. Psychol Aging. 2003; 18: 250-267.PubMedCrossRef Pinquart M, Sorensen S. Differences between caregivers and non-caregivers in psychological health and physical health: A meta-analysis. Psychol Aging. 2003; 18: 250-267.PubMedCrossRef
8.
go back to reference Dyck DG, Short R, Vitaliano PP. Predictors of burden and infectious illness in schizophrenia caregivers. Psychosom Med. 1999; 61: 411-419.PubMed Dyck DG, Short R, Vitaliano PP. Predictors of burden and infectious illness in schizophrenia caregivers. Psychosom Med. 1999; 61: 411-419.PubMed
9.
10.
go back to reference Mosher CE, Danoff-Burg S. Psychosocial impact of parental cancer in adulthood: A conceptual and empirical review. Clin Psychol Rev. 2005; 25: 365-382.PubMedCrossRef Mosher CE, Danoff-Burg S. Psychosocial impact of parental cancer in adulthood: A conceptual and empirical review. Clin Psychol Rev. 2005; 25: 365-382.PubMedCrossRef
11.
go back to reference Molloy GJ, Johnston DW, Witham MD. Family caregiving and congestive heart failure. Review and analysis. Eur J Heart Fail. 2005; 7: 592-603.PubMedCrossRef Molloy GJ, Johnston DW, Witham MD. Family caregiving and congestive heart failure. Review and analysis. Eur J Heart Fail. 2005; 7: 592-603.PubMedCrossRef
12.
go back to reference Schieve LA, Blumberg SJ, Rice C, Visser SN, Boyle C. The relationship between autism and parenting stress. Pediatrics. 2007; 119: 114-121.CrossRef Schieve LA, Blumberg SJ, Rice C, Visser SN, Boyle C. The relationship between autism and parenting stress. Pediatrics. 2007; 119: 114-121.CrossRef
13.
go back to reference Whitlatch CJ, Feinberg LF, Stevens EJ. Predictors of institutionalization for persons with Alzheimer's disease and the impact on family caregivers. J Ment Health Aging. 1999; 5: 275-288. Whitlatch CJ, Feinberg LF, Stevens EJ. Predictors of institutionalization for persons with Alzheimer's disease and the impact on family caregivers. J Ment Health Aging. 1999; 5: 275-288.
14.
go back to reference Miller B, Cafasso L. Gender differences in caregiving: Fact or artifact? Gerontologist. 1992; 32: 498-507.PubMedCrossRef Miller B, Cafasso L. Gender differences in caregiving: Fact or artifact? Gerontologist. 1992; 32: 498-507.PubMedCrossRef
17.
go back to reference Vitaliano P, Echeverria D, Shelkey M, Zhang JP, Scanlan J. A cognitive psychophysiological model to predict functional decline in chronically stressed older adults. J Clin Psychol Med S. 2007; 14: 177-190.CrossRef Vitaliano P, Echeverria D, Shelkey M, Zhang JP, Scanlan J. A cognitive psychophysiological model to predict functional decline in chronically stressed older adults. J Clin Psychol Med S. 2007; 14: 177-190.CrossRef
18.
go back to reference Mittelman MS. A family intervention to delay nursing home placement of patients with Alzheimer's disease. A randomized controlled trial. J Am Med Assoc. 1996; 276: 1725-1731.CrossRef Mittelman MS. A family intervention to delay nursing home placement of patients with Alzheimer's disease. A randomized controlled trial. J Am Med Assoc. 1996; 276: 1725-1731.CrossRef
19.
go back to reference Zubin J, Spring B. Vulnerability—a new view of schizophrenia. J Abnorm Psychol. 1977; 86: 103-126.PubMedCrossRef Zubin J, Spring B. Vulnerability—a new view of schizophrenia. J Abnorm Psychol. 1977; 86: 103-126.PubMedCrossRef
20.
go back to reference Vitaliano PP, Zhang J, Scanlan JM. Is caregiving hazardous to one's physical health? A meta-analysis. Psychol Bull. 2003; 129: 946-972.PubMedCrossRef Vitaliano PP, Zhang J, Scanlan JM. Is caregiving hazardous to one's physical health? A meta-analysis. Psychol Bull. 2003; 129: 946-972.PubMedCrossRef
21.
go back to reference Russo J, Vitaliano PP, Brewer DD, Katon W, Becker J. Psychiatric disorders in spouse caregivers of care recipients with Alzheimer's disease and matched controls: A diathesis-stress model of psychopathology. J Abnorm Psychol. 1995; 104: 197-204.PubMedCrossRef Russo J, Vitaliano PP, Brewer DD, Katon W, Becker J. Psychiatric disorders in spouse caregivers of care recipients with Alzheimer's disease and matched controls: A diathesis-stress model of psychopathology. J Abnorm Psychol. 1995; 104: 197-204.PubMedCrossRef
22.
go back to reference Little RJ, Rubin DB. Causal effects in clinical and epidemiological studies via potential outcomes: Concepts and analytical approaches. Annu Rev Publ Health. 2000; 21: 121-145.CrossRef Little RJ, Rubin DB. Causal effects in clinical and epidemiological studies via potential outcomes: Concepts and analytical approaches. Annu Rev Publ Health. 2000; 21: 121-145.CrossRef
23.
24.
go back to reference Rubin DB. For objective causal inference, design trumps analysis. Ann Appl Stat. 2008; 2: 808-840.CrossRef Rubin DB. For objective causal inference, design trumps analysis. Ann Appl Stat. 2008; 2: 808-840.CrossRef
25.
go back to reference Afari N, Noonan C, Goldberg J, et al. University of Washington Twin Registry: Construction and characteristics of a community-based twin registry. Twin Res Hum Genet. 2006; 9: 1023-1029.PubMedCentralPubMedCrossRef Afari N, Noonan C, Goldberg J, et al. University of Washington Twin Registry: Construction and characteristics of a community-based twin registry. Twin Res Hum Genet. 2006; 9: 1023-1029.PubMedCentralPubMedCrossRef
26.
go back to reference Strachan E, Hunt C, Afari N, et al. The University of Washington Twin Registry: Poised for the next generation of twin research. Twin Res Hum Genet. 2012; 1–8. Strachan E, Hunt C, Afari N, et al. The University of Washington Twin Registry: Poised for the next generation of twin research. Twin Res Hum Genet. 2012; 1–8.
27.
go back to reference Kendler KS, Prescott CA. A population-based twin study of lifetime major depression in men and women. Arch Gen Psychiat. 1999; 56: 39-44.PubMedCrossRef Kendler KS, Prescott CA. A population-based twin study of lifetime major depression in men and women. Arch Gen Psychiat. 1999; 56: 39-44.PubMedCrossRef
28.
go back to reference Kendler KS, Kessler RC, Walters EE, et al. Stressful life events, genetic liability, and onset of an episode of major depression in women. Am J Psychiat. 1995; 152: 833-842.PubMed Kendler KS, Kessler RC, Walters EE, et al. Stressful life events, genetic liability, and onset of an episode of major depression in women. Am J Psychiat. 1995; 152: 833-842.PubMed
29.
go back to reference Federenko IS, Schlotz W, Kirschbaum C, Bartels M, Hellhammer DH, Wust S. The heritability of perceived stress. Psychol Med. 2006; 36: 375-385.PubMedCrossRef Federenko IS, Schlotz W, Kirschbaum C, Bartels M, Hellhammer DH, Wust S. The heritability of perceived stress. Psychol Med. 2006; 36: 375-385.PubMedCrossRef
30.
go back to reference Reed T, Plassman BL, Tanner CM, Dick DM, Rinehart SA, Nichols WC. Verification of self-report of zygosity determined via DNA testing in a subset of the NAS-NRC Twin Registry 40 years later. Twin Res Hum Genet. 2005; 8: 362-367.PubMedCentralPubMedCrossRef Reed T, Plassman BL, Tanner CM, Dick DM, Rinehart SA, Nichols WC. Verification of self-report of zygosity determined via DNA testing in a subset of the NAS-NRC Twin Registry 40 years later. Twin Res Hum Genet. 2005; 8: 362-367.PubMedCentralPubMedCrossRef
31.
go back to reference Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Heal Soc Behav. 1983; 24: 385-396.CrossRef Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Heal Soc Behav. 1983; 24: 385-396.CrossRef
32.
go back to reference Mitchell AM, Crane PA, Kim Y. Perceived stress in survivors of suicide: Psychometric properties of the perceived stress scale. Res Nurs Health. 2008; 31: 576-585.PubMedCrossRef Mitchell AM, Crane PA, Kim Y. Perceived stress in survivors of suicide: Psychometric properties of the perceived stress scale. Res Nurs Health. 2008; 31: 576-585.PubMedCrossRef
33.
go back to reference Lazarus RS, Folkman S. Stress, Appraisal, and Coping. New York: Springer Publishing Company; 1984. Lazarus RS, Folkman S. Stress, Appraisal, and Coping. New York: Springer Publishing Company; 1984.
34.
go back to reference Leventhal H, Brown D, Shacham S, Engquist G. Effects of preparatory information about sensations, threat of pain, and attention on cold pressor distress. J Pers Soc Psychol. 1979; 37: 688-714.PubMedCrossRef Leventhal H, Brown D, Shacham S, Engquist G. Effects of preparatory information about sensations, threat of pain, and attention on cold pressor distress. J Pers Soc Psychol. 1979; 37: 688-714.PubMedCrossRef
35.
go back to reference Selye H. The Stress of Life. New York: McGraw-Hill; 1956. Selye H. The Stress of Life. New York: McGraw-Hill; 1956.
36.
go back to reference Ware J, Kosinski M, Dewey J, Gandek B. A Manual for Users of the SF-8 Health Survey. Lincoln, RI: Quality Metrics Inc.; 2001. Ware J, Kosinski M, Dewey J, Gandek B. A Manual for Users of the SF-8 Health Survey. Lincoln, RI: Quality Metrics Inc.; 2001.
37.
go back to reference Derogatis LR, Melisaratos N. The brief symptom inventory: An introductory report. Psychol Med. 1983; 13: 595-605.PubMedCrossRef Derogatis LR, Melisaratos N. The brief symptom inventory: An introductory report. Psychol Med. 1983; 13: 595-605.PubMedCrossRef
38.
go back to reference De Jong MM, An K, McKinley S, Garvin BJ, Hall LA, Moser DK. Using a 0–10 scale for assessment of anxiety in patients with acute myocardial infarction. Dimens Crit Care Nurs. 2005; 24: 139-146.PubMedCrossRef De Jong MM, An K, McKinley S, Garvin BJ, Hall LA, Moser DK. Using a 0–10 scale for assessment of anxiety in patients with acute myocardial infarction. Dimens Crit Care Nurs. 2005; 24: 139-146.PubMedCrossRef
39.
go back to reference Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: Validity of a two-item depression screener. Med Care. 2003; 41: 1284-1292.PubMedCrossRef Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: Validity of a two-item depression screener. Med Care. 2003; 41: 1284-1292.PubMedCrossRef
40.
go back to reference Daig I, Herschbach P, Lehmann A, Knoll N, Decker O. Gender and age differences in domain-specific life satisfaction and the impact of depressive and anxiety symptoms: A general population survey from Germany. Qual Life Res. 2009; 18: 669-678.PubMedCrossRef Daig I, Herschbach P, Lehmann A, Knoll N, Decker O. Gender and age differences in domain-specific life satisfaction and the impact of depressive and anxiety symptoms: A general population survey from Germany. Qual Life Res. 2009; 18: 669-678.PubMedCrossRef
41.
go back to reference Bergen SE, Kendler KS, Gardner CO, Aggen SH. Socioeconomic status and social support following illicit drug use: Causal pathways or common liability? Twin Res Hum Genet. 2008; 11: 266-274.PubMedCentralPubMedCrossRef Bergen SE, Kendler KS, Gardner CO, Aggen SH. Socioeconomic status and social support following illicit drug use: Causal pathways or common liability? Twin Res Hum Genet. 2008; 11: 266-274.PubMedCentralPubMedCrossRef
42.
go back to reference Vitaliano PP, Russo J, Young HM, Teri L, Maiuro RD. Predictors of burden in spouse caregivers of individuals with Alzheimer's disease. Psychol Aging. 1991; 6: 392-402.PubMedCrossRef Vitaliano PP, Russo J, Young HM, Teri L, Maiuro RD. Predictors of burden in spouse caregivers of individuals with Alzheimer's disease. Psychol Aging. 1991; 6: 392-402.PubMedCrossRef
43.
go back to reference Monroe SM, Simmons AD. Diathesis-stress theories in the context of life stress research: Implications for the depressive disorders. Psychological Bulletin. 1991; 110: 406-425.PubMedCrossRef Monroe SM, Simmons AD. Diathesis-stress theories in the context of life stress research: Implications for the depressive disorders. Psychological Bulletin. 1991; 110: 406-425.PubMedCrossRef
44.
go back to reference Robins LN. Sturdy childhood predictors of adult antisocial behavior: Replications from longitudinal studies. Psychol Med. 1978; 8: 611-622.PubMedCrossRef Robins LN. Sturdy childhood predictors of adult antisocial behavior: Replications from longitudinal studies. Psychol Med. 1978; 8: 611-622.PubMedCrossRef
45.
go back to reference Adler NE, Coriell M. Socioeconomic status and health: Do we know what explains the association? Adv J Mind Body Health. 1995; 11: 6-9. Adler NE, Coriell M. Socioeconomic status and health: Do we know what explains the association? Adv J Mind Body Health. 1995; 11: 6-9.
46.
go back to reference Adler N, Boyce T, Chesney M, et al. Socioeconomic status and health. The challenge of the gradient. Am Psychol. 1994; 49: 15-24.PubMedCrossRef Adler N, Boyce T, Chesney M, et al. Socioeconomic status and health. The challenge of the gradient. Am Psychol. 1994; 49: 15-24.PubMedCrossRef
47.
go back to reference Regier DA. The linkage of health care reform and health services research. Am J Psychiat. 1993; 150: 1613-1615.PubMed Regier DA. The linkage of health care reform and health services research. Am J Psychiat. 1993; 150: 1613-1615.PubMed
48.
go back to reference Bourdon K, Rae D, Narrow W, Manderschild R, Regier D. National prevalence and treatment of mental and addictive disorders. In: Mandershild R, Sonnenschein M, eds. Mental Health, United States, 1994. Washington, DC: Center for Mental Health Services; 1994: 22-51. Bourdon K, Rae D, Narrow W, Manderschild R, Regier D. National prevalence and treatment of mental and addictive disorders. In: Mandershild R, Sonnenschein M, eds. Mental Health, United States, 1994. Washington, DC: Center for Mental Health Services; 1994: 22-51.
49.
go back to reference McGinnis JM, Williams-Russo P, Knickman JR. The case for more active policy attention to health promotion. Health Affair. 2002; 21: 78-93.CrossRef McGinnis JM, Williams-Russo P, Knickman JR. The case for more active policy attention to health promotion. Health Affair. 2002; 21: 78-93.CrossRef
50.
go back to reference McGrath E, American Psychological Association National Task Force on Women and Depression. Women and Depression: Risk Factors and Treatment Issues: Final Report of the American Psychological Association's National Task Force on Women and Depression. Washington, DC: American Psychological Association; 1990.CrossRef McGrath E, American Psychological Association National Task Force on Women and Depression. Women and Depression: Risk Factors and Treatment Issues: Final Report of the American Psychological Association's National Task Force on Women and Depression. Washington, DC: American Psychological Association; 1990.CrossRef
51.
go back to reference Conger RD, Wallace LE, Sun Y, Simons RL, McLoyd VC, Brody GH. Economic pressure in African-American families: A replication and extension of the family stress model. Dev Psychol. 2002; 38: 179-193.PubMedCrossRef Conger RD, Wallace LE, Sun Y, Simons RL, McLoyd VC, Brody GH. Economic pressure in African-American families: A replication and extension of the family stress model. Dev Psychol. 2002; 38: 179-193.PubMedCrossRef
53.
go back to reference Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997; 349: 1436-1442.PubMedCrossRef Murray CJ, Lopez AD. Global mortality, disability, and the contribution of risk factors: Global Burden of Disease Study. Lancet. 1997; 349: 1436-1442.PubMedCrossRef
54.
go back to reference Kendler KS, Karkowski-Shuman L. Stressful life events and genetic liability to major depression: Genetic control of exposure to the environment? Psychol Med. 1997; 27: 539-547.PubMedCrossRef Kendler KS, Karkowski-Shuman L. Stressful life events and genetic liability to major depression: Genetic control of exposure to the environment? Psychol Med. 1997; 27: 539-547.PubMedCrossRef
55.
go back to reference Saudino KJ, Pedersen NL, Lichtenstein P, McClearn GE, Plomin R. Can personality explain genetic influences on life events? J Pers Soc Psychol. 1997; 72: 196-206.PubMedCrossRef Saudino KJ, Pedersen NL, Lichtenstein P, McClearn GE, Plomin R. Can personality explain genetic influences on life events? J Pers Soc Psychol. 1997; 72: 196-206.PubMedCrossRef
56.
go back to reference Hansell NK, Wright MJ, Medland SE, et al. Genetic comorbidity between neuroticism, anxiety/depression, and somatic distress in a population sample of adolescent and young adult twins. Psychol Med. 2012; 42: 1249-1260.PubMedCrossRef Hansell NK, Wright MJ, Medland SE, et al. Genetic comorbidity between neuroticism, anxiety/depression, and somatic distress in a population sample of adolescent and young adult twins. Psychol Med. 2012; 42: 1249-1260.PubMedCrossRef
57.
go back to reference Schulz R, Beach SR. Caregiving as a risk factor for mortality—The caregiver health effects study. J Amer Med Assoc. 1999; 282: 2215-2219.CrossRef Schulz R, Beach SR. Caregiving as a risk factor for mortality—The caregiver health effects study. J Amer Med Assoc. 1999; 282: 2215-2219.CrossRef
58.
go back to reference Vitaliano PP, Scanlan JM, Zhang J, Savage MV, Hirsch IB, Siegler IC. A path model of chronic stress, the metabolic syndrome, and coronary heart disease. Psychosom Med. 2002; 64: 418-435.PubMed Vitaliano PP, Scanlan JM, Zhang J, Savage MV, Hirsch IB, Siegler IC. A path model of chronic stress, the metabolic syndrome, and coronary heart disease. Psychosom Med. 2002; 64: 418-435.PubMed
59.
go back to reference Vitaliano PP, Zhang J, Young HM, Caswell LW, Scanlan JM, Echeverria D. Depressed mood mediates decline in cognitive processing speed in caregivers. Gerontologist. 2009; 49: 12-22.PubMedCentralPubMedCrossRef Vitaliano PP, Zhang J, Young HM, Caswell LW, Scanlan JM, Echeverria D. Depressed mood mediates decline in cognitive processing speed in caregivers. Gerontologist. 2009; 49: 12-22.PubMedCentralPubMedCrossRef
60.
go back to reference Vitaliano PP, Persson R, Kiyak A, Saini H, Echeverria D. Caregiving and gingival symptom reports: Psychophysiologic mediators. Psychosom Med. 2005; 67: 930-938.PubMedCrossRef Vitaliano PP, Persson R, Kiyak A, Saini H, Echeverria D. Caregiving and gingival symptom reports: Psychophysiologic mediators. Psychosom Med. 2005; 67: 930-938.PubMedCrossRef
61.
go back to reference Kiecolt-Glaser JK, Glaser R, Gravenstein S, Malarkey WB, Sheridan J. Chronic stress alters the immune response to influenza virus vaccine in older adults. Proc Natl Acad Sci U S A. 1996; 93: 3043-3047.PubMedCentralPubMedCrossRef Kiecolt-Glaser JK, Glaser R, Gravenstein S, Malarkey WB, Sheridan J. Chronic stress alters the immune response to influenza virus vaccine in older adults. Proc Natl Acad Sci U S A. 1996; 93: 3043-3047.PubMedCentralPubMedCrossRef
62.
go back to reference Kiecolt-Glaser JK, Marucha PT, Malarkey WB, Mercado AM, Glaser R. Slowing of wound healing by psychological stress. Lancet. 1995; 346: 1194-1196.PubMedCrossRef Kiecolt-Glaser JK, Marucha PT, Malarkey WB, Mercado AM, Glaser R. Slowing of wound healing by psychological stress. Lancet. 1995; 346: 1194-1196.PubMedCrossRef
Metadata
Title
Does Caregiving Cause Psychological Distress? The Case for Familial and Genetic Vulnerabilities in Female Twins
Authors
Peter P. Vitaliano, Ph.D.
Eric Strachan, Ph.D.
Elizabeth Dansie, Ph.D.
Jack Goldberg, Ph.D.
Dedra Buchwald, M.D.
Publication date
01-04-2014
Publisher
Springer US
Published in
Annals of Behavioral Medicine / Issue 2/2014
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-013-9538-y

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