William N. Friedrich's research while affiliated with Mayo Clinic - Rochester and other places
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Publications (85)
The primary goal of this study was to determine if the Adolescent Clinical Sexual Behavior Inventory–Self-Report conformed to the five-factor scale format that was initially used with a clinical sample that included adolescents referred for sexual abuse evaluations. Participants were 141 teenagers, ages 12–19 (M = 15.11, SD = 1.4), and their primar...
Parents' responses to their children's emotional expressivity have been shown to significantly influence children's subsequent psychosocial functioning. This study hypothesized that adolescents' deliberate self-harm (DSH) may be an outcome associated with poor emotion regulation as well as an invalidating family environment. The mediational role of...
The Association for the Treatment of Sexual Abusers (ATSA) Task Force on Children With Sexual Behavior Problems was formed by the ATSA Board of Directors as part of ATSA's overall mission of promoting effective intervention and management practices for individuals who have engaged in abusive sexual behavior. The task force was charged to produce a...
Encopresis is typically characterized as resulting from chronic constipation with overflow soiling but has been portrayed as an indicator of sexual abuse. The predictive utility of fecal soiling as an indicator of sexual abuse status was examined. In a retrospective analysis of three comparison groups of 4-12 year olds, we studied 466 children docu...
Expert ratings and confirmatory factor analyses were used to derive a posttraumatic stress disorder (PTSD), dissociation, and a combined PTSD/dissociation scale from the Child Behavior Checklist (CBCL). Validity was established by examining the relationship of these scales to features of sexual abuse thought to relate to severity and chronicity, as...
This study assessed continuity of problematic sexualized behaviors (PSB) over a 1-year period. Ninety-seven 10-12-year-olds in either foster boarding homes or a residential treatment center participated at Time 1. Twelve months later, 78 youth were available for a second data collection assessment. At both data collection phases, researchers interv...
The primary aim of this study was to develop, standardize, and establish initial reliability and validity for the Adolescent Minor Stress Inventory (AMSI), a new measure of minor stress for adolescents. The AMSI improves upon existing adolescent stress measures in a number of important ways in that it does not emphasize school or classroom-based st...
Self-destructive and delinquent behaviors were assessed in three samples of adolescent females. The first sample (N=140) were substantiated victims of sexual abuse recruited from clinical settings. They were contrasted to a second sample (N=430) of secondary school students, and a third sample from the same school setting (N=94), that reported that...
Age inappropriate sexual behavior is strongly associated with sexual abuse but is also correlated with other factors that often co-occur in the lives of vulnerable children, including physical abuse, domestic violence, excessive life stress, and inappropriate exposure to family sexuality. In addition, an objective observer is required to rate the s...
A community sample of 610 adults were grouped into those who reported no sexual abuse experience, others who reported noncoercive sexual contact with an individual that was at most 4 years older, and those who reported more severe sexual abuse. The first two groups did not differ from each other on current social support, trauma-specific symptomato...
This study examined the reliability and validity of the Adolescent Clinical Sexual Behavior Inventory (ACSBI), a new 45-item measure, designed to elicit parent-and self-report regarding a range of sexual behaviors in high-risk adolescents. Using this measure, this study also investigated predictors of adolescent sexual behavior. Participants were 1...
After the Soviet Union dissolved in 1989, it became apparent that there was little recognition of the problems of child abuse and neglect, professionally, legally, or societally. There were no effective systems or laws in place to deal with these problems.
Beginning in 1995 the Children's Mental Health Alliance, in conjunction with the Open Society...
This study was designed to assess the incidence of child emotional and physical abuse, associated risk factors and psychosocial symptoms in a cross-cultural comparison between post-communist bloc countries. Method: One-thousand one-hundred forty-five children ages 10-14 from Latvia (N = 297), Lithuania ( N = 300), Macedonia (N = 302), and Moldova (...
Goal: The goal of this symposium is to identify ‘state-of-the-art’ strategies for the use of antipsychotic medications in the management of children and adolescents with major psychiatric disorders. Learning objectives: 1. Define pediatric populations for whom second-generation antipsychotics are indicated 2. Identify the role of second-generation...
We examined the associations of children's reported “cruelty to animals” and “touching animal's sex parts” with the reported presence of physical abuse and parental physical fighting for three groups of children. Maternal caregivers of 1433 6- to 12-year-old children completed the Child Behavior Checklist (CBCL) and the Child Sexual Behavior Invent...
A large sample of 2-12 year old children (N = 2311) was studied to determine the relationship between three sexually intrusive behavior items (SIBs) measured by the Child Sexual Behavior Inventory (CSBI) and a range of developmental, ecological, and behavioral correlates. The variables studied included age, gender, race, family income, single paren...
Empirical research by scholars from several disciplines provides the basis for an outline of the process of sexual development. The process of achieving sexual maturity begins at conception and ends at death. It is influenced by biological maturation/aging, by progression through the socially-defined stages of childhood, adolescence, adulthood, and...
To determine the usefulness of measurements of the vaginal opening and amount of hymenal tissue present inferiorly and laterally in the diagnosis of vaginal penetration.
The transhymenal diameters and the amount of tissue present between the hymenal edge and vestibule inferiorly at 6 o'clock and laterally at 3 o'clock and 9 o'clock were measured fr...
The transition of the Eastern European countries in the past 12 years from totalitarian, communist societies to democratic societies has had a broad impact on children's mental health, both positively and negatively. This transition has not been without economic difficulties. All countries in the region experienced a significant deterioration of ou...
Two samples of adolescents were studied to assess the validity of several measures of dissociation. The first sample included 70 males from a residential treatment program for adolescent sex offenders (ASO). The second were 47 psychiatric inpatients. The measures included the DSM-IV field trial questionnaire for Dissociative Disorders of Childhood,...
Expert ratings and confirmatory factor analyses were used to develop an alternative system for scoring the Child Behavior Checklist (CBCL; T. M. Achenbach, 1991) to measure specific dimensions corresponding to current conceptualizations of child symptomatology. Data were from a nonclinic and 2 independent clinic samples. Subscales measuring Anxiety...
A normative sample of 1,114 children was contrasted with a sample of 620 sexually abused children and 577 psychiatric outpatients on the Child Sexual Behavior Inventory (CSBI), a 38-item behavior checklist assessing sexual behavior in children 2 to 12 years old. The CSBI total score and each individual item differed significantly between the three...
This paper describes the evolution of child and adolescent mental health emergency services in Eastern European countries over the past decade since the dissolution of the Iron Curtain. The process of helping countries to organize services, as facilitated by the authors through their training and mentoring of Eastern European mental health professi...
A sample of 119 consecutively hospitalized adolescents, including 32 sexually abused teenagers, was assessed with the Trauma Symptom Checklist for Children (TSCC). Participants also completed the Beck Depression Inventory, Symptom Checklist-90-Revised (SCL-90-R), Adolescent-Dissociative Experience Scale, Minnesota Multiphasic Personality Inventory...
Three samples, one American (N = 500) and two from the Netherlands (N = 460, N = 297) of 2-6 year old children, screened for the absence of sexual abuse, were assessed with 25 items derived from the Child Sexual Behavior Inventory (Friedrich et al. 1992). Considerable differences existed between the three groups across a number of the behaviors rat...
Although the dissolution of the Soviet Union in 1989 brought a welcome end to the Cold War, the subsequent reestablishment of independent Eastern European countries revealed a host of problems. Among these was frequent child abuse and neglect, although lack of epidemiological data precluded any accurate estimate of prevalence. In an effort to addre...
Our goal was to identify vulvar and hymenal characteristics associated with sexual abuse among female children between the ages of 3 and 8 years.
Using a case-control study design, we examined and photographed the external genitalia of 192 prepubertal children with a history of penetration and 200 children who denied prior abuse. Bivariate analyses...
To describe normative sexual behavior in Dutch-speaking children; to assess the frequencies of different types of sexual behaviors reported in children by their parents; to analyze the relation of these sexual behaviors to demographic, personal, familial, and general behavioral variables; and to compare the Dutch-speaking sample with American sampl...
Exner's scoring (1990) was used on the responses by 46 sexually abused girls (6 to 14 years old) and 46 nonsexually abused girls (6 to 14 years old). Subjects were matched for age, race, family income, and family constellation. Sexually abused children exhibited significantly more unusual content, e.g., sex and blood, in their protocols as well as...
Sexual behavior in children can cause uncertainty in the clinician because of the relationship between sexual abuse and sexual behavior. Consequently, it is important to understand normative childhood sexual behavior.
Sexual behavior in 1114 2- to 12-year-old children was rated by primary female caregivers. These children were screened for the abse...
There were two aims: first, to evaluate the feasibility of applying a standard assessment protocol to Franco-Quebec victims of child sexual abuse and nonoffending mothers; and second, to compare results from an initial sample with available data from English-speaking samples.
A standard individual case study design was used for victims and mothers;...
The relationship between sexual abuse history and sexual responses to Card 15 of the Roberts Apperception Test for Children (RATC) was examined with a sample of children (N = 93), ages 4–13. Sexual content was reported significantly more often in children with actual or suspected abuse histories in comparison to their nonabused psychiatric patient...
A random sample of 610 adults, enrolled in a population-based, prospective cohort study, were examined by questionnaire on two occasions (separated by an average of 20 months) about unwanted sexual experiences, physical abuse, and psychological abuse that might have occurred when they were younger. Although the screening questions for these types o...
Dissociative and sexual behaviors were assessed in a sample of 350 children ages 7-18. Four groups were evaluated: a nonpsychiatric comparison sample, a psychiatric sample with no history of sexual abuse, a psychiatric sample with clear evidence of sexual abuse, and another group for whom sexual abuse was likely but not substantiated. All children...
The following questions are considered in this article from a clinician's perspective, in light of the data provided by three articles in this special section: Should therapy be abuse specific? Who should be the focus of treatment, children or families? Is more severe abuse harder to treat than moderate abuse? Are certain symptoms harder to treat t...
Contrasted a nonabused sample of 3 to 12-year-old children (n = 847) with a sexually abused sample (n = 252) with regards
to somatic symptoms assessed via parent report, including the Child Behavior Checklist. Using ANCOVA, and controlling for
family income, maternal education, age, and sex, the girls 3–6 years old who were abused and the boys 7–12...
Many devices are used in child assessment and treatment as communication aids, projective tools, and symbolic means of interaction. None are as hotly debated in their application among mental health professionals as dolls with genital details. Anatomically detailed (AD) dolls are often used in sexual-abuse evaluation and treatment with children, bu...
The authors studied five adolescent male practitioners of autoerotic asphyxia to determine contributors to its etiology. Extensive histories including detailed sexual histories were obtained from each boy. Their life histories suggested an early history of choking, in combination with physical or sexual abuse, was related to the development of auto...
Within the context of a coping model, the present study attempted to determine variables associated with good and poor adjustment for siblings (N = 129) of pediatric cancer patients. Family cohesion and adaptability were found to mediate the impact of pediatric cancer on the healthy sibling. Specifically, high levels of family cohesion and adaptabi...
In summary, the psychological assessment of sexually abused children is complicated significantly by the fact that there is no single syndrome that reflects the impact of sexual abuse (Kendall-Tackett, Williams, and Finkelhor, 1993). A number of generic measures of psychopathology in children continue to find large percentages of children relativel...
Ten children with lipomyelomeningocele were evaluated with the WISC--R, the Wide Range Achievement Test--Revised, the Developmental Test of Visual-motor Integration, and the Child Behavior Checklist. These children were consecutive referrals to a birth defects clinic. Unlike their meningomyelocele counterparts, as a group these children appear to b...
Empirical research pertaining to sexual behavior in sexually abused children, including record reviews, parent ratings, psychological assessment, self-report, and behavioral observation is reviewed and discussed. Sexual behavior is reported significantly more often in sexually abused children than nonabused children. However, the consistency of thi...
A normative sample of 880 children was contrasted with a sample of 276 sexually abused children on the Child Sexual Behavior Inventory (CSBI), a 35-item behavior checklist assessing sexual behavior in children 2–12 yrs old. The CSBI total score differed significantly between the 2 groups after controlling for age, sex, maternal education, and famil...
Describes a group treatment intervention program for young sexually abused boys, and examines outcomes of 33 (aged 4–16 yrs) who completed therapy. The treatment approach included a combination of group, individual, parent training, and family therapy. At follow-up, improvements were noted in a number of areas, including overall behavior problems a...
The relationship between childhood sexual abuse and subsequent health risk behaviors and medical problems was examined in 511 women who had used a family practice clinic in a rural midwestern community during a 2-year period (1988 and 1989). These women completed a questionnaire that assessed various health risk behaviors--smoking, drinking, drug a...
Thirty-seven mothers of sexually abused children were contrasted with 41 mothers who were receiving outpatient psychotherapy and with 76 women with no history of psychiatric disturbance on the MMPI. The groups were matched on age and socioeconomic status, and significant between-group differences were noted. Outpatients and mothers of sexually abus...
Thirty-seven mothers of sexually abused children were contrasted with 41 mothers who were receiving outpatient psychotherapy and with 76 women with no history of psychiatric disturbance on the MMPI. The groups were matched on age and socioeconomic status, and significant between-group differences were noted. Outpatients and mothers of sexually abus...
A large-scale, community-based survey was done to assess the frequency of a wide variety of sexual behaviors in normal preadolescent children and to measure the relationship of these behaviors to age, gender, and socioeconomic and family variables. A sample of 880 2- through 12-year-old children screened to exclude those with a history of sexual ab...
A large-scale, community-based survey was done to assess the frequency of a wide variety of sexual behaviors in normal preadolescent children and to measure the relationship of these behaviors to age, gender, and socioeconomic and family variables. A sample of 880 2-through 12-year-old children screened to exclude those with a history of sexual abu...
Designed study as a conceptual replication of Shaffer, Friedrich, Shurtleff, and Wolf (1985). Intelligence, school achievement, and perceptual motor skill data from 73 children with uncomplicated myelomeningocele were examined to determine their deviation from test norms. The respective impact of shunting and functional motor level was also assesse...
The psychological impact of trauma can include cognitive, affective, and behavioral components. The degree to which a child is either overwhelmed by or unable to access the traumatic event can make the working through of the event in therapy difficult. Hypnotherapy is a useful modality not only for alleviating symptoms but also for uncovering the t...
Sexual behavior is reported more often in sexually abused children than in nonabused children, but the consistency of this finding varies with the research method.
A sample of 78 women meeting the DSM-III criteria for bulimia completed the MMPI. Heterogeneity in the sample was noted with a variety of code-types present, including 2-8, 2-4, 4-3, 4-6, 4-9, 3-6, 4-8, and 6-9. These code-types are differentially related to such variables as relational status, history of suicide attempts, and alcohol abuse. In add...
The development of two brief self-report measures for assessing parent-child communication specific to pediatric cancer is reported The instruments assess the quality of parent-child communication with their ill child and the sibling of the ill child The measures have good internal consistency and are significantly related to the overall level of h...
The psychological functioning and behavior of 46 sexually abused girls (ages 6-14) was compared with that of 46 nonabused girls who were matched on age, race, family income, and family constellation. Sexually abused children demonstrated heightened sexual preoccupation and behavior problems, lower cognitive abilities and school achievement, and mor...
The psychological functioning and behavior of 46 sexually abused girls (ages 6–14) was compared with that of 46 nonabused girls who were matched on age, race, family income, and family constellation. Sexually abused children demonstrated heightened sexual preoccupation and behavior problems, lower cognitive abilities and school achievement, and mor...
We report a brief treatment format for young sexually abused boys that has both diagnostic and therapeutic implications. A general format is outlined, and then a group is described in more detail. Examples from each session are given that illustrate both therapeutic issues and issues related to the effects of sexual abuse on this sample. Implicatio...
Two coping resources, religiosity and locus of control, derived from a cognitive theory of coping were assessed in a sample of 140 mothers of retarded children Data analysis examined the relationship of these variables to measures of coping and to maternal demographic characteristics Results indicated that both religiosity and locus of control were...
This study examined sex differences in the self-report of depression in early adolecents. A sample of 269 junior high adolescents completed a biographical data sheet, short forms of the Beck Depression Inventory, the Family Environment Scale, a Social Support Index, and a Life Stress Inventory. A subset of 61 mothers completed a Beck inventory, and...
As the full spectrum of sexual abuse sequelae is becoming known, a subset of child victims has been noted to exhibit sexually aggressive behavior. Their sexual behavior far exceeds the mutual exploratory behavior normally seen in young children and resembles more closely the behavior of older sex offenders. We present data from the psychological ev...
A sample of 31 boys sexually assaulted in the previous 18 months was compared on the Child Behavior Checklist with 33 boys who had a diagnosis of oppositional or conduct disorder. The boys ranged in age from 3 to 8 years old. The conduct-disordered boys were being seen in outpatient therapy with their parents. The two groups did differ significantl...
The quality of both family relations and marital satisfaction was assessed in 131 two-parent families who had a mentally retarded child. Both family relations and marital satisfaction were seen as outcome variables reflecting how families cope with the chronic strain of a special child. Social desirability was controlled, and family relations and m...
The sexually abused child has been described as more fearful, anxious, depressed, and guilty in comparison to normal children. However, these descriptions are largely derived from clinical impressions and little systematic exploration of the nature and extent of behavior problems among these children. The present study investigated the problem beha...
Assessed 8 sexually abused (SA) children (aged 3–7 yrs) repeatedly with the Child Behavior Checklist during a 10–18 mo period to explore the course of psychological symptoms that emerged in response to the abuse. Their individual courses were linked to whether treatment was provided and pathology in the parents. In some Ss, symptoms reflected a sim...
A sample of 85 children, ages 3 to 12, and sexually abused within the previous 24 months, were avaluated with the Child Behavior Checklist (CBCL). Data relating to the nature of the abuse were also collected. This sample was clearly more deviant behaviorally as measured by the CBCL. Internalizing behavior was related to the frequency of abuse, the...
This book provides both an integrated conceptual basis for assessment and diagnosis of bulimia and an applied approach to treatment. The conceptualization of bulimia and subsequent treatment approaches offered reflect our blend of feminist and family systems theory.
The book is divided into 6 sections which take the reader from a foundation for d...
Intelligence and achievement test data from 60 children with uncomplicated myelomeningocele were examined to determine their
deviation from test norms. The impact of functional motor level and shunting was also assessed. Although the sample as a whole
functioned below WJSC and WRAT norms, the degree of deviation varied with functional motor level....
The clinical‐research literature relating to the abused child is critically reviewed. Included are demographic and epidemiological studies, behavioral studies, and studies of the cognitive/intellectual functioning of these children. Research which suggests that characteristics of the child contribute to abuse is also presented, along with suggestio...
Behavioral problems that frequently occur in pediatric cancer treatment settings, such as food refusal and the resistance to treatment, have been successfully treated utilizing family therapy techniques. The theoretical background that supports this mode of intervention and several case studies are presented.
Compared 11 physically abused males (aged 3 yrs 11 mo to 5 yrs 8 mo) on the McCarthy Scales of Children's Abilities (MSCA) and the Wide Range Achievement Test with 10 nonabused males matched on age, family income, and maternal age and education. In addition, behavioral observations of their performance on a persistence task were coded. Significant...
Compared 11 physically abused males (aged 3 yrs 11 mo to 5 yrs 8 mo) on the McCarthy Scales of Children's Abilities (MSCA) and the Wide Range Achievement Test with 10 nonabused males matched on age, family income, and maternal age and education. In addition, behavioral observations of their performance on a persistence task were coded. Significant...
This study compared two groups of parents of mentally retarded children on the Questionnaire on Resources and Stress (QRS), with one group of children also having cerebral palsy The groups differed on two scales, Limits on Family Opportunity and Physical Incapacitation, and provided some support for the sensitivity of the QRS to differing levels of...
States that play therapy training often proceeds in a haphazard fashion, with the trainee given little more direction than to "play with the child." A model is proposed that takes into consideration the developmental aspects of relationships, of play, and of the therapy process. (8 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Therapeutic groups of parents of children with cancer have been seen as potentially helpful to those parents who utilize the groups. The authors report on a study of the differing content raised in two parent groups, one English-speaking and one Spanish-speaking.
The concept of extreme interpersonal sensitivity is introduced and the literature relating to it is reviewed. Although considerable clinical evidence gives credence to the relative ubiquity of this phenomenon in enmeshed families, the concept is only indirectly alluded to by family theorists. Extreme interpersonal sensitivity seems to be characteri...
Citations
... Non sexual child maltreatment which is inclusive of physical abuse, emotional abuse and neglect significantly predicted internalizing and externalizing behavior problems however sexual abuse was not significantly related to internalizing and externalizing behavior problems (Vachon et al., 2015). However, in other studies sexual abuse predicts internalizing and externalizing behaviors (Einbender & Friedrich, 1989). Therefore, each type of child maltreatment needs to be addressed because they all have equal consequences on internalizing behaviors (Valentino, Cicchetti, Rogosch, & Toth, 2008). ...
... Children engage in a range of sexual behaviors. Normative or common sexual behaviors occur often and without negative consequences to self or others during particular developmental stages (Friedrich et al., 1991(Friedrich et al., , 1998. For example, infants begin to touch their bodies, including genitalia, within months of birth (Mesman et al., 2019). ...
... Play therapy is one of the fastest growing professions in the mental health field. One concern of professionals in the field of play therapy is that treatment should be provided by expert clinicians who are trained in established play therapy procedures to ensure that children receive high-quality help from competent play therapists (Brady & Friedrich, 1982;Cohen, 1995;Landreth, 1991). Phillips and Landreth (1995) conducted a national survey of the field of play therapy and found that most play therapists had not received explicit graduatelevel training in play therapy. ...
... As far as we know, there is no specific pattern of psychosocial symptoms (including sexual behavior) that indicates CSA (Briere & Elliott, 1994;Finkelhor & Berliner, 1995;Kendall-Tackett et al., 1993). In about 30% of the children, no psychosocial signs are apparent at all (Conte, 1988;Friedrich, Urquiza, & Beilke, 1986;Mian, Klanjer-Diamond, Lebaron, & Winder, 1986). This might be due to specific aspects of the abuse (nature, frequency, duration, severity, and relationship with perpetrator), environmental factors (how safe is the child?), and the child's character (Briere & Elliott, 1994). ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/332359841927168-1456252169075_Q64/Anthony-Urquiza.jpg)
... Some studies have suggested that family environment variables account for a significant amount of variance in the psychological adjustment of the child. For example, Friedrich, Beilke, and Urquiza (1988) found that family conflict and family cohesion explained the greatest proportion of variance in parent reports of both internalizing and externalizing symptoms of their male children who had disclosed sexual abuse. ...
... Western studies on short term effects of CSA reported high prevalence of behaviour problems (Friedrich et al., 1987), depression, low self-esteem (Stern et al., 1995), sexualized behaviour (Kendall-Tackett et al., 1993), Post-traumatic Stress Disorder and Dissociation (Collin-Vé zina and Hé bert, 2005). ...
... There are a number of predictors of PSB-CY that exist such as child social immaturity, experience of maltreatment, sexual abuse victimization, externalizing behavior, and exposure to domestic violence, sexually explicit behaviors and materials (e.g., pornography), and family adversity (Dong et al., 2003;Friedrich et al., 2003). Previous studies have shown that children with sexual abuse histories have higher rates of PSB-CY than children without such a history (Cosentino et al., 1995;Friedrich et al., 1997). However, the vast majority of children who are sexually abused will not engage in PSB-CY (Kendall-Tackett et al., 1993). ...
... There are various tools used to measure parental stress level. 12,13,14,15 The Friedrich Short-Form of the Questionnaire on Resources and Stress (QRS-F) is one of the widely used questionnaires used to measure parental stress. 16,17 It was developed from Holroyd's longer version of Questionnaire on Resources and Stress which was designed to measure the impact of a child with developmental disability or a family member with chronic illness on the parent or caregiver. ...
... Researchers have found that religious and spiritual coping strategies are positively related to mental health and faster adaptation to stress Pargament, 1997;Pargament et al., 1988), with religion perhaps moderating the relationship between stress and depression (Friedrich, Cohen, & Wilturner, 1988;Idler & Kasl, 1992;Kendler, Gardner, & Prescott, 1997). In addition, religious beliefs and behaviors are particularly important for coping for African Americans (Conway, 1985(Conway, -1986Krause & Van Tran, 1989), the elderly, and women (Koenig et al., 2001, p. 94). ...
... This potential recall bias might be dependent on gender. For instance, women might report more traumatic events perpetrated by someone close, whereas men might report more events perpetrated by someone not so close (Friedrich, Talley, Panser, Fett, & Zinsmeister, 1997;Goldberg & Freyd, 2006). Again, prospective research would be important to explore this potential bias. ...
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