Neuroticism and ADHD: Trait Associations, Comorbidity, and What They Mean
Author: Ukrainian Psychological Hub · Published: September 30, 2026 · Editorial Policy
Neuroticism and attention-deficit/hyperactivity disorder (ADHD) are related in personality and clinical research, but they are not the same construct. Neuroticism is a dimensional personality trait describing relatively stable individual differences in negative emotionality, stress sensitivity, and proneness to experiences such as worry, irritability, sadness, and emotional volatility. ADHD is a neurodevelopmental disorder defined by persistent, impairing patterns of inattention and/or hyperactivity-impulsivity that begin in development. A person can have high, average, or low neuroticism whether or not they have ADHD, and a neuroticism score cannot diagnose ADHD.
Across meta-analyses, people with ADHD tend on average to score higher on neuroticism or closely related negative-emotionality dimensions, while also tending to score lower on conscientiousness-related dimensions. The association is meaningful at the group level, yet it is heterogeneous across samples, instruments, ages, symptom dimensions, and comorbid conditions. A 2014 meta-analysis of up to 40 data sets linked both ADHD inattention and hyperactivity/impulsivity with higher negative emotionality or neuroticism, while a later adult meta-analysis again found strong average associations with high Negative Emotionality and low Conscientious Inhibition. See the 2014 meta-analysis and the 2021 adult meta-analysis.
The practical meaning is therefore specific: neuroticism can help describe emotional style and vulnerability within an ADHD population, but it does not define ADHD, replace an ADHD assessment, identify an ADHD presentation by itself, or establish that ADHD caused a person's emotional style. This article focuses on the neuroticism × ADHD relationship. For the broader personality construct, see Neuroticism: What It Is in the Big Five Personality Model.
The Short Answer
Research supports an average association between ADHD and higher neuroticism or negative emotionality. The strongest evidence comes from meta-analyses combining multiple studies, and the pattern appears in both adult and youth research. In the 2021 adult meta-analysis, ADHD showed its largest personality associations with higher Negative Emotionality and lower Conscientious Inhibition, although the size of associations varied substantially between studies. In a 2025 systematic review and meta-analysis of children and adolescents, ADHD groups also showed higher neuroticism and negative affectivity on average, but the authors emphasized limited evidence and considerable heterogeneity. Read the adult review and the youth meta-analysis.
These findings do not mean that neuroticism is a symptom of ADHD. They also do not mean that a highly neurotic person probably has ADHD. Neuroticism is common across the population and is associated with many forms of distress and psychopathology; ADHD is diagnosed from a developmental and functional pattern of attention and/or hyperactivity-impulsivity symptoms. The overlap is probabilistic and dimensional, not a one-to-one mapping.
What Neuroticism Means in This Article
Here, neuroticism refers to the modern Big Five personality dimension. It describes a relatively enduring tendency to experience negative emotion more readily, intensely, or persistently and to perceive or react to stressors with greater emotional sensitivity. It is not the historical concept of neurosis, not a synonym for being “neurotic” in everyday speech, and not a diagnosis.
Measurement matters because different instruments organize the domain differently. The NEO Personality Inventory-Revised (NEO PI-R) measures a Neuroticism domain with six facets: Anxiety, Angry Hostility, Depression, Self-Consciousness, Impulsiveness, and Vulnerability. The BFI-2 labels the corresponding broad Big Five domain Negative Emotionality and divides it into Anxiety, Depression, and Emotional Volatility facets. Other IPIP and Eysenck measures use their own item sets, scoring systems, and factor structures. Costa and McCrae describe the NEO hierarchical domain-and-facet model, while Soto and John describe the BFI-2 hierarchical model.
For that reason, “high neuroticism” in one study cannot automatically be translated into the same raw score, percentile, cutoff, or facet profile in another study. A group difference reported with the NEO PI-R is not a universal threshold for the BFI-2, IPIP, Eysenck scales, or an online personality test. For a fuller measurement guide, see Neuroticism Test: What It Measures and How to Interpret Results.
What ADHD Means Clinically
ADHD is a neurodevelopmental disorder characterized by persistent patterns of inattention and/or hyperactivity-impulsivity that interfere with functioning. The National Institute of Mental Health describes inattention, hyperactivity, and impulsivity as the core symptom areas and emphasizes that the behaviors are frequent, occur across situations, and interfere with daily life.
ADHD diagnosis is not based on a Big Five profile. The CDC notes that there is no single test that diagnoses ADHD and that other problems, including anxiety, depression, sleep disorders, and learning difficulties, can produce similar concerns. NICE guidance likewise grounds diagnosis in a full clinical and psychosocial assessment, developmental and psychiatric history, reports across settings, and evidence of impairment.
This distinction is central to interpreting the neuroticism literature. Personality measures ask how a person typically feels and behaves across time and situations. ADHD assessments ask whether a developmentally rooted pattern of specific symptoms and impairment meets diagnostic criteria. Some questionnaire items can look superficially similar, but the constructs, purposes, scoring systems, and clinical decisions are different.
What the Meta-Analyses Show
ADHD and Big Five traits across multiple studies
The broadest early quantitative synthesis was Gomez and Corr's 2014 meta-analysis of up to 40 data sets. Across Five-Factor Model and integrated personality measures, inattention and hyperactivity/impulsivity were associated with higher negative emotionality or neuroticism, lower conscientiousness, and lower agreeableness. The pattern was not uniform across traits: conscientiousness was more strongly related to inattention, whereas agreeableness was more strongly related to hyperactivity/impulsivity. The meta-analysis is indexed in PubMed.
That pattern matters because it argues against reducing ADHD to “high neuroticism.” ADHD's personality correlates are multidimensional. Difficulties with organization, persistence, and task completion map more strongly onto conscientiousness-related dimensions; interpersonal impulsivity and oppositional tendencies can map onto agreeableness-related dimensions; and emotional distress or negative emotionality contributes another partially overlapping axis.
Adult ADHD
Jacobsson and colleagues' 2021 meta-analysis focused on adults and integrated several dimensional personality systems. Thirteen original articles contributed 2,023 adults with ADHD and 16,835 controls. The largest average effects were higher Negative Emotionality and lower Conscientious Inhibition. The review reported a large standardized difference for Negative Emotionality and substantial heterogeneity across studies, with variability partly related to measurement approach and facet composition. Read the full meta-analytic record.
The term Negative Emotionality in this integrated literature should not be treated as a universal synonym for every neuroticism scale. It is a closely related higher-order trait dimension assembled across personality models. When a study uses a standard Big Five instrument, its own domain name and scoring structure should be retained rather than converting results into another test's scores.
Children and adolescents
The newer developmental evidence points in the same broad direction but deserves more caution. A 2025 systematic review and meta-analysis included 31 studies with 2,525 children or adolescents with ADHD and 3,039 controls. The pooled Big Five estimate indicated higher neuroticism in ADHD groups, with a standardized mean difference of 0.92 and a wide confidence interval. The same review found higher negative affectivity and lower effortful control, while emphasizing that relatively few studies covered each temperament or personality construct and that instruments and case definitions varied. See the 2025/2026 youth meta-analysis.
A standardized group difference does not tell us what a particular child's personality score should be. It also does not establish a diagnostic cutoff. Youth personality is developing, informants can disagree, and ADHD symptoms, stress exposure, family context, learning difficulties, sleep, anxiety, depression, and other factors can influence how questionnaires are answered.
ADHD Symptom Dimensions Do Not Have One Personality Profile
Inattention and hyperactivity-impulsivity are related but separable ADHD dimensions, and personality associations differ between them. In six studies totaling 1,620 participants, Nigg and colleagues found inattention-disorganization substantially associated with low Conscientiousness and, to a lesser degree, Neuroticism, whereas hyperactivity-impulsivity and oppositional behaviors were more closely associated with low Agreeableness. See the original Big Five–ADHD study series.
The 2014 meta-analysis later reinforced this differential pattern. This is why a simple rule such as “ADHD equals high neuroticism” loses important information. Two people with the same ADHD diagnosis can differ markedly in their emotional reactivity, conscientiousness, agreeableness, extraversion, openness, anxiety, depression, and day-to-day functioning.
A 2017 study of adults with ADHD also found higher Neuroticism and lower Extraversion, Agreeableness, and Conscientiousness compared with controls, yet Neuroticism did not distinguish the study's different neurocognitive profiles. The authors concluded that ADHD status and symptoms were more closely related to personality traits than the specific cognitive profiles they had identified. See the Psychiatry Research study.
Association Is Not Identity
Neuroticism and ADHD overlap statistically because some people with ADHD experience more worry, frustration, emotional volatility, sensitivity to stress, or internalizing symptoms. But statistical overlap does not make the constructs interchangeable. Neuroticism exists continuously in people with and without ADHD; ADHD is a clinical diagnosis with developmental criteria and impairment requirements.
The same logic applies in the opposite direction. A person who scores high on neuroticism may have ADHD, an anxiety disorder, depression, another condition, several conditions, or no psychiatric disorder at all. A personality score describes a tendency relative to the scale and comparison group. It does not explain the cause of that tendency or identify a diagnosis.
Neuroticism, Negative Affect, and Emotional Dysregulation Are Different Constructs
Several terms are easily blurred in ADHD discussions. Neuroticism is a broad personality trait. Negative affect usually refers to unpleasant emotional experience and may be measured as a state, a recent tendency, or a trait depending on the instrument. Emotional dysregulation refers to difficulty modulating, understanding, accepting, or responding flexibly to emotional states. Trait anxiety refers to a relatively stable tendency toward anxiety, while anxiety symptoms describe a current clinical or subclinical experience. These constructs correlate, but they are not identical.
Recent adult ADHD research illustrates the distinction. In a 2026 study of 231 adults with DSM-5 ADHD assessed with DIVA-5, emotional dysregulation was measured with the Difficulties in Emotion Regulation Scale (DERS). Higher DERS scores were associated with ADHD symptom burden, depressive symptoms, state and trait anxiety, impulsivity, and poorer ADHD-related quality of life. That result shows clinically meaningful affective difficulties in some adults with ADHD, but DERS emotional dysregulation is not itself a neuroticism score. See Landi and colleagues' study.
Another 2026 cross-sectional study compared adults with ADHD, emotional dysregulation, both, and neither. The ADHD-plus-emotional-dysregulation group showed elevated negative emotionality and more affective comorbidity, but the authors argued that emotional dysregulation should not simply be treated as “more severe ADHD.” See the multigroup comparison. This emerging work supports keeping ADHD, neuroticism, negative emotionality, and emotion-regulation difficulty conceptually separate even when they cluster in the same person.
Comorbidity Can Change the Observed Neuroticism Profile
ADHD commonly co-occurs with other psychiatric conditions, especially internalizing disorders such as anxiety and depression. This matters because neuroticism is also strongly associated with internalizing symptoms and disorders. An ADHD sample with high rates of depression or anxiety may therefore show higher average neuroticism than an ADHD sample with fewer internalizing comorbidities, even if both samples have similar core ADHD symptoms.
A 2023 methodological review of very large adult data sets found substantially higher rates of anxiety, major depression, bipolar disorder, and substance use disorders among adults with ADHD than among adults without ADHD. Its pooled estimates showed strong associations across these comorbidity domains. See Hartman and colleagues' review. A 2025 systematic review and meta-analysis of 121 studies involving 39,894 children and adolescents with ADHD similarly found psychiatric comorbidity to be common, including anxiety disorders. See the child and adolescent comorbidity meta-analysis.
Comorbidity does not mean that neuroticism is merely a disguised anxiety or depression score. Rather, it means that a study's average neuroticism level can reflect several overlapping sources of variance: stable personality, current symptoms, past episodes, stress exposure, self-perception, measurement content, and the selection of participants into a clinical sample.
A 2026 Depression Study Shows Why Comorbidity Matters
A 2026 study compared adults with ADHD who had a lifetime history of major depressive disorder with adults who had ADHD but no history of depression. The ADHD-plus-depression group had higher neuroticism, more internalizing comorbidity, and higher depression-related polygenic risk. The ADHD-related polygenic score did not distinguish the depression-comorbid subgroup in the same way. See Kranz and colleagues' study.
This is a group-level genetic and clinical finding, not an individual prediction. Polygenic scores summarize many genetic associations and explain only part of population-level variation; they do not diagnose ADHD, depression, or high neuroticism in a particular person. The study is useful here because it demonstrates a broader point: elevated neuroticism within ADHD samples may partly track an internalizing comorbidity profile rather than a unitary “ADHD personality.”
Does Neuroticism Cause ADHD?
Current evidence does not establish that high neuroticism causes ADHD. Most personality–ADHD studies are cross-sectional, case-control, or correlational. Even meta-analysis can show a robust average association without determining which variable caused the other. Shared genetic liabilities, developmental processes, measurement overlap, psychiatric comorbidity, chronic stress, and the consequences of living with persistent ADHD symptoms can all contribute to the observed relationship.
A causal claim would require stronger evidence about temporal order, confounding, measurement, and mechanism. Because ADHD begins in development while personality traits themselves also develop over childhood and adolescence, a simple one-direction model is especially unlikely to capture the full relationship.
Does ADHD Cause Higher Neuroticism?
ADHD may influence experiences that shape later personality, but the evidence does not support a universal claim that ADHD makes a person neurotic. Persistent academic difficulty, criticism, interpersonal conflict, repeated failure experiences, sleep disruption, and chronic stress could plausibly affect emotional development. At the same time, pre-existing temperament and personality may shape how a person encounters and responds to these environments.
The five-year longitudinal study by Bell, John, and Hinshaw is informative. In a diverse sample of girls, childhood ADHD diagnosis predicted higher self-reported Neuroticism and lower Conscientiousness and Agreeableness in adolescence. Yet after accounting for ADHD diagnosis, the separate inattention and hyperactivity-impulsivity dimensions did not independently predict adolescent Neuroticism. See the longitudinal study. The design strengthens temporal inference compared with a cross-sectional study, but it still does not prove a single causal pathway from ADHD to neuroticism.
Why the Constructs Can Look Similar in Everyday Life
Some observable experiences can arise from several pathways. Frequent worry may reflect higher neuroticism, an anxiety disorder, stress about repeated ADHD-related difficulties, or more than one of these. Irritability may appear during frustration, sleep deprivation, mood symptoms, emotional dysregulation, or high negative emotionality. Difficulty recovering from criticism may reflect personality, prior experiences, current depression or anxiety, or context.
Likewise, “impulsiveness” is not one unitary variable across psychological instruments. The NEO PI-R includes an Impulsiveness facet within Neuroticism, where the construct emphasizes difficulty resisting cravings and urges under emotional pressure. ADHD impulsivity is defined through a different clinical symptom framework. A person can score high on one form of impulsivity and not another. For the NEO structure, see Neuroticism Facets.
Why Low Conscientiousness Often Appears Beside High Neuroticism
One of the most reproducible personality findings in ADHD is lower conscientiousness or conscientious inhibition. This association is often stronger than the neuroticism association for inattention. Conscientiousness covers organization, persistence, responsibility, planning, and goal-directed self-control—domains that can overlap behaviorally with the executive and attentional difficulties seen in ADHD.
That overlap creates both genuine psychological relationships and measurement challenges. If a Big Five item asks whether someone is organized or easily distracted, and an ADHD questionnaire asks about organization and distractibility, correlated scores are unsurprising. Researchers therefore need to consider item content as well as underlying constructs. The presence of correlated questionnaire content is not evidence that personality and ADHD are the same condition.
Neuroticism in Children and Adolescents With ADHD
In youth, developmental context is essential. Personality traits become increasingly organized and stable with age, but childhood and adolescence are periods of substantial change. Parent, teacher, and self-reports may capture different contexts. A child can appear emotionally reactive at home and relatively regulated at school, or the reverse. ADHD symptoms can also change across development.
The youth meta-analysis found higher average neuroticism and negative affectivity in ADHD groups, but it also highlighted sparse data for some constructs and substantial heterogeneity in instruments and definitions. This means the pooled effect is best read as a population-level tendency rather than an individual developmental forecast. The meta-analysis explicitly discusses these limitations.
Neuroticism in Adults With ADHD
Adult studies provide more direct evidence for the Big Five construct because many use standard personality inventories in clinically diagnosed samples. The 2021 meta-analysis found especially large average differences in Negative Emotionality and Conscientious Inhibition, while individual studies using Five-Factor Model measures also report higher Neuroticism in ADHD groups. Van Dijk and colleagues' adult study is one example.
Still, “adults with ADHD” is not a psychologically uniform category. Samples differ in sex distribution, age, treatment history, recruitment setting, diagnostic method, comorbidity, medication use, socioeconomic context, and personality instrument. Those differences help explain why effect sizes vary and why a single personality profile should not be treated as the template for every adult with ADHD.
Can a Neuroticism Test Detect ADHD?
No. A neuroticism scale measures personality. It is neither an ADHD diagnostic test nor an ADHD screening instrument. Even when ADHD groups score higher on average, the score distributions overlap. Many people without ADHD will score high on neuroticism, and many people with ADHD will score in the average or lower range.
A high neuroticism percentile therefore cannot be converted into an ADHD probability without a validated diagnostic model designed for that purpose. The percentile itself is meaningful only relative to the specific test, scoring method, normative sample, and population. Our neuroticism-test guide explains these measurement limits.
Can an ADHD Screening Result Tell You Your Neuroticism?
Also no. ADHD screening tools estimate the presence or frequency of ADHD-related symptoms; personality inventories estimate enduring trait tendencies. A positive ADHD screen is not an assessment of Big Five Neuroticism. Likewise, a symptom questionnaire administered during a period of severe stress, anxiety, or depression may reflect current state influences that should not automatically be interpreted as stable personality.
Trait, State, Symptom, and Diagnosis
The cleanest way to interpret the literature is to keep four levels separate. A trait is a relatively stable tendency, such as neuroticism. A state is a temporary condition, such as acute stress or momentary negative affect. A symptom is a clinically relevant experience or behavior, such as persistent inattention, depressed mood, or panic. A diagnosis is a defined clinical syndrome established from criteria, history, context, impairment, and differential assessment.
These levels influence each other without collapsing into one another. A high-neuroticism person may experience stronger state distress under stress. Repeated distress may increase symptom reporting. ADHD-related impairment may create stressful circumstances. Depression or anxiety can alter how a person describes their typical emotional life. Good interpretation asks which level a measure actually assessed.
What High Neuroticism Might Mean in a Person With ADHD
When someone with established ADHD also scores high on a well-validated neuroticism measure, the result may describe a tendency toward stronger negative emotional reactions, worry, stress sensitivity, self-consciousness, anger, sadness, or vulnerability depending on the instrument and facet profile. It may help explain why two people with similar ADHD symptom severity experience very different levels of distress.
It can also prompt useful questions about anxiety, depression, sleep, chronic stress, interpersonal strain, emotion regulation, and coping. Those questions require their own assessment. The personality score itself should not be used as evidence that a comorbid disorder is present.
For everyday expressions of the trait, see Neuroticism Traits: Worry, Sensitivity, Reactivity, and Vulnerability to Stress. The examples there describe a personality dimension rather than ADHD symptoms.
Does High Neuroticism Make ADHD More Severe?
Higher neuroticism can be associated with greater subjective distress and burden, but “more severe ADHD” is too broad a conclusion. ADHD severity is assessed from core symptoms and functional impairment. Neuroticism may modify how stress, frustration, criticism, and setbacks are experienced, while comorbid anxiety or depression can independently increase impairment.
A study using the NEO PI-R in 511 adults with ADHD reported that neuroticism moderated reported burden across ADHD presentations, illustrating that personality can shape experienced illness burden. That type of result supports a modifier role; it does not redefine the diagnostic criteria or prove that lowering neuroticism would reduce every core ADHD symptom. See Retz-Junginger and colleagues' study
Clinical Assessment: What Should Be Evaluated Separately?
When ADHD and high negative emotionality appear together, a careful assessment separates the ADHD developmental history from current emotional distress. Clinicians may examine onset and persistence of inattention or hyperactivity-impulsivity, impairment across settings, school and work history, sleep, substance use, trauma exposure, mood episodes, anxiety symptoms, learning problems, and other neurodevelopmental features.
Personality assessment can add descriptive information, especially when a validated instrument is used, but it is supplementary. NICE recommends a full clinical, psychosocial, developmental, and psychiatric assessment for ADHD, while the CDC emphasizes that no single test establishes the diagnosis.
Treatment Implications
Neuroticism is a personality trait, so it is not treated as though it were an ADHD symptom or a separate disease. ADHD treatment targets ADHD symptoms and impairment. Co-occurring anxiety, depression, substance use, sleep problems, and other clinical conditions require their own assessment and treatment plan. Emotional-regulation difficulties may also warrant targeted psychological strategies when they are clinically important.
This distinction prevents a common interpretive error: if treatment reduces anxiety, depression, stress, or ADHD-related impairment, a person may feel much less emotionally distressed even if a personality measure has not changed to the same degree. Conversely, personality traits can show gradual or intervention-related change over time, but symptom improvement and trait change are not interchangeable outcomes.
Common Misinterpretations
“People with ADHD are neurotic.”
Population studies support a higher average neuroticism or negative-emotionality score in many ADHD samples. They do not support labeling every person with ADHD as highly neurotic. Group means do not define individuals.
“High neuroticism means I probably have ADHD.”
A neuroticism score does not provide that inference. High neuroticism is associated with many forms of emotional distress and also occurs without psychiatric disorder. ADHD requires a developmental symptom and impairment assessment.
“Emotional dysregulation is just neuroticism.”
The constructs overlap but are measured differently. DERS-based emotion-regulation difficulty, Big Five neuroticism, negative affect, and trait anxiety are correlated dimensions with distinct definitions and instruments. The 2026 ADHD emotional-dysregulation studies illustrate why the distinctions matter clinically.
“If ADHD treatment works, neuroticism should disappear.”
ADHD treatment is not a neuroticism cure. Treatment can reduce core ADHD symptoms and improve functioning, which may also reduce stress and secondary distress. Whether a measured personality trait changes is a separate empirical question.
Frequently Asked Questions
Do people with ADHD have higher neuroticism?
On average, many studies find higher neuroticism or negative emotionality in ADHD groups than in comparison groups. Meta-analyses in adults and youth support the association. The distributions overlap substantially, so the finding does not describe every individual with ADHD.
Is neuroticism a symptom of ADHD?
No. Neuroticism is a Big Five personality trait. ADHD's core diagnostic domains are inattention and/or hyperactivity-impulsivity. Emotional difficulties can be clinically important in ADHD, but they should be described with the construct and instrument actually measured.
Can high neuroticism cause ADHD?
A direct causal pathway has not been established. Association studies cannot by themselves determine causation, and both ADHD and personality develop through interacting biological and environmental processes.
Does ADHD cause high neuroticism later in life?
Longitudinal research suggests developmental links, but not a universal one-way effect. Childhood ADHD diagnosis has predicted higher later neuroticism in some studies, while symptom-specific analyses and other designs show a more complex pattern involving conscientiousness, agreeableness, comorbidity, and context.
Is emotional dysregulation the same as neuroticism?
No. Neuroticism is a broad personality trait; emotional dysregulation refers to difficulties managing and responding to emotions. They can correlate strongly, especially in distressed samples, but they are assessed with different instruments and should not be substituted for each other.
Can a Big Five test diagnose ADHD?
No. Big Five tests describe personality dimensions. ADHD diagnosis requires clinical evaluation of developmental symptoms, impairment, context, and alternative explanations. A personality profile can supplement a broader assessment but cannot replace it.
Why do ADHD studies often find low conscientiousness too?
Conscientiousness includes organization, persistence, planning, responsibility, and self-regulation. These behaviors overlap with areas commonly affected by ADHD, especially inattention and executive difficulties, so low conscientiousness is often one of the strongest personality correlates of ADHD.
Does comorbid anxiety or depression matter when interpreting neuroticism in ADHD?
Yes. Anxiety and depression are common in ADHD and are themselves associated with negative emotionality. Studies that contain more internalizing comorbidity may show higher average neuroticism. That does not make neuroticism a diagnostic proxy for those disorders.
Key Takeaway
Neuroticism and ADHD are reliably associated at the group level, but they belong to different levels of psychological description. Neuroticism is a dimensional personality trait; ADHD is a neurodevelopmental diagnosis. Meta-analyses show that ADHD groups often have higher neuroticism or negative emotionality and lower conscientiousness, with additional differences depending on symptom dimension, age, instrument, and comorbidity.
The most useful interpretation is therefore relational rather than diagnostic. Neuroticism can help describe emotional vulnerability and heterogeneity among people with ADHD, while ADHD can shape life experiences that interact with personality development. Neither construct should be used as a substitute for the other, and neither a personality score nor an ADHD screening result should be converted into a diagnosis it was not designed to make.
Related Articles
Neuroticism Facets: Anxiety, Anger, Depression, Self-Consciousness, Impulsiveness, and Vulnerability
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