Parental Risk and Protective Factors Associated with Bullying Victimization in Children and Adolescents: A Systematic Review and Meta-analysis.

The main objective of this meta-analysis was to investigate how modifiable parental factors are related to traditional and cyberbullying victimization in children and adolescents. A systematic literature search of modifiable parental factors associated with bullying victimization was conducted using PubMed, PsycINFO, Scopus, and Web of Science electronic databases. Meta-analyses were performed to assess the mean effect sizes of the associations between the broader categories of parental factors (risk and protective) and bullying victimization (traditional and cyber), as well as between specific parental factors and bullying victimization (traditional and cyber). The differential impact of maternal and paternal factors (risk and protective) was examined. Age and gender were tested as moderators. Out of the 13,171 records identified, 158 studies met the inclusion criteria. Larger evidence was found for the association between parental risk (i.e., authoritarian parenting, aversiveness, inter-parental conflict, over-involvement, permissive parenting, and withdrawal) and protective (i.e., authoritative parenting, autonomy granting, warmth, and monitoring) factors, respectively, and traditional bullying victimization, with parental warmth, aversiveness, and withdrawal being the only common related predictors for traditional and cyberbullying victimization. The effect sizes were generally small. Maternal and paternal factors showed similar patterns of association with both types of bullying victimization. Age had a moderating effect on the association between parental protective factors and cyberbullying victimization. Overall, the present findings suggest that parental factors are relevant in protecting or putting children at risk for bullying victimization, especially in the offline context.

Preliminary efficacy of a transdiagnostic parent-led internet-delivered intervention for children with anxiety and depressive symptoms: a pilot randomized controlled trial.

BACKGROUND: There is extensive research indicating that transdiagnostic interventions are effective for adults and children with anxiety and depressive disorders; however, limited research has been conducted on the efficacy of such programs targeting parents of children with anxiety and depressive symptoms delivered via the Internet. This study aims to investigate the preliminary efficacy of a transdiagnostic Internet-delivered intervention for Romanian parents of children with elevated anxiety and depressive symptoms. METHODS: We conducted a single-blinded pilot randomized controlled trial. Forty-two parents of children with anxiety and depressive symptoms (Mage = 39.79, 78.6% women) from Romania were randomly assigned to one of the two groups, to ParentKIT, an Internet-delivered intervention based on Rational Emotive and Behavioral Therapy (n = 21), or to a delayed treatment condition (waitlist group) (n = 21). ParentKIT consisted of a brief transdiagnostic intervention delivered through nine modules with therapist guidance. RESULTS: A significant Group by Time effect was found for child emotional problems as reported by parents (Cohen's d = - 0.85) and for parental self-efficacy (Cohen's d = 0.71). CONCLUSION: A transdiagnostic Internet-delivered intervention addressed to parents of children with elevated anxiety and depressive symptoms is a promising approach. Future research should include blind assessments as well as multiple outcome assessors and investigate the long-term efficacy of the intervention. TRIAL REGISTRATION: NCT05341297.

Use of automated conversational agents in improving young population mental health: a scoping review.

Automated conversational agents (CAs) emerged as a promising solution in mental health interventions among young people. Therefore, the objective of this scoping review is to examine the current state of research into fully automated CAs mediated interventions for the emotional component of mental health among young people. Selected databases were searched in March 2023. Included studies were primary research, reporting on development, feasibility/usability, or evaluation of fully automated CAs as a tool to improve the emotional component of mental health among young population. Twenty-five studies were included (N = 1707). Most automated CAs applications were standalone preventions targeting anxiety and depression. Automated CAs were predominantly AI-based chatbots, using text as the main communication channel. Overall, the results of the current scoping review showed that automated CAs mediated interventions for emotional problems are acceptable, engaging and with high usability. However, the results for clinical efficacy are far less conclusive, since almost half of evaluation studies reported no significant effect on emotional mental health outcomes. Based on these findings, it can be concluded that there is a pressing need to improve the existing automated CAs applications to increase their efficacy as well as conducting more rigorous methodological research in this area.

Measurement Invariance of the Lemmens Internet Gaming Disorder Scale-9 Across Age, Gender, and Respondents.

Although Internet gaming disorder (IGD) has gained increased attention in scientific, clinical, and community contexts, there is still a lack of consensus regarding the best assessment tools (i.e., self-report or other reports) for assessing its symptoms. The present study aimed to investigate the reliability, validity, and measurement invariance of both versions (youth and parent) of The Lemmens Internet Gaming Disorder Scale-9. To achieve this goal, we recruited between June and October 2019 from five Romanian highschools a total of 697 adolescents (11-19 years old) and one of their parents (N = 391). The internal consistency was good in both versions of the instrument (α = 0.772 for the youth version and α = 0.781 for the parent version). Construct validity assessed through confirmatory factor analysis showed support for the one factor structure of the scales, while multigroup confirmatory factor analysis endorsed the invariance across age, gender, and respondents (i.e., parent vs. youth report). The current research identifies both IGD scales to be reliable and valid, arguing for their utility for assessing IGD symptomatology among adolescents. Implications for theory, assessment, and future directions are discussed.

Explaining the "parenting - callous-unemotional traits - antisocial behavior" axis in early adolescence: The role of affiliative reward.

In explaining the "parenting - callous-unemotional traits - antisocial behavior" axis, recent theoretical advances postulate a critical role for affiliative reward. Existing empirical studies focus on early childhood and the appetitive phase of the reward process (i.e. affiliation-seeking behavior) rather than the consummatory phase (i.e. affective rewards). This study focuses on experienced affiliative reward (i.e. companionship, intimacy, affection, and worth) in relation to parents and best friends in early adolescence. The Alabama Parenting Questionnaire, Network of Relationships Inventory, Inventory of Callous and Unemotional Traits, and Youth Self Report were completed by 1132 12-year-olds and analyzed via structural equation models. In this cross-sectional sample, parent-related affiliative reward mediated the path from perceived parenting practices to callousness and further to aggression and rule-breaking. Parent-related affiliative reward was also related to uncaring traits and further to aggression and rule-breaking. In contrast, friend-related affiliative reward was not a mediator in this theoretical causal chain and largely not related to perceived parenting practices or CU traits. Low parent-related experienced affiliative reward is a mechanism through which corporal punishment, poor monitoring, and low involvement translate into callousness, and therefore to aggression and rule-breaking. Friend-related affiliative reward does not yet play a role in early adolescence.

Cultural contributions to adults' self-rated mental health problems and strengths: 7 culture clusters, 28 societies, 16 906 adults.

BACKGROUND: It is unknown how much variation in adult mental health problems is associated with differences between societal/cultural groups, over and above differences between individuals. METHODS: To test these relative contributions, a consortium of indigenous researchers collected Adult Self-Report (ASR) ratings from 16 906 18- to 59-year-olds in 28 societies that represented seven culture clusters identified in the Global Leadership and Organizational Behavioral Effectiveness study (e.g. Confucian, Anglo). The ASR is scored on 17 problem scales, plus a personal strengths scale. Hierarchical linear modeling estimated variance accounted for by individual differences (including measurement error), society, and culture cluster. Multi-level analyses of covariance tested age and gender effects. RESULTS: Across the 17 problem scales, the variance accounted for by individual differences ranged from 80.3% for DSM-oriented anxiety problems to 95.2% for DSM-oriented avoidant personality (mean = 90.7%); by society: 3.2% for DSM-oriented somatic problems to 8.0% for DSM-oriented anxiety problems (mean = 6.3%); and by culture cluster: 0.0% for DSM-oriented avoidant personality to 11.6% for DSM-oriented anxiety problems (mean = 3.0%). For strengths, individual differences accounted for 80.8% of variance, societal differences 10.5%, and cultural differences 8.7%. Age and gender had very small effects. CONCLUSIONS: Overall, adults' self-ratings of mental health problems and strengths were associated much more with individual differences than societal/cultural differences, although this varied across scales. These findings support cross-cultural use of standardized measures to assess mental health problems, but urge caution in assessment of personal strengths.

ADHDCoach-a virtual clinic for parents of children with ADHD: Development and usability study.

Attention-deficit/ hyperactivity disorder (ADHD) is one of the most common mental health problems in childhood. Despite the fact that evidence-based treatments exist, behavioral parent training programs are the gold standard in the care of children with ADHD, a significant percentage of parents of children with ADHD do not access such interventions. Internet-delivered interventions are effective for a range of mental health problems, however, there is limited research conducted on the efficacy of such interventions in the treatment of ADHD. Objective: The aim of this study is to present the development and feasibility of an Internet-delivered intervention for parents of children with ADHD. Methods: The intervention was based on Behavioral Parent Training and Rational Emotive Behavior Therapy. Participants were mental health specialists (N = 16) and parents of children diagnosed with ADHD (N = 24). Results: Our results indicated high usability and parental satisfaction with the intervention. Conclusion: In conclusion, an Internet-delivered intervention addressed to parents of children diagnosed with ADHD is a promising approach. Future research should investigate the efficacy of this Internet-delivered intervention in a randomized controlled trial.

The Development and Usability of a Mobile App for Parents of Children with ADHD.

BACKGROUND: Attention-Deficit/ Hyperactivity Disorder (ADHD) is one of the most prevalent mental health problems in children. Behavioral parent training (BPT) is the first-line treatment recommended by clinical guidelines; however, parental dropout is high. Mobile apps could be used as an adjunct to BPT in order to increase treatment adherence, homework compliance, and parental engagement. In this paper, we describe the development process of a mobile app for parents of children with ADHD. METHODS: We conducted a study to investigate parents' perceived usability of the ADHD Coping Card. RESULTS: The mobile app developed has a high usability. Future improvements in the app were suggested by parents. CONCLUSIONS: Given the increasing importance of digital mental health interventions in psychotherapy, it is important that future research is conducted with a higher number of participants to investigate the key factors implicated in choosing such an intervention in the future, both by parents and by mental health specialists. A mobile app can be used as an add-on in psychotherapy with parents of children with ADHD. Digital health interventions could help surpass gaps in treatment access for child mental health problems.

Measurement Invariance of Alabama Parenting Questionnaire Across Age, Gender, Clinical Status, and Informant.

This study aimed to investigate the measurement invariance of the Alabama Parenting Questionnaire (for both long [APQ-lg] and short [APQ-9] forms) across age, gender, clinical status, and informant (i.e., parent vs. child reports). The sample was composed of adolescents (community sample: N = 1,746; clinical sample: N = 166) and parents (N = 149). The analyses were conducted in R. Measurement invariance was assessed via multi-group confirmatory factor analysis, equivalence test, and subsampling approach. The original model of APQ-lg (five factors) showed a significantly better fit than other concurrent models (five concurrent models were specified, based on prior literature). For APQ-lg, we found measurement invariance across gender and partial measurement invariance across age, clinical status, and informant. For APQ-9, we confirmed the measurement invariance across gender and clinical status, while across age and informant partial measurement invariance was attested. Overall, our study indicated that APQ-lg and APQ-9 are two valid tools for measuring parenting practices with some caveats.

The effectiveness of a single session of mindfulness-based cognitive training on cardiac vagal control and core symptoms in children and adolescents with attention-deficit/hyperactivity disorder (ADHD): a preliminary randomized controlled trial.

This study examined the effectiveness of a mindfulness-based intervention (MBI) on Conners' continuous performance test scores (CPTs), cardiac vagal control (CVC) assessed by vagally mediated heart rate variability (HRV), and mood in children and adolescents with ADHD. We conducted a randomized controlled trial (RCT) recruiting 70 children and adolescents (M age 11.03, SD 2.78) with a clinical diagnosis of ADHD, which were allocated to either 1 session of mindfulness cognitive training, or an active control condition and were examined at baseline, post-treatment and 4-week follow-up. See clinicaltrials.gov: NCT04316832. There was a significant main effect of time on the primary outcomes measured by CPT scores of attention-related problems (omission errors, reaction time) and hyperactivity-impulsivity (commission errors). However, time-by-group interaction did not achieve statistical significance for commission errors and hit RT, indicating that the changes over time in these outcomes were not significantly different between the MBI and Control conditions. In addition, there was a significant time-by-group interaction for omission errors. Relative to control, MBI resulted in a small (d = 0.011) non-statistically significant reduction in omission errors post-treatment. Furthermore, there were no significant differences in detectability. Secondary outcomes were CVC and mood. A small treatment effect on CVC (d = 0.37) was observed; there was a slight increase in vagally mediated HRV measure post-treatment. There were no significant differences in mood improvement over time between conditions. One brief session of MBI effectively enhances CVC but does not significantly improve CPT scores of attention-related problems and hyperactivity-impulsivity or mood in children with ADHD.Clinicaltrials.gov: NCT04316832.

A brief history of Romanian psychology.

The evolution of Romanian psychology followed several stages, similarly to other countries in Eastern Europe, yet with its own particularities. The first psychology institutes were introduced by former students of Wilhelm Wundt, and the field saw a rapid development, with distinguished scholars making relevant scientific contributions. However, after the communist regime was enforced, psychology stagnated somewhat due to ideological, financial, and political reasons, and, in 1977, it was even removed from academia. After 1989, psychology revived in academia and research, and as a profession as well. This article summarizes the evolution of Romanian psychology through these stages, focusing on its postcommunist revival.

Parental stress and child mental health: a network analysis of Romanian parents.

Parental stress is related to child mental health problems, with numerous evidence indicating that it is an important predictor of parenting and parent-child relationship. New approaches to psychopathology could be particularly informative for clinical research, however, there is limited research that employs network analysis with parents. Network analysis could contribute to a better understanding of the relationship between child mental health problems and parental stress by highlighting the most central nodes and how the two constructs influence each other. The scope of the study was to identify potential new intervention targets to reduce the mental health problems of children and prevent contagion between parent stress and child psychopathology. Furthermore, we also sought to test whether the dynamic between parental stress and child psychopathology differs across the level of parent stress and child total difficulties. In this endeavor, we had three main directions. First, we estimated a network at the level of child mental health problems and identified the most central nodes. Second, we mapped the main paths through which parent stress and child mental health problems communicate with each other. Third, we investigated the network invariance across the level of parent stress (high vs moderate) and child mental health problems (low vs. high total difficulties). Participants (N = 1014) were parents of children with ages between four and 17 years old. The analyses were conducted in RStudio. Results indicated that perceived coping was a central node, bridging the two constructs. The global strength of the network was higher for parents who reported high levels of stress compared to those who reported only moderate levels of stress. In contrast, we found that the global strength of the network was lower for children with high levels of total difficulties compared to those with low levels of total difficulties. In conclusion, we argue the importance of focusing on the targeting nodes with high bridge centrality, such as perceived coping, for designing prevention and intervention programs. Future research should use temporal dynamics between parental stress and child mental health problems and explore mechanisms between the two constructs. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-022-03520-1.

Effects of individual differences, society, and culture on youth-rated problems and strengths in 38 societies.

BACKGROUND: Clinicians increasingly serve youths from societal/cultural backgrounds different from their own. This raises questions about how to interpret what such youths report. Rescorla et al. (2019, European Child & Adolescent Psychiatry, 28, 1107) found that much more variance in 72,493 parents' ratings of their offspring's mental health problems was accounted for by individual differences than by societal or cultural differences. Although parents' reports are essential for clinical assessment of their offspring, they reflect parents' perceptions of the offspring. Consequently, clinical assessment also requires self-reports from the offspring themselves. To test effects of individual differences, society, and culture on youths' self-ratings of their problems and strengths, we analyzed Youth Self-Report (YSR) scores for 39,849 11-17 year olds in 38 societies. METHODS: Indigenous researchers obtained YSR self-ratings from population samples of youths in 38 societies representing 10 culture cluster identified in the Global Leadership and Organizational Behavioral Effectiveness study. Hierarchical linear modeling of scores on 17 problem scales and one strengths scale estimated the percent of variance accounted for by individual differences (including measurement error), society, and culture cluster. ANOVAs tested age and gender effects. RESULTS: Averaged across the 17 problem scales, individual differences accounted for 92.5% of variance, societal differences 6.0%, and cultural differences 1.5%. For strengths, individual differences accounted for 83.4% of variance, societal differences 10.1%, and cultural differences 6.5%. Age and gender had very small effects. CONCLUSIONS: Like parents' ratings, youths' self-ratings of problems were affected much more by individual differences than societal/cultural differences. Most variance in self-rated strengths also reflected individual differences, but societal/cultural effects were larger than for problems, suggesting greater influence of social desirability. The clinical significance of individual differences in youths' self-reports should thus not be minimized by societal/cultural differences, which-while important-can be taken into account with appropriate norms, as can gender and age differences.

Early adolescents' perceptions of parenting practices and mental health problems: A network approach.

This study aims to identify possible primary targets for the parenting programs designed to reduce (or prevent) the mental health problems of adolescents. We used network analysis to estimate networks for parenting practices and for the interplay between parenting practices and adolescents' mental health problems. A community sample of early adolescents (10-13 years old, N = 1,125) reported both parenting (Alabama Parenting Questionnaire, Child Global Report) and mental health outcomes (Youth Self-Report). The behavior "You stay out later than you are supposed to and your parents don't know it" was the most central in the parenting practices network. Poor monitoring and conduct problems were the main paths through which parenting practices and youths' mental health influenced each other. Regarding the interplay between parenting practices and adolescent mental health, the network for males had a significantly higher connectivity (p = .035) than that for females. Although in the early stages, the network approach promises to provide a better understanding of parenting practices and their interaction with the mental health problems of adolescents. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Older adult psychopathology: international comparisons of self-reports, collateral reports, and cross-informant agreement.

OBJECTIVES: To conduct international comparisons of self-reports, collateral reports, and cross-informant agreement regarding older adult psychopathology. PARTICIPANTS: We compared self-ratings of problems (e.g. I cry a lot) and personal strengths (e.g. I like to help others) for 10,686 adults aged 60-102 years from 19 societies and collateral ratings for 7,065 of these adults from 12 societies. MEASUREMENTS: Data were obtained via the Older Adult Self-Report (OASR) and the Older Adult Behavior Checklist (OABCL; Achenbach et al., ). RESULTS: Cronbach's alphas were .76 (OASR) and .80 (OABCL) averaged across societies. Across societies, 27 of the 30 problem items with the highest mean ratings and 28 of the 30 items with the lowest mean ratings were the same on the OASR and the OABCL. Q correlations between the means of the 0-1-2 ratings for the 113 problem items averaged across all pairs of societies yielded means of .77 (OASR) and .78 (OABCL). For the OASR and OABCL, respectively, analyses of variance (ANOVAs) yielded effect sizes (ESs) for society of 15% and 18% for Total Problems and 42% and 31% for Personal Strengths, respectively. For 5,584 cross-informant dyads in 12 societies, cross-informant correlations averaged across societies were .68 for Total Problems and .58 for Personal Strengths. Mixed-model ANOVAs yielded large effects for society on both Total Problems (ES = 17%) and Personal Strengths (ES = 36%). CONCLUSIONS: The OASR and OABCL are efficient, low-cost, easily administered mental health assessments that can be used internationally to screen for many problems and strengths.

The Adolescent Peer Relations Instrument- Bully/Target: Measurement Invariance Across Gender, Age, and Clinical Status.

Adolescent Peer Relations Instrument-Bully/Target (APRI-BT) is a multidimensional scale designed to assess bullying involvement both as target and perpetrator. Although existing research has shown that the APRI-BT satisfies the assumption of measurement invariance across age and gender, these findings come from western individualistic countries (e.g., Australia). This study aimed to investigate the factorial structure and measurement invariance across age, gender, and clinical status in a sample of Romanian youths. Participants were 1,024 adolescents, 10 to 18 years, recruited from both community and clinical setting. Our results confirmed a six first-order factor structure and two second-order factors (Bully including Bullying Physical, Bullying Verbal, Bullying Social and Victimization including Physical Victimization, Verbal Victimization, Social Victimization). In addition, measurement invariance across age, gender, and clinical status was demonstrated. This study identifies APRI-BT as an instrument with solid psychometric proprieties for measuring bullying and victimization among preadolescents and adolescents.

From Victims to Perpetrators of Bullying: The Role of Irrational Cognitions, Externalizing Problems, and Parental Attachment.

The transition from bullying victimization to bullying perpetration is well documented in the literature. However, the mechanisms linking bullying victimization to perpetration are not fully understood. The main aim of the current study was to conduct a preliminary research investigating the indirect effects of youths bullying victimization on bullying perpetration through irrational cognitions and externalizing problems. The second aim of the study was to explore the moderating role of the type of parental attachment (secure vs. insecure) in the proposed model in explaining the association of bullying victimization and bullying perpetration. Data were collected from 269 adolescents (11-15 years; M = 11.98, SD = .68), enrolled in middle public schools from Romania. Path analysis and moderated path analysis were conducted to explore the direct and indirect effects and moderating effects, respectively. Study findings indicate that bullying victimization was indirectly related to bullying perpetration separately through youths' irrational cognition as well as through externalizing problems. The serial indirect pathway from victimization to perpetration through irrational cognitions leading further to externalizing problems was also significant. However, the type of attachment that adolescents reported having toward their parents failed to moderate the indirect pathways, since all the interaction terms were nonsignificant. These findings advance the field prevention and intervention by identifying irrational cognitions and externalizing problems as important targets that anti-bullying programs should address to stop the transition from victims of bullying to perpetrators.

Feasibility and clinical utility of a transdiagnostic Internet-delivered rational emotive and behavioral intervention for adolescents with anxiety and depressive disorders.

BACKGROUND: Transdiagnostic interventions delivered for children and adolescents show promising results. In order to increase access to treatment, recent developments in technology have led to alternatives to face-to-face interventions. Transdiagnostic Internet-delivered interventions can be effective for adult anxiety and depressive disorders, but research is more limited regarding the efficacy of such treatments for young populations diagnosed with anxiety and or depressive disorders. OBJECTIVE: This study aims to investigate the feasibility and clinical utility of a transdiagnostic Internet-delivered intervention based on Rational emotive behavior therapy for adolescents diagnosed with anxiety and depressive disorders. METHODS: We tested the preliminary efficacy of a six-week intervention in an open trial, pre-post design. RESULTS: Our results suggest that the intervention is feasible and can be included as a treatment for adolescents with anxiety and depressive disorders, being associated with moderate to large pre-post effect sizes on self-reported anxiety and depressive symptoms, as well as on negative patterns of thinking and knowledge acquisition. Satisfaction with the intervention was high. CONCLUSIONS: Transdiagnostic Internet-delivered interventions for adolescents with anxiety and depressive symptoms are feasible. Future testing of the efficacy of such interventions in randomized controlled trials should be conducted.

Thyroseq v3, Afirma GSC, and microRNA Panels Versus Previous Molecular Tests in the Preoperative Diagnosis of Indeterminate Thyroid Nodules: A Systematic Review and Meta-Analysis.

Background: Molecular tests are being used increasingly as an auxiliary diagnostic tool so as to avoid a diagnostic surgery approach for cytologically indeterminate thyroid nodules (ITNs). Previous test versions, Thyroseq v2 and Afirma Gene Expression Classifier (GEC), have proven shortcomings in malignancy detection performance. Objective: This study aimed to evaluate the diagnostic performance of the established Thyroseq v3, Afirma Gene Sequencing Classifier (GSC), and microRNA-based assays versus prior iterations in ITNs, in light of "rule-in" and "rule-out" concepts. It further analyzed the impact of noninvasive follicular thyroid neoplasm with papillary-like nuclear features (NIFTP) reclassification and Bethesda cytological subtypes on the performance of molecular tests. Methods: Pubmed, Scopus, and Web of Science were the databases used for the present research, a process that lasted until September 2020. A random-effects bivariate model was used to estimate the summary sensitivity, specificity, positive (PLR) and negative likelihood ratios (NLR), and area under the curve (AUC) for each panel. The conducted sensitivity analyses addressed different Bethesda categories and NIFTP thresholds. Results: A total of 40 eligible studies were included with 7,831 ITNs from 7,565 patients. Thyroseq v3 showed the best overall performance (AUC 0.95; 95% confidence interval: 0.93-0.97), followed by Afirma GSC (AUC 0.90; 0.87-0.92) and Thyroseq v2 (AUC 0.88; 0.85-0.90). In terms of "rule-out" abilities Thyroseq v3 (NLR 0.02; 95%CI: 0.0-2.69) surpassed Afirma GEC (NLR 0.18; 95%CI: 0.10-0.33). Thyroseq v2 (PLR 3.5; 95%CI: 2.2-5.5) and Thyroseq v3 (PLR 2.8; 95%CI: 1.2-6.3) achieved superior "rule-in" properties compared to Afirma GSC (PLR 1.9; 95%CI: 1.3-2.8). Evidence for Thyroseq v3 seems to have higher quality, notwithstanding the paucity of studies. Both Afirma GEC and Thyroseq v2 performance have been affected by NIFTP reclassification. ThyGenNEXT/ThyraMIR and RosettaGX show prominent preliminary results. Conclusion: The newly emerged tests, Thyroseq v3 and Afirma GSC, designed for a "rule-in" purpose, have been proved to outperform in abilities to rule out malignancy, thus surpassing previous tests no longer available, Thyroseq 2 and Afirma GEC. However, Thyroseq v2 still ranks as the best rule-in molecular test. Systematic Review Registration: http://www.crd.york.ac.uk/PROSPERO, identifier CRD42020212531.

Exploring autonomic regulation in children with ADHD with and without comorbid anxiety disorder through three systematic levels of cardiac vagal control analysis: Rest, reactivity, and recovery.

Autonomic nervous system (ANS) dysregulation, characterized by reduced vagally mediated Heart Rate Variability (HRV), has been associated with Attention-Deficit/ Hyperactivity Disorder (ADHD). This study investigated the dynamic vagal modulation of cardiac output in response to shifts in environmental demands in children and adolescents with ADHD, with and without a comorbid anxiety disorder. High-frequency HRV (HF-HRV) measures were obtained from 46 children and adolescents ranging from 6 to 17 (M = 9.38; SD = 2.31) years old, during three successive experimental conditions: a baseline recording followed by a sustained attention task, and a post-task recovery period. Findings support the reliability of the d2 Test, a cancelation test of attention and concentration, to induce parasympathetic withdrawal and extend prior work on "vagal flexibility". Further, these findings suggest a pattern of group differences in ANS functioning in children with ADHD, with and without a comorbid anxiety disorder. Only the ADHD without comorbid anxiety group showed a normative autonomic response to the cognitive challenge (reduced HF-HRV). The participants did not display an adaptive process of restoration following the cognitive challenge; the HRV suppression was prolonged during post-task recovery period, suggesting that ANS responded as if the cognitive stressor was still present. The current paper covers and discusses theoretical implications for the abnormalities in neurophysiological functioning and the different physiological responses in the two ADHD subtypes.