Effectiveness and moderators of individual cognitive behavioral therapy versus treatment as usual in clinically depressed adolescents:A randomized controlled trial

We examined if manualized cognitive behavioral therapy (CBT) was more effective than Treatment As Usual (TAU) for clinically depressed adolescents within routine care. This multisite Randomized controlled trail included 88 clinically depressed adolescents (aged 12-21 years) randomly assigned to CBT or TAU. Multiple assessments (pre-, post treatment and six-month follow-up) were done using semi-structured interviews, questionnaires and ratings and multiple informants. The primary outcome was depressive or dysthymic disorder based on the KSADS. Completers, CBT (n = 19) and TAU (n = 26), showed a significant reduction of affective diagnoses at post treatment (76% versus 76%) and after six months (90% versus 79%). Intention-to-treat analyses on depressive symptoms showed that 41.6% within CBT and 31.8% within the TAU condition was below clinical cut-off at post treatment and after six-months, respectively 61.4% and 47.7%. No significant differences in self-reported depressive symptoms between CBT and TAU were found. No prediction or moderation effects were found for age, gender, child/parent educational level, suicidal criteria, comorbidity, and severity of depression. We conclude that CBT did not outperform TAU in clinical practice in the Netherlands. Both treatments were found to be suitable to treat clinically referred depressed adolescents. CBT needs further improvement to decrease symptom levels below the clinical cut-off at post treatment

Disequilibrium in development finance: the contested politics of institutional accountability and transparency at the World Bank inspection panel

This article examines the dynamic nature with which independent accountability mechanisms operate. Focusing on the World Bank, the authors argue that its Inspection Panel evolves according to internal and external pressures. In seeking to achieve equilibrium, and protect its authority and independence, the Panel has gone through several distinct phases: negotiation, emergence, protracted resistance, assertion of independence and authority, renewed tension, and contestation. The core novelty of the article is its application of concepts from outside the field of development studies — notably institutional accountability from the governance literature, and judicialization from the legal studies literature — to the topic of the Inspection Panel. Examining the Panel in this way demonstrates that accountability mechanisms represent a hybrid of transnational governance influenced by a range of actors including project-affected peoples, national governments, managers and development donors. Accountability in development finance is about competing interests as well as competing conceptions and expectations of accountability. In such a complex and multi-scalar system, the Panel is not only concerned with delivering well-researched investigation reports; it is also an entity seeking to ensure its own survival, as well as an arbiter of its own brand of legitimacy and accountability. © 2018 The Authors. Development and Change published by John Wiley & Sons Ltd on behalf of Institute of Social Studie

The effects of methylphenidate on striatal dopamine system are dependent on age: a pharmacological magnetic resonance imaging study

Neuro Imaging Researc

Improving methylphenidate titration in children with attention-deficit/hyperactivity disorder (ADHD): a randomized controlled trial using placebo-controlled titration implemented in clinical practice

Education and Child Studie

Effects of methylphenidate during emotional processing in amphetamine users: preliminary findings

D-amphetamine (dAMPH) and methylphenidate (MPH) are stimulants used in the treatment of Attention Deficit Hyperactivity Disorder (ADHD). Preclinical studies have shown that in healthy animals, dAMPH induces dopamine (DA) dysfunction, as evidenced for instance by loss of DA levels and its transporters. It has also been suggested that DA plays an important role in emotional processing, and that altered DA-ergic intervention may modulate amygdala function. To explore the role of the DA system in emotional processing we examined emotional processing using functional magnetic resonance imaging (fMRI) in eight male recreational users of dAMPH and eight male healthy controls. We compared brain activation between both groups during an emotional face-processing task with and without an oral MPH challenge. All subjects were abstinent for at least 2 weeks during the baseline scan. The second scan was performed on the same day 1A1/2 hours after receiving an oral dose of 35 mg MPH. A significant Valence*Group interaction (p = .037) indicated amygdala hyperreactivity to fearful facial expressions in dAMPH users that wasrobust against adjustment for age (p = .015). Furthermore, duration of amphetamine use in years was positively correlated with amygdala reactivity in dAMPH users (r = .76; p = .029). These exploratory findings are in line with previous findings suggesting that DA plays a role in emotional processing

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