Editorial: Standardizing methods and measures in randomized controlled trials: a necessary catalyst for clinical translation
Joan L. Luby
Abstract
The pressing need for more randomized controlled trials (RCTs) of treatments for childhood mental disorders has been emphasized by researchers and clinicians as well as in recent commentaries in JCPP (e.g. Stringaris, 2014). Despite the significant increase in research on aetiology, course and antecedents of developmental psychopathology more generally, and the numerous important discoveries that have been made in this domain in the last two decades, the translation of these findings into clinical practice has lagged behind (Insel and Gotay, 2014). Currently, based on limitations in the extant literature, treatment decisions by child mental health clinicians are still made largely based on personal anecdotal experience. Consistent with this, wide variation in prescribing practices have been found by region internationally (Steinhausen, 2015). When it comes to psychotherapeutic interventions, these clinical strategies are often driven by the limited availability of empirically supported treatments in any given community. In the case of psychopharmacologic treatments, while some clinical guidelines are now available, much more definitive data are needed to inform indications, optimal dosing and duration of treatment, uses of polypharmacy, as well as more nuanced information about differential developmental effects. Therefore, a significant gap still exists between clinical practice and the empirical database in the treatment of child mental disorders. Further, the available database is also limited by small sample sizes and mixed findings, making it much less straightforward to coherently guide clinical treatment of childhood psychopathology.
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Professor Luby’s research interests include: studies of early onset depression, validators, clinical characteristics, biological markers and alterations in brain structure and function related to early onset depression; psychotherapeutic treatments for early onset depression focusing on emotion development; studies of early experience and brain development; effects of poverty on brain development; investigation of the mechanisms of adversity and nurturance on neurodevelopment; and sensitive periods in emotion development.
