Notice of Retraction and Replacement. Pornpattananangkul et al. Association between childhood anhedonia and alterations in large-scale resting-state networks and task-evoked activation. JAMA Psychiatry. 2019;76(6):624-633

Abstract

In Reply We welcome the interest in our Original Investigation 1 expressed by ElSayed and Gupta. Regarding the question posed in their title, the answer is yes, the results from our clinical trial show that degarelix holds potential to be a tolerable treatment with significant short-term risk-reduction effects in help-seeking patients with pedophilic disorder, including high-risk patients. The following is an item-by-item response to the other issues raised. (1) We disagree with the assertion that our article equated sexual desire and pedophilic attraction with sexually abusive behavior, and we concur that these are separate issues. (2) The duration of the testosterone suppression in our study is consistent with the existing literature, including the article 2 cited by ElSayed and Gupta. (3) At every visit, the participants reported on their compliance with current medications and on the possible use of anything else outside prescription. We believe the crossing from baseline medications to other medications, reported at baseline in Table 1 of our article 1 (placebo group, n = 3 switch from sertraline to citalopram, initiation of mirtazapine, initiation of risperidone; degarelix group, n = 1 switch from vortioxetine to sertraline) unlikely affected the validity of the results. No patient reported any use of other antiandrogen medications, and we could monitor signs of testosterone supplementation via blood tests. (4) We believe it would be incorrect to claim that the study participants in the degarelix group reported high risk for committing child sexual abuse at the end of the study, as evinced in Table 3 of our article. 1 The fact that the difference is not statistically significant is most likely related to floor effect. (5) ElSayed and Gupta raise an important ethical issue, which is whether evidence-based interventions should be preferred to interventions that seem good but are unsupported by scientific documentation. We believe that interventions should be scientifically scrutinized, and we encourage patients with pedophilic disorder to specifically ask for such interventions. When these are unavailable, most optimally, patients should be offered the possibility to be enrolled in randomized clinical trials to evaluate interventions suggested by their physician. That does not exclude the possibility to combine or replace the supported intervention with other interventions, such as psychotherapy, provided that the patient and physician agree. This is an ethical question that entails pondering potential benefits and risks of the available therapeutic options. (6) The focus of this trial was efficacy of treatment with rapid onset. We agree that a longer trial would have provided useful additional information. However, evaluating the short-term effects is essential to help physicians intervene in the acute phase of the disorder and prevent a chronic course of the disorder. Finally, we want to emphasize that the research on treatment of pedophilic disorder should take a step forward toward embracing the modern pa...

Associations between resting state functional brain connectivity and childhood anhedonia: A reproduction and replication study

“…Like the previous authors, we identified 215 individuals who endorsed past and/or present anhedonia and 2,222 controls who reported neither past nor present anhedonia at the baseline timepoint, indicating the samples were exactly the same. In line with the previous authors’ findings, we reproduced significant differences in 11 rsfMRI connectivity measures between those with and without anhedonia indicated by the lnBF statistic, though the effect sizes were small ( Table 2 , left) [ 15 ]. To be consistent with the previous authors, individuals with anhedonia were the reference group for all t-test analyses.…”

“…However, findings from these studies generally converge on the significance of disruptions in the reward, default mode, and salience networks [ 12 – 14 ]. A recent study using the early 1.0 release of the Adolescent Brain Cognitive Development (ABCD)® study data found several rsfMRI brain network connectivity measures associated with anhedonia in children aged 9–10 years old [ 15 ]. Importantly, it was one of the largest studies of anhedonia in children with a sample size of ~2,500 participants including 215 children reporting past and/or present anhedonia.…”

Associations Between Resting State Functional Brain Connectivity and Childhood Anhedonia: A Reproduction and Replication Study

“…Note that although the two groups appear to exhibit differences in a few of these characteristics, they were not controlled for statistically when we performed in our t-tests in order to remain consistent with the previous authors' approach. We were able to successfully reproduce their findings (13). To assess how well we reproduced the previous authors' results, we calculated Pearson correlations of the tstatistics and lnBF values between our values and those reported by the previous authors when comparing individuals with or without anhedonia (Fig.…”

“…We were able to successfully reproduce their findings (13). To assess how well we reproduced the previous authors’ results, we calculated Pearson correlations of the t-statistics and lnBF values between our values and those reported by the previous authors when comparing individuals with or without anhedonia (Fig.…”

“…However, findings from these studies generally converge on the significance of disruptions in the reward, default mode, and salience networks (10–12). A recent study using the early 1.0 release of the Adolescent Brain Cognitive Development (ABCD) study data found several resting state functional MRI (rsfMRI) brain network connectivity measures associated with anhedonia in children aged 9-10 years old (13). Importantly, it was one of the largest studies of anhedonia in children with a sample size of ∼2,500 participants including 215 children reporting past and/or present anhedonia.…”