A tale of two cultures Goertz, Gary; Mahoney, James
2012., 20120909, 2012, 2012-09-09, 20120101
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Some in the social sciences argue that the same logic applies to both qualitative and quantitative methods. InA Tale of Two Cultures, Gary Goertz and James Mahoney demonstrate that these two ...paradigms constitute different cultures, each internally coherent yet marked by contrasting norms, practices, and toolkits. They identify and discuss major differences between these two traditions that touch nearly every aspect of social science research, including design, goals, causal effects and models, concepts and measurement, data analysis, and case selection. Although focused on the differences between qualitative and quantitative research, Goertz and Mahoney also seek to promote toleration, exchange, and learning by enabling scholars to think beyond their own culture and see an alternative scientific worldview. This book is written in an easily accessible style and features a host of real-world examples to illustrate methodological points.
This book contributes to emerging debates in political science and sociology on institutional change. Its introductory essay proposes a new framework for analyzing incremental change that is grounded ...in a power-distributional view of institutions and that emphasizes ongoing struggles within but also over prevailing institutional arrangements. Five empirical essays then bring the general theory to life by evaluating its causal propositions in the context of sustained analyses of specific instances of incremental change. These essays range widely across substantive topics and across times and places, including cases from the United States, Africa, Latin America, and Asia. The book closes with a chapter reflecting on the possibilities for productive exchange in the analysis of change among scholars associated with different theoretical approaches to institutions.
This article discusses developments in the field of qualitative methodology since the publication of King, Keohane, and Verba's (KKV's) Designing Social Inquiry. Three areas of the new methodology ...are examined: (1) process tracing and causal-process observations; (2) methods using set theory and logic; and (3) strategies for combining qualitative and quantitative research. In each of these areas, the article argues, the new literature encompasses KKV's helpful insights while avoiding their most obvious missteps. Discussion focuses especially on contrasts between the kind of observations that are used in qualitative versus quantitative research, differences between regression-oriented approaches and those based on set theory and logic, and new approaches for bringing out complementarities between qualitative and quantitative research. The article concludes by discussing research frontiers in the field of qualitative methodology.
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In this comparative-historical analysis of Spanish America, Mahoney offers a new theory of colonialism and postcolonial development. He explores why certain kinds of societies are subject to certain ...kinds of colonialism and why these forms of colonialism give rise to countries with differing levels of economic prosperity and social well-being. Mahoney contends that differences in the extent of colonialism are best explained by the potentially evolving fit between the institutions of the colonizing nation and those of the colonized society. Moreover, he shows how institutions forged under colonialism bring countries to relative levels of development that may prove remarkably enduring in the postcolonial period. The argument is sure to stir discussion and debate, both among experts on Spanish America who believe that development is not tightly bound by the colonial past, and among scholars of colonialism who suggest that the institutional identity of the colonizing nation is of little consequence.
It is well-documented in the literature that individuals repeatedly exposed to cocaine exhibit cognitive impairment and that cognitive dysfunction is a risk factor for poor treatment outcomes in ...those with cocaine use disorder (CUD). Specific deficits related to attention, episodic memory, working memory, and executive functioning are the most common deficits noted in this population. Given that cognitive impairment is a risk factor for poor treatment outcomes in those with CUD, identifying possible moderating factors contributing to and/or exacerbating cocaine-related cognitive deficits is of great importance. Some of these factors may include premorbid intellectual functioning, cocaine use patterns, polysubstance use, comorbid emotional symptoms, and sleep dysfunction. It is plausible that by identifying moderating factors impacting cognition, behavioral interventions can then be modified accordingly and/or treatment regimens can be augmented with pharmacological interventions (e.g., cognitive enhancing agents), leading to a reduction in treatment attrition and improved treatment outcomes. The currently available treatments for CUD are mainly behavioral with variable efficacy, and even though there have been great preclinical and clinical research efforts focused on medication development for CUD, there are currently no Food and Drug Administration-approved medications for CUD. A description of some of the several potential moderating factors, along with some pharmacological treatments which have been shown to ameliorate, at least to some extent, cognitive dysfunction in those with CUD are discussed.
Public Health Significance
Individuals repeatedly exposed to cocaine exhibit cognitive impairment and cognitive dysfunction is a risk factor for poor treatment outcomes. Identifying potential moderating factors contributing to and/or exacerbating cognitive deficits in cocaine users is of importance given the relationship between cognition and treatment outcomes. By accounting for possible moderating factors early in treatment and modifying and/or augmenting treatment plans accordingly, treatment outcomes may subsequently be improved.
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Given the high prevalence of individuals diagnosed with substance use disorder, along with the elevated rate of relapse following treatment initiation, investigating novel approaches and new ...modalities for substance use disorder treatment is of vital importance. One such approach involves neuromodulation which has been used therapeutically for neurological and psychiatric disorders and has demonstrated positive preliminary findings for the treatment of substance use disorder. The following article provides a review of several forms of neuromodulation which warrant consideration as potential treatments for substance use disorder. PubMed, PsycINFO, Ovid MEDLINE, and Web of Science were used to identify published articles and clinicaltrials.gov was used to identify currently ongoing or planned studies. Search criteria for Brain Stimulation included the following terminology: transcranial direct current stimulation, transcranial magnetic stimulation, theta burst stimulation, deep brain stimulation, vagus nerve stimulation, trigeminal nerve stimulation, percutaneous nerve field stimulation, auricular nerve stimulation, and low intensity focused ultrasound. Search criteria for Addiction included the following terminology: addiction, substance use disorder, substance-related disorder, cocaine, methamphetamine, amphetamine, alcohol, nicotine, tobacco, smoking, marijuana, cannabis, heroin, opiates, opioids, and hallucinogens. Results revealed that there are currently several forms of neuromodulation, both invasive and non-invasive, which are being investigated for the treatment of substance use disorder. Preliminary findings have demonstrated the potential of these various neuromodulation techniques in improving substance treatment outcomes by reducing those risk factors (e.g. substance craving) associated with relapse. Specifically, transcranial magnetic stimulation has shown the most promise with several well-designed studies supporting the potential for reducing substance craving. Deep brain stimulation has also shown promise, though lacks well-controlled clinical trials to support its efficacy. Transcranial direct current stimulation has also demonstrated promising results though consistently designed, randomized trials are also needed. There are several other forms of neuromodulation which have not yet been investigated clinically but warrant further investigation given their mechanisms and potential efficacy based on findings from other studied indications. In summary, given promising findings in reducing substance use and craving, neuromodulation may provide a non-pharmacological option as a potential treatment and/or treatment augmentation for substance use disorder. Further research investigating neuromodulation, both alone and in combination with already established substance use disorder treatment (e.g. medication treatment), warrants consideration.
•Several forms of neuromodulation are being investigated for SUD treatment.•Neuromodulation shows promise in reducing SUD risk factors for relapse (e.g. substance craving).•Further research investigating neuromodulation warrants consideration for SUD treatment.
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Psychiatric disorders are among the leading contributors to global disease burden and disability. A significant portion of patients with psychiatric disorders remain treatment-refractory to best ...available therapy. With insights from the neurocircuitry of psychiatric disorders and extensive experience of neuromodulation with deep brain stimulation (DBS) in movement disorders, DBS is increasingly being considered to modulate the neural network in psychiatric disorders. Currently, obsessive-compulsive disorder (OCD) is the only U.S. FDA (United States Food and Drug Administration) approved DBS indication for psychiatric disorders. Medically refractory depression, addiction, and other psychiatric disorders are being explored for DBS neuromodulation. Studies evaluating DBS for psychiatric disorders are promising but lack larger, controlled studies. This paper presents a brief review and the current state of DBS and other neurosurgical neuromodulation therapies for OCD and other psychiatric disorders. We also present a brief review of MR-guided Focused Ultrasound (MRgFUS), a novel form of neurosurgical neuromodulation, which can target deep subcortical structures similar to DBS, but in a noninvasive fashion. Early experiences of neurosurgical neuromodulation therapies, including MRgFUS neuromodulation are encouraging in psychiatric disorders; however, they remain investigational. Currently, DBS and VNS are the only FDA approved neurosurgical neuromodulation options in properly selected cases of OCD and depression, respectively.
In 2021, while overdose (OD) deaths were at the highest in recorded history, it is estimated that >80% of ODs do not result in a fatality. While several case studies have indicated that ...opioid-related ODs can result in cognitive impairment, the possible association has not yet been systematically investigated.
78 participants with a history of OUD who reported experiencing an OD in the past year (n=35) or denied a lifetime history of OD (n=43) completed this study. Participants completed cognitive assessments including the Test of Premorbid Functioning (TOPF) and the NIH Toolbox Cognition Battery (NIHTB-CB). Comparisons were made between those who experienced an opioid-related OD in the past year versus those who denied a lifetime OD history while controlling for factors including age, premorbid functioning, and number of prior ODs.
When comparing those who experienced an opioid-related OD within the past year to those without a history of OD, uncorrected standard scores were generally comparable; however, differences emerged in the multivariable model. Specifically, compared to those without a history of OD, those who experienced a past year OD evidenced significantly lower total cognition composite scores (coef. = −7.112; P=0.004), lower crystalized cognition composite scores (coef. = −4.194; P=0.009), and lower fluid cognition composite scores (coef. = −7.879; P=0.031).
Findings revealed that opioid-related ODs may be associated with, or contribute to, reduced cognition. Extent of the impairment appears contingent upon individuals’ premorbid intellectual functioning and the cumulative number of past ODs. While statistically significant, clinical significance may be limited given that performance differences (∼4 – 8 points) were not particularly robust. More rigorous investigation is warranted, and future studies must also account for the many other variables possibly contributing to cognitive impairment.
•Opioid-related ODs may be associated with, or contribute to, reduced cognition.•Extent of cognitive impairment appears to be contingent upon factors other than OD.•Premorbid cognitive functioning and cumulative number of ODs may impact extent of impairment.•Future studies must account for other possible variables contributing to cognitive impairment.
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•Brain injuries and cognitive deficits have been reported after opioid overdose (OD).•Opioid OD causes respiratory depression and potentially cerebral hypoxia.•Studies over 50 years, across 21 ...countries, reported OD-related brain injuries.•Prevalence and consequences of OD-related brain injuries is unknown.•Rigorous methodological within-subject studies are needed to establish causality.
Non-fatal opioid-related overdoses have increased significantly over the past two decades and there have been increasing reports of brain injuries and/or neurocognitive impairments following overdose events. Limited preclinical research suggests that opioid overdoses may cause brain injury; however, little is known about such injuries in humans. The purpose this systematic review is to summarize existing studies on neurocognitive impairments and/or brain abnormalities associated with an opioid-related overdose in humans.
PubMed, Web of Science, Ovid MEDLINE and PsyINFO were searched, without year restrictions, and identified 3099 articles. An additional 24 articles were identified by reviewing references. Articles were included if they were published in English, reported study findings in humans, included individuals 18 years of age or older, and reported an objective measure of neurocognitive impairments and/or brain abnormalities resulting from an opioid-related overdose. Six domains of bias (selection, performance, attrition, detection (two dimensions) and reporting were evaluated and themes were summarized.
Seventy-nine journal articles, published between 1973–2020, were included in the review. More than half of the articles were case reports (n = 44) and there were 11 cohort studies, 18 case series, and 6 case-control studies. All of the studies were categorized as at-risk of bias, few controlled for confounding factors, and methodological differences made direct comparisons difficult. Less than half of the studies reported toxicology results confirming an opioid-related overdose; 64.6 % reported brain MRI results and 27.8 % reported results of neuropsychological testing. Only two studies had within subject comparative data to document changes in the brain possibly associated with an overdose. Despite these limitations, existing publications suggest that brain injuries and neurocognitive impairments are associated with opioid overdose. Additional research is needed to establish the incidence of overdose-related brain injuries and the potential impact on functioning, as well as engagement in treatment of substance use disorders.
Respiratory depression is a defining characteristic of opioid overdose and prolonged cerebral hypoxia may cause brain injuries and/or neurocognitive impairments. The onset, characteristics, and duration of such injuries is variable and additional research is needed to understand their clinical implications.
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While pharmacological and/or behavioral treatments are effective in managing symptoms for many patients with psychiatric diagnoses and disorders with behavioral/cognitive manifestations, a subset of ...individuals are treatment-refractory, unable to achieve appreciable benefit or symptom relief from traditional methods. In recent years, neuromodulation has gained momentum as an adjunctive treatment for improving outcomes in patients who are treatment-refractory. One form of neuromodulation, deep brain stimulation (DBS), has been investigated for the treatment of various psychiatric disorders and behavioral/cognitive symptoms. The following article provides a review of DBS investigations for several psychiatric and behavioral-related disorders, including depression, obsessive-compulsive disorder, substance use disorder, Alzheimer's disease, anorexia, obesity, schizophrenia, and posttraumatic stress disorder. PubMed, PsycINFO, Scopus, Ovid MEDLINE, and Web of Science were used to identify published articles, and Clinicaltrials.gov was used to identify currently ongoing or planned studies. Findings revealed the potential utility of DBS in improving outcomes for various psychiatric and behavioral/cognitive-related disorders. While promising, there are several limitations present in the available literature, and further well-designed clinical trials are necessary before conclusive decisions regarding the utility of DBS for the treatment of these psychiatric/behavioral/cognitive-related disorders can be made. Regardless, the studies included in this review demonstrate positive preliminary findings for the potential benefit of DBS for treatment of a variety of psychiatric disorders, and further research is warranted to better determine the potential utility of DBS for those who are treatment-refractory and unable to achieve symptom relief with standard care.
•DBS has been investigated in those with various treatment refractory psychiatric disorders.•DBS has demonstrated positive findings in reducing symptoms associated with several psychiatric disorders.•Further DBS research warrants consideration for treatment refractory psychiatric disorders.
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