We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.
To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure no-reply@cambridge.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
Repetitive transcranial magnetic stimulation (TMS) is an evidenced based treatment for adults with treatment resistant depression (TRD). The standard clinical protocol for TMS is to stimulate the left dorsolateral prefrontal cortex (DLPFC). Although the DLPFC is a defining region in the cognitive control network of the brain and implicated in executive functions such as attention and working memory, we lack knowledge about whether TMS improves cognitive function independent of depression symptoms. This exploratory analysis sought to address this gap in knowledge by assessing changes in attention before and after completion of a standard treatment with TMS in Veterans with TRD.
Participants and Methods:
Participants consisted of 7 Veterans (14.3% female; age M = 46.14, SD = 7.15; years education M = 16.86, SD = 3.02) who completed a full 30-session course of TMS treatment and had significant depressive symptoms at baseline (Patient Health Questionnaire-9; PHQ-9 score >5). Participants were given neurocognitive assessments measuring aspects of attention [Wechsler Adult Intelligence Scale 4th Edition (WAIS-IV) subtests: Digits Forward, Digits Backward, and Number Sequencing) at baseline and again after completion of TMS treatment. The relationship between pre and post scores were examined using paired-samples t-test for continuous variables and a linear regression to covary for depression and posttraumatic stress disorder (PTSD), which is often comorbid with depression in Veteran populations.
Results:
There was a significant improvement in Digit Span Forward (p=.01, d=-.53), but not Digit Span Backward (p=.06) and Number Sequencing (p=.54) post-TMS treatment. Depression severity was not a significant predictor of performance on Digit Span Forward (f(1,5)=.29, p=.61) after TMS treatment. PTSD severity was also not a significant predictor of performance on Digit Span Forward (f(1,5)=1.31, p=.32).
Conclusions:
Findings suggested that a standard course of TMS improves less demanding measures of working memory after a full course of TMS, but possibly not the more demanding aspects of working memory. This improvement in cognitive function was independent of improvements in depression and PTSD symptoms. Further investigation in a larger sample and with direct neuroimaging measures of cognitive function is warranted.
This chapter explains the three core steps in the book’s argument about the power of scarce states. First, I begin by considering the potential for direct effects on society by a scarce state through the distribution of state resources. Second, I suggest that isolated state actions can have effects through a more indirect channel as well. Third, I describe how the societal changes produced – directly or indirectly – by isolated state actions have downstream consequences for who wields political authority and how local actors contest for political power.
This chapter traces the history of the modern state in Northern Ghana. I document state scarcity and explain why it occurred and, only recently, has begun to recede. I then detail the three major actions the modern state still took in the periphery across the colonial and post-colonial periods. he chapter concludes by putting Northern Ghana in comparative perspective, showing how the region’s experience of state scarcity is representative of many hinterlands.
The scarce state’s actions – especially the invention of chieftaincy – have had lasting implications for distributive politics. This chapter connects clientelism to the scarce state’s actions, showing that one particularly large effect of the state on political competition has been through the creation of the community-level brokers that allow parties to engage in clientelism at scale. Clientelism in this hinterland is facilitated most effectively by the chiefs that the state itself created.
This chapter explores how scarce states can also reshape hinterland society indirectly by incentivizing society to change itself. My main focus is a modern-day attempt to invent chieftaincy institutions from scratch among the largest “never recognized” ethnic group, the Konkomba. I track the creation of Konkomba chieftaincy over time, concluding with a theoretical discussion of how the state’s scarcity incentivized Konkomba communities into action.
The book’s evidence has implications for scholars of state-building and rural politics, as well as for policymakers concerned with improving state effectiveness in the developing world. I conclude by highlighting three of these implications.
This chapter shows how the modern state’s first two major interventions into society explain the origins of contemporary intra-ethnic inequality in Northern Ghana. The chapter begins by explaining the research design, detailing how the pre-1914 colonial border creates an opportunity to estimate long-run effects of the colonial state’s imposition of new intra-ethnic elites. I then introduce the data and explain how inequality is measured. The analysis first establishes a strong correlation between the invention of chieftaincy and inequality today, comparing the “invented chiefs” and “never recognized” communities. I then explain how the state’s selective provision of education accounts for this relationship. The final section rules out a series of alternative explanations and mechanisms.