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Results for “Structural equation modeling”

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PubMed2006

A longitudinal evaluation of a social support model of medication adherence among HIV-positive men and women on antiretroviral therapy.

Nonadherence in the management of chronic illness is a pervasive clinical challenge. Although researchers have identified multiple correlates of adherence, the field remains relatively atheoretical. The authors propose a cognitive-affective model of medication adherence based on social support theory and research. Structural equation modeling of longitudinal survey data from 136 mainly African American and Puerto Rican men and women with HIV/AIDS provided preliminary support for a modified model. Specifically, baseline data indicated social support was associated with less negative affect and greater spirituality, which, in turn, were associated with self-efficacy to adhere. Self-efficacy to adhere at baseline predicted self-reported adherence at 3 months, which predicted chart-extracted viral load at 6 months. The findings have relevance for theory building, intervention development, and clinical practice.

Anti-Retroviral Agents↗

PubMed2003

Linking depressive symptoms and functional disability in late life.

We hypothesized that the relationship of depressive symptoms to functional disability might be mediated by cognitive processes such as memory and problem-solving. The study sample consisted of 147 community-dwelling older adults (mean age = 74.0 years, SD = 5.9). In regression models that included terms for age, gender, and years of education, depressive symptoms were significantly inversely associated with two performance-based measures of functioning: everyday problems test (beta = -0.15, p = 0.04) and observed tasks of daily living (beta = -0.14, p = 0.02). When memory and problem-solving ability were added to the model, the relationship of depressive symptoms with function was attenuated. A structural equation model based on our conceptual framework revealed that both memory and problem-solving abilities were important mediators in the relationship of depressive symptoms and functional disability. The results suggest that intervention studies intended to limit functional disability secondary to depression among older adults may need to consider the effect of depression on cognition.

Aged↗

PubMed2005

Self-rated health in a longitudinal perspective: a 9-year follow-up twin study.

OBJECTIVES: This study first considers age and cohort explanations for age-related changes in mean values and variance in self-rated health. Second, it evaluates the contributions of genes and environments to self-rated health measured longitudinally. METHODS: Subjects were participants in the Swedish Adoption/Twin Study of Aging. Self-rated health assessments were collected in four waves over a 9-year follow-up period, from one or both members of 788 twin pairs. Linear mixed effect models were used to test for differences in means and variances. Structural equation modeling provided estimates of genetic and environmental components of variance and contributions to stability. RESULTS: Changes in means and variance within cohorts seem to reflect illness. Earlier-born cohorts are more variable and have lower self-rated health. These cohort differences were not explained by childhood socioeconomic status. Correlations between time points reflect both environmental and genetic factors. DISCUSSION: Both genes and environments contribute to self-rated health longitudinally, and both age and cohort effects are seen. Age-related changes in self-rated health can be attributed to illness. Cohort differences are most likely attributable to socially mediated and individual-specific environmental factors.

Adoption↗

PubMed2002

Differential effects of high-dose amisulpride versus flupentixol on latent dimensions of depressive and negative symptomatology in acute schizophrenia: an evaluation using confirmatory factor analysis.

While many acutely ill schizophrenic patients suffer from depressive symptoms, most studies on the efficacy of antipsychotic drugs focus on positive and negative symptoms. Dimensional models of schizophrenic symptoms, based on confirmatory factor analysis (CFA) using structural equation modelling, offer a methodological alternative to compare antipsychotics on empirically justified latent factors. The present report is a refined analysis of a published double-blind study on the D2/D3-selective antagonist amisulpride (ASP) versus the mixed D1-5/5-HT2 antagonist flupentixol (FPX). CFA was applied to Brief Psychiatric Rating Scale, Scale for the Assessment of Negative Symptoms, Bech-Rafaelsen Melancholia Scale and Simpson-Angus Scale subscores to examine differential effects of high doses of ASP and FPX on negative and depressive symptom dimensions in 126 acutely ill schizophrenic patients. A four-factor model comprising the full spectrum of acute symptomatology and a three-factor model ('negative', 'anhedonia-apathy', 'depressive') restricted to negative and depressive symptoms were yielded with an identical 'depressive' dimension in both models. Analyses of CFA-derived factor scores showed that ASP was significantly superior to FPX regarding the latent 'depressive' dimension, independent of baseline scores, dosage and changes in akinesia. Neither the negative' dimension nor 'anhedonia-apathy' showed significantly different treatment effects. CFA-based analyses appear to be suitable for psychotropic drug evaluation when more refined and data-related information on drug efficacy profiles are required.

Adolescent↗

PubMed2004

Everyday life for black american adults: stress, emotions, and blood pressure.

The purpose of this study was to examine the stress process in Black Americans by exploring chronic stress, emotions, age, body mass index, and blood pressure within the context of gender and socioeconomic position (SEP). The convenience sample of middle-class Black Americans ( N = 211) ranged from ages 25 to 79 years. A sociopsychophysiological model of everyday life for Black American adults was tested using structural equation modeling. The model explained 27% of the variance in systolic and 17% of the variance in diastolic blood pressure. SEP had a significant effect on chronic stress, and chronic stress had a significant effect on negative affect. Although men had lower negative affect scores than women, men's diastolic blood pressures were on average 4 mm Hg higher than women's. These findings are useful to the development and implementation of interventions to eliminate health disparities and improve years of healthy life for Black Americans.

Adult↗

PubMed2000

[Intermittent claudication and quality of life. Psychometric validation of the French version of the CLAU-S questionnaire].

CLAU-S is a disease-specific quality of life (QoL) scale for patients with intermittent claudication due to peripheral arterial disease of the lower limbs. Initially developed in Germany, the scale has been translated into French according to classical forward/backward methodology. The objective of this study was to test the validity of the French version of CLAU-S. In its current format, the CLAU-S scale evaluates 5 dimensions: "Daily Living"; "Pain"; "Social Life"; "Disease-specific anxiety"; and "Mood", for a total of 47 items. The QoL scores and clinical findings in 157 patients with intermittent claudication were analysed. Validation of the convergence and discriminatory power of the scale were confirmed. Analysis of structural validity showed grouping of items in accordance with initial scale construction and a clear separation between the different dimensions. Analysis of the internal reliability of the questionnaire confirmed the good internal coherence of these dimensions. Reproducibility of the scores over time was confirmed by test-retest analysis. In addition to the actual validation of CLAU-S, a new, innovative mathematical technique called Structural Modelling Equations was used on this QoL instrument. It related the causal structure of the QoL components in peripheral arterial disease of the lower limbs (stage 2). An indisputable causal relationship was demonstrated between clinical parameters, particularly walking distance, and the QoL components. The classical symptom-deficit-disability causal structure of disease- specific QoL questionnaires was also studied. In particular, we found an essential relationship between the Daily Living dimension and, to a lesser extent, the Social Life activities and Disease- specific anxiety dimension, and QoL. The Pain dimension proved to be an explanatory variable of the other QoL components without being directly related to QoL. Finally, the Mood dimension was a resultant variable of QoL and not an explanatory variable of QoL. This study therefore enabled validation of the psychometric properties of the French version of CLAU-S and also demonstrated the complementary roles of walking distance and QoL in the management of patients with intermittent claudication.

Activities of Daily Living↗

PubMed2000

Worldview and health promoting behavior: a causal model.

The present study investigated the manner in which Pepper's (1942) worldview theory relates to health promoting behavior. A sample of 259 subjects completed a battery of inventories measuring worldview, health promoting behavior (HPB), social class, and sex. The data were analyzed by means of structural equation modeling using the statistical program for the social sciences (SPSS) and the analysis of moment and structure (AMOS) computer programs. The results support the idea that a modest relationship exists between worldview and HPB, with organismic thinkers more likely than mechanistic thinkers to engage in HPB. There was also a slight indirect effect of sex on worldview and HPB, with women more likely to endorse an organismic worldview and therefore more likely to engage in HPB than men. No relationship was found between socioeconomic status and HPB.

Adolescent↗

PubMed2001

A model of predictors and outcomes of outness among lesbian and bisexual women.

In a structural equation model of 2,401 lesbian and bisexual women, three variables of lesbian sexual identity were found to predict outness, which predicted lower psychological distress, which, in turn, predicted lower suicidality. The model held true for the subsamples of European-American and African-American women, and to a lesser extent for those of Latina, Asian-American, Native-American, and Jewish women.

Adult↗

PubMed2004

Measurement equivalence of the German Job Satisfaction Survey used in a multinational organization: implications of Schwartz's culture model.

The authors tested measurement equivalence of the German Job Satisfaction Survey (GJSS) using structural equation modeling methodology. Employees from 18 countries and areas provided data on 5 job satisfaction facets. The effects of language and culture on measurement equivalence were examined. A cultural distance hypothesis, based on S. H. Schwartz's (1999) theory, was tested with 4 cultural groups: West Europe, English speaking, Latin America, and Far East. Findings indicated the robustness of the GJSS in terms of measurement equivalence across countries. The survey maintained high transportability across countries speaking the same language and countries sharing similar cultural backgrounds. Consistent with Schwartz's model, a cultural distance effect on scale transportability among scales used in maximally dissimilar cultures was detected. Scales used in the West Europe group showed greater equivalence to scales used in the English-speaking and Latin America groups than scales used in the Far East group.

Culture↗

PubMed1991

Modeling age using cognitive, psychosocial and physiological variables: the Boston Normative Aging Study.

A structural equation model is computed for 36 variables from eight domains of data using 100 healthy male subjects whose age varies between 30 and 80 years. Chronological age is required to be an exogenous variable while cognitive function variables are required to be an ultimate endogenous or outcome set. The model suggests that the direct effect of age on cognition is substantially reduced when social, life style, physiological, and brain state variables are allowed to become intervening variables. The study also finds that there is an association between cognitive function and psychosocial measures relating to general psychiatric symptomatology and social support systems.

Adult↗

PubMed2002

A model for predicting dating violence: anxious attachment, angry temperament, and need for relationship control.

Structural equation modeling (SEM) was used to test a model incorporating anxious attachment, angry temperament, and attempts to control one's partner as predictors of the severity and frequency of dating violence. To date, these concepts have not been clearly established as having direct or indirect effects on dating violence. It was hypothesized that anxious attachment and angry temperament would influence the need for and attempts to control one's partner which, in turn, would predict a person's actual use of force. College students (213 males; 199 females) completed measures assessing these constructs. Cross-validation was accomplished through using two successive freshmen samples. Statistics indicated the application of the model fit well to both samples. All specified paths were significant except for the direct path from anxious attachment to need for control in the second sample. While exploratory, this model seemed satisfactory for explaining potentially causal relationships of attachment, anger, and attempts to control one's partner leading to dating violence.

Adult↗

PubMed2005

Factor analytic models: viewing the structure of an assessment instrument from three perspectives.

The overarching purpose of this article is to present a nonmathematical introduction to the application of confirmatory factor analysis (CFA) within the framework of structural equation modeling as it applies to psychological assessment instruments. In the interest of clarity and ease of understanding, I model exploratory factor analysis (EFA) structure in addition to first- and second-order CFA structures. All factor analytic structures are based on the same measuring instrument, the Beck Depression Inventory-II (BDI-II; Beck, Steer, & Brown, 1996). Following a "walk" through the general process of CFA modeling, I identify several common misconceptions and improper application practices with respect to both EFA and CFA and tender caveats with a view to preventing further proliferation of these pervasive practices.

Data Interpretation, Statistical↗

PubMed2002

Drinking-driving as a component of problem driving and problem behavior in young adults.

OBJECTIVE: This study replicated and extended a conceptual model of drinking-driving and its relationship to other problem behavior to determine (1) if the model characterized the problem driving and problem behavior of young adults from the general population and (2) if the model applied to women as well as to men. METHOD: Telephone survey data (measures of drinking-driving, drug-driving, risky driving, problem drinking, drug use and delinquent behavior) collected from young adults (N = 4,230, 53% female) were used in structural equation modeling. Two models were developed--one for problem driving and one for problem behavior--each testing the structural associations among latent variables and testing them as latent indicators of common second-order latent variables. RESULTS: The results supported the hypothesis that drinking-driving (along with problem drinking, drug use and delinquent behavior) is an indicator of problem behavior in the general population sample. Also, drinking-driving, drug-driving and risky driving were demonstrated to be indicators of a common construct: problem driving. The models fit the data equally well for both young men and young women, and a crossvalidation conducted on an independent sample confirmed the results. CONCLUSIONS: The results provide empirical support for the inclusion of drinking-driving and problem driving in an extended model of Problem Behavior Theory. Drinking-driving, drug-driving and risky driving all relate to a common construct: problem driving. These results have important implications for research and for interventions to treat or prevent drinking-driving, especially among young adults.

Adult↗

PubMedDate not supplied

Predictors of functional ability in geriatric rehabilitation patients.

This study explored the impact that motivation, cognitive status, depression, age, and physical status have on the functional ability of older adults in a rehabilitation program. The study was based on a hypothesized model and was conducted with 200 patients on a geriatric rehabilitation unit. Structural equation modeling was done to test the hypothesized model. The average age of participants was 78 years, and the majority were female, Caucasian, unmarried, and had been admitted for rehabilitation after an orthopedic event. The data fit the hypothesized model; however, only five paths were significant. Mental status was a significant predictor of function on admission and a direct and indirect predictor of function at discharge, and diagnosis and age directly predicted function at discharge.

Activities of Daily Living↗

PubMed2006

Cognitive mediators linking social support networks to colorectal cancer screening adherence.

This paper argues that normative considerations are more important than attitudinal factors in engaging colorectal cancer screening, and tests a model explaining how unique cultural expressions of social networks influence screening adherence. Structural equation modeling was used to understand colorectal cancer screening in a population-based sample of 341 Japanese Americans aged 50 and over. The model accounted for 25% of the variance in screening adherence. Adherence was most strongly associated with family/friend subjective norms about colorectal cancer screening use. Emotional family support, but not the size of the networks, was indirectly related to adherence via increased family/friend subjective norms, while emotional friend support was directly related to adherence. While usual source of care was directly associated with adherence, better provider-patient communication was directly and indirectly associated with adherence via increased perceived benefits. The findings of this study support strengthening informal support networks to enhance adherence among Japanese Americans at risk.

Aged↗

PubMed2002

Impact of services, met needs, and service empowerment on consumer outcomes.

The current study examined service characteristics, needs, and outcomes of consumers with severe mental disabilities served in a public mental health setting. The study utilized a longitudinal design with three yearly waves of measurement. Data were obtained from consumer interviews and case manager questionnaires. A model specifying relationships between service characteristics, needs, and outcomes was tested using structural equation modeling. This model incorporated service-related variables pertaining to service amounts, service empowerment, and needs in order to gain a better understanding of factors that mediate service effects and account for mental health outcomes. The model focused on consumers' perspectives, in order to highlight the importance of consumers' opinions about their mental health services and needs. The results suggested that consumers' perceptions that their needs are met were related to better symptomatology and quality of life outcomes. In addition, consumers' perceptions that they had some say in service-related decisions had an indirect effect on mental health outcomes by increasing the likelihood that needs were met according to consumers' perspectives. Results were mixed with regard to the effects of these variables on level of functioning outcomes. Service amount was unrelated to mental health outcomes. Furthermore, service amount was unrelated to consumers' perceptions of needs, suggesting that consumers' views regarding met and unmet needs may not be included sufficiently in decision-making surrounding the provision of services.

Adaptation, Psychological↗

PubMed1997

On the factorial and construct validity of the Intrinsic Motivation Inventory: conceptual and operational concerns.

The Intrinsic Motivation Inventory (IMI) has been gaining acceptance in the sport and exercise domain since the publication of research by McAuley, Duncan, and Tammen (1989) and McAuley, Wraith, and Duncan (1991), which reported confirmatory support for the factorial validity of a hierarchical model of intrinsic motivation. Authors of the present study argue that the results of these studies did not conclusively support the hierarchical model and that the model did not accurately reflect the tenets of cognitive evaluation theory (Deci & Ryan, 1985) from which the IMI is drawn. It is also argued that a measure of perceived locus of causality is required to model intrinsic motivation properly. The development of a perceived locus of causality for exercise scale is described, and alternative models, in which perceived competence and perceived locus of causality are held to have causal influences on intrinsic motivation, are compared with an oblique confirmatory factor analytic model in which the constructs are held at the same conceptual level. Structural equation modeling showed support for a causal model in which perceived locus of causality mediates the effects of perceived competence on pressure-tension, interest-enjoyment, and effort-importance. It is argued that conceptual and operational problems with the IMI, as currently used, should be addressed before it becomes established as the instrument of choice for assessing levels of intrinsic motivation.

Adult↗

PubMed2003

Tobacco Craving Questionnaire: reliability and validity of a new multifactorial instrument.

This study documented the initial reliability and validity of the Tobacco Craving Questionnaire (TCQ), a new multidimensional questionnaire to assess tobacco craving. Current cigarette smokers (n=213) not attempting to reduce or quit smoking completed the 47-item TCQ and other forms assessing demographics, tobacco and other drug use history, quit attempts, and current mood. Exploratory factor analyses and structural equation modeling indicated that a four-factor solution best described the item structure. Factor subscales derived from the 17 items with significant loadings had low to high internal consistencies and interitem correlations and exhibited low to moderate, positive intercorrelations. Factor scales were significantly correlated with single-item measures of craving, current mood, and daily cigarette smoking. Results indicated that four specific constructs characterized craving for tobacco: (a) Emotionality, or smoking in anticipation of relief from withdrawal symptoms or negative mood, (b) expectancy, or anticipation of positive outcomes from smoking, (c) compulsivity, or an inability to control tobacco use, and (d) purposefulness, or intention and planning to smoke for positive outcomes. These preliminary data suggest that the TCQ is a reliable and valid instrument for assessing tobacco craving in individuals not attempting to reduce or quit smoking.

Adult↗