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Results for “Structural equation modeling”

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PubMed2006

Course of functioning 1 year following admission for treatment of alcohol use disorders.

Research on alcohol treatment outcomes has the potential to advance knowledge about how treatment combines with other variables to influence post treatment course of functioning. The purpose of this study was to replicate and extend [Connors, G. J., Maisto, S. A., & Zywiak, W. H. (1996). Understanding relapse in the broader context of post-treatment functioning. Addiction, 91 (Suppl.), S173-S189] test of a multivariate model of course by testing the model's fit to data from a larger sample and the use of stronger statistical methods. The participants were 400 men and women presenting for alcohol treatment in two cities in the US. These individuals completed a pretreatment (baseline) assessment battery at treatment initiation and then completed follow-up assessments bimonthly for a period of 1 year. The model included pretreatment, treatment (months 1-6), and post-baseline (months 1-6) factors to predict alcohol use (percent days abstinent, drinks/drinking day, and total number drinks/month, all for months 7-12). The application of structural equation modeling methods revealed that the model fit the data adequately for all three dependent variables, with the major significant findings of direct effects of treatment setting, coping skills, and the mediation of treatment effects through coping skills. Overall, the data replicated several findings from the Connors et al.'s study and point to the importance of investigating the mechanisms underlying treatment effects and the mediation of treatment effects by coping skills in future research.

Adaptation, Psychological↗

PubMed2000

Genetic analysis of deciduous tooth size in Australian twins.

Investigations of permanent dental crown size in twins and family groups indicate a high degree of transmissible control, but little is known about the relative contributions of genetic and environmental factors to variation in size of the deciduous (primary) teeth. Here, maximum mesiodistal and buccolingual crown dimensions of maxillary and mandibular primary teeth were measured from dental models of 602 individuals, including 99 monozygous (MZ) twin pairs, 81 dizygous (DZ) same-sex pairs, 41 DZ opposite-sex pairs, and 160 singletons. Data were subjected to univariate genetic analysis with the structural-equation-modelling package, Mx using the normal assumptions of the twin model. A model incorporating additive genetic (A) and unique environmental (E) variation was found to be the most parsimonious for all tooth-size variables. Estimates of heritability for deciduous crown size ranged from 0.62 to 0.91. This study shows that variation in deciduous crown size has a strong genetic component, similar to that observed in the permanent dentition. Further studies are required to determine whether the underlying genetic mechanisms are the same for both deciduous and permanent teeth.

Analysis of Variance↗

PubMed1994

Impact of social support, social cognitive variables, and perceived threat on depression among adults with diabetes.

Tested was a model of social support and cognitive appraisal of self-efficacy, outcome expectancies, and illness threat on depression. Study participants were community-dwelling adults with diabetes who completed a mailed questionnaire (N = 362). Results of structural equation modeling indicated that 52% of the variance in depression was explained by the model--largely by the direct effects of physical functioning, the perceived availability of social support, and the perceived threat of diabetes as well as the indirect paths from perceived support to perceived threat and from physical functioning to perceived support and perceived threat of diabetes. Diabetes-specific social support, self-efficacy, and outcome expectancies were not significant predictors of depression.

Adaptation, Psychological↗

PubMed2006

Extending a model of shift-work tolerance.

The present study contributes to theory and practice through the development of a model of shift-work tolerance with the potential to indicate interventions that reduce nurses' intention toward turnover and increase job satisfaction in hospital-based settings. Survey data from 1257 nurses were used to conduct structural equation modeling that examine the direct and indirect effects of supervisor and colleague support, team identity, team climate, and control over working environment on time-based work/life conflict, psychological well-being, physical symptoms, job satisfaction, and turnover intention. The analysis of the proposed model revealed a good fit The chi-square difference test was non-significant (chi2(26) = 338.56), the fit indices were high (CFI = .923, NFI = .918, and NNFI = .868), the distribution of residuals was symmetric and approached zero, the average standardized residual was low (AASR = .04), and the standardized RMR was .072. In terms of the predictor variable, the final model explained 48% of the variance in turnover intention. The data revealed considerable evidence of both direct effects on adjustment and complex indirect links between levels of adjustment and work-related social support, team identity, team climate, and control. Nurses with high supervisor and coworker support experienced more positive team climates, identified more strongly with their team, and increased their perceptions of control over their work environment. This in turn lowered their appraisals of their time-based work/life conflict, which consequently increased their psychological well-being and job satisfaction and reduced their physical health symptoms and turnover intention. The type of shift schedule worked by the nurses influenced levels of turnover intention, control over work environment, time-based work/life conflict, and physical symptoms.

Adult↗

PubMed2005

Tests of causal linkages between cannabis use and psychotic symptoms.

AIM: To examine possible causal linkages between cannabis use and psychosis using data gathered over the course of a 25-year longitudinal study. DESIGN: A 25-year longitudinal study of the health, development and adjustment of a birth cohort of 1265 New Zealand children (635 males, 630 females). SETTING: The Christchurch Health and Development Study, a general community sample. PARTICIPANTS: A total of 1055 participants from the Christchurch Health and Development Study (CHDS) cohort for whom data on cannabis use and psychotic symptoms were available on at least one occasion from 18, 21 and 25 years. MEASUREMENTS: As part of this study, data were gathered on frequency of cannabis use and psychotic symptoms at ages 18, 21 and 25 years. FINDINGS: Regression models adjusting for observed and non-observed confounding suggested that daily users of cannabis had rates of psychotic symptoms that were between 1.6 and 1.8 times higher (P < 0.001) than non-users of cannabis. Structural equation modelling suggested that these associations reflected the effects of cannabis use on symptom levels rather than the effects of symptom levels on cannabis use. CONCLUSIONS: The results of the present study add to a growing body of evidence suggesting that regular cannabis use may increase risks of psychosis. The present study suggests that: (a) the association between cannabis use and psychotic symptoms is unlikely to be due to confounding factors; and (b) the direction of causality is from cannabis use to psychotic symptoms.

Adolescent↗

PubMed2004

The effects of physician empathy on patient satisfaction and compliance.

The present study attempted to develop new scales of patient-perceived, empathy-related constructs and to test a model of the relationships of physician empathy and related constructs to patient satisfaction and compliance. Five hundred fifty outpatients at a large university hospital in Korea were interviewed with the questionnaire. The data were analyzed using structural equation modeling. Patient-perceived physician empathy significantly influenced patient satisfaction and compliance via the mediating factors of information exchange, perceived expertise, inter-personal trust, and partnership. Improving physician empathic communication skills should increase patient satisfaction and compliance. Health providers who wish to improve patient satisfaction and compliance should first identify components of their empathic communication needing improvement and then try to refine their skills to better serve patients.

Communication↗

PubMed2005

Applying a cognitive-behavioral model of HIV risk to youths in psychiatric care.

This study examined the utility of cognitive and behavioral constructs (AIDS information, motivation, and behavioral skills) in explaining sexual risk taking among 172 12-20-year-old ethnically diverse urban youths in outpatient psychiatric care. Structural equation modeling revealed only moderate support for the model, explaining low to moderate levels of variance in global sexual risk taking. The amount of explained variance improved when age was included as a predictor in the model. Findings shed light on the contribution of AIDS information, motivation, and behavioral skills to risky sexual behavior among teens receiving outpatient psychiatric care. Results suggest that cognitive and behavioral factors alone may not explain sexual risk taking among teens whose cognitive and emotional deficits (e.g., impaired judgment, poor reality testing, affect dysregulation) interfere with HIV preventive behavior. The most powerful explanatory model will likely include a combination of cognitive, behavioral, developmental, social (e.g., family), and personal (e.g., psychopathology) risk mechanisms.

Adolescent↗

PubMed1994

Differential influence of parental smoking and friends' smoking on adolescent initiation and escalation of smoking.

Smoking-related behaviors and attitudes of significant others (especially friends and parents) are among the most consistent predictors of adolescent smoking. However, theorists remain divided on whether the behaviors of significant others influence adolescent smoking directly or indirectly, and the relative influence of parental and peer smoking on adolescents' own smoking is still a matter of debate. In addition, little research has examined the role of significant others' behavior on different stages of smoking onset. In particular, not much information is available regarding gender and ethnic differences in social influences on smoking behavior. We use structural equation modeling to address these issues. Different theoretical perspectives from cognitive-affective theories (Ajzen 1985; Ajzen and Fishbein 1980) and social learning theories (Akers et al. 1979; Bandura 1969, 1982, 1986) have been integrated into a structural model of smoking influence. The results show that friends' smoking affects adolescent initiation into smoking both directly and indirectly, whereas parental smoking influences smoking initiation only indirectly. The data also show that friends' and parents' smoking affect smoking escalation only indirectly. In general, friends' smoking has a stronger effect on adolescents' smoking behavior, particularly on initiation. Multiple group comparisons of the structural models predicting smoking initiation among males and females reveal that parental approval of smoking plays a significant mediating role for females, but not for males. Comparisons of Whites, Blacks, Hispanics, and other ethnic groups reveal that there are some significant differences in the pathways of friends' influences among the four groups.

Adolescent↗

PubMed1993

Construct validity of dimensions of adaptive behavior: a multitrait-multimethod evaluation.

The construct validity of four dimensions of adaptive and maladaptive behavior was investigated using the multitrait-multimethod matrix procedure of Campbell and Fiske (1959). Measures of four traits--cognitive competence, social competence, social maladaption, and personal maladaption--were obtained on a sample of 157 persons with moderate, severe, or profound mental retardation using each of three methods of measurement--standardized assessment instrument, day shift staff ratings, and evening shift staff ratings. Applying the Campbell and Fiske rules of thumb and recently proposed structural equation modeling techniques to the data demonstrated strong convergent validity, clear discriminant validity, and only moderate levels of method variance in the observed measures. Implications of the results for the assessment of adaptive behavior and its dimensional structure were discussed.

Adaptation, Psychological↗

PubMed2006

Acculturation and aggression in Latino adolescents: a structural model focusing on cultural risk factors and assets.

The specific aim of this investigation was to map cultural factors associated with aggressive behavior in Latino adolescents. Interviews were conducted with a sample of 481 foreign- and U.S.-born Latino adolescents living in North Carolina and Arizona. Structural Equation Modeling was used to validate a conceptual model linking adolescent and parent culture-of-origin and U.S. cultural involvement, acculturation conflicts, and perceived discrimination to family processes (familism and parent-adolescent conflict) and adolescent aggression. Parent-adolescent conflict was the strongest cultural risk factor followed by perceived discrimination. Familism and adolescent culture-of-origin involvement were key cultural assets associated with less aggressive behavior. Exploratory mediation analyses suggested that familism and parent-adolescent conflict mediated the effects of acculturation conflicts, parent and adolescent culture-of-origin involvement, and parent U.S. cultural involvement on adolescent aggression. Implications for prevention programming were discussed.

Acculturation↗

PubMed2006

A model of disease-specific worry in heritable disease: the influence of family history, perceived risk and worry about other illnesses.

Disease-related worry is associated with family history and perceived risk of that disease; however, the influences of general risk perceptions and tendencies to worry about diseases have been neglected in the literature. This study investigates a model of disease-specific worry which includes family history, disease-specific perceived risk, and perceived risk for and worry about other diseases. Participants completed a survey assessing these variables in relation to several heritable diseases. Structural equation modeling found that family history predicted disease-specific perceived risk but not perceived risk for other diseases. Disease-specific perceived risk predicted disease-specific worry and worry about other diseases. Perceived risk for other diseases predicted worry about other diseases and disease-specific perceived risk but not disease-specific worry. Disease-specific worry predicted worry about other diseases. This model was supported across several diseases and indicates that disease-specific and general considerations of risk influence worry about a disease and should be considered in interventions.

Adult↗

PubMed1995

Poor interpersonal problem solving as a mechanism of stress generation in depression among adolescent women.

The authors examined C. Hammen's (1991) model of stress generation in depression and the role of interpersonal problem-solving strategies (IPS) in the stress generation process in a longitudinal sample of 140 young women who entered the study at ages 17-18. Structural equation modeling was used to test a model in which IPS and subsequent interpersonal stress mediated the relationship between initial and later depressive symptoms. Results supported the main prediction of the stress generation model: Interpersonal stress mediated the relationship between initial and later depressive symptoms. In addition, IPS predicted interpersonal stress. However, no association was found between depressive symptoms and IPS. An alternative model in which IPS moderated the relationship between stress and depressive symptoms was tested; it was not supported.

Adolescent↗

PubMedDate not supplied

The influence of time on changes in health status and patient satisfaction.

This article develops a framework that investigates the impact that a change in health status has on satisfaction with structure and process elements of health care delivery over time. We develop and present a structural equation model that encompasses these relationships based on a survey of 284 consumers of health care services. The results indicate that health status is directly related to satisfaction with process of care elements but not directly related to structural elements. These results contribute to the literature by examining the impact of health status on satisfaction in two distinct elements related to structure and process.

Delivery of Health Care↗

PubMed2004

The structure of reflective practice in medicine.

BACKGROUND: The capability to reflect consciously upon one's professional practice is generally considered important for the development of expertise and, hence, for education. However, to our knowledge no empirical research has been conducted to date into the nature of reflective practice in medicine. PURPOSE: To study the structure of reflective practice in medicine. METHODS: A questionnaire based on the literature was developed and administered to a group of primary care doctors. The data were subjected to confirmatory factor analysis using structural equations modelling. RESULTS: A 5-factor model of reflective practice emerged. It consisted of the following factors: deliberate induction; deliberate deduction; testing and synthesising; openness for reflection, and meta-reasoning. The model fitted the data sufficiently. CONCLUSION: A multidimensional structure of reflective practice in medicine was brought to light by the study. Its components in terms of reasoning processes, behaviours and attitudes were identified and measured among doctors. Once conceptualised and measured, reflective practice can be studied to gain a better understanding of its relation to expertise development in medicine. In addition, training students to apply reflective practices may become a goal in medical education.

Attitude of Health Personnel↗

PubMed2006

Integrating personality and psychosocial theoretical approaches to understanding safer sexual behavior: implications for message design.

The purpose of this study was to propose and conduct tests of a multivariate model of condom use utilizing data from 2 independent samples of young adults (City 1, N=746; City 2, N=743). The model examined the relations between personality characteristics, including sexual sensation seeking and sexual impulsive decision making; psychosocial variables, including condom attitudes, norms, and self-efficacy; and condom use behaviors, including carrying, communicating about, and using condoms. Structural equation modeling analyses indicated a good fit for both models (Confirmatory Fit Index=.93; Average Absolute Standardized Residuals=.05 for both), with each explaining 25% of the variance ( R (2)=.25) in condom use behaviors. Results support the fusion of personality and psychosocial approaches to gain a broader theoretical understanding of condom use in young adults. In addition, those developing and implementing health communication campaigns may find sexual sensation seeking and sexual impulsive decision making to be fruitful variables on which to target messages aimed at increasing safer sexual behavior.

Adolescent↗

PubMed2003

Family instability and young adolescent maladjustment: the mediating effects of parenting quality and adolescent appraisals of family security.

Examined relations among family instability and adolescent's psychological functioning using family models of children's emotional security in a sample of 220 young adolescents and their primary caregivers. Primary caregiver reports of family instability were associated with multiple informant measures of adolescent internalizing and externalizing symptoms. Findings from structural equation models supported the hypothesis that family instability increases adolescent risk for psychological problems by directly undermining their insecure appraisals of the family. Results also supported a pathway whereby family instability predicted parenting difficulties and parenting difficulties, in turn, indirectly predicted adolescents' internalizing and externalizing symptoms through its association with lower levels of perceived insecurity in the family. Results are discussed in relation to how they advance process-oriented conceptualizations of family instability.

Adaptation, Psychological↗

PubMed2003

Women and acquired preparedness: personality and learning implications for alcohol use.

OBJECTIVE: The purpose of this study was to begin the process of examining the validity of the acquired preparedness model of alcohol use for women. The model holds that trait disinhibition influences the formation of alcohol expectancies, which then influence drinking levels. METHOD: College women (N = 290) completed measures of trait disinhibition, positive and negative expectancies for alcohol and drinking measures. RESULTS: Using structural equation modeling, support was found for the hypothesized processes. Cross-sectional analyses were consistent with two hypothesized mediational pathways: disinhibition was associated with increased positive alcohol expectancies and decreased negative alcohol expectancies; both higher positive and lower negative alcohol expectancies correlated with drinking; and disinhibition's association with drinking was significantly reduced when each type of expectancy was added to a prediction model. CONCLUSIONS: Cross-sectional support for this causal model indicates the value of testing it further with longitudinal trials.

Adolescent↗

PubMedDate not supplied

Death or illness of a family member, violence, interpersonal conflict, and financial difficulties as predictors of sickness absence: longitudinal cohort study on psychological and behavioral links.

OBJECTIVE: Although an association between stressful life events and health problems has been demonstrated, the underlying mechanisms have remained unclear. We examined whether psychological problems and health-risk behaviors underpin the health effects of different event categories. METHOD: The initially healthy participants were 2991 (796 men, 2195 women) municipal employees who had taken no sick leave in 1995. In 1997, they completed a questionnaire requesting information on recent life events and psychological and behavioral factors. The outcome was recorded sickness absences in 1998. RESULTS: In men, the death or serious illness of a family member, violence, and financial difficulties increased the risk of later sickness absence. According to structural equation modeling, violence and financial difficulties also induced psychological problems such as anxiety, mental distress, and lowered sense of coherence. Psychological problems were associated with heightened cigarette and alcohol consumption, which in turn increased sickness absence. A corresponding structural model did not fit the data in relation to death or serious illness of a family member. In women, life events were associated with psychological problems and smoking but not sickness absence. CONCLUSIONS: Longitudinal evidence suggests that increased psychological problems and behaviors involving risk to health partially mediate the effect of stressful life events on health, as indicated by sickness absence. This model received support among men and for the event categories of violence and financial difficulties. Women were less affected by stressful life events than men.

Attitude to Death↗