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Results for “Structural equation modeling”

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PubMed1998

Causal modeling of epidemiological data on psychiatric disorders.

This paper reviews the logic of causal inference from epidemiological data. I maintain that the clearest causal statements can be made when the philosophical causal principles of association, direction and isolation are upheld in epidemiological research. After reviewing the argument by Holland that only experimental manipulation affords clear causal claims, I examine the utility of structural equation models and longitudinal methods for making causal claims from non-experimental data. This examination leads to the conclusion that mental health epidemiologists should begin to incorporate intervention trials into the last phases of their research programmes when they want to make strong causal claims.

Humans↗

PubMed2001

Using intervention theory to model factors influencing behavior change. Project RESPECT.

Project RESPECT was a multisite randomized trial comparing three clinic-based interventions' ability to increase condom use and prevent infection with HIV and sexually transmitted diseases. Because Project RESPECT had guiding concepts that determined the content of the sessions, the authors investigated how the intervention operated using these theoretical variables. Growth curve analysis and structural equation modeling estimated the correlation between intentions toward condom use and self-reports of condom use and isolated the treatment effects on mediating variables--attitudes, self-efficacy, and social norms--that predict intentions. The correlations between intentions and behavior exceeded .70 for both genders, justifying the emphasis on intentions. Project RESPECT was effective through changing attitudes and self-efficacy for females in both counseling interventions. For males, only enhanced counseling had significant effects on these two mediator variables.

Analysis of Variance↗

PubMed2005

Modeling ADHD child and family relationships.

Little information is available on how to help families manage common negative sequelae of attention deficit/hyperactivity disorder (ADHD). This article is a report of the extent to which a theoretical formulation of child behavior, maternal distress, and family conflict was explained by data obtained from a community sample of families with children and adolescents with ADHD. Structural equation modeling was used to test the theoretical model. The primary variables of interest were (a) child behavior problems, (b) maternal distress, and (c) family conflict. The results suggest that maternal distress may mediate the relationship between child behavior problems and family conflict, indicating the critical importance of mothers in ADHD families and the need to provide them with additional support.

Adaptation, Psychological↗

PubMed2003

Psychological distress: testing hypotheses based on Roy's adaptation model.

This study examined the relationships among social support, parenting stress, coping style, and psychological distress in parents caring for children with cancer. The hypothesis that coping style plays a mediating role between social support and parenting stress, and psychological distress was tested for both mothers and fathers. In total, 246 mothers and 195 fathers of 270 children participated in the study. Structural equation modeling was used to test the hypothesis. The findings indicate that the hypotheses derived from the Roy adaptation model were supported for both mothers and fathers. A longitudinal study is suggested to examine the circular process of stimulus, coping process, and adaptation outcomes.

Adaptation, Psychological↗

PubMed2004

Self-concept and adolescents' refusal of unprotected sex: a test of mediating mechanisms among African American girls.

During adolescence, girls form self-concepts that facilitate the transition to adulthood. This process may entail engaging in risky sexual behaviors resulting in STD infection and pregnancy. This study assessed the relation between self-concept and unwanted, unprotected sex refusal among 335 African American adolescent girls. The second aim was to determine whether attributes of partner communication about sex would act as a mediating mechanism on this hypothesized relationship. These assessments were made within the context of several theoretical models (social cognitive theory and theory of gender and power). Self-concept was composed of self-esteem, ethnic identity, and body image, whereas attributes of partner communication about sex was conceptualized as frequency of communication, fear of condom use negotiation, and self-efficacy of condom use negotiation. Structural equation modeling was used to analyze data. The results showed that self-concept was associated with partner communication attributes about sex, which in turn, was associated with frequency of unprotected sex refusal. The hypothesized mediating role of partner communication was also supported. STD-HIV preventive interventions for this population may be more effective if they target self-concept as opposed to only self-esteem, incorporate an Afrocentric approach, and focus on enhancing several attributes of partner communication about sex.

Adolescent↗

PubMed2004

Emotional distress in nonmetropolitan persons living with HIV disease enrolled in a telephone-delivered, coping improvement group intervention.

The study delineated depressive symptoms and modeled emotional distress in persons living with HIV disease in nonmetropolitan areas of 13 U.S. states. Participants (N=329) were enrolled in a randomized clinical trial of a telephone-delivered, coping improvement group intervention, and 60% reported moderate or severe levels of depressive symptomatology on the Beck Depression Inventory. Structural equation modeling indicated that participants who experienced more severe HIV symptomatology, received less social support, and engaged in more avoidant coping also experienced more emotional distress (a latent construct comprising depressive symptoms and emotional well-being). Greater HIV-related stigma and rejection by family led to more emotional distress, with social support and avoidant coping mediating almost entirely the effects of the former 2 variables. The model accounted for 72% of the variance in emotional distress in nonmetropolitan persons living with HIV disease.

Adaptation, Psychological↗

PubMed2001

Psychosomatic complaints in schoolchildren: a Nordic comparison.

AIMS: This study investigates the association between psychosomatic complaints (PSC) and background factors from children in the five Nordic countries, their families, and their social context in a model using proximal (child), intermediate (family), and distal (society) levels. Similarities and differences between the countries were compared. METHODS: A questionnaire was sent to the parents of a representative sample of 3,760 Nordic children aged seven to 12 years. The relationship between PSC and background factors was analysed using structural equation modelling. RESULTS: Headaches and stomach complaints were most common. The prevalence was higher in girls than in boys. A LISREL analysis showed that determinants of PSC varied little between countries. The most important factors associated with PSC were the mother's health and well-being, the child's mental stability and social competence, and the family's socioeconomic status. Families with low education, blue-collar work, low income, and unemployed fathers were found to be most vulnerable. High risk factors could be influenced by other intervening protective factors. The greatest country differences were found on the distal level, where macroeconomic, legislative, and social factors dominated. CONCLUSIONS: The pattern of PSC was quite similar between the Nordic countries, although there were some small differences. The results also confirm that the determinants of PSC are multidimensional. Longitudinal studies are needed to clarify the complex reality.

Adolescent↗

PubMed2006

Family and cognitive factors: modeling risk for aggression in children with ADHD.

OBJECTIVE: To explore the relationships of family and cognitive factors to aggression as reported by parents and teachers. METHOD: Data regarding different types of aggressive behavior were collected from parents and teachers of 165 school-age (7-11 years old) children referred to a study of attention-deficit/hyperactivity disorder and disruptive behavior. Structural equation modeling was used to examine the differential relationships of family and cognitive factors to aggression in the home and school settings. RESULTS: Family risk factors influenced aggression reported at home and at school, whereas cognitive risk factors may exert their influence on aggression at school. Significant covariance between parent and teacher report of aggressive behavior was observed. CONCLUSIONS: Intervention at the family level may serve to reduce aggressive behaviors in both home and school environments.

Aggression↗

PubMed2000

Test of a model of psychosocial resources, stress, and health among undereducated adults.

The purpose of this study was to test a model drawn from the modeling and role-modeling theory depicting relationships among psychosocial resources, perceived stress, and health for undereducated adults. A purposive sample of 171 adults enrolled at an urban adult education center completed several self-report measures: Modified Erikson Psychological Stage Inventory, Basic Need Satisfaction Inventory, Perceived Stress, and Positive Health Index. Based on a structural equation modeling analysis, psychosocial development and basic need satisfaction had significant direct effects on health, with the expected positive signs. Psychosocial development had the strongest direct effect on health and also had a strong direct effect on basic need satisfaction and an indirect effect on health. Support for the hypothesized model has important implications for nursing and other community-based care provider interventions regarding health, including strengthening psychosocial resources.

Adaptation, Psychological↗

PubMed2005

Evaluation of a depression-related model of alcohol problems in 430 probands from the San Diego prospective study.

BACKGROUND: Some individuals might use alcohol to help cope with stress and feelings of depression. Studies of such depression or affect-related models have produced divergent results, which might reflect different definitions of affective disturbances, varying emphasis on excluding substance-induced depressions, and different approaches to defining family histories (FH). This paper describes a prospective study that evaluates a model of the role of depressive episodes in the development of alcohol-related problems, while controlling for substance-induced mood disorders. METHODS: Personal interviews were obtained 10 and 15 years after 430 Caucasian subjects entered a study of drinking but not alcohol-dependent 20-year olds. An AMOS Structural Equation Model (SEM) was used to evaluate the development of alcohol problems in the context of the FH of alcoholism and independent (i.e., not substance induced) depressive episodes, personal histories of independent depression, levels of stress, social support, drinking to cope with stress, expectations of the effects of alcohol, and peer drinking. RESULTS: The SEM explained 51% of the variance for the 15-year outcome, and demonstrated good fitness characteristics. The FH of mood disorders (FHdep) predicted depressive episodes through interactions with higher stress and an FH of alcoholism (FHalc), as well as in the context of lower social support. Depressive episodes contributed to the development of alcohol problems both directly and through drinking to cope. CONCLUSIONS: In this model when independent depressive syndromes developed in individuals with a FH of alcoholism, they modestly enhanced the risk for alcohol-related problems, but FHalc did not by itself increase the risk for independent depressions.

Adaptation, Psychological↗

PubMed2003

The impact of attitudes and beliefs on length of benzodiazepine use: a study among inexperienced and experienced benzodiazepine users.

Prolonged benzodiazepine use is a widespread phenomenon in medical practice. In the present article, we argue that psychological models may contribute to our understanding of benzodiazepine use. This study examined variables derived from the theory of planned behaviour and the health belief model in relation to the length of benzodiazepine use. Data were collected from a sample of all benzodiazepine users with a request for this medicine in the only pharmacy in a Dutch community (N=467). Determinants of the length of benzodiazepine use were analysed separately for inexperienced and experienced users using structural equation modelling (SEM) analyses. For both groups, results showed that the intention to use benzodiazepines was a predictor of length of use. Attitudes towards benzodiazepine use had an indirect influence on length of use, through intentions. Furthermore, a positive attitude toward using benzodiazepines was related to the perceived norm of the prescriber. Experienced users were more inclined to consume benzodiazepines when they had less control over drug taking. In this group, the belief that benzodiazepine use leads to dependence was associated with less control over drug taking and a high intention to use the drug. In addition, older experienced users reported a higher intention to use the drug. For inexperienced users, the perceived attitude of the prescriber towards use of the medicine was a strong determinant. Finally, results of SEM-analyses showed that the model accounted for far more variance in behaviour for experienced users (67%), than for inexperienced users (18%).

Adult↗

PubMed2006

Parenting and adolescent problem behavior: an integrated model with adolescent self-disclosure and perceived parental knowledge as intervening variables.

Parental monitoring, assessed as (perceived) parental knowledge of the child's behavior, has been established as a consistent predictor of problem behavior. However, recent research indicates that parental knowledge has more to do with adolescents' self-disclosure than with parents' active monitoring. Although these findings may suggest that parents exert little influence on adolescents' problem behavior, the authors argue that this conclusion is premature, because self-disclosure may in itself be influenced by parents' rearing style. This study (a) examined relations between parenting dimensions and self-disclosure and (b) compared 3 models describing the relations among parenting, self-disclosure, perceived parental knowledge, and problem behavior. Results in a sample of 10th- to 12th-grade students, their parents, and their peers demonstrated that high responsiveness, high behavioral control, and low psychological control are independent predictors of self-disclosure. In addition, structural equation modeling analyses demonstrated that parenting is both indirectly (through self-disclosure) and directly associated with perceived parental knowledge but is not directly related to problem behavior or affiliation with peers engaging in problem behavior.

Adolescent↗

PubMedDate not supplied

Women's sexual functioning, lifestyle, mid-age, and menopause in 12 European countries.

OBJECTIVE: To assess whether there are differences between women from different European countries in lifestyles and sexual functioning, and to identify the relative impact of social, hormonal, and lifestyle factors on mid-aged women's sexual functioning. DESIGN: Cross-sectional survey of a convenience sample of 601 women aged 45 to 60 years, consulting general practitioners in 12 European countries. Women completed the Short Personal Experiences Questionnaire and questions regarding social factors, lifestyle, attitudes, well-being, stress, health, and menopause status. RESULTS: Significant differences were found in psychosocial and lifestyle variables between countries. The only domain of sexual functioning that varied between countries was frequency of sexual intercourse (P < 0.05), the highest being for the group of Latin or southern countries (France, Portugal, Italy, Spain). General linear modeling found that change of partner, existence of partner, well-being, parity, and exercise were associated with both sexual response and frequency of sexual intercourse. Menopause status and stress were significantly associated with sexual response. Country of origin and body mass index were significantly associated with frequency of sexual intercourse. Structured equation modeling found that recalled experience on each sexual domain was the most important factor influencing that domain, whereas feelings for partner and change of partner had significant effects. A similar explanatory model was found for the sexual functioning for mid-aged European women as for Australian mid-aged women. CONCLUSIONS: There are significant differences between European countries in women's reports of lifestyles, psychosocial factors, and frequency of sexual intercourse but not in other aspects of their sexual response. These findings generate hypotheses to be tested in larger studies of female sexual functioning.

Aging↗

PubMed2005

The heritability of CHD mortality in danish twins after controlling for smoking and BMI.

Cause-specific mortality data on Danish monozygotic and dizygotic twins are used to analyze heritability estimates of susceptibility to coronary heart disease (CHD) after controlling for smoking and Body Mass Index (BMI). The sample includes 1209 like-sexed twin pairs born between 1890 and 1920, where both individuals were still alive in 1966. The participants completed a questionnaire in 1966 which included questions on smoking, height and weight. The analysis was conducted with both sexes pooled due to the relatively small number of twin pairs. Follow-up was conducted from January 1, 1966 to December 31, 1993. The correlated gammafrailty model with observed covariates was used for the genetic analysis of frailty to account for censoring and truncation in the lifetime data. During the follow-up, 1437 deaths occurred, including 435 deaths due to CHD. Proportions of variance of frailty attributable to genetic and environmental factors were analyzed using the structural equation model approach. Different standard biometric models are fitted to the data to evaluate the magnitude and nature of genetic and environmental factors on mortality. Using the best-fitting model without covariates, heritability of frailty to CHD was found to be 0.45 (0.11). This result changes only slightly to 0.55 (0.13) in a DE model after controlling for smoking and BMI. This analysis underlines the existence of a substantial genetic influence on individual frailty associated with mortality caused by CHD.

Body Mass Index↗

PubMed2006

Perceived risk and worry about prostate cancer: a proposed conceptual model.

Prostate cancer is one of the most common forms of cancer among American men, and worry about the disease has psychological, behavioral, and biological consequences. To better understand prostate cancer-specific worry, the authors tested a model of the interrelationships among family history of prostate cancer; perceived risk of and worry about prostate cancer; and perceived risk of and worry about other diseases. Men who attended prostate cancer-screening appointments at a general urology practice (n=209) were given a brief anonymous self-report measure. Structural equation modeling (LISREL) results indicated: (1) perceived risk of prostate cancer mediated the relationship between family history of prostate cancer and prostate cancer worry; (2) perceived risk of other diseases increased perceived risk of prostate cancer; and (3) prostate cancer worry and increased other disease worry.

Adult↗

PubMed2002

Extension of the behavioral model of healthcare utilization with ethnically diverse, low-income women.

OBJECTIVE: Psychosocial vulnerabilities were added to a model of healthcare utilization. This extension was tested among low-income women with ethnicity addressed as a moderator. DESIGN: Structured interviews were conducted at 2 points in time, approximately 1 year apart. The constructs of psychosocial vulnerability, demographic predisposing, barriers, and illness were measured by multiple indicators to allow use of Structural Equation Modeling to analyze results. The models were tested separately for each ethnic group. SETTING: Community office. PARTICIPANTS: African-American (N = 266), Euro-American (N = 200), and Mexican-American (N = 210) women were recruited from the Dallas Metropolitan area to participate in Project HOW: Health Outcomes of Women, a multi-year, multi-wave study. Face-to-face interviews were conducted with this sample. Participants had been in heterosexual relationships for at least 1 year, were between 20 and 49 years of age, and had incomes less than 200% of the national poverty level. MAIN OUTCOME MEASURES: Healthcare utilization, defined as physician visits and general healthcare visits. RESULTS: Illness mediated the effect of psychosocial vulnerability on healthcare utilization for African Americans and Euro-Americans. The model for Mexican Americans was the most complex. Psychosocial vulnerability on illness was partially mediated by barriers, which also directly affected utilization. CONCLUSIONS: Psychosocial vulnerabilities were significant utilization predictors for healthcare use for all low-income women in this study. The final models for the 2 minority groups, African Americans and Mexican Americans, were quite different. Hence, women of color should not be considered a homogeneous group in comparison to Euro-Americans.

Adult↗

PubMed2001

Effects of supervisor support and coping on shiftwork tolerance.

This study examines the effects of supervisor support and coping on work/non-work conflict and health in shiftwork. It describes a model of shiftwork tolerance that is tested on samples from two populations of shiftworkers. The samples--of nurses and ambulance workers--differed by occupation, gender and shift schedule. Quantitative (survey questionnaire) and qualitative methods (in-depth interviews) were used to triangulate results and to yield richer data on psychosocial variables. Structural equation modelling, using EQS, was used to describe the common path relationships observed within both samples of shiftworkers. The results demonstrated important relationships between social support from supervisors, coping strategies, work/non-work conflict and symptoms that transferred robustly between the two populations of shiftworkers.

Adaptation, Psychological↗

PubMed2006

Mediators and moderators of parental involvement on substance use: a national study of adolescents.

Current social developmental theories of drug use often incorporate mediation processes, but it is generally unknown whether these mediation processes generalize across ethnicity and gender. In the present study, we developed a mediation model of substance use based on current theory and research and then tested the extent to which the model was moderated by gender and ethnicity (African American, European American, and Hispanic American), separately for 8th and 10th graders. The respondents were adolescents from the 1994, 1995, and 1996 cohorts of the Monitoring the Future (MTF) project, which conducts yearly in-school surveys with nationally representative samples. Multi-group, structural equation modeling (SEM) results indicated much similarity across gender and ethnicity for school success and time spent with friends as partial mediators of risk taking and parental involvement on drug use (controlling for parental education). However, there were some differences in the magnitude of indirect effects of parental involvement and risk taking on substance use for 8th-grade African American girls. Discussion focuses on the potential success of prevention efforts across different ethnicities and gender that target parent-child relationship improvement and risk taking, and considers possible culture- and gender-specific issues.

Adolescent↗