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Longitudinal direct and indirect pathways linking older sibling competence to the development of younger sibling competence.

A 4-wave longitudinal model tested direct and indirect links between older sibling (OS; M = 11.7 years) and younger sibling (YS; M = 9.2 years) competence in 152 rural African American families. Data were collected at 1-year intervals. At each wave, different teachers assessed OS competence, YS competence, and YS self-regulation. Mothers reported their own psychological functioning; mothers and YSs reported parenting practices toward the YS. OS competence was stable across time and was linked with positive changes in mothers' psychological functioning from Wave 1 to Wave 2. Mothers' Wave 2 psychological functioning was associated with involved-supportive parenting of the YS at Wave 3. OS Wave 2 competence and Wave 3 parenting were indirectly linked with Wave 4 YS competence, through Wave 3 YS self-regulation. Structural equation modeling controlled for Wave 1 YS competence; thus, the model accounted for change in YS competence across 3 years.

Achievement↗

The importance of a positive family history of alcoholism, parental rejection and emotional warmth, behavioral problems and peer substance use for alcohol problems in teenagers: a path analysis.

OBJECTIVE: The purpose of this study was to test a hypothetical model of alcohol problems in German adolescents. Among 180 offspring, family history of alcoholism, parenting styles, behavioral and emotional problems, peer-group characteristics, feelings of self-esteem, behavioral problems and psychiatric comorbidity of the parents were examined. METHOD: Data were generated from the Study of Health in Pomerania (SHIP), in which families were randomly selected if 12-18 year old biological offspring were members of the household; a smaller group of subjects was selected from local outpatient treatment centers. Members of 133 families, including 180 (50.6% male) offspring who were appropriate for the current analyses, received personal semistructured diagnostic interviews and several self-rating questionnaires. Analyses compared offspring with alcohol problems (AP; n = 40) and with no alcohol problems (NAP; n = 140), and used structural equation modeling to test a hypothetical model. RESULTS: The comparisons revealed that the AP group had significantly more behavioral problems (e.g., aggression/delinquency), more perceived parental rejection and less emotional warmth, a higher amount of alcohol consumption, were more likely to associate with substance-using peers and more often received a diagnosis of conduct disorder or antisocial personality disorder. Whereas the family history of alcoholism did not differ significantly between groups, parents of offspring with an alcohol use disorder had significantly more additional diagnoses on DSM-IV Axis I. The evaluation of the model supported the importance of aggression/delinquency and association with substance-using peers for alcohol problems in people. An additional diagnosis in the parents was directly and indirectly (through aggression/delinquency) related to alcohol problems of the adolescents. CONCLUSIONS: The data indicate that alcohol problems in the offspring are associated with several domains of influence in their environment. Prospective studies measuring both biological and environmental factors using sufficient sample sizes will be needed for optimal understanding of the development of alcohol problems in youth.

Adolescent↗

Psychosocial, behavioral, and medical outcomes in children with epilepsy: a developmental risk factor model using longitudinal data.

OBJECTIVE: We studied factors predicting the risk of adverse long-term psychosocial, behavioral, and medical outcomes in children with epilepsy. METHODS: Children (N = 157, 4.5 to 13 years) were enrolled in a prospective longitudinal study when first seen. Potential subjects were excluded if they were moderately or severely mentally retarded, had motor or sensory handicaps interfering with testing, or did not speak either English or Spanish. MEASURES: To develop risk predictors, we collected information regarding the child's medical and seizure history, cognitive functioning, and behavior problems, and family functioning. Children and their families were followed for a minimum of 18 months, then underwent reassessment of medical status, parent's attitudes toward epilepsy, and the child's behavioral and cognitive functioning. Data were analyzed by confirmatory factor analysis to develop baseline factors (Sociocultural Risk, Seizure Risk, and Behavior Problems) and outcome factors (Medical/Seizure Problems, Parent's Negative Attitudes Toward Epilepsy, and Behavior Problems), followed by structural equation modeling to determine across-time causal effects. Eighty-eight subjects completed all baseline and outcome measures. RESULTS: Among significant across-time effects, Medical Outcome was predicted by Seizure Risk. An increased number of stressful life events predicted better Medical Outcome. Low acculturation increased Parent's Negative Attitudes and was associated with increased Behavior Problems at baseline. Behavior Problems were stable across time. It is interesting that IQ did not affect any of the outcomes, although its effect may have been mediated through other baseline measures. CONCLUSIONS: Seizure history was the best predictor of ongoing medical difficulties, whereas the most important causes of ongoing parental anxiety and negative attitudes toward epilepsy were sociocultural. Variation in medical or attitudinal outcomes was not influenced by either the child's IQ or reported behavioral problems. These findings suggest that to alter attitudes toward epilepsy, programs should be tailored to the sociocultural background of the family. Studies of quality of life of children with epilepsy should include appropriate sociocultural measures.

Acculturation↗

Counselor emotional exhaustion and turnover intention in therapeutic communities.

Counselor turnover is a significant problem facing substance abuse treatment agencies. Understanding the role of organizational culture in predicting burnout and turnover intention may yield important information on how to address turnover in treatment organizations. Using data collected from 817 counselors employed in a national sample of 253 therapeutic communities (TCs), structural equation modeling was used to estimate the associations between emotional exhaustion, turnover intention, and three measures of organizational culture: centralized decision making, distributive justice, and procedural justice. The model controlled for counselor demographics, credentials, and earnings. Counselors' emotional exhaustion scores were higher in TCs with greater centralized decision making (p < .01) but lower in TCs where greater distributive justice (p < .05) and procedural justice (p < .001) were reported. Likewise, turnover intention was positively associated with centralized decision making (p < .05) and inversely associated with the workplace justice measures (p < .001). These data suggest that management practices in TCs and perhaps in other types of substance abuse treatment facilities likely play a substantial role in counselors' well-being and in their decisions to leave their jobs. Because these practices are not structural features of organizations, they may be targeted for intervention and change.

Adult↗

Hopelessness depression as a distinct dimension of depressive symptoms among clinical and non-clinical samples.

Subtyping depression has been an interest of theorists and clinicians for at least four centuries. In this paper, we examined the validity of the symptom cluster component of the hopelessness theory of depression. We used structural equation modeling analyses on large samples of psychiatric outpatients (N=1604, 844, and 680) and Air Force cadets (N=1404) who completed the items of the Beck Depression Inventory (BDI). Findings were supportive of the hopelessness depression cluster as a distinct depressive syndrome. Implications for the nosology of depression and for depression theory were discussed.

Adolescent↗

The looming maladaptive style predicts shared variance in anxiety disorder symptoms: further support for a cognitive model of vulnerability to anxiety.

Looming vulnerability pertains to a distinct cognitive phenomenology characterized by mental representations of dynamically intensifying danger and rapidly rising risk as one projects the self into an anticipated future [J. Pers. Soc. Psychol. 79 (2000) 837]. While looming appraisals can be experienced as state elicitation, some individuals are hypothesized to develop an enduring cognitive pattern of cross-situational looming appraisals, the looming maladaptive style (LMS), which functions as a cognitive vulnerability to anxiety. In the present study, we examined the extent to which the LMS predicts common variance in numerous anxiety disorder symptoms, independent of the potentially confounding effects of current depressive symptoms. Specifically, we hypothesized that controlling for depressive symptoms, LMS would predict shared variance in a latent factor comprised of indicators of five anxiety disorder symptoms: obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, social phobia, and specific phobic fears. Measures of these anxiety disorder symptoms, depressive symptoms, and looming vulnerability were administered to unselected college student population. Structural equations modeling analyses provided support for our hypothesis that LMS predicts shared variance in anxiety disorder symptoms and suggest that this cognitive style may be an overarching dimension of vulnerability to anxiety.

Adaptation, Psychological↗

A model of smoking among inner-city adolescents: the role of personal competence and perceived social benefits of smoking.

BACKGROUND: Based on current trends, smoking will remain a major public health problem in the 21st century. Effective smoking prevention approaches offer the best hope for decreasing the rise in adolescent smoking rates. Competence enhancement approaches to smoking prevention are among the most successful. Yet, there is not a full understanding of how effective prevention approaches work. This study tests whether a deficiency in competence (poor decision-making skills and low personal efficacy) is linked to acquiring beliefs in the perceived benefits of smoking and whether these perceived benefits are then related to subsequent smoking. METHODS: A sample of 1459 students attending 22 middle and junior high schools in New York City participated. Students completed surveys at baseline, 1-year follow-up and 2-year follow-up during a regular class period. They self-reported smoking, decision-making skills, personal efficacy and beliefs in the perceived benefits of smoking. RESULTS: The tested structural equation model had a good fit and was parsimonious and consistent with the theory underlying the competence approach to smoking prevention. CONCLUSIONS: This research highlights the importance of addressing decision-making skills, personal efficacy, and beliefs in the social benefits of smoking within adolescent smoking prevention programs.

Adolescent↗

The effects of interpersonal and personal agency on perceived control and psychological well-being in adulthood.

A theoretical model that links social support with global beliefs in primary control and provides a developmental perspective on how normative age-related changes alter control beliefs was examined with data from 482 adults aged 18 to 93. Generalized belief in primary control was hypothesized to have a direct positive effect on psychological well-being and to arise from two distinct sources: (a) interpersonal agency (obtaining positive ends through interactions with others) and (b) personal agency (achieving desired outcomes on one's own behalf). Age was believed to affect both types of agency indirectly as a result of age-related changes in physical health and emotional support. Although physical health was presumed to have a direct positive effect on psychological well-being, the effect of emotional support on well-being was mediated by interpersonal agency and perceived primary control. Structural equation modeling analyses with the EQS 5.4 program revealed good model fit (goodness-of-fit index = .98, comparative fit index = .94, root mean square residual [RMR] = .02, standardized RMR = .05, root mean square error of approximation = .06) after a negative direct path from age to generalized beliefs in primary control was added to the a priori model.

Adult↗

Neurodevelopmental outcomes of infants born prematurely.

Long-term follow-up of infants born prematurely is necessary to determine neurodevelopmental outcomes, particularly with the expansion of interest from major disabilities to high prevalence/low severity dysfunctions. Models of pathogenesis include changes due to developmental disruptions and to injury, the magnitude and type of change influenced by the infant's age, and central nervous system recovery and reorganization. Alterations in neurogenesis, migration, myelination, cell death, and synaptogenesis occur even in the absence of insult. Despite increased knowledge regarding these processes, the functional significance of brain abnormalities is unclear. Because of methodologic problems in follow-up studies, it is difficult to characterize outcome definitively. Nonetheless, an acceptable degree of agreement across studies is found with regard to specific neurodevelopmental outcomes: motor/neurologic function, visuomotor integrative skills, IQ, academic achievement, language, executive function, and attention-deficit hyperactivity disorder/behavioral issues. In general, children born prematurely have more problems in these areas than do their normal birth weight counterparts. Suggestions for improved analyses and clarification of outcomes include use of cluster analysis, structural equation modeling, growth curve analysis, developmental epidemiologic approaches, and better control of background variables using risk indexes and factor scores. Better assessment techniques measuring functions documented to be at higher risk of problems are discussed.

Brain Diseases↗

Professional nursing practice: impact on organizational and patient outcomes.

OBJECTIVE: To test a causal model of the impact of (a) nursing unit context on professional nursing practice; (b) professional practice on selected organizational (nurses' work satisfaction, nursing turnover, average length of patient stay) and patient outcomes (patient satisfaction, rate of reported medication errors, and falls); and (c) nursing unit context on these same organizational and patient outcomes. SUMMARY BACKGROUND DATA: Professional nursing practice has been linked to positive outcomes for both nurses and patients. In contrast to other studies, this study focuses on professional nursing practice specifically at the nursing unit level, and uses a new analytic technique that permits examination of the simultaneous effects of professional nursing practice on both organizational and patient outcomes. METHODS: Data were collected from 1682 registered nurses, and 1326 patients on 124 general medical-surgical nursing units in 64 general short-term acute care hospitals in the southeast. Multilevel structural equation modeling was used to analyze the data. RESULTS: We found that professional nursing practice had consistent effects across model levels on nursing satisfaction, but very limited effects on other outcomes. Important differences in the hospital- and nursing unit level models support continued use of multilevel modeling techniques in the study of organizational and patient outcomes.

Accidental Falls↗

Frame of Reference Effects Following the Announcement of Exam Results.

The internal/external frame of reference (I/E) model by Marsh (e.g., 1990a) assumes two central information sources for the constitution of domain-specific academic self-concepts: (1) social comparisons (external frame of reference), in which students compare their own achievements with those of their classmates; and (2) intraindividual comparisons (internal frame of reference), in which students compare their own achievements in one subject with their achievements in other subjects. In path analyses, it has been found that the latter type of comparison leads to negative paths from achievement indicators in subject A to self-concept measures in subject B. To investigate the actual impact of achievement feedback and of the frames of reference on changes in self-concept variables, we analyzed math and German self-concepts immediately following the announcement of exam results in each subject. Participants were 258 7th- to 9th-graders. Path analyses using structural equation modeling supported the validity of the I/E model with respect to the impact of simultaneously given current exam results. In particular, German achievement had a negative impact on subsequent math self-concept. Copyright 2001 Academic Press.

Journal Article↗

Testing a causal model of community-based education in the Sudan.

PURPOSE: To develop and test a model of community-based education. METHOD: In 1995, after developing a hypothesized causal model for community-based education, the authors collected data for 106 students at the University of Gezira, the Sudan, who had participated over three summers in an interdisciplinary field training research and rural development course. The students rated each other on leadership, interaction with the community, subject-matter contributions, and effort. Teaching staff assessed the readiness of the community to collaborate. The students' achievement was measured by short essays measuring knowledge, supervisors' assessments of the students' performances in the community, the community's observations of the students' activities, the community's satisfaction, and a group-produced report evaluated by faculty. The effect of the students' activities on the community was measured by comparing baseline and post-intervention community health data. The students also indicated their levels of interest in the community's problems. The authors analyzed the resulting covariances using structural-equations modeling. RESULTS: After minor adaptations, the model fitted the data reasonably well. The path coefficients were quite high, particularly among the peer ratings. Leadership had a potent effect on the outcome measures, as did, to a lesser extent, the readiness of the community to collaborate with the students. CONCLUSION: This study was the first reported attempt to test a model of community-based education. Although the fit of the data to the model in the study was reasonable, further study is needed to unearth additional important elements of community-based education. This article also discusses methodologic shortcomings of the present study, such as a possible "halo effect" in the peer ratings and the retrospective nature of many of the measurements.

Ambulatory Care Facilities↗

Assessing remedial effectiveness through the blood lead:soil/dust lead relationship at the Bunker Hill Superfund Site in the Silver Valley of Idaho.

The 21 square mile Bunker Hill Superfund Site in northern Idaho includes several thousand acres of contaminated hillsides and floodplain, a 365-acre abandoned lead/zinc smelter and is home to more than 7000 people in 5 residential communities. Childhood lead poisoning was epidemic in the 1970s with >75% of children exceeding 40 microg/dl blood lead. Health response activities have been ongoing for three decades. In 1991, a blood lead goal of 95% of children with levels less than 10 microg/dl was adopted. The cleanup strategy, based on biokinetic pathways models, was to reduce house dust lead exposure through elimination of soil-borne sources. An interim health intervention program, that included monitoring blood lead and exposures levels, was instituted to reduce exposures through parental education during the cleanup. In 1989 and 2001, 56% and 3% of children, respectively, exceeded the blood lead criteria. More than 4000 paired blood lead/environmental exposure observations were collected during this period. Several analyses of these data were accomplished. Slope factors derived for the relationship between blood lead, soil and dust concentrations are age-dependent and similar to literature reported values. Repeat measures analysis assessing year to year changes found that the remediation effort (without intervention) had approximately a 7.5 microg/dl effect in reducing a 2-year-old child's mean blood lead level over the course of the last ten years. Those receiving intervention had an additional 2-15 microg/dl decrease. Structural equations models indicate that from 40 to 50% of the blood lead absorbed from soils and dusts is through house dust with approximately 30% directly from community-wide soils and 30% from the home yard and immediate neighborhood. Both mean blood lead levels and percent of children to exceed 10 microg/dl have paralleled soil/dust lead intake rates estimated from the pathways model. Application of the IEUBK model for lead indicates that recommended USEPA default parameters overestimate mean blood lead levels, although the magnitude of over-prediction is diminished in recent years. Application of the site-specific model, using the soil and dust partitions suggested in the pathways model and an effective bioavailability of 18%, accurately predicts mean blood lead levels and percent of children to exceed 10 microg/dl throughout the 11-year cleanup period. This reduced response rate application of the IEUBK is consistent with the analysis used to originally develop the cleanup criteria and indicates the blood lead goal will be achieved.

Absorption↗

Ethnic and gender differences in psychosocial risk, protection, and adolescent alcohol use.

Theoretical models suggest that many diverse psychosocial factors contribute to the etiology of substance use among youth. It has been suggested that substance use is a function of the total number of etiologic factors, rather than a specific type or set of factors. This study examined whether cumulative psychosocial risk and protection measured in the 7th grade predicted alcohol use in the 9th grade across ethnically diverse samples of adolescents. Participants consisted of black (n = 775) and Hispanic (n = 467) inner-city youth and white suburban youth (n = 708). Prevalence rates for alcohol use and risk/protection varied more widely based on ethnic group compared to gender. Black youth reported the fewest risk factors and lowest levels of alcohol use, white youth reported the most risk factors and highest levels of alcohol use, and Hispanic youth reported the fewest protective factors and intermediate levels of alcohol use. Despite these differences, structural equation modeling indicated that a latent factor consisting of cumulative risk, protection, and their interaction significantly predicted later alcohol use for the combined sample as well as for each ethnic/ gender subgroup. However, the proportion of variance explained in alcohol use varied across subgroups, and moderator analyses indicated that protection significantly buffered the effects of risk differentially across subgroups. The strongest protective effects were observed among black inner-city youth. Findings suggest that prevention approaches should focus on enhancing protection in addition to reducing risk, particularly among youth with lower levels of psychosocial protection.

Adolescent↗

JSEM: a framework for identifying and evaluating indicators.

There are two issues in indicator development that have not been adequately addressed: (1) how to select an optimal combination of potentially redundant indicators that together best represent an endpoint, given cost constraints; (2) how to identify and evaluate indicators when the endpoint is unmeasured. This paper presents an approach to identifying and evaluating combinations of indicators when the mathematical relationships between the indicators and an endpoint may not be quantified, a limitation common to many ecological assessments. The approach uses the framework of Structural Equation Modeling (SEM), which combines path analysis with measurement models, to formalize available information about potential indicators and to evaluate their potential adequacy for representing an endpoint. Unlike traditional applications of SEM which require data on all variables, our approach---judgement-based SEM (JSEM)--can utilize expert judgement regarding the strengths and shapes of indicator-endpoint relationships. JSEM is applied in two stages. First, a conceptual model that relates variables in a network of direct and indirect linkages is developed, and is used to identify indicators relevant to an endpoint. Second, an index of indicator strength--i.e., the strength of the relationship between the endpoint and a set of indicators--is calculated from estimates of correlation between the modeled variables, and is used to compare alternative sets of indicators. The second stage is most appropriate for large, long-term assessments. Although JSEM is not a statistical technique, basing JSEM on SEM provides a structure for validating the conceptual model and for relining the index of indicator strength as data become available. Our main objective is to contribute to a rigorous and consistent selection of indicators even when knowledge about the ability of indicators to represent an endpoint is limited to expert judgement.

Ecosystem↗

Routes of success: influences on the occupational attainment of young British males.

Using data from the National Child Development Study, the paper develops a complex path model predicting the occupational grade achieved by 4,298 employed British males at age 33. Most British social mobility research has been based in the 'class structurationist' tradition, and the paper begins by comparing this with the 'status attainment' tradition, which is more common in the USA. The class structurationist approach has rarely analysed the factors influencing individual occupational attainment, and those working in this tradition in Britain have often assumed that people from working-class origins fare worse on average than those from the middle class because of factors associated with their class disadvantage rather than any difference in individual characteristics such as ability or ambition. Status attainment research, however, has generally found that individual ability and motivation are the key factors influencing occupational attainment, and that class origins count for comparatively little. Using various measures of class origins, parental support, qualifications, and individual ability and ambition, the paper goes on to develop a linear structural equations model which achieves a good fit to the data. The model demonstrates that individual ability is by far the strongest influence on occupational achievement, that motivation is also important, and that factors like class background and parental support, while significant, are relatively much weaker. The paper concludes that occupational selection in Britain appears to take place largely on meritocratic principles.

Adult↗

Assessing the transtheoretical model of change constructs for physicians counseling smokers.

Baseline data from a population-based sample of 259 primary care physicians were used to examine the interrelations of 3 central constructs of the Transtheoretical Model of Change (TTM; stages of change, self-efficacy, and decisional balance) in regard to smoking cessation counseling behavior. In this article we explore the potential use of the TTM for future interventions to help understand and guide physicians' behavior change toward increasing adoption of smoking cessation interventions with their patients. It was hypothesized that self-efficacy and the decisional balance of counseling would be significantly related to physicians' stages of change, which in turn would be related to self-reported physician counseling behavior. Principal components analyses were conducted to examine the self-efficacy and decisional balance constructs. Coefficient alphas were.90 for self-efficacy and.84 and.78 for the pros and cons scales, respectively. Consistent with the TTM, analyses of variance revealed that later stages of physicians' readiness to provide smoking cessation counseling were associated with higher self-efficacy scores. Earlier stages showed significantly higher cons and lower pros of smoking cessation counseling. Structural equation modeling procedures supported the hypothesized path analysis model in which 3 constructs related to stage of readiness, which in turn related to reported physicians' counseling behavior.

Adult↗

Self-determination, smoking, diet and health.

A Clinical Trial will test (1) a Self-Determination Theory (SDT) model of maintained smoking cessation and diet improvement, and (2) an SDT intervention, relative to usual care, for facilitating maintained behavior change and decreasing depressive symptoms for those who quit smoking. SDT is the only empirically derived theory which emphasizes patient autonomy and has a validated measure for each of its constructs, and this is the first trial to evaluate an SDT intervention. Adult smokers will be stratified for whether they are at National Cholesterol Education Program (1996) recommended goal for low-density lipoprotein cholesterol (LDL-C). Those with elevated LDL-C will be studied for diet improvement as well as smoking cessation. Six-month interventions involve a behavior-change counselor using principles of SDT to facilitate autonomous motivation and perceived competence for healthier behaving. Cotinine-validated smoking cessation and LDL-C-validated dietary recall of reduced fat intake, as well as depressive symptoms, will be assessed at 6 and 18 months. Structural equation modeling will test the model for both behaviors within the intervention and usual-care conditions.

Adult↗