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30 - Mediation, Moderation, and Conditional Process Analysis

Regression-Based Approaches for Clinical Research

from Part VII - General Analytic Considerations

Published online by Cambridge University Press:  23 March 2020

By
Nicholas J. Rockwood  and
Andrew F. Hayes
Edited by
Aidan G. C. Wright  and
Michael N. Hallquist
Aidan G. C. Wright
Affiliation:
University of Pittsburgh
Michael N. Hallquist
Affiliation:
Pennsylvania State University
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Summary

Clinical psychological science is improved when it seeks to understand not only whether an effect exists but also how that effect operates and its boundary conditions. Mediation and moderation analysis are widely used in clinical psychological research to explore and test hypotheses about the mechanisms by which causal effects operate and the contingencies of those effects. Their integration as conditional process analysis allows for the examination of the contingencies of those mechanisms – for whom or in what circumstances a particular mechanism is in operation or whether it is strong as opposed to weak. This chapter reviews the fundamentals of mediation, moderation, and conditional process analysis using ordinary least squares regression, commenting along the way on good practice as well as various misunderstandings in circulation. It illustrates the application of these fundamentals and their implementation using the PROCESS macro for SPSS and SAS.

Keywords

mediationmoderationinteractionconditional process analysismoderated mediation
Type
Chapter
Information
The Cambridge Handbook of Research Methods in Clinical Psychology , pp. 396 - 414
Publisher: Cambridge University Press
Print publication year: 2020

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References

Aroian, L. A. (1947). The Probability Function of the Product of Two Normally Distributed Variables. Annals of Mathematical Statistics, 265–271.Google Scholar
Barnett, N. P., Apodaca, T. R., Magill, M., Colby, S. M., Gwaltney, C., Rohsenow, D. J., & Monti, P. M. (2010). Moderators and Mediators of Two Brief Interventions for Alcohol in the Emergency Department. Addiction, 105(3), 452–465.Google Scholar
Baron, R. M., & Kenny, D. A. (1986). The Moderator-Mediator Variable Distinction in Social Psychological Research: Conceptual, Strategic, and Statistical Considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182.Google Scholar
Bauer, D. J., & Curran, P. J. (2005). Probing Interactions in Fixed and Multilevel Regression: Inferential and Graphical Techniques. Multivariate Behavioral Research, 40, 373–400.CrossRefGoogle ScholarPubMed
Bollen, K. A. (1989). Structural Equation Modeling with Latent Variables. New York: Wiley.Google Scholar
Cerin, E., & MacKinnon, D. P. (2009). A Commentary on Current Practice in Mediating Variable Analyses in Behavioural Nutrition and Physical Activity. Public Health Nutrition, 12(8), 1182–1188.Google Scholar
Collins, L. M., Murphy, S. A., & Bierman, K. L. (2004). A Conceptual Framework for Adaptive Preventive Interventions. Prevention Science, 5(3), 185–196.Google Scholar
Darlington, R. B., & Hayes, A. F. (2017). Regression Analysis and Linear Models: Concepts, Applications, and Implementation. New York: Guilford Press.Google Scholar
Duchesne, A.-P., Dion, J., Lalande, D., Bégin, C., Émond, C., Lalande, G., & McDuff, P. (2017). Body Dissatisfaction and Psychological Distress in Adolescents: Is Self-Esteem a Mediator? Journal of Health Psychology, 22(12), 1563–1569.Google Scholar
Edwards, J. R., & Lambert, A. L. (2007). Methods for Integrating Moderation and Mediation: A General Analytical Framework Using Moderated Path Analysis. Psychological Methods, 12, 1–22.Google Scholar
Efron, B., & Tibshirani, R. J. (1994). An Introduction to the Bootstrap. Boca Raton, FL: Chapman and Hall.CrossRefGoogle Scholar
Emmelkamp, P. M., David, D., Beckers, T., Muris, P., Cuijpers, P., Lutz, W., … Berking, M. (2014). Advancing Psychotherapy and Evidence-Based Psychological Interventions. International Journal of Methods in Psychiatric Research, 23(S1), 58–91.CrossRefGoogle ScholarPubMed
Finney, J. W. (1995). Enhancing Substance Abuse Treatment Evaluations: Examining Mediators and Moderators of Treatment Effects. Journal of Substance Abuse, 7(1), 135–150.Google Scholar
Frazier, P. A., Tix, A. P., & Barron, K. E. (2004). Testing Moderator and Mediator Effects in Counseling Psychology Research. Journal of Counseling Psychology, 51(1), 115–134.Google Scholar
Gaume, J., Longabaugh, R., Magill, M., Bertholet, N., Gmel, G., & Daeppen, J.-B. (2016). Under What Conditions? Therapist and Client Characteristics Moderate the Role of Change Talk in Brief Motivational Intervention. Journal of Consulting and Clinical Psychology, 84(3), 211–220.Google Scholar
Hayes, A. F. (2009). Beyond Baron and Kenny: Statistical Mediation Analysis in the New Millennium. Communication Monographs, 76, 408–420.CrossRefGoogle Scholar
Hayes, A. F. (2015). An Index and Test of Linear Moderated Mediation. Multivariate Behavioral Research, 50(1), 1–22.Google Scholar
Hayes, A. F. (2018). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach (2nd edn.). New York: Guilford Press.Google Scholar
Hayes, A. F., & Matthes, J. (2009). Computational Procedures for Probing Interactions in OLS and Logistic Regression: SPSS and SAS Implementations. Behavior Research Methods, 41, 924–936.CrossRefGoogle ScholarPubMed
Hayes, A. F., & Montoya, A. K. (2017). A Tutorial on Testing, Visualizing, and Probing an Interaction Involving a Multicategorical Variable in Linear Regression Analysis. Communication Methods and Measures, 11(1), 1–30.CrossRefGoogle Scholar
Hayes, A. F., & Preacher, K. J. (2014). Statistical Mediation Analysis with a Multicategorical Independent Variable. British Journal of Mathematical and Statistical Psychology, 67(3), 451–470.CrossRefGoogle ScholarPubMed
Hayes, A. F., & Rockwood, N. J. (2017). Regression-Based Statistical Mediation and Moderation Analysis in Clinical Research: Observations, Recommendations, and Implementation. Behaviour Research and Therapy, 98, 39–57.Google Scholar
Hayes, A. F., & Scharkow, M. (2013). The Relative Trustworthiness of Inferential Tests of the Indirect Effect in Statistical Mediation Analysis Does Method Really Matter? Psychological Science, 24(10), 1918–1927.Google Scholar
Hayes, A. F., Montoya, A. K., & Rockwood, N. J. (2017). The Analysis of Mechanisms and Their Contingencies: PROCESS versus Structural Equation Modeling. Australasian Marketing Journal, 25, 76–81.Google Scholar
Imai, K., Keele, L., & Tingley, D. (2010). A General Approach to Causal Mediation Analysis. Psychological Methods, 15(4), 309–334.Google Scholar
Kazdin, A. E. (2007). Mediators and Mechanisms of Change in Psychotherapy Research. Annual Review of Clinical Psychology, 3, 1–27.Google Scholar
Kenny, D. A., & Judd, C. M. (2014). Power Anomalies in Testing Mediation. Psychological Science, 25, 334–339.CrossRefGoogle ScholarPubMed
Kraemer, H. C., Kiernan, M., Essex, M., & Kupfer, D. J. (2008). How and Why Criteria Defining Moderators and Mediators Differ between the Baron & Kenny and MacArthur Approaches. Health Psychology, 27, S101–S108.Google Scholar
Kraemer, H. C., Wilson, G. T., Fairburn, C. G., & Agras, W. S. (2002). Mediators and Moderators of Treatment Effects in Randomized Clinical Trials. Archives of General Psychiatry, 59(10), 877–883.Google Scholar
MacKinnon, D. P., Lockwood, C. M., & Williams, J. (2004). Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods. Multivariate Behavioral Research, 39(1), 99–128.CrossRefGoogle ScholarPubMed
Magill, M. (2011). Moderators and Mediators in Social Work Research: Toward a More Ecologically Valid Evidence Base for Practice. Journal of Social Work, 11(4), 387–401.Google Scholar
Mason, M., Mennis, J., Way, T., & Campbell, L. F. (2015). Real-Time Readiness to Quit and Peer Smoking within a Text Message Intervention for Adolescent Smokers: Modeling Mechanisms of Change. Journal of Substance Abuse Treatment, 59, 67–73.Google Scholar
Maxwell, S. E., & Cole, D. A. (2007). Bias in Cross-Sectional Analyses of Longitudinal Mediation. Psychological Methods, 12(1), 23–44.Google Scholar
Maxwell, S. E., Cole, D. A., & Mitchell, M. A. (2011). Bias in Cross-Sectional Analyses of Longitudinal Mediation: Partial and Complete Mediation under an Autoregressive Model. Multivariate Behavioral Research, 46(5), 816–841.CrossRefGoogle ScholarPubMed
Muthén, L. K., & Muthén, B. (2015). Mplus Version 7.4 [Computer software manual]. Los Angeles: Muthén & Muthén.Google Scholar
Norcross, J. C., & Wampold, B. E. (2011). What Works for Whom: Tailoring Psychotherapy to the Person. Journal of Clinical Psychology, 67(2), 127–132.Google Scholar
Onken, L. S., Carroll, K. M., Shoham, V., Cuthbert, B. N., & Riddle, M. (2014). Re-envisioning Clinical Science: Unifying the Discipline to Improve the Public Health. Clinical Psychological Science, 2(1), 22–34.Google Scholar
O’Rourke, H. P., & MacKinnon, D. P. (2018). Reasons for Testing Mediation in the Absence of an Intervention Effect: A Research Imperative in Prevention and Intervention Research. Journal of Studies on Alcohol and Drugs, 79, 171–181.Google Scholar
Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and Resampling Strategies for Assessing and Comparing Indirect Effects in Multiple Mediator Models. Behavior Research Methods, 40(3), 879–891.Google Scholar
Preacher, K. J., & Selig, J. P. (2012). Advantages of Monte Carlo Confidence Intervals for Indirect Effects. Communication Methods and Measures, 6(2), 77–98.Google Scholar
Preacher, K. J., Rucker, D. D., & Hayes, A. F. (2007). Addressing Moderated Mediation Hypotheses: Theory, Methods, and Prescriptions. Multivariate Behavioral Research, 42(1), 185–227.Google Scholar
Rosseel, Y. (2012). lavaan: An R Package for Structural Equation Modeling. Journal of Statistical Software, 48(2), 1–36.CrossRefGoogle Scholar
Rucker, D. D., Preacher, K. J., Tormala, Z. L., & Petty, R. E. (2011). Mediation Analysis in Social Psychology: Current Practices and New Recommendations. Social and Personality Psychology Compass, 5(6), 359–371.CrossRefGoogle Scholar
Schmidt, S. J., & Schimmelmann, B. G. (2015). Mechanisms of Change in Psychotherapy for Children and Adolescents: Current State, Clinical Implications, and Methodological and Conceptual Recommendations for Mediation Analysis. European Child and Adolescent Psychiatry, 24, 249–253.Google Scholar
Shanmugam, V., & Davies, B. (2015). Clinical Perfectionism and Eating Psychopathology in Athletes: The Role of Gender. Personality and Individual Differences, 74, 99–105.CrossRefGoogle Scholar
Shrout, P. E., & Bolger, N. (2002). Mediation in Experimental and Nonexperimental Studies: New Procedures and Recommendations. Psychological Methods, 7(4), 422–445.Google Scholar
Singewald, N., Schmuckermair, C., Whittle, N., Holmes, A., & Ressler, K. J. (2015). Pharmacology of Cognitive Enhancers for Exposure-Based Therapy of Fear, Anxiety and Trauma-Related Disorders. Pharmacology & Therapeutics, 149, 150–190.Google Scholar
Sobel, M. E. (1982). Asymptotic Confidence Intervals for Indirect Effects in Structural Equation Models. Sociological Methodology, 13(1982), 290–312.Google Scholar
Stanley, I. H., Joiner, T. E., & Bryan, C. J. (2017). Mild Traumatic Brain Injury and Suicide Risk among a Clinical Sample of Deployed Military Personnel: Evidence for a Serial Mediation Model of Anger and Depression. Journal of Psychiatric Research, 84, 161–168.CrossRefGoogle ScholarPubMed
Torres, L., & Taknint, J. T. (2015). Ethnic Microaggressions, Traumatic Stress Symptoms, and Latino Depression: A Moderated Mediational Model. Journal of Counseling Psychology, 62(3), 393–401.CrossRefGoogle ScholarPubMed
Valeri, L., & VanderWeele, T. J. (2013). Mediation Analysis Allowing for Exposure-Mediator Interactions and Causal Interpretation: Theoretical Assumptions and Implementation with SAS and SPSS Macros. Psychological Methods, 18(2), 137–150.Google Scholar
Windgassen, S., Goldsmith, K., Moss-Morris, R., & Chalder, T. (2016). Establishing How Psychological Therapies Work: The Importance of Mediation Analysis. Journal of Mental Health, 25(2), 93–99.Google Scholar
Zhang, H., Neelarambam, K., Schwenke, T. J., Rhodes, M. N., Pittman, D. M., & Kaslow, N. J. (2013). Mediators of a Culturally-Sensitive Intervention for Suicidal African-American Women. Journal of Clinical Psychology in Medical Settings, 20(4), 401–414.Google Scholar

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