Explanation of Two Anomalous Results in Statistical Mediation Analysis

Previous studies of different methods of testing mediation models have consistently found two anomalous results. The first result is elevated Type I error rates for the bias-corrected and accelerated bias-corrected bootstrap tests not found in nonresampling tests or in resampling tests that did not include a bias correction. This is of special concern as the bias-corrected bootstrap is often recommended and used due to its higher statistical power compared with other tests. The second result is statistical power reaching an asymptote far below 1.0 and in some conditions even declining slightly as the size of the relationship between X and M, a, increased. Two computer simulations were conducted to examine these findings in greater detail. Results from the first simulation found that the increased Type I error rates for the bias-corrected and accelerated bias-corrected bootstrap are a function of an interaction between the size of the individual paths making up the mediated effect and the sample size, such that elevated Type I error rates occur when the sample size is small and the effect size of the nonzero path is medium or larger. Results from the second simulation found that stagnation and decreases in statistical power as a function of the effect size of the a path occurred primarily when the path between M and Y, b, was small. Two empirical mediation examples are provided using data from a steroid prevention and health promotion program aimed at high school football players (Athletes Training and Learning to Avoid Steroids; Goldberg et al., 1996), one to illustrate a possible Type I error for the bias-corrected bootstrap test and a second to illustrate a loss in power related to the size of a. Implications of these findings are discussed.     

The frustrating problem for four-dimensionalism

I argue that four-dimensionalism and the desire satisfaction account of well-being are incompatible. For every person whose desires are satisfied, there will be many shorter-lived individuals (‘person-stages’ or ‘subpersons’) who share the person’s desires but who do not exist long enough to see those desires satisfied; not only this, but in many cases their desires are frustrated so that the desires of the beings in whom they are embedded as proper temporal parts may be fulfilledI call this the frustrating problem for four-dimensionalism. In the first half of the paper I lay the groundwork for understanding the frustrating problem, and then in the second half, I will examine six possible responses to the frustrating problem on behalf of the four-dimensionalist, (i) the Parfit (1984) inspired claim that identity is not what matters, (ii) the personal pronoun revisionism of Noonan (Analysis 70(1):93–98, 2010), (iii) the indirect concern account of Hudson (A materialist metaphysics of the human person, Cornell University Press, Ithaca, 2001), (iv) the sensible stages account of Lewis (On the plurality of worlds, Wiley Blackwell Press, Oxford, 1986), (v) a multiple-concepts account of desire satisfaction, and (vi) a No Desire View according to which subpersons have no mental states and thus no desires to frustrate. I argue that none of these solutions will help the four-dimensionalist; she does better to reject the desire satisfaction theory, while the defender of the desire satisfaction theory does better to reject four-dimensionalism.     

Negative Affect Shares Genetic and Environmental Influences with Symptoms of Childhood Internalizing and Externalizing Disorders

The co-occurrence of internalizing and externalizing disorders suggests that they may have common underlying vulnerability factors. Research has shown that negative affect is moderately positively correlated with both internalizing and externalizing disorders in children. The present study is the first to provide an examination of negative affect in relation to a wide spectrum of childhood internalizing and externalizing problems using a biometric model. This study extends prior findings of more narrowly focused associations by using a factor approach including multiple disorders. The sample for this study included families of 691 same-sex 7- to 13-year old twin pairs. A multifactorial independent pathway model was used to examine the genetic and environmental influences underlying the covariation of parent-reported negative affect, internalizing symptoms, and externalizing symptoms. Results of the current study suggest that negative affect shares genetic and environmental influences with both internalizing and externalizing disorders in childhood. These common influences may partially explain their comorbidity. Understanding that negative affect is at least one contributor to the covariation among these disorders may highlight avenues for early risk assessment, intervention, and perhaps prevention.     

Women's views about intimate examinations and sexually inappropriate practices by their general practitioners

Abstract

The aim of this survey of 472 adult women was to assess women patients' feelings about intimate examinations and their perceptions and experiences of sexually inappropriate medical practice. Two-thirds of women preferred a women doctor for intimate examinations. Slightly more than two-thirds found intimate examinations embarrassing and stressful, and strongly expressed the need for information and on-task, health-related comments during these examinations. General personal comments or non-medical touching were not particularly welcomed, even for the purpose of comforting the patient. There was a range of views about patients' personal relationships with doctors, with the lines between acceptable and unacceptable behaviour somewhat ambiguous. A small but significant number of women perceived that they had been sexually harassed (5%) or abused (3%) by a doctor, with this experience more common for non-English speaking women. Results were discussed in terms of implications for improved doctor practice, particularly during intimate examinations and with vulnerable patients.     

Life events and psychological well-being in old age

Abstract

Although life event research has burgeoned in recent years, little attention has been paid to the prevalence of events among the elderly or their relationship to psychological well-being. This paper presents data from a three-wave longitudinal study of community elderly in Aberdeen. Negative life events were highly prevalent among both survivors [N=349) and non-survivors [N=108], but the relatively small differences between the groups indicate that attrition does not seriously affect longitudinal findings. Longitudinal analysis of survivors' data was performed using LISREL and yielded a model with a goodness of fit index of 0.918, demonstrating a close fit between the data and the model. The model parameters indicate that those in poor psychological state were more likely to report serious non-health events than health events, although the latter were more likely than the former to result in a decline in psychological well-being, even after prior psychological state was taken into account. While elderly people with low social integration experienced more severe reactions to life events in the short term than those with high social integration, there were no significant long term effects, even for those reporting highly stressful events. There was no evidence of a sub-group of elderly people lacked into a cycle of serious life events. However life events were not random occurrences; serious health events were more often reported by those with low education while women and those in lower social classes were more likely to report serious non-health events. Overall, long term disruption, directly attributable to life events, was minimal when viewed within the context of the community elderly's stable psychological state.     

Living with Hereditary Haemorrhagic Telangiectasia: stigma,coping with unpredictable symptoms,and self-advocacy

Abstract

Objective: Hereditary Haemorrhagic Telangiectasia (HHT) is a genetic condition causing frequent nose bleeds, skin lesions (telangiectasia) and arteriovenous malformations. Approximately, 50% of people experience life-threatening HHT symptoms including haemorrhages in the brain, lungs and liver. This study aimed to gain a qualitative understanding of the psychosocial impact of HHT over time. Design: Using a phenomenological framework, a rigorous narrative analysis was performed on 20 semi-structured interviews with individuals with HHT aged 20s–60s. Main outcome measures: Qualitative themes explaining life experiences prior to and following a clinical diagnosis of HHT. Results: Narratives highlighted four psychosocial themes: (i) the psychological impact of visible symptoms was significant and related to experiences of social stigma, (ii) individuals struggled to identify triggers of symptoms in order to reduce unpredictability, (iii) an illness identity was rejected by minimising HHT when talking about the present self, and by positive reframing as ‘lucky’ and (iv) self-advocacy was necessitated due to lack of expert coordinated care. Conclusion: HHT has a demanding impact on social, physical and psychological well-being. These findings have significant implications for health care, as narratives about interactions with health professionals often used the terms ‘frustrating’ and ‘not being heard’.     

Social Problem-Solving Skills in Children with Traumatic Brain Injury: Long-Term Outcomes and Prediction of Social Competence

The effects of childhood traumatic brain injury (TBI) on social problem-solving were examined in 35 children with severe TBI, 40 children with moderate TBI, and 46 children with orthopedic injuries (OI). The children were recruited prospectively following injuries that occurred between 6 and 12 years of age. They were followed longitudinally, and ranged from 9 to 18 years of age at the time of the current study, which occurred on average 4 years post injury. They were administered a semi-structured interview used in previous research on social problem-solving to assess the developmental level of their responses to hypothetical dilemmas involving social conflict. Children in the severe TBI group defined the social dilemmas and generated alternative strategies to solve those dilemmas at the same developmental level as did children in the OI group. However, they articulated lower-level strategies as the best way to solve the dilemmas and used lower-level reasoning to evaluate the effectiveness of the strategies. After controlling for group membership, race, socioeconomic status, IQ, and age, children's social problem-solving, and particularly the developmental level of their preferred strategies for resolving conflicts, predicted parents ratings of children's social skills, peer relationships, aggressive behavior, and academic performance. The findings indicate that children with severe TBI demonstrate selective, long-term deficits in their social problem-solving skills that may help to account for their poor social and academic outcomes.     

Benchmarking key service quality indicators in UK Employee Assistance Programme Counselling: A CORE System data profile

Background: Levels of psychological distress appear to be increasing in the workplace, in parallel with the growth of employee assistance programme (EAP) provision offering a range of talking treatments. However, such growth takes place in the absence of a substantive body of supporting research evidence despite a quarter of a decade of research activity. Aims: To analyse a national sample of EAP data and profile relative service quality on a set of key service indicators. Method: CORE System data profiles of over 28,000 clients were voluntarily donated by six EAP service providers. An established benchmarking methodology was used to assess the relative quality of EAP service provision compared with published CORE System benchmarks for NHS primary care and UK higher education student counselling services. Results: High quality data profiled an EAP service clientele who were quantifiably distressed, accessed treatment quickly, with the majority completing treatment and demonstrating high rates of recovery and/or improvement relative to published benchmarks from the NHS and HE comparative sectors. Limitations of the study and implications for practice and further investigation are considered.     

The spatial thinking of origami: evidence from think-aloud protocols

Origami, the ancient Japanese art of paper folding, involves spatial thinking to both interpret and carry out its instructions. As such, it has the potential to provide spatial training (Taylor and Hutton under review). The present work uses cognitive discourse analysis to reveal the spatial thinking involved in origami and to suggest how it may be beneficial for spatial training. Analysis of think-aloud data while participants folded origami and its relation to gender, spatial ability measures, and thinking style suggest that one way that people profit from spatial training is through the possibility to verbalize concepts needed to solve-related spatial tasks.