A Monte Carlo study compared 14 methods to test the statistical significance of the intervening variable effect. An intervening variable (mediator) transmits the effect of an independent variable to a dependent variable. The commonly used R. M. Baron and D. A. Kenny (1986) approach has low statistical power. Two methods based on the distribution of the product and 2 difference-in-coefficients methods have the most accurate Type I error rates and greatest statistical power except in 1 important case in which Type I error rates are too high. The best balance of Type I error and statistical power across all cases is the test of the joint significance of the two effects comprising the intervening variable effect.

/pdf/a-comparison-of-methods-to-test-mediation-and-other-21xho8v2xm.pdf

A comparison of methods to test mediation and other intervening variable effects.

The most commonly used method to test an indirect effect is to divide the estimate of the indirect effect by its standard error and compare the resulting z statistic with a critical value from the standard normal distribution. Confidence limits for the indirect effect are also typically based on critical values from the standard normal distribution. This article uses a simulation study to demonstrate that confidence limits are imbalanced because the distribution of the indirect effect is normal only in special cases. Two alternatives for improving the performance of confidence limits for the indirect effect are evaluated: (a) a method based on the distribution of the product of two normal random variables, and (b) resampling methods. In Study 1, confidence limits based on the distribution of the product are more accurate than methods based on an assumed normal distribution but confidence limits are still imbalanced. Study 2 demonstrates that more accurate confidence limits are obtained using resampling methods, with the bias-corrected bootstrap the best method overall.

/pdf/confidence-limits-for-the-indirect-effect-distribution-of-2yv44tb6it.pdf

Confidence Limits for the Indirect Effect: Distribution of the Product and Resampling Methods.

Poorly controlled cancer pain is a significant public health problem throughout the world. There are many barriers that lead to undertreatment of cancer pain. One important barrier is inadequate measurement and assessment of pain. To address this problem, the Pain Research Group of the WHO Collaborating Centre for Symptom Evaluation in Cancer Care has developed the Brief Pain Inventory (BPI), a pain assessment tool for use with cancer patients. The BPI measures both the intensity of pain (sensory dimension) and interference of pain in the patient's life (reactive dimension). It also queries the patient about pain relief, pain quality, and patient perception of the cause of pain. This paper describes the development of the Brief Pain Inventory and the various applications to which the BPI is suited. The BPI is a powerful tool and, having demonstrated both reliability and validity across cultures and languages, is being adopted in many countries for clinical pain assessment, epidemiological studies, and in studies of the effectiveness of pain treatment.

Pain assessment: Global use of the Brief Pain Inventory.

https://onlinelibrary.wiley.com/doi/epdf/10.1002/acr.20543

Measures of Adult Pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP)

I use a divorce-stress-adjustment perspective to summarize and organize the empirical literature on the consequences of divorce for adults and children. My review draws on research in the 1990s to answer five questions: How do individuals from married and divorced families differ in well-being? Are these differences due to divorce or to selection? Do these differences reflect a temporary crisis to which most people gradually adapt or stable life strains that persist more or less indefinitely? What factors mediate the effects of divorce on individual adjustment? And finally, what are the moderators (protective factors) that account for individual variability in adjustment to divorce? In general, the accumulated research suggests that marital dissolution has the potential to create considerable turmoil in people's lives. But people vary greatly in their reactions. Divorce benefits some individuals, leads others to experience temporary decrements in well-being, and forces others on a downward trajectory from which they might never recover fully. Understanding the contingencies under which divorce leads to these diverse outcomes is a priority for future research.

The Consequences of Divorce for Adults and Children

Most states' child support guidelines adopt a “cliff” model in providing credits or adjustments for time spent in the nonresidential parent's home. Such guidelines implicitly or explicitly assume that no appreciable expenditures are made directly by obligors for child-rearing expenses at levels of contact or visitation beneath some threshold value, typically assumed to be around 30% time. As guideline developers are acutely aware, these assumptions have proceeded in the absence of any data. The present investigation sought to provide preliminary evidence of such expenditures by using the approach of getting information about the provision of certain benchmark items: clothes, toys and games, bicycles, a bedroom, and support for car-related expenses for teenage drivers. The authors generally found a linear, rather than a cliff-like, relationship of expenditures to time in the nonresidential father's home, with unexpectedly high levels of father's provision of these benchmark items even at quite low levels of contact. These findings support more generous and more continuous adjustments for visitation in child support schemes, to offset nonresidential parent's direct expenditures on children, which appear to be unexpectedly high and arise on a non-cliff-like pattern.

/pdf/non-child-support-expenditures-on-children-by-nonresidential-32loxaxx2l.pdf

NON-CHILD SUPPORT EXPENDITURES ON CHILDREN BY NONRESIDENTIAL DIVORCED FATHERS: Results of a Study

Parental divorce is one of the most prevalent adversities experienced by adults and children in the U.S. Each year, over 1.5 million youth experience parental divorce (US Census Bureau, 1999). Currently, it is estimated that 34% of children in the U.S. will experience parental divorce before reaching age 16 (Bumpass & Lu, 2000). The high prevalence of divorce and the fact that parental divorce is a risk factor for multiple mental health and substance abuse problems means that its impact on population rates of problem outcomes in youth is substantial (Scott et al., 1999). Thus, the widespread implementation of effective preventive interventions for children from divorced families could have significant public health benefits.

Although several interventions have been rigorously evaluated and shown to improve short-term outcomes for children in divorced families (e.g., Forgatch & DeGarmo, 1999; Pedro-Carroll & Cowen, 1985; Wolchik et al., 2000), these interventions are not widely available to the population of divorcing families. In this article, we focus on the New Beginnings Program (NBP), a theory-based preventive intervention targeting parenting skills which has been shown to improve multiple youth outcomes in two efficacy trials. The purpose of efficacy trials is to evaluate the benefits of an intervention when delivered under tightly controlled conditions. In efficacy trials, multiple steps are taken to ensure high quality delivery of the program to strengthen inferences about program effects. These steps include providing detailed descriptions of each program session, conducting extensive training of leaders, and assessing whether and how well the leaders complete the program activities. In addition, multiple eligibility criteria are used, such as parents and children not being involved in other interventions, an assurance that the family will remain in the geographical area where the study is conducted throughout the planned assessments, and families having children in a particular age range. Prior to widespread dissemination of programs that have been shown to have positive effects in efficacy trials, it is critical to conduct effectiveness trials of these programs. Effectiveness trials differ from efficacy trials in that the targeted population is defined as those served by the natural service delivery system. Also, program delivery is typically more variable in effectiveness trials than it is in efficacy trials (Kellam & Langevin, 2003). Research on other programs has shown that their implementation in community settings typically deviates markedly from that in the efficacy trials (e.g., Gottfredson & Gottfredson, 2002). Also, research has consistently shown that fidelity of implementation, which is typically defined as the proportion of program content delivered, and quality of implementation, which refers to the clinical and interactive skills providers use to convey the program information, are positively related to program effects (e.g., Mayer & Davidson, 2000). Effectively transporting interventions evaluated in efficacy trials into community settings requires understanding aspects of these settings that present barriers to high levels of fidelity and quality of implementation.

The goal of the program of research described here is to proactively identify such barriers and develop strategies to maximize the likelihood that the NBP will be delivered with high levels of fidelity and quality in natural service delivery systems. Below, we describe four steps in this research: (1) Selecting a community partner; (2) Developing effective methods of engaging parents; (3) Redesigning the NBP so it is easy to deliver with high quality and fidelity in community settings, and (4) Adapting the NBP to meet the needs of the full population of divorcing families.1 Before describing the status of our work in each area, we briefly describe the conceptual framework underlying the NBP, its format and content and its short-term and long-term effects on youth outcomes. We conclude with a brief discussion of plans for an effectiveness trial to evaluate the NBP when delivered in community settings.

/pdf/the-new-beginnings-program-for-divorcing-and-separating-4lm1eovox5.pdf

The new beginnings program for divorcing and separating families: moving from efficacy to effectiveness

Using an ecological perspective, the comprehensive effect of divorce variables on children's post-divorce adjustment was investigated. The microsystem, exosystem and overall composite scores accounted for significant proportions of variance in children's self-reported maladjustment and self-esteem, but not in parents' reports of children's maladjustment. The implications for preventive interventions are discussed.

Understanding Children's Divorce Adjustment from an Ecological Perspective

The controversy that has raged since the early fifties regarding the admissibility of one-tailed tests of hypotheses was examined. From the review of that literature, it was concluded that the main advantage of the one-tailed test was the gain in power for the prediction while its main disadvantage was its inability to test for significance if the results were opposite to prediction. It is argued here that splitting α unequally between the two tails, placing most of the rejection region on the side of the prediction but a smaller fraction on the opposite side provides both power and the ability to detect opposite-to-prediction outcomes. This compromise procedure requires a finer choice in the splitting of α than the dichotomous choice of putting either all or exactly half of α in the favored tail, i.e., the choice between a one- or a two-tailed test. Rules for the most effective split, based on Bayesian considerations, are prescribed. The fraction of α in the predicted tail should be equal to the investig...

On Splitting the Tails Unequally: a New Perspective on One-Versus Two-Tailed Tests:

SUMMARY We performed several re-analyses of data presented in Braver, Ellman, and Fabricius (2003) to examine whether their findings that parental relocation after divorce was associated with negative long-term outcomes in their grown children could be due to pre-existing levels of parent conflict and domestic violence Conflict and violence might have caused parents to relocate, and might have caused the negative outcomes Evidence from analyses of covariance, controlling for levels of conflict and violence (as reported by the grown children), confirmed that relocation was associated with negative outcomes over and above the associations of conflict and violence with negative outcomes These new findings support the original recommendation of Braver et al that “courts should give greater weight to the child's separate interests in deciding such [relocation] cases” (p 206) Additionally, there was little indication that moves reduced levels of conflict, but that finding is tentative

Sanford L. Braver

Papers

NON-CHILD SUPPORT EXPENDITURES ON CHILDREN BY NONRESIDENTIAL DIVORCED FATHERS: Results of a Study

The new beginnings program for divorcing and separating families: moving from efficacy to effectiveness

Understanding Children's Divorce Adjustment from an Ecological Perspective

On Splitting the Tails Unequally: a New Perspective on One-Versus Two-Tailed Tests:

Relocation, Parent Conflict, and Domestic Violence: Independent Risk Factors for Children of Divorce