Multilevel Mediation Analysis Research Articles

The Mediation Role of Teacher Recognition Between Transformational Leadership and Teacher Professionalism: A Multilevel Mediation Analysis

The Mediation Role of Teacher Recognition Between Transformational Leadership and Teacher Professionalism: A Multilevel Mediation Analysis

Relationship among group learning, individuals’ and groups’ internalization of evidence-based practice, and nurses’ sustainment of the practice: a cross-sectional study

PurposeThis study, by applying the feedback process of the organizational learning model, examined the relationships among group learning, individuals’ and groups’ internalization of institutionalized evidence-based practice (I-EBP), and nurses’ sustainment of I-EBP.Design/methodology/approachTwelve hospitals were included in this cross-sectional study, with 1,741 nurses from 59 wards. Anonymous questionnaires were administered from October to December 2021. Participants self-reported their wards’ group learning, internalization of I-EBP, sustainment of I-EBP, EBP beliefs, intra-hospital transfers, and nursing research experiences. The number of nurses and I-EBP introduction length and type of I-EBP were assessed. Internalization of I-EBP of nurses and groups was considered the mediating variable, while group learning and nurses’ sustainment of I-EBP were the independent and dependent variables, respectively. Significant variables in bivariate analyses were used as control variables. Multi-level Mediation Analysis and a significance test of indirect effect using the bootstrap method were conducted.FindingsResponses from 360 nurses in 48 wards from 12 hospitals were analyzed. Groups’ internalization of I-EBP significantly mediated the relationship between group learning and nurses’ sustainment of I-EBP. In contrast, no significant mediating effect of nurses’ internalization of I-EBP was observed.Originality/valueIn the feedback process of organizational learning, group learning and its subsequent effects on individuals and groups have not been previously examined. Regardless of the nurses’ degree of internalization of I-EBP, those who belong to the ward with a high degree of internalization of I-EBP are more likely to sustain it. Conducting group learning may prevent superficial practice, resulting in its sustainability.

Temporal associations between trauma-related sleep disturbances and PTSD symptoms: An experience sampling study.

There is robust evidence for the influence of sleep disturbances on the maintenance of PTSD symptoms. However, little is known about day-to-day variation in trauma-related sleep disturbances (namely insomnia symptoms and nightmares) and their associations with PTSD symptoms. Therefore, we explored the dynamic interplay of these symptoms in daily life using an experience sampling method (ESM). For 15 consecutive days, participants with PTSD symptomatology as primary complaint (N = 48) reported momentary levels of insomnia symptoms and nightmares as well as PTSD symptoms via a mobile app. Multilevel model analyses revealed that insomnia and nightmares were significant predictors of PTSD symptomatology on the following day; furthermore, nightmares were predictive of each of the four PTSD symptom clusters, namely reexperiencing, avoidance, cognition and hyperarousal as well as symptoms of dissociation. However, PTSD symptoms did not predict insomnia or nightmares during the following night. Multilevel mediation analyses suggested that nightmares mediate the relationship between insomnia and next-day PTSD symptoms. These findings support accumulating evidence that trauma-related sleep disturbances play an important role in the maintenance of PTSD symptoms, by elevating symptoms daily. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Poor-Quality Daily Social Encounters, Daily Stress, and Subjective Cognitive Decline Among Older Adults.

Although prior research has shown that social relationships and daily stress are strongly associated with cognitive function, few studies have explored the link between the quality of daily social encounters and subjective cognitive decline (SCD). The present study explores whether the quality of older adults' daily social encounters is associated with SCD through daily stress. This study used data from 254 adults aged 70 or older (M age = 76.5 years, SD = 4.4; 67.7% women) who completed the Einstein Aging Study, a 2-week experience sampling study. Multilevel mediation analyses were conducted to account for daily measurements nested within individuals. We tested the indirect effect of the quality of daily social encounters on SCD through daily stress levels. There was a significant positive association between ambivalent and neutral social encounters and daily stress levels at both the within- and between-person levels. Between-person daily stress was, in turn, associated with greater SCD. Specifically, there was a significant indirect path from ambivalent social encounters to SCD through daily stress. This study contributes to a more detailed understanding of how the quality of daily social encounters can influence cognition via increased exposure to daily stress. The findings suggest that emotional support may be crucial to preserving perceptions of older adults' cognitive functioning.

The role of psychosis and clozapine load in excessive checking in treatment-resistant schizophrenia: longitudinal observational study.

A significant proportion of people with clozapine-treated schizophrenia develop 'checking' compulsions, a phenomenon yet to be understood. To use habit formation models developed in cognitive neuroscience to investigate the dynamic interplay between psychosis, clozapine dose and obsessive-compulsive symptoms (OCS). Using the anonymised electronic records of a cohort of clozapine-treated patients, including longitudinal assessments of OCS and psychosis, we performed longitudinal multi-level mediation and multi-level moderation analyses to explore associations of psychosis with obsessiveness and excessive checking. Classic bivariate correlation tests were used to assess clozapine load and checking compulsions. The influence of specific genetic variants was tested in a subsample. A total of 196 clozapine-treated individuals and 459 face-to-face assessments were included. We found significant OCS to be common (37.9%), with checking being the most prevalent symptom. In mediation models, psychosis severity mediated checking behaviour indirectly by inducing obsessions (r = 0.07, 95% CI 0.04-0.09; P < 0.001). No direct effect of psychosis on checking was identified (r = -0.28, 95% CI -0.09 to 0.03; P = 0.340). After psychosis remission (n = 65), checking compulsions correlated with both clozapine plasma levels (r = 0.35; P = 0.004) and dose (r = 0.38; P = 0.002). None of the glutamatergic and serotonergic genetic variants were found to moderate the effect of psychosis on obsession and compulsion (SLC6A4, SLC1A1 and HTR2C) survived the multiple comparisons correction. We elucidated different phases of the complex interplay of psychosis and compulsions, which may inform clinicians' therapeutic decisions.

Finding an autonomous path to positive change: a self-determination theory view of daily change-oriented organizational citizenship behavior

AbstractThe present study investigates the relationship between employee daily social and temporal comparison and positive change in the form of change-oriented organizational citizenship behavior (OCB-CH). Using insights from self-determination theory, social comparison theory and the two-facet model of authentic and hubristic pride, we tested two distinct process models in this relationship, namely an autonomous and a controlled path. The autonomous path represents the expression of intrinsic growth tendencies relating to prosociality, creativity and healthy emotion regulation. We hypothesized that this expression is instigated by the experience of growth denoted by favorable, downward temporal comparisons and leads to authentic, rather than hubristic, pride. Subsequently, proceeding through the satisfaction of the basic psychological needs, the path eventually leads to OCB-CH. Participants from various occupational sectors (N=68) responded to a daily diary questionnaire (N=340) at the end of each of five working days. Multilevel mediational analyses supported the autonomous path: on days when employees perceived themselves as engaging in more downward temporal comparison, they were more likely to engage in OCB-CH via the experience of authentic pride and satisfaction of the basic psychological needs. These findings expand self-determination theory by revealing why downward temporal comparison information fosters proactive behaviors within organizational contexts in general and the initiation of positive change in the form of OCB-CH in particular.

Shedding light on relations between teacher emotions, instructional behavior, and student school well-being – Evidence from disadvantaged schools

BackgroundDespite broad theoretical consensus on the direct and indirect relevance of teacher emotions for instructional behavior and student outcomes, empirical evidence is inconclusive. Moreover, there is limited research in this area involving disadvantaged and younger student populations, and addressing students’ school well-being as an outcome explicitly. AimsThis study investigates associations between teacher emotions (joy, anger, anxiety), teacher-reports of instructional behavior (cognitive and motivational stimulation, classroom management, and social support), and students' reported school well-being (positive emotions and intrinsic motivation experienced at school), hypothesizing effects of teacher emotions on student school well-being, mediated via teachers’ instructional behavior. SampleParticipants were 1550 primary school students and their 134 homeroom teachers from 50 Austrian disadvantaged schools. MethodsData were collected using written online questionnaires and analyzed applying Bayesian multilevel mediation analysis. ResultsTeachers' joy positively related to aspects of all assessed dimensions of instructional behavior. Anger and anxiety related negatively only to aspects of classroom management. No associations were identified between teachers' instructional behavior and student school well-being, or teachers’ joy or anxiety and student school well-being, rejecting the mediation assumption. Surprisingly, teacher anger positively related to student intrinsic motivation. ConclusionsThis study supports theoretical assumptions on the role of teacher emotions for instruction but did not replicate theorized indirect effects of teacher emotions via instructional behavior on student outcomes. In contrast, the identified direct association between teacher anger and student intrinsic motivation represents a valence-incongruent link which evokes interesting perspectives and stimulates a further differentiation of established theoretical assumptions.

From hate speech to HateLess. The effectiveness of a prevention program on adolescents’ online hate speech involvement

Hate speech, a societal scourge, has found a potent conduit in modern technology, exacerbating its reach and impact. Adolescents are particularly vulnerable to the pernicious effects of online hate speech, which threaten their well-being and social cohesion. Addressing this critical issue, the current study uses a quasi-experimental design to evaluate the efficacy of “HateLess. Together Against Hatred” in reducing adolescents' online hate speech perpetration and victimization and increasing their online hate speech countering. A sample of 820 adolescents aged 12 to 16 (M = 13.27, SD = 1.04) from 11 German schools was divided into an intervention group (n = 567), who underwent the one-week anti-hate speech program, and a control group (n = 253). Utilizing multilevel mediation analysis, the study revealed that program participation significantly reduced online hate speech perpetration and victimization while enhancing countering hate speech. Notably, the intervention's success was partially mediated by increased empathy, which, in turn, predicted a decrease in hate speech perpetration and an increase in counter-speech, and by increased self-efficacy, which, in turn, was linked to reduced victimization and heightened countering hate speech. These promising outcomes suggest that HateLess could be a viable strategy for mitigating hate speech engagement and fostering a more respectful online discourse among adolescents.

Head teacher leadership behavior, class collective efficacy and school adjustment of junior high school students: A 2-2-1 multilevel mediation analysis

Based on Bass' leadership theory and Bandura's social cognitive theory, we tested the direct relationship between head teacher transformational leadership behavior, head teacher transactional leadership behavior, and junior high school students’ school adjustment as well as explored the role of class collective efficacy in mediating this relationship. Surveying 5,083 junior high school students in 168 classes and controlling for grade, head teacher gender, and class size, the hypothesized relationships were tested through a 2-2-1 mediation model using multilevel structural equation modeling. The results indicated that there was not only a direct relationship between head teacher transformational leadership behavior and school adjustment ( b = .326, 95% confidence interval [CI] [.218, .434]), but also an indirect relationship through class collective efficacy (.047, 95% CI [.007, .087]), although the direct link was stronger. Moreover, there was only an indirect relationship between head teacher transactional leadership behavior and school adjustment through class collective efficacy (.051, 95% CI [.007, .096]), and the link between head teacher transformational leadership behavior and school adjustment was stronger than the link between head teacher transactional leadership behavior and school adjustment (diff = .351, 95% CI [.126, .577]). This study extended Bass' leadership theory to a class organization, and the relationship between head teacher leadership behavior and school adjustment was explored at the class level in a junior high school.

Evaluating a longitudinal multilevel mediation model of self-concept clarity, hope, and subjective well-being in adolescents

This study examined the longitudinal relationships among self-concept clarity (SCC), hope, and subjective well-being (i.e., emotional well-being and cognitive well-being). Specifically, we tested both the between-person and within-person associations of SCC with subjective well-being among 2,001 Chinese adolescents (age range 11–24 years, 42.9% males) during the first year. In addition, we examined the longitudinal mediating role of hope. Results showed that SCC had positive correlations with hope and subjective well-being both at one time point and over time. Multilevel mediation analysis indicated that hope could serve as a mediator in the association between SCC and subjective well-being, at both the between-person and within-person levels. Moreover, the model of longitudinal multilevel mediation was found to be moderated by gender and age. Our results indicated that hope could be an underlying mechanism for the longitudinal relationship between SCC and subjective well-being among Chinese adolescents, which provides a potential intervention target for improving adolescents’ well-being.

Effects of a Mindfulness-Based Strengths Intervention on Adolescent Mental Health are Mediated by Changes in Negative Emotions

AbstractPrevious studies in adult samples have shown that emotions, especially positive emotions, are one of the key mechanisms of change in positive psychology interventions. The current research aimed to investigate whether these emotions also mediate the effect of a positive psychology intervention, based on mindfulness and strengths use for adolescents, on mental health outcomes (i.e., well-being, peer-related and attentional problems). A quasi-experimental study was performed, including assessments one week before and one week after the intervention. The results of the multilevel mediation analyses showed that adolescents who completed the intervention (N=70) experienced a significant decrease in negative emotions but no significant increase in positive emotions compared to adolescents who did not participate in the intervention (N=236). Changes in negative emotions mediated changes in mental health outcomes (i.e., well-being and peer-related problems) associated with the intervention. Further, adolescents who started, but not necessarily completed the intervention (N=116) experienced no significant decrease in negative emotions. Findings suggest that positive psychology interventions may have an effect on health outcomes by decreasing negative emotions in addition to fostering positive emotions.

Do reductions of daily activities mediate the relationship between COVID-19 restrictions and mental ill-health among older persons in Europe?

Objective Previous research has shown that daily activities are crucial for mental health among older people, and that such activities declined during the COVID-19 pandemic. While previous studies have confirmed a link between stringent restrictions and an increase in mental ill-health, the role of daily activities as a mediator in this relationship remains underexplored. We analyzed whether reductions in daily activities mediated the impact of these COVID-19 restrictions on mental ill-health during the pandemic’s initial phase. Methods We used data from Wave 8 SHARE Corona Survey covering 41,409 respondents from 25 European countries and Israel as well as data on COVID-19 restrictions from the Oxford Government Response Tracker (OxCGRT). Multilevel regression and multilevel-mediation analysis were used to examine the relationships between restrictions, daily activities and mental ill-health. Results Reductions in walking and shopping showed a notably stronger association with increases in mental ill-health compared to social activities. Furthermore, declines in walking could account for about a quarter of the relationship between restrictions and increased mental ill-health, but the mediating effects of the other activates were negligible. Conclusions The study highlights the essential role of maintaining daily activities, particularly walking, to mitigate the negative psychological effects of pandemic-related restrictions among older populations in Europe.

Unraveling the relationship between ESCS and digital reading performance: A multilevel mediation analysis of ICT-related psychological needs

Unraveling the relationship between ESCS and digital reading performance: A multilevel mediation analysis of ICT-related psychological needs

Childhood maltreatment and depressed mood in female college students: A daily diary analysis

BackgroundChildhood maltreatment has well-documented relations with depressed mood. However, few studies have used a daily diary methodology to investigate the association between all five forms of childhood maltreatment (emotional, physical, and sexual abuse, emotional and physical neglect) and depressed mood, and the mechanisms underlying the association remain unclear. ObjectiveThe current study sought to examine the associations of multiple forms of childhood maltreatment with depressed mood via a 14-day daily diary methodology, and investigate the mediating effects of self-compassion and perceived social support. MethodsA sample of 220 Chinese female college students (Mage = 19.13 years) participated in this study and completed questionnaires regarding childhood maltreatment, self-compassion, perceived social support and depressed mood. ResultsThe multilevel regression analysis indicated that only emotional abuse was slightly associated with depressed mood, while emotional neglect, physical abuse, physical neglect, or sexual abuse were not associated with depressed mood. The multilevel mediation analysis further revealed that self-compassion and perceived social support independently mediated the association of childhood emotional abuse with depressed mood. ConclusionsOverall, these results emphasize the specific association between childhood emotional abuse and daily depressed mood, and further support self-compassion and perceived social support as explanatory mechanisms linking childhood emotional abuse with later depressed mood.

DAILY SOCIAL RELATIONSHIP QUALITY, DAILY STRESS, AND SUBJECTIVE COGNITIVE DECLINE AMONG OLDER ADULTS

Abstract Although prior research has shown that social relationships are strongly associated with cognitive function, few studies have explored the link between the quality of daily relationships and subjective cognitive decline (SCD). The present study explores whether the quality of daily relationships is associated with daily stress and how daily stress mediates the relationship between the quality of daily relationships and SCD among older adults. This study uses data from 254 older adults aged 70 or older who completed the Einstein Aging Study. Multilevel mediation analyses were conducted to account for daily measurements nested within individuals. The cognitive change index was used to measure SCD. We tested the indirect effect of daily relationship quality on SCD through daily stress levels. There was a significant positive association between ambivalent (β=.148, p&amp;lt;.001; β=.324, p&amp;lt;.001) and neutral (β=.095, p&amp;lt;.001; β=.297, p&amp;lt;.001) relationships and daily stress levels at both the within- and between-person levels. Between-person daily stress was, in turn, associated with greater SCD (β= .169, p&amp;lt;.05). In particular, there was a significant indirect path from ambivalent relationships to SCD through daily stress. This study contributes to a more detailed understanding of how relationship quality can impact cognition through increased exposure to daily stress. The quality of daily social relationships may be crucial to preserving older adults’ cognitive function.

Patient-physician discordance impairs outcomes in early rheumatoid arthritis through less consistent treat-to-target implementation.

We aimed to assess whether patient-physician discordance regarding disease activity affects T2T-implementation and clinical outcomes in rheumatoid arthritis (RA). This was an analysis of the 2-year T2T-guided trial Care in early RA (CareRA). During year 1, DMARD escalations were mandated by the protocol when DAS28-CRP was >3.2. During year 2, treatment was at the rheumatologists' discretion. At each visit we assessed T2T-implementation, defined as escalating DMARDs if DAS28-CRP >3.2. Patient-physician discordance was defined by the discordance score (DS), a weighted difference between patient-reported and clinical/laboratory outcomes. Using generalised linear mixed models and multilevel mediation analysis, we studied the association between time-varying DS, T2T-implementation and the odds of remission (SDAI ≤3.3), physical functioning (HAQ-score), and radiographic progression at year 2. Over 2 years, 379 patients were assessed at 3129 follow-up visits. On 445 (14%) of these visits, DAS28-CRP was >3.2, and DMARDs were escalated in 217/445 (49%) of such cases. T2T-implementation declined over time and was consistently lower during the second year (year 1: 57-66%; year 2: 17-52%). Higher DS over time was negatively associated with remission and physical functioning at year 2, partly mediated by a lower proportion of T2T-adherent visits. No such association was found for radiographic progression. Even in a trial setting, T2T was applied on only around 50% of visits. T2T was less likely to be implemented with increasing patient-physician discordance regarding disease activity, which was in turn associated with less remission and worse functional outcome, but not with radiographic progression.

Mediation of the association between social environmental characteristics of family childcare home and weight status in children by diet quality

BackgroundThe food and beverages served in family childcare homes (FCCHs) may play an important role in the development of childhood overweight and obesity. This analysis examines whether children’s diet quality mediates the relationship between foods and beverages served in FCCHs and preschool-aged children’s weight status.MethodsTrained and certified staff conducted observations for two days in each FCCH, using the Environment and Policy Assessment and Observation (EPAO) measure to determine the foods and beverages served to children (N = 370) in FCCHs (N = 120). They also used the Dietary Observation in Child Care (DOCC) protocol to assess children’s food and beverage intake during childcare, from which we calculated the Healthy Eating Index-2015 (HEI), a measure of diet quality. Height and weight were measured for each child with parent consent from which the child’s body mass index (BMI) z-scores were calculated. A multilevel mediation analysis was conducted to indicate whether children’s diet quality mediates the relations between food and beverage served in FCCHs and preschool-aged children’s weight status.ResultsChildren’s total HEI scores significantly mediated the relationship between the EPAO subscale Food Provided and children’s BMI z-scores (B=-0.01, p < .05, 95% CI = [-0.03, − 0.002]). Further, the EPAO subscale Food Provided was positively associated with the total HEI score (B = 0.75, p < .01, 95% CI = [0.32, 1.18]). Total HEI scores were negatively associated with BMI z-score (B=-0.01, p < .05, 95% CI = [-0.02, − 0.001]).ConclusionChildren’s diet quality did significantly mediate the relationship between the food served in FCCHs and children’s weight status. More longitudinal studies with longer follow-up periods need to be conducted to confirm these relationships. Further, future studies need to examine the relationships between a broader spectrum of FCCH environmental characteristics and home environment with children’s weight status, as well as other mediators including physical activity.

The role of posttraumatic guilt and anger in integrated treatment for PTSD and co-occurring substance use disorders among primarily male veterans.

PTSD and substance use disorders (SUD) frequently co-occur among veterans. Integrated exposure-based treatments, such as Concurrent Treatment of PTSD and SUD Using Prolonged Exposure (COPE), are efficacious in reducing PTSD and SUD symptoms and posttraumatic emotions. This study examines whether guilt and anger (a) decreased in a randomized clinical trial comparing COPE with Relapse Prevention (RP) therapy for SUD and (b) mediated PTSD and SUD symptom reductions or vice versa. Veterans (90.1% men) diagnosed with PTSD and SUD were randomized to 12 sessions of COPE (n = 54) or RP (n = 27). Guilt and anger were assessed at 10 time points during treatment. Multilevel linear models assessed changes in guilt and anger across treatments and lagged multilevel mediation analyses assessed within-subject change in guilt and anger predicting PTSD and percent days of substance use, and vice versa. Guilt (B = -.12, SE = .02, p < .001) and anger (B = -.13, SE = .02, p < .001) improved in both treatments, however guilt was significantly lower in Sessions 7 through 11 among veterans receiving COPE. Improvement in guilt mediated PTSD symptom improvement in both treatment groups (B = -.08, SE = .04, 95% CI [-.16, -.01]), and PTSD symptom improvement mediated anger reduction in COPE (B = -.03, SE = .01, 95% CI [-.06, -.01]). The substance use models were insignificant. Among veterans, integrated, trauma-focused treatments may be associated with greater guilt (directly) and anger (indirectly) reductions due to processing trauma. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Does Distributed Leadership Deliver on Its Promises in Schools? Implications for Teachers’ Work Satisfaction and Self-Efficacy

Although surrounded by theoretical confusion and methodological ambiguity, distributed leadership has been acclaimed as beneficial for teacher performance and student achievement. We set out to explore organizational identification and empowerment as two mechanisms that explain the positive and negative association between distributed leadership and teacher work-related outcomes. We build on social identity, social interdependence and cognitive schema theories to argue that teachers’ cognitive dysfunctional schema of distrust and dependence moderate the association between distributed leadership on the one hand and organizational identification and empowerment on the other hand. We used multilevel mediation analyses to test our hypotheses in a sample of 3528 teachers, nested in 329 Romanian schools and our overall results reveal a negative association between distributed leadership and empowerment as well as organizational identification. Distrust cognitive schema accentuate the negative association between distributed leadership and empowerment, while dependence schema accentuate the negative association between distributed leadership and organizational identification. Finally, organizational identification mediates the association between distributed leadership and teachers’ work self-efficacy as well as satisfaction, while empowerment only mediates the association between distributed leadership and work satisfaction.

Relationship between teacher and student psychological well-being in a Japanese context

ABSTRACT Psychological well-being (PWB) encompasses the positive aspects of mental health, such as hedonic wellbeing (experience of enjoyment and pleasure), eudaimonic wellbeing (experience of self-actualization), and life satisfaction (global evaluation of quality of life). Japanese teachers suffer from poor PWB with a high incidence of mental health problems. Despite the potentially significant impact of poor Japanese teachers’ PWB on their students’ PWB, these associations have remained largely unexplored. The present study investigated if teacher PWB has any relationship with student PWB and if teacher-student relationship, students’ abilities for resilience, and classroom climate mediate the teacher and student PWB relationship, with 46 teachers and 1,256 children aged 8–12 years from Japanese schools. A multilevel mediation analysis revealed an indirect positive relationship between Japanese teacher life satisfaction and Japanese student hedonic and eudaimonic wellbeing mediated by students’ abilities for resilience. There was no relationship between teacher and student hedonic and eudaimonic wellbeing. Nonetheless, the findings still imply that promoting teacher life satisfaction may contribute to the promotion of student hedonic and eudaimonic wellbeing. Future researchers could investigate if a school-based intervention targeted at both Japanese teachers and students would more effectively promote PWB among students than would such interventions aimed only at students.