Multiple Mediation Research Articles

The role of health literacy in the association between social support and self-rated health: a Danish population-based study in 10,787 individuals with a long-term condition.

Managing a long-term condition requires higher health literacy. Social networks may play a crucial role for self-management. However, the pathway is not entirely understood. This study aimed to examine whether the association between social support and self-rated health is mediated by health literacy among individuals with a long-term condition. This cross-sectional study used data from the "How are you?" 2021 survey in Central Denmark Region. Social support was assessed using a single question, health literacy with two dimensions from the Health Literacy Questionnaire (HLQ): 'Understanding health information' and 'Engaging with healthcare providers', and self-rated health with a single question from SF-36. Multiple logistic regression analyses were used to examine the associations, and multiple mediation analyses were performed using the Karlson-Holm-Breen method. A total of 10,787 individuals with a long-term condition were included in the study, whereas 6% (n = 595) reported a low level of social support. Both health literacy scales mediated the association between social support and self-rated health, particularly the ability to engage with healthcare providers, accounting for 25% of the variance. After adjustment for sociodemographic factors, individuals with a low level of social support had significantly higher odds of reporting difficulties in understanding health information (OR 2.53 (95% CI: 1.84-3.48)) and engaging with healthcare providers (OR 3.77 (95% CI: 2.96-4.79)). Health literacy, particularly the ability to engage with healthcare providers, was a mediator between social support and self-rated health. Additionally, a low level of social support was associated with higher odds of reporting lower health literacy. These findings suggest that strategies to enhance health literacy, improve health outcomes, and reduce health inequities may benefit from strengthening individuals' social network, particularly focusing on those with limited support.

Preventive health-care behavior: a serial multiple mediation analysis

Purpose Preventive health-care behavior (PHB) adoption as a primordial prevention to stay healthy and avoid lifestyle disease risk is a global trend. This paper aims to use the PHB model and stimulus-organism-response theory to empirically examine the role of individual and technological factors in influencing primordial PHB. Design/methodology/approach A sequential mixed-method was adopted to identify the primordial PHB adoption and propose a conceptual framework. The identified determinants and the hypothesized relationships were empirically tested using a convenience sample of 406 urban Indians. Partial least square structural equation modeling is used for data analysis. Findings The derived conceptual framework was empirically tested to assess the role of health literacy (HL), health value (HV) and digital health information seeking (DHIS) on primordial PHB. Findings confirmed the significant influence of DHIS on HL, HL on HV and PHB and HV on PHB. The direct effects of DHIS on PHB and HV were insignificant. HL solely mediated the indirect effect of DHIS on PHB, while the mediation of HV was insignificant. HL and HV fully mediated the relationship between DHIS and PHB. Research limitations/implications The impact of DHIS on PHB adoption and the serial multiple mediating roles of HL and HV are significant in understanding primordial PHB adoption for both academic theory and practice. However, the cross-sectional study on urban Indians needs further validation across geographies. Originality/value To the best of the authors’ knowledge, this pioneering study is among the first to propose and validate a comprehensive model of primordial PHB adoption.

Service quality and repurchase intentions in the airline industry: a multiple mediation analysis through customer citizenship behaviour

ABSTRACT Building on expectation confirmation theory (ECT), this study examines the nexus between service quality and consumer repurchase intention in the airline industry, with a particular emphasis on the mediating role of customer citizenship behaviour (CCB). Utilising data from 260 respondents in the United Kingdom, the research employs partial least squares structural equation modelling (PLS-SEM) for the analysis. The findings indicate that service quality has a direct positive effect on CCB and repurchase intention. The study indicates that CCB, manifested through advocacy and tolerance, exerts a significant positive impact on consumer repurchase intention. The study uncovers that advocacy and tolerance behaviours serve as mediators in the relationship between service quality and repurchase intention, while feedback and helping do not play this role. The findings of the study contribute to the literature in the field of CCB and service quality in the airline industry.

On the importance of congruence between personal and work values – How value incongruence affects job satisfaction: A multiple mediation model

This study proposes a novel conceptualization of work values designed to quantify the degree of incongruity between personal values and workplace demands. We define work values as the priorities individuals wish to be recognized for in their workplace, while personalvalues are those the individual personally identifies with. By contrasting personal and work values, we provide evidence for value incongruence among employees and showed that this measurement of value incongruence effectively predicts key job-related metrics. Value incongruence directly reduces job satisfaction, but its primary impact is indirect. Our multiple mediation analysis reveals that it mainly affects job satisfaction through perceived job meaningfulness, relationships with supervisors, and opportunities for career advancement. We discuss the implications of our findings for various stakeholders and suggest potential improvements for individual and societal well-being linked to the future of work.

The Impact of Abusive Supervision on Nurses' Organizational Silence: The Multiple Linear Mediation of Psychological Capital and Fear.

To assess abusive supervision and organizational silence among nurses and investigate the mediating influence of psychological capital and fear. Since the end of 2019, China's National Development and Reform Commission (NDRC) department has decided to start the construction of regional medical centers in Shanxi, reducing cross-provincial and cross-regional medical care. In order to improve the overall standard of care in a hospital in a short period of time, health care leadership decision makers may adopt various effective leadership management practices to achieve the set goals and have high work pressure at the same time. In this case, abusive management may occur. A cross-sectional survey design was employed. In January -March 2024, a convenience sampling method was used to collect data from 470 nurses in a total of 5hospitals in Shanxi province they were required to complete the questionnaires online anonymously. The chain mediation model was tested using the PROCESS macro program in the SPSS software and multiple linear regression model was used to verify the mediating effect. Psychological capital and fear mediate the relationship between abusive supervision and nurses' organizational silence, playing indirect mediating roles. Abusive supervision was positively associated with nurses' organizational silence. Additionally, psychological capital plays a negative mediating role, accounting for 48.48% of the indirect effect, and fear plays a positive mediating role, accounting for 45.83% of the indirect effect. They form a chain intermediary, accounting for 5.69% of the indirect effect. Psychological capital and fear mediate the impact of abusive supervision on nurses' organizational silence. Positive leadership training should be conducted to help reducing the level of head nurses' abusive supervision behaviors, while also fostering actions that elevate nurses' psychological capital levels.

Dissatisfaction with working conditions associated with lower vaccine confidence, commitment and behaviors among nurses: A large scale cross-sectional survey in France

BackgroundBefore, during, and after the COVID-19 pandemic, doctor shortages led many countries to expand nurses' role in their mass vaccination programs. Nonetheless, nurses often express marked vaccine hesitancy. Simultaneously, their working conditions have been deteriorating. ObjectivesTo study 1) the association between nurses' perceptions of their working conditions and their vaccination-related behaviors (vaccination recommendations to their patients), and 2) the mediating role in this associations of their trust in health authorities, vaccine confidence, and vaccine proactive efficacy. DesignA cross-sectional survey. SettingsSalaried, community (self-employed) and mixed nurses in France. Participants18,888 nurses registered with the French national order of nurses (ONI, registration is mandatory) (N = 439,323). MethodsIn February 2023, this cross-sectional study used an online questionnaire to survey the nurses mandatorily registered with the French national order of nurses. Seven items adapted from models of psychosocial risk factors at work assessed their satisfaction with their working conditions. The international short version of the Pro-VC-Be (health professionals, vaccine confidence and behaviors) a validated instrument measuring psychosocial determinants of health-care professionals' vaccine behaviors) evaluated their vaccine-related attitudes and behaviors. Multiple group mediation analysis with structural equation modeling measured the associations between satisfaction at work, trust in health authorities, vaccine confidence, proactive efficacy (commitment and self-efficacy) in vaccination, and vaccination recommendations (against seasonal influenza for those with a chronic disease and against COVID-19 among adults). ResultsAmong the 18,888 participants, satisfaction at work had generally deteriorated, and only 47 % considered vaccines safe. Among salaried nurses (61 %), satisfaction at work was statistically significantly associated (p < 10−3) with trust in health authorities (β = 0.26 [0.24; 0.28]), vaccine confidence (total effect: β = 0.35 [0.31; 0.38]), proactive efficacy (total effect: β = 0.18 [0.16; 0.21]), and, to a smaller extent, with seasonal influenza and Covid-19 vaccine recommendations (total effect: β = 0.13 [0.09; 0.16]). Trust in health authorities played a statistically significant role (p < 10−3) mediating the associations of satisfaction at work with vaccine confidence and proactive efficacy. These three dimensions in turn mediated the relation between satisfaction at work and frequency of vaccination recommendations. These relations were similar among community nurses. ConclusionsSatisfaction at work appears to enhance nurses' vaccination attitudes and behaviors, which are likely to reinforce their capacity to promote their patients' vaccination. Significant improvement in their working conditions is needed to enable them to accomplish this role serenely.

In Vitro Treatment with Metformin Significantly Reduces Senescent B Cells Present in the Adipose Tissue of People with Obesity

BackgroundOur previous work has shown that senescent B cells accumulate in the human adipose tissue (AT) from people with obesity, where they express transcripts for markers associated with the senescence-associated secretory phenotype (SASP) and secrete multiple inflammatory mediators. These functions of AT-derived B cells are metabolically supported. ObjectivesTo show that Metformin (MET), a widely used hypoglycemic and antidiabetic drug, is able at least in vitro to decrease frequencies, secretory profile, and metabolic requirements of senescent B cells isolated from the AT from people with obesity. MethodsWe recruited adult females with obesity (n = 8, age 40 ± 2 y, BMI range: 33–42) undergoing breast reduction surgery, who donated their discarded subcutaneous AT. B cells from stromal vascular fractions isolated after collagenase digestion of the AT were evaluated after in vitro incubation with MET (1 mM × 106 B cells) or with a medium for the following measures. The expression of transcripts for SASP-associated markers (p16INK4a and p21CIP1/WAF1) measured by quantitative polymerase chain reaction (qPCR); secretion of inflammatory cytokines (TNF-α, IL-6, IFN-γ and IL-17A) measured by a Cytometric Bead Array); metabolic characteristics as identified by a glycolytic test and Seahorse technology, and by the expression of transcripts for glucose transporters and metabolic enzymes involved in glucose metabolic pathways, measured by qPCR. To examine differences between MET-treated compared with untreated groups, paired Student’s t tests (two-tailed) were employed. ResultsMET in vitro was able to reduce frequencies and numbers of senescent B cells, as identified by staining with β-galactosidase, as well as the secretion of inflammatory cytokines, the expression of transcripts for SASP, and metabolic markers that support intrinsic B cell inflammation. ConclusionsOur results provide evidence to support the beneficial effects of MET in reducing AT-related inflammation through its effects on senescent B cells.

Self-regulatory and self-efficacy mechanisms of weight loss in women within a community-based behavioral obesity treatment.

Given the traditional methods of treating obesity through education on controlling eating and increasing exercise have largely failed beyond the very short term, a more intensive focus on psychosocial correlates of those weight-loss behaviors has been suggested. Multiple behavioral theories incorporate self-regulation, self-efficacy, and mood; however, their interrelations and effects over both the short and long term within cognitive-behavioral obesity treatments remain unclear. Within a novel community-based program with women with obesity who had either low (n = 29) or high (n = 71) mood disturbance scores, there were significant improvements in exercise- and eating-related self-regulation and eating-related self-efficacy-primary targets of that intervention-with no significant difference in those changes by mood disturbance grouping. Changes in the summed exercise- and eating-related self-regulation scores significantly mediated relationships between changes in eating-related self-efficacy and weight (over both 6 and 12months). There were similar results with mediation assessed via the extent exercise-related self-regulation carried over to eating-related self-regulation. In both of those models a reciprocal relationship between self-regulation and self-efficacy changes was indicated. In serial multiple mediation equations, paths of changes in exercise-related self-regulation → eating-related self-regulation → eating-related self-efficacy → weight were significant. However, paths were not significant when change in self-efficacy was entered as the predictor (initial) variable. Findings suggest viability in first focusing on exercise-related self-regulation, then eating-related self-regulation, in the course of increasing self-efficacy and probabilities for inducing enough sustained weight loss to improve obesity-associated health risks. Benefits of field-based research findings generalizing to weight-management applications were suggested.

The Effects of E-Commerce Recommendation System Transparency on Consumer Trust: Exploring Parallel Multiple Mediators and a Moderator

Recommendation systems are used in various fields of e-commerce and can bring many benefits to consumers but consumers’ trust in recommendation systems (CTRS) is lacking. Recommendation system transparency (RST) is an important factor that affects CTRS. Applying a three-layered trust model, this paper discusses the influence of RST on CTRS in the e-commerce domain, demonstrating the mediating role of perceived effectiveness and discomfort and the moderating role of consumers’ domain knowledge. We recruited 500 participants for an online hypothetical scenario experiment. The results show that consumers’ perceived effectiveness and discomfort can mediate the relationship between RST and CTRS. Specifically, RST (vs. non-transparency) leads to higher perceived effectiveness ( promoting CTRS) and lower levels of discomfort (which inhibits CTRS), in turn increasing CTRS. Domain knowledge positively moderates the positive impact of RST on perceived effectiveness, while negatively moderating the negative impact of RST on discomfort. Further, gender has a negative impact on CTRS when consumers are purchasing experience products but there is no effect when purchasing search products.

Helping Others Facilitates Well-Being for Indigenous Peoples Living With HIV/AIDS in Canada.

Research has found that helping others facilitates well-being for Indigenous peoples living with HIV and AIDS, but limited research exists that investigates the mechanism(s) underlying this relationship. Indigenous perspectives posit that helping others facilitates well-being through the development of an individual's spiritual, physical, emotional, and mental aspects (four aspects). Similarly, self-determination theory posits that helping others facilitates well-being by satisfying basic psychological needs. In the present study, we examined if helping others facilitates well-being through the fulfillment of the spiritual, physical, emotional, and mental aspects among Indigenous peoples living with HIV and AIDS. We used a convergent parallel mixed methods design, coupled with a community-engaged approach grounded in the United Nations Greater Involvement of People Living with HIV and AIDS principles and Indigenous and decolonizing research methodologies. Survey (n = 117) and interview data (n = 9) collected by an Indigenous-led HIV/AIDS organization in Canada were employed to examine the relationship between helping, the four aspects, and well-being. Participants were primarily First Nations leaders and mentors who live with HIV/AIDS, with some Métis and Inuit. A parallel multiple mediation model and reflexive thematic analysis were used to analyze the relationship between helping, the four aspects, and well-being. Mixed-methods findings support the idea that helping others promotes well-being by fulfilling the emotional and mental aspects. Qualitative findings demonstrated this relationship for all four aspects. This research may facilitate the development of programs to support Indigenous peoples living with HIV/AIDS well-being and contribute to the literature on integrating Indigenous perspectives and methodologies within psychological research.

Supplementary information for: On the importance of congruence between personal and work values–How value incongruence affects job satisfaction: A multiple mediation model

Supplementary information for: On the importance of congruence between personal and work values–How value incongruence affects job satisfaction: A multiple mediation model

The Nexus of Quality of the e-Tax System, Taxpayers’ Attitude, Multiple Mediators, and Tax Compliance Behaviour: A Theoretical Paper

The Nexus of Quality of the e-Tax System, Taxpayers’ Attitude, Multiple Mediators, and Tax Compliance Behaviour: A Theoretical Paper

The Impact of Academic Achievement, Clinical Performance Ability, and Mental Toughness on Burnout Among Nursing College Students During Practicum: A Multiple Mediation Model Analysis

The Impact of Academic Achievement, Clinical Performance Ability, and Mental Toughness on Burnout Among Nursing College Students During Practicum: A Multiple Mediation Model Analysis

The Associations between Depression and Sugar Consumption Are Mediated by Emotional Eating and Craving Control in Multi-Ethnic Young Adults.

Individuals with mental health conditions such as depression are vulnerable to poor dietary habits, potentially due to the maladaptive eating behaviors often used to regulate negative emotion. However, the specific dietary components most associated with depression, as well as the mediating roles of emotion regulation and other eating behaviors, remains ambiguous in young adults. For this cross-sectional evaluation, a total of 151 (86 F, 65 M; BMI: 22.0 ± 5.1 kg/m2; age: 21.4 ± 2.5 y) multi-ethnic participants (50 White, 36 Black, 60 Asian, and 5 White Hispanic) completed a digital 24-h dietary recall and self-reported measures of depressive symptoms, emotional regulation, and eating behaviors. LASSO regression was used to identify the dietary variables most associated with each subscale and to remove extraneous dietary variables, and multiple regression and mediation analyses were conducted for the remaining variables. Out of >100 dietary factors included, only added sugar in the combined sample (p = 0.043), and relative sugar in females (p = 0.045), were retained and positively associated with depressive symptoms. However, the relationships between depression and added and relative sugar intake were mediated by craving control and emotional eating, respectively. Individuals with higher added sugar intake (p = 0.012-0.037), and females with higher relative sugar intake (p = 0.029-0.033), had significantly higher odds of risk for major depression disorder and the use of mental health medications. Added and relative sugar intake are significantly associated with depressive symptoms in young adults, but these relationships may be mediated by facets of emotional dysregulation, such as emotional eating and craving control.

The multiple mediation model of social support and postpartum anxiety symptomatology: the role of resilience, postpartum stress, and sleep problems

ObjectiveThis study aimed to assess the prevalence of postpartum anxiety and the factors influencing it, while also exploring the multiple mediating roles of related factors between social support and postpartum anxiety symptomatology among postpartum women in China.MethodsBetween April and August 2023, we recruited a total of 824 postpartum women through a convenience sampling method. These participants completed a series of general survey questionnaires and were evaluated using the depression anxiety stress scale, perceived social support scale, 10-item Connor–Davidson resilience scale, maternal postpartum stress scale, and Pittsburgh sleep quality index. Additionally, we employed a hierarchical multiple regression model to investigate the relevant factors and mediators of postpartum anxiety symptomatology. A structural equation model was used to examine the mediating role of resilience, postpartum stress, and sleep problems in the relationship between social support and postpartum anxiety symptomatology.ResultsOur study found a postpartum anxiety symptomatology prevalence rate of 18.40%. The factors influencing postpartum anxiety symptomatology included age, education of their husband, mastitis, social support, resilience, postpartum stress, and sleep problems. Through a multiple mediation analysis, we found that resilience, postpartum stress, and sleep problems completely mediated the effects of social support on postpartum anxiety symptomatology, with the mediating effect accounting for 83.57% of the total effect.ConclusionThe multiple mediation analysis revealed that among postpartum women, the impact of social support on postpartum anxiety symptomatology is channeled through resilience, postpartum stress, and sleep problems. Therefore, enhancing social support, resilience, postpartum stress, and sleep problems might alleviate postpartum anxiety symptomatology.

The mediating role of individual evaluation, anxiety, and depression in the association between leisure activity and cognitive function among Chinese older adults.

The purpose of this research was to investigate the association between leisure activity and cognitive function in Chinese older adults, and to explore the mediating role of individual evaluation, anxiety and depression. Using cross-sectional data from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS), Pearson correlation analyses were employed to examine the relationships among various indicators. A multiple mediation model was constructed to investigate the mediating pathways through which leisure activities impact cognitive function in elderly individuals. Leisure activities, individual evaluation, anxiety, and depression were significantly correlated with cognitive function (p < 0.01). Leisure activities not only directly positively impacted cognitive function in elderly individuals (effect = 0.3780; 95% CI = [0.3459, 0.4101]), but also exerted indirect effects through five pathways. Individual evaluation, anxiety, depression, they plays a mediating role in the association between leisure activity and cognitive function in older adults in China. Leisure activities can positively impact cognitive function in elderly individuals by enhancing individual evaluation and subsequently reducing anxiety and depression.

Genomic and Socioeconomic Determinants of Racial Disparities in Breast Cancer Survival: Insights from the All of Us Program.

Background: Breast cancer outcomes are worse among Black women in the U.S. compared to White women. While extensive research has focused on risk factors contributing to breast cancer; the role of genomic elements in health disparities between these racial groups remains unclear. This study aims to identify genomic variants and socioeconomic status (SES) determinants influencing racial disparities in breast cancer survival through multiple mediation analyses. Methods: Our investigation is based on the NIH-supported All of Us (AoU) program and analyzes 7452 female participants with malignant tumors of breast, including 5073 with genomic data. A log-rank test reveals significant racial differences in overall survival time between Black and White participants (p-value = 0.04). Multiple mediation analysis examines the effects of 9481 genetic variables across 23 chromosomes in explaining the racial disparity in survival, adjusting for SES variables. Results: 15 gene mutations, in addition to age, general health, and general quality of life, have significant effects (p-values < 0.001) in explaining the observed racial disparity. Mutations in TMEM132B, NARFL, SALL1, PAD12, RIPK1, ASB14, DCX, GNB1L, ARHGAP32, AL135787.1, WBP11, SLC16A12AS1, AP000345.1, IKBKB, and SUPT20H have significantly different distributions between Black and White participants. The disparity is completely explained by the included variables as the direct effect is insignificant (p-value = 0.73). Conclusions: The combined impact of SES determinants and genetic mutations can explain the observed differences in breast cancer survival among Black and White participants. Future studies will explore pathways and design in vivo and in vitro experiments to validate the functions of these genes.

The impact of social participation on the quality of life among older adults in China: a chain mediation analysis of loneliness, depression, and anxiety.

This cross-sectional study investigates the impact of social participation on the quality of life (QOL) among older adults in China. Using convenience sampling, data were collected from 508 individuals aged 60 and above (M_age = 70.53 ± 7.90 years; 56.5% women). Statistical analyses were conducted using SPSSAU software, including Pearson correlation analysis to assess relationships between social participation, psychological health indicators (loneliness, depression, and anxiety), and QOL. Multiple regression analysis and chain mediation analysis were subsequently performed to explore the mediating effects of loneliness, depression, and anxiety on the relationship between social participation and QOL. The results indicated significant correlations between social participation and loneliness (r = -0.313, p < 0.001), depression (r = -0.487, p < 0.001), anxiety (r = -0.305, p < 0.001), and QOL (r = 0.476, p < 0.001). The mediation analysis revealed significant chain mediation effects of loneliness, depression, and anxiety on the relationship between social participation and QOL (β = 0.006, p < 0.001, 95% CI [0.001, 0.007]). Higher levels of social participation were associated with lower levels of loneliness, which in turn reduced depression and anxiety, thereby enhancing QOL. These findings highlight the importance of promoting social participation to improve psychological wellbeing and QOL among older adults in China. The study advocates for active social engagement and the provision of relevant services, as well as psychological support and emotional counseling for those facing mental health challenges due to insufficient social participation.

Effects of Influencer Attitudes on Persistent Brand Engagement: Mediating Roles of Relationship Maintenance and Purchase Intention

Purpose: This study analyzes the effects of influencer attributes on relationship maintenance, purchase intention, and brand engagement. In doing so, we also attempt to understand the moderating effects of relationship maintenance and purchase intention on brand engagement. In addition, we also verified the differential direct and indirect relationship between gender and product usage.Methods: The study sample comprises 320 respondents representing the overall population. The measurement items in the questionnaire were based on previous literature with some modifications. The SPSS software was utilized for statistical analyses. We first verified the reliability and validity of the research constructs and used multiple regression and mediation models to confirm the research questions.Results: Research question 1’s results showed that influencers’ attributes significantly affect relationship maintenance and intention of purchase. However, just the familiarity of an influencer significantly affects persistent brand engagement. These findings imply that firms need to carefully choose influencers, who closely resemble their target customers for close representation. The indirect effects in research question 2’s results show that relationship maintenance and purchase intention significantly mediate the effects of influencer attributes on brand engagement.Conclusion: Thus, to achieve positive long-term brand engagement, it is crucial to maintain a positive relationship with participating influencers and emphasize consumers’ experience and feedback with the focal products.

Drinking motives and alcohol sensitivity mediate multi-dimensional genetic influences on alcohol use behaviors.

Genetic influences account for a substantial proportion of individual differences in alcohol use behaviors (AUBs). However, multiple distinct sets of genes are linked to different AUBs, which may explain their dramatic variability in risk factors and manifestations. In this study, we explore whether intermediate neurobiological traits and alcohol-related cognitions mediate the relationship between polygenic scores (PGS) and multiple AUBs, with the aim to better understand processes captured by different genetic profiles. Using results from prior genome-wide association studies, we derived PGS for 6 AUBs in participants from Spit for Science, a longitudinal study of college students in the U.S. (n=4,549). Self-report measures included personality traits, alcohol expectancies, drinking motivations, and alcohol sensitivity measures as well as drinking frequency, drinking quantity, alcohol use disorder (AUD) symptoms, and maximum drinks in 24 hours. Using linear regression and multiple mediation models, we investigated the direct and indirect effects of PGS on AUBs. In univariable regression results, PGSs indexing broad AUB dimensions such as drinks per week (DPW) and AUD predicted higher levels of sensation-seeking and multiple drinking motives, while BeerPref PGSs (indexing a variable pattern of alcohol problems associated with a preference for beer) predicted higher negative urgency and lower alcohol sensitivity. Mediational models indicated strong direct and indirect effects of DPW PGSs on multiple AUBs via social/enhancement drinking motives and alcohol sensitivity, indirect effects of AUD PGSs on AUD symptoms via coping motives, and indirect effects of BeerPref PGS on all AUBs via the joint effect of mediators including alcohol sensitivity. These findings provide initial evidence that the genetic influences on different AUBs are associated with and partially mediated by intermediate neurobiological and cognitive factors, which may be more amenable to intervention. Greater focus on drinking motives and alcohol sensitivity is warranted in genetic research, as well as attention to the heterogeneous pathways linking genes to alcohol use outcomes.