Regression-based statistical mediation and moderation analysis in clinical research: Observations, recommendations, and implementation
Section snippets
Statistical mediation analysis
Mediation analysis is used when a researcher seeks to test hypotheses about or better understand how an effect of X on Y operates. The causal antecedent X could be which of two forms of therapy a client receives, or it could be an individual difference measure such as exposure to various sources of trauma, or any other conceivable variable that has some kind of causal force on a consequent outcome variable. That consequent Y could be something like frequency or severity of symptoms of some
Moderation analysis
Whereas mediation analysis focuses on how a causal effect operates, moderation analysis is used to address, when, or under what circumstances, or for what types of people that effect exists or does not and in what magnitude. Fig. 3, panel A, graphically depicts the concept of moderation. In this figure, the arrow linking W to the effect of X on Y denotes that X's effect on Y depends in some way on W. More specifically, X's effect on Y is said to be moderated by W if the size or sign of X's
Integrating moderation and mediation: Conditional process analysis
We have seen that effects can operate indirectly through mediators, and that the size of effects can be dependent on other variables. As an indirect effect (mediation) is an effect, and effects can be contingent (moderation), it follows that an indirect effect can be contingent. In other words, the size of an indirect effect can be dependent on another variable—moderated mediation. For instance, a therapeutic method might indirectly influence later symptoms by changing people's cognitive
Summary
In this article, using nothing more complicated than the principles of ordinary least squares regression analysis, we have described the analysis of mediation and moderation effects and their integration as conditional process analysis. We also illustrated implementation using PROCESS, a freely available computational tool for SPSS and SAS that takes much of the computational burden off the researcher's shoulders. We discussed some new developments in thinking over the last several years,
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