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Mediation of the Effects of the Family Bereavement Program on Mental Health Problems of Bereaved Children and Adolescents

Prevention Science volume 7, pages 179–195 (2006)Cite this article

Abstract

This study presents an analysis of mediation of the effects of the Family Bereavement Program (FBP) to improve mental health outcomes of girls at 11 months following program participation. The FBP was designed based on a theory that program-induced change in multiple child and family level mediators would lead to reductions in children’s mental health problems. Mediational models were tested using a three wave and a two wave longitudinal design. Using a three wave longitudinal design, FBP effects on three variables at T2 (increased positive parenting, decreased negative events, and decreased inhibition of emotional expression) were found to mediate the effects of the FBP on mental health problems at 11-month follow-up. Using a two-wave longitudinal design, support was found for FBP effects on three additional variables at 11-month follow-up (increased positive coping, decreased negative thoughts about stressors, and decreased unknown control beliefs) to mediate program effects to reduce mental health problems at 11-month follow-up. The discussion focuses on theoretical explanations for the mediational effects and on implications for identifying “core components” of the FBP that are responsible for its effects to reduce mental health problems of girls.

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Fig. 1

Notes

  1. Randomized trials have demonstrated efficacy for prevention programs for specialized populations of bereaved children such as AIDS orphans (Rotheram-Borus et al., 2001).

  2. Although mediational analysis allows us to rule out some alternative explanations of the relations between the risk factor and the mental health outcomes (e.g., third variable explanations such as genes as a shared common cause) it does not prove causality because the effect of the mediator on the outcome is still a correlational rather than experimental effect and alternative explanations for this effect may still be plausible (e.g., an unmeasured variable that is correlated with the measured mediator and is also affected by the intervention may be the true cause of the program induced change in outcomes).

  3. A full list of eligibility requirements and the procedure for random assignment is provided in Sandler et al., 2003.

  4. The computation of the weighted alpha coefficients excluded the two observation variables.

  5. The findings from the program effect on the mediators may not be consistent with those in the outcome evaluation presented in Sandler et al. (2003). This is because in the analyses conducted in the Sandler et al. (2003) study, both boys and girls were included in the analyses. Also, in the mediation models, not only T1 mediator but also T1 symptom scores (i.e., baseline internalizing or externalizing problems) were controlled for when examining the program effect on T2 mediators and T3 outcomes. In the Sandler et al. (2003) outcome evaluation, only the respective T1 variable was controlled for in evaluating the intervention effect on each of the mediator or the symptom measures at T2 or T3.

  6. To reflect the findings that T3 negative thought about stressful events had mediation effects only if children had high levels of negative thoughts, following the procedures outlined by Tein et al. (2004) and Aiken and West (1991), the scores on the negative thought about stressful events were recalibrated so that the mean of the new scores were one standard deviation below the mean from the original scores.

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Acknowledgements

Support for this research was provided by the National Institute of Mental Health Grant R01 MH49155-05 to evaluate the Family Bereavement Program and P30 MH068685 to fund the Advanced Center for Intervention and Services Research (ACISR) at Arizona State University. We are grateful to multiple people for their help in conducting this study including Laura Legge, Sonia Krainz, Diane Mignella, all of our dedicated interviewers, and the children and parents who participated in this study.

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  1. Prevention Research Center and Department of Psychology, Arizona State University, Tempe, Arizona, USA

    Jenn-Yun Tein, Irwin N. Sandler, Tim S. Ayers & Sharlene A. Wolchik

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  1. Jenn-Yun Tein
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  2. Irwin N. Sandler
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Correspondence to Jenn-Yun Tein.

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Tein, JY., Sandler, I.N., Ayers, T.S. et al. Mediation of the Effects of the Family Bereavement Program on Mental Health Problems of Bereaved Children and Adolescents. Prev Sci 7, 179–195 (2006). https://doi.org/10.1007/s11121-006-0037-2

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Keywords

  • Mediation
  • Preventive intervention
  • Bereavement