# Causal mediation methods for studying mechanisms in mental health

> **NIH NIH R01** · JOHNS HOPKINS UNIVERSITY · 2021 · $327,500

## Abstract

Project Summary
In mental health research, it is important to understand the mechanisms underlying the effects
of interventions, for example whether cognitive/behavioral factors mediate the effect of a
treatment for youth with anxiety disorders, or whether a primary care service intervention
reduces depression and suicidality in elderly adults through increasing depression treatment
provision, or through improving treatment quality, or both. Such knowledge has the potential to
help tailor interventions to optimize mental health outcomes (NIMH strategic objective 3.2).
However, commonly used mediation methods are generally not appropriate and can lead to
misleading results. Recently developed causal mediation methods have the potential to provide
more accurate results but have not been widely adopted by applied researchers. This is likely
due to their complexity, lack of methods for certain settings, and lack of clear dissemination of
the methods. The goals of the proposed project are to extend causal mediation methods with a
focus on common data structures in mental health research, and to disseminate the existing and
new causal mediation methods to mental health researchers and provide guidance to facilitate
adoption and appropriate use. In particular, the work will 1) Conduct a review of mental health
articles published in the past 10 years that include mediation analyses, focusing on the temporal
ordering of the variables and the handling of confounding, 2) Extend and tailor causal mediation
methods to common data situations in mental health research that are under-covered by
existing methods, and 3) Disseminate existing and newly developed causal mediation methods
to mental health researchers and provide guidance to facilitate adoption and appropriate use,
using applications to mental health studies for illustration. The methods will be developed
informed by three randomized trials in mental health: of adolescent depression treatment
(TADS), of anxiety (CAMS) treatment, and of a service intervention to improve depression care
for elderly individuals (PROSPECT). The work has the potential to help mental health
researchers better understand what works, and why, thus improving mental health in the
population through better interventions and treatments.

## Key facts

- **NIH application ID:** 10085166
- **Project number:** 5R01MH115487-04
- **Recipient organization:** JOHNS HOPKINS UNIVERSITY
- **Principal Investigator:** Elizabeth A. Stuart
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $327,500
- **Award type:** 5
- **Project period:** 2018-03-01 → 2023-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10085166

## Citation

> US National Institutes of Health, RePORTER application 10085166, Causal mediation methods for studying mechanisms in mental health (5R01MH115487-04). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10085166. Licensed CC0.

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