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Cited by 4,188Advanced Causal Inference TechniquesStatistical Methods and Bayesian InferenceStatistical Methods in Epidemiology

Equivalence of the Mediation, Confounding and Suppression Effect

Open access
MacKinnon, David P., Krull, Jennifer L., Lockwood, Chondra M.·2000·Prevention Science
DOI 10.1023/a:1026595011371PMC PMC2819361
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Abstract

This paper describes the statistical similarities among mediation, confounding, and suppression. Each is quantified by measuring the change in the relationship between an independent and a dependent variable after adding a third variable to the analysis. Mediation and confounding are identical statistically and can be distinguished only on conceptual grounds. Methods to determine the confidence intervals for confounding and suppression effects are proposed based on methods developed for mediated effects. Although the statistical estimation of effects and standard errors is the same, there are important conceptual differences among the three types of effects.

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Crossref · 10.1023/a:1026595011371

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  • Simple mediation analyses accompanied the multiple mediation analysis to bypass suppression effects.

    “As has been recommended (see MacKinnon, Krull, & Lockwood, 2000; Preacher & Hayes, 2008), the multiple mediation analysis was accompanied by simple mediation analyses to bypass the issues that suppression effects can obscure possible indirect effects of individual mediators.”

    From Change in Decentering Mediates Improvement in Anxiety in Mindfulness-Based Stress Reduction for Generalized Anxiety Disorder (2015) · cites this paper as MacKinnon, Krull, & Lockwood, 2000

  • The change from minus to plus on the effect of time on pain interference when psychological inflexibility was entered into the model can be a sign of inconsistent mediation or a negative suppressor variable.

    “The change from minus to plus on the effect of time on pain interference when psychological inflexibility was entered into the model makes the interpretation more unclear, but according to both Kenny et al. and MacKinnon et al. (59,60) this change in direction of effect can also be a sign of inconsistent mediation or a negative suppressor variable.”

    From Internet-delivered acceptance and commitment therapy (iACT) for chronic pain—feasibility and preliminary effects in clinical and self-referred patients (2020) · cites this paper as [59]

  • The pattern of relations in the regulatory model amounts to inconsistent mediation, in which the direct effect of an adverse event is directionally opposite to its indirect effect via nostalgia.

    “In statistical terms, the pattern of relations depicted in Figure 1 amounts to inconsistent mediation (MacKinnon et al., 2000). This occurs when the direct effect of a predictor (here, an adverse event) is directionally opposite to its indirect effect via a mediator (nostalgia).”

    From Water From the Lake of Memory: The Regulatory Model of Nostalgia (2023) · cites this paper as MacKinnon et al., 2000

  • There was a positive direct association between FoMO and psychological well-being when PSMU and DBO were included as mediators.

    “However, the most theoretically noteworthy result was the positive direct association between FoMO and psychological well-being, shown through a suppressor effect (i.e. when a variable masks the true association between two constructs due to statistical suppression; MacKinnon et al., 2000).”

    From Fear of missing out and psychological well-being: Examining the dual pathways of problematic social media use and digital burnout (2026) · cites this paper as MacKinnon et al., 2000

  • The positive direct association between FoMO and psychological well-being is a suppressor effect.

    “However, the most theoretically noteworthy result was the positive direct association between FoMO and psychological well-being, shown through a suppressor effect (i.e. when a variable masks the true association between two constructs due to statistical suppression; MacKinnon et al., 2000).”

    From Fear of missing out and psychological well-being: Examining the dual pathways of problematic social media use and digital burnout (2026) · cites this paper as MacKinnon et al., 2000

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Authors
MacKinnon, D. P., Krull, J. L., & Lockwood, C. M.
Affiliations
Arizona State University (US)
Corresponding author
MacKinnon, David P.
ORCID
MacKinnon, David P.
Venue
Prevention Science
Publisher
Springer Science and Business Media LLC
Published
2000-12
Volume
1
Issue
4
Pages
173-181
ISSN
  • 1389-4986 (ISSN-L)
  • 1573-6695
DOI
10.1023/a:1026595011371
PMC
PMC2819361
OpenAlex
W1715619412
Cited by
4,188
References
52
Citations by year
2026: 403 · 2025: 291 · 2024: 253 · 2023: 278 · 2022: 306 · 2021: 271 · 2020: 275 · 2019: 210 · 2018: 205 · 2017: 190 · 2016: 197 · 2015: 166 · 2014: 215 · 2013: 167 · 2012: 169
FWCI
8.35
Type
journal article
Language
en
Open access
Licence
Locations
  • Prevention Science (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute on Drug Abuse (DA 09757, R01DA009757, R37DA009757)
Topics
  • Physical Sciences › Mathematics › Statistics and Probability › Advanced Causal Inference Techniques
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods and Bayesian Inference
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
Keywords
mediation, confounding, suppression effect, third variable, causal inference, confidence intervals, standard errors, effect estimation
MeSH terms
Data Interpretation, Statistical, Humans, Reproducibility of Results, Models, Statistical, Bias, Causality, Confounding Factors, Epidemiologic, Effect Modifier, Epidemiologic, Confidence Intervals, Least-Squares Analysis

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