An introduction to using structural equation models in rehabilitation psychology

Objective: To provide an overview of structural equation modeling (SEM) using an example drawn from the rehabilitation psychology literature. Design: To illustrate the 5 steps in SEM (model specification, identification, estimation methods, interpretation of results, and model modification), an example is presented, with details on determining whether alternataive models result in a significant improvement to fit to the observed data. Data are from a sample of 274 people with spinal cord injury. Issues commonly encountered in preparing data for SEM analyses (e.g., missing data, nonnormality) are reviewed, as is the debate surrounding some aspects of SEM (e.g., acceptable sample size). Conclusion: SEM can be a powerful procedure for empirically representing complex and sophisticated theoretical models of interest to rehabilitation psychologists.