The combinatorial nature of neurexin/neuroligin interactions is believed to be key to neuronal plasticity mechanisms such as learning and memory, and also a likely mediator of mental disorders such as autism [6].
Further support for the hypothesis that perinatal factors may often act as indicators instead of mediators of poor mental health was reported in a series of elegantly designed studies by Thapar and colleagues [ 24– 26].
The aim of the study is to examine, using self reported data, the association between perinatal and psychosocial risk factors and mental health outcomes, thereby testing the hypothesis that both perinatal circumstances and more chronologically proximate psycho-social circumstances are risk mediators, (rather than indicators) of mental ill-health in early adulthood.
There is also emerging evidence regarding other important biological mediators of the diet-mental health association that are particularly pertinent to development and early life, including neurotrophic plasticity [ 14], disturbances in neurotransmitter systems [ 15], and epigenetic programming [ 16].
Knauper et al. [ 30] revealed that the effectiveness of a mental imagery intervention was mediated by motivation and Pham and Taylor [ 31] demonstrated that planning was a key mediator of the effect of mental simulations on studying behavior, which is highly salient given increased recent interest in planning interventions in health contexts [ 59].
Instead of using subjunctive moods as mediators, the mental processes of reality/beliefs and imaginations/desires in theory of mind tightly link counterfactual conditionals with yàobúshì in Chinese.
However, because of the possibility of unidentified confounding variables, it is important to attempt to distinguish between factors which, although linked to increased risk, do not in themselves mediate that risk (risk indicators), as opposed to factors which directly contribute to the causal pathway leading to the development of mental illness (risk mediators).
Still, psychobiological mediators of the impact of attachment disruptions on mental and perhaps also physical health [ 21] are a likely complement to the psychological mediators proposed by Bowlby and Ainsworth in the form of mental models of attachment relationships [ 13].
The first examined attitudes as a mediator between autonomy and help-seeking for a broader range of mental health issues, including emotional problems and suicidal ideation.
