Causal Mediation Analysis for Zero-inflated Mixture Mediators

Causal mediation analysis is an important statistical tool to quantify effects transmitted by intermediate variables from a cause to an outcome. There is a gap in mediation analysis methods to handle mixture mediator data that are zero-inflated with multi-modality and atypical behaviors. We propose an innovative way to model zero-inflated mixture mediators from the perspective of finite mixture distributions to flexibly capture such mediator data. Multiple data types are considered for modeling such mediators including the zero-inflated log-normal mixture, zero-inflated Poisson mixture and zero-inflated negative binomial mixture. A two-part mediation effect is derived to better understand effects on outcomes attributable to the numerical change as well as binary change from 0 to 1 in mediators. The maximum likelihood estimates are obtained by an expectation maximization algorithm to account for unobserved mixture membership and whether an observed zero is a true or false zero. The optimal number of mixture components are chosen by a model selection criterion. The performance of the proposed method is demonstrated in a simulation study and an application to a neuroscience study in comparison with standard mediation analysis methods.