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Fong TCT, Junus A, Wen M, Yip PSF. Comorbidity among symptoms of internet gaming disorder, social withdrawal, and depression in 3430 young people in Hong Kong: A network analysis. J Affect Disord 2024; 359:319-326. [PMID: 38777272 DOI: 10.1016/j.jad.2024.05.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 04/22/2024] [Accepted: 05/18/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND The present study aimed to examine the comorbidity among symptoms of internet gaming disorder (IGD), social withdrawal, and depression using the network perspective. METHODS An online survey recruited 3430 young people in Hong Kong (mean age = 19.4 years, 80.5 % male) via gaming channels in 2019. The participants completed the 9-item IGD Scale, Hikikomori Questionnaire, and Patient Health Questionnaire-9. Network analysis was conducted using R to estimate the central symptoms of IGD and depression in individual networks and identified the bridge symptoms in combined network of IGD, social withdrawal, and depressive symptoms. RESULTS All network models showed high stability. 'Withdrawal', 'Loss of control', and 'Tolerance' were the central IGD symptoms, while 'Depressed mood' and 'Self-blame/guilt' were the central depressive symptoms. The bridge symptoms were 'Gaming as escape or mood relief' from IGD cluster, 'Depressed mood' and 'Self-blame/guilt' from depression cluster, and 'Marked social isolation at home' and 'Significant distress due to social isolation' from social withdrawal cluster. The combined network showed no significant differences in network structure and global strength across gender and age groups. LIMITATIONS The cross-sectional sample only indicated undirected associations between the symptoms in the three clusters and could not model the intra-individual variation. CONCLUSIONS The present study provided the first results on the comorbidity among IGD, social withdrawal, and depression at a symptom level among Chinese young people via network analysis. The bridge symptoms highlight potential targets for interventions of comorbidity among the disorders.
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Affiliation(s)
- Ted C T Fong
- Faculty of Social Sciences, University of Hong Kong, Hong Kong; Centre on Behavioral Health, University of Hong Kong, Hong Kong.
| | - Alvin Junus
- Centre for Urban Mental Health, University of Amsterdam, Amsterdam, The Netherlands
| | - Ming Wen
- Department of Sociology, University of Hong Kong, Hong Kong; Department of Sociology, University of Utah, Salt Lake City, USA
| | - Paul S F Yip
- Department of Social Work & Social Administration, University of Hong Kong, Hong Kong; HKJC Centre for Suicide Research and Prevention, University of Hong Kong, Hong Kong.
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Wang GY, Simkute D, Griskova-Bulanova I. Neurobiological Link between Stress and Gaming: A Scoping Review. J Clin Med 2023; 12:jcm12093113. [PMID: 37176554 PMCID: PMC10179187 DOI: 10.3390/jcm12093113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/14/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
Research on video gaming has been challenged by the way to properly measure individual play experience as a continuum, and current research primarily focuses on persons with gaming disorder based on the diagnostic criteria established in relation to substance use and gambling. To better capture the complexity and dynamic experience of gaming, an understanding of brain functional changes related to gaming is necessary. Based on the proinflammatory hypothesis of addiction, this scoping review was aiming to (1) survey the literature published since 2012 to determine how data pertinent to the measurement of stress response had been reported in video gaming studies and (2) clarify the link between gaming and stress response. Eleven studies were included in this review, and the results suggest that gaming could stimulate a stress-like physiological response, and the direction of this response is influenced by an individual's biological profile, history of gaming, and gaming content. Our findings highlight the need for future investigation of the stress-behaviour correlation in the context of gaming, and this will assist in understanding the biological mechanisms underlying game addiction and inform the potential targets for addiction-related proinflammatory research.
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Affiliation(s)
- Grace Y Wang
- School of Psychology and Wellbeing, University of Southern Queensland, Toowoomba, QLD 4350, Australia
- Centre of Health Research, University of Southern Queensland, Toowoomba, QLD 4350, Australia
| | - Dovile Simkute
- Institute of Biosciences, Life Sciences Centre, Vilnius University, 10257 Vilnius, Lithuania
| | - Inga Griskova-Bulanova
- Institute of Biosciences, Life Sciences Centre, Vilnius University, 10257 Vilnius, Lithuania
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The genomic impact of kindness to self vs. others: A randomized controlled trial. Brain Behav Immun 2022; 106:40-48. [PMID: 35905861 DOI: 10.1016/j.bbi.2022.07.159] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 07/19/2022] [Accepted: 07/23/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Prosocial behavior has been linked to improved physical health, but the biological mechanisms involved remain unclear. This study tested whether a 4-week kindness intervention could reduce expression of a stress-related immune response gene signature known as the Conserved Transcriptional Response to Adversity (CTRA). METHODS In a diverse sample of community adults (N = 182), study participants were randomly assigned to perform 3 kind acts for other people, to perform 3 kind acts for themselves, or to list daily activities (control), on one day per week over 4 weeks. CTRA gene expression was measured by RNA sequencing of dried blood spots (DBS) collected at baseline and 5 weeks later (1 week after completing study assignments). Participants' descriptions of their kind acts were coded for protocol adherence and act content. RESULTS Participants who were randomized to perform kind acts for others showed significant reductions in CTRA gene expression relative to controls. Participants who were randomized to perform kind acts for themselves also showed significant reductions in CTRA gene expression relative to controls, but this pattern emerged only for those who failed to perform the requested self-kind acts (protocol non-adherent). Those who fully adhered to the self-kindness protocol showed no change in CTRA gene expression and did not differ from controls. Act content analyses implicated self-stress-reducing behavior in the paradoxical effects of self-kindness and the physical presence of others in the effects of prosocial behavior. CONCLUSIONS Prosocial engagement-doing something kind for others rather than oneself-reduces CTRA gene expression. The nature of kind acts and their intended recipient plays a key role in shaping the genomic impact of kindness.
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Snodgrass JG, Bendeck S, Zhao KX, Sagstetter S, Lacy MG, Nixon C, Branstrator JR, Arevalo JMG, Cole SW. Social connection and gene regulation during the COVID-19 pandemic: Divergent patterns for online and in-person interaction. Psychoneuroendocrinology 2022; 144:105885. [PMID: 35961191 PMCID: PMC9335856 DOI: 10.1016/j.psyneuen.2022.105885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Social connection has been linked to reduced disease risk and enhanced antiviral immunity, but it is unclear whether online social connections have similar effects to those previously documented for in-person/offline social relationships, or whether online connections can substitute for in-person social relations when the latter are restricted. We examined this question in the context of the COVID-19 pandemic, focusing specifically on an immune system gene regulation profile known as the conserved transcriptional response to adversity (CTRA), which is characterized by up-regulation of proinflammatory genes and down-regulation of genes linked to innate antiviral responses and antibody production. METHODS We analyzed CTRA RNA profiles in blood samples from 142 healthy young adults (69% female, 87% white) during the "social distancing" period of the COVID-19 pandemic. Mixed effect linear models quantified the relation of CTRA gene expression to measures of in-person social connection (number of friends, social eudaimonia, loneliness) and online psychosocial connection (online loneliness, perceived social value in online leisure and educational contexts, and internet use) while controlling for demographic and health factors. RESULTS Multiple indicators of in-person and generalized social connection were associated with lower CTRA gene expression, whereas no measure of online social connection showed any significant association with CTRA gene expression. CONCLUSION Experiences of in-person social connection are associated with reduced CTRA gene expression during a period of restricted social interaction. In contrast, online social relationships show no such association. Digitally mediated social relations do not appear to substantially offset the absence of in-person/offline social connection in the context of immune cell gene regulation.
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Affiliation(s)
- Jeffrey G Snodgrass
- Department of Anthropology and Geography, Colorado State University, Fort Collins, CO 80523-1787, USA.
| | - Shawna Bendeck
- Department of Sociology, Colorado State University, Fort Collins, CO 80523-1784, USA
| | - Katya Xinyi Zhao
- Department of Anthropology and Geography, Colorado State University, Fort Collins, CO 80523-1787, USA
| | - Seth Sagstetter
- Department of Anthropology and Geography, Colorado State University, Fort Collins, CO 80523-1787, USA
| | - Michael G Lacy
- Department of Sociology, Colorado State University, Fort Collins, CO 80523-1784, USA
| | - Cody Nixon
- Department of Anthropology and Geography, Colorado State University, Fort Collins, CO 80523-1787, USA
| | - Julia R Branstrator
- Department of Human Dimensions of Natural Resources, Colorado State University, Fort Collins, CO 80523, USA
| | - Jesusa M G Arevalo
- Division of Hematology-Oncology, Department of Medicine, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095, USA
| | - Steven W Cole
- Division of Hematology-Oncology, Department of Medicine, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095, USA; Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles School of Medicine, Los Angeles, CA 90095, USA
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Cabeza-Ramírez LJ, Sánchez-Cañizares SM, Fuentes-García FJ, Santos-Roldán LM. Exploring the connection between playing video games and watching video game streaming: Relationships with potential problematic uses. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2021.107130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Mascaro JS, Wallace A, Hyman B, Haack C, Hill CC, Moore MA, Lund MB, Nehl EJ, Bergquist SH, Cole SW. Flourishing in Healthcare Trainees: Psychological Well-Being and the Conserved Transcriptional Response to Adversity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:2255. [PMID: 35206440 PMCID: PMC8871849 DOI: 10.3390/ijerph19042255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/02/2022] [Accepted: 02/07/2022] [Indexed: 02/01/2023]
Abstract
While much attention has been paid to healthcare provider and trainee burnout, less is known about provider well-being (i.e., flourishing) or about the effects of well-being on immune function. This study examined the demographic and psycho-social correlates of well-being among healthcare trainees (resident physicians and physician assistant (PA) trainees) and evaluated the association of well-being with the "conserved transcriptional response to adversity" (CTRA) characterized by up-regulated expression of pro-inflammatory genes and down-regulated expression of innate antiviral genes. Participants (n = 58) completed self-reported assessments of sleep disturbance, loneliness, depressive symptoms, anxiety, stress, and well-being (flourishing). Blood sample RNA profiles were analyzed by RNA sequencing to assess the CTRA. Slightly over half (n = 32; 55.2%) of healthcare trainees were categorized as flourishing. Flourishing was less prevalent among primary caregivers, and more prevalent among trainees who exercised more frequently and those with fewest days sick. Loneliness (AOR = 0.75; 95% CI = 0.61, 0.91; p = 0.003) and stress (AOR = 0.65; 95% CI = 0.45, 0.94; p = 0.02) were associated with decreased odds of flourishing when controlling for other variables. Flourishing was associated with down-regulated CTRA gene expression, whereas loneliness was associated with up-regulated CTRA gene expression (both p < 0.05). Assessing these relationships in a larger, multi-site study is of critical importance to inform policy, curricula, and interventions to bolster sustainable trainee well-being.
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Affiliation(s)
- Jennifer S. Mascaro
- Department of Family and Preventive Medicine, Division of Preventive Medicine, Emory University, Atlanta, GA 30329, USA;
| | - Amanda Wallace
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (A.W.); (E.J.N.)
| | - Brooke Hyman
- Department of Gynecology and Obstetrics, Emory University, Atlanta, GA 30322, USA; (B.H.); (C.C.H.)
| | - Carla Haack
- Department of Surgery, Emory University, Atlanta, GA 30322, USA;
| | - Cherie C. Hill
- Department of Gynecology and Obstetrics, Emory University, Atlanta, GA 30322, USA; (B.H.); (C.C.H.)
| | - Miranda A. Moore
- Department of Family and Preventive Medicine, Division of Preventive Medicine, Emory University, Atlanta, GA 30329, USA;
- Department of Medicine, Emory University, Atlanta, GA 30322, USA;
| | - Maha B. Lund
- Department of Family and Preventive Medicine, Physician Assistant Program, Emory University, Atlanta, GA 30322, USA;
| | - Eric J. Nehl
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA; (A.W.); (E.J.N.)
| | | | - Steve W. Cole
- Department of Psychiatry & Biobehavioral Sciences, Department of Medicine, University of California, Los Angeles, CA 90095, USA;
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Snodgrass JG, Lacy MG, Cole SW. Internet gaming, embodied distress, and psychosocial well-being: A syndemic-syndaimonic continuum. Soc Sci Med 2022; 295:112728. [PMID: 31879045 PMCID: PMC7289667 DOI: 10.1016/j.socscimed.2019.112728] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 11/28/2019] [Accepted: 12/09/2019] [Indexed: 02/03/2023]
Abstract
We examine internet gaming-related suffering as a novel syndemic most prevalent among contemporary emerging adults. Synthetic analysis of our prior research on internet gaming and health affirms how social factors and mental and physical wellness mutually condition each other in this online play context. Employing biocultural anthropological mixed methods, we focus on statistical interactions between intensive gaming and social well-being in relation to genomic markers of immune function. We show that among gamers with low social well-being, intensive game play is associated with compromised immunity markers, but among those with robust social connection, that same play correlates with decreased activation of stress-related immunity activation. The apparently beneficial interaction of higher social well-being and intensive game play resonates with an emerging body of research showing how positive practices-in this case, engaged and pleasurable videogame play-can increase resilience to the negative linked psychological and genomic responses to precarity. Based on these findings, we argue, in relation to gaming behaviors, a syndemics analysis could usefully be expanded by attending to both sides of the synergistic interaction between two social conditions: not just exacerbation of dysfunction in relation to their combined effect, but also non-additive enhancement of health that may stem from such combinations. We draw on literature emphasizing the relevance to health of "eudaimonic" well-being-psychosocial processes that transcend immediate self-gratification and involve the pursuit of meaningful and pro-social goals. On that basis, we propose the term "syndaimonics" to capture synergies between social context and mental flourishing, which, in this context and presumably others, can illuminate sources of health resilience and overall improved psychosocial wellbeing.
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Affiliation(s)
- Jeffrey G. Snodgrass
- Department of Anthropology, Colorado State University, Fort Collins, CO, 80523-1787, USA,Corresponding author. (J.G. Snodgrass)
| | - Michael G. Lacy
- Department of Sociology, Colorado State University, Fort Collins, CO, 80523-1784, USA
| | - Steven W. Cole
- Division of Hematology-Oncology, Department of Medicine, University of California, Los Angeles School of Medicine, Los Angeles, CA, 90095, USA,Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles School of Medicine, Los Angeles, CA, 90095, USA
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Walia B, Kim J, Ijere I, Sanders S. Video Game Addictive Symptom Level, Use Intensity, and Hedonic Experience: An Empirical Analysis of a Novel Survey Instrument (Preprint). JMIR Serious Games 2021; 10:e33661. [PMID: 35471995 PMCID: PMC9227790 DOI: 10.2196/33661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 01/25/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background The effects of behavioral addiction to video games has received increasing attention in the literature, given increased use intensity among subgroups of video game players. Objective This study seeks to empirically determine the relationship between intensity of video gaming and hedonic experience of the player. Methods We conducted a survey of 835 individuals who regularly play video games to determine the relationship between intensity of use and hedonic experience. We divided the sample into quartiles by self-reported video game addictive symptom level (from the Internet Gaming Disorder Scale) and conducted polynomial regressions separately for each quartile. Results We found that the higher video game addictive symptom level groups experienced a U-shaped (curvilinear) relationship between hedonic experience and intensity of play, whereas groups with lower video game addictive symptom levels exhibited no such relationship. The coefficients for the highest addictive symptom level group (quartile 4) for marginal effects for hours played per week and hours played per week squared were significantly negative (P=.005) and significantly positive (P=.004), respectively. Conclusions Our results are consistent with sensitization and tolerance theories, which suggest that high-symptom groups experience frustration and disappointment until they achieve excessive dopamine release, at which point their hedonic experience is expected to improve with additional play. Conversely, low-symptom groups experience no such fall-and-rise pattern. This result is consistent with the outcome that members of the latter group play the game for the direct experience, such that their hedonic experience is more directly related to events occurring in the game than to the increasingly elusive pursuit of excessive dopamine release. We also find that high-symptom groups spend substantially more time and money to support video game use and are much more likely to engage in video game use at the expense of other important activities, such as working, sleeping, and eating.
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Affiliation(s)
- Bhavneet Walia
- Department of Public Health, Falk College, Syracuse University, Syracuse, NY, United States
| | - Jeeyoon Kim
- Department of Sport Management, Falk College, Syracuse University, Syracuse, NY, United States
| | - Ignatius Ijere
- Department of Public Health, Falk College, Syracuse University, Syracuse, NY, United States
| | - Shane Sanders
- Department of Sport Management, Falk College, Syracuse University, Syracuse, NY, United States
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Cabeza-Ramírez LJ, Muñoz-Fernández GA, Santos-Roldán L. Video Game Streaming in Young People and Teenagers: Uptake, User Groups, Dangers, and Opportunities. Healthcare (Basel) 2021; 9:healthcare9020192. [PMID: 33578675 PMCID: PMC7916337 DOI: 10.3390/healthcare9020192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 01/28/2021] [Accepted: 02/06/2021] [Indexed: 12/24/2022] Open
Abstract
In recent years, live video streaming platforms for video games have been gaining popularity. These types of services, which enable anyone to broadcast and consume live content, are revolutionising the current video game landscape. Users approach the emergence of and participation in these platforms driven by a range of motivations. It is essential to characterise the different forms of participation in services such as Twitch to evaluate the phenomenon and reflect on its advantages and disadvantages. To that end, a survey was carried out of 580 young people and adolescents aged between 14 and 24. The aim of this study is thus to explore the uptake of these platforms, as well as identify user groups, distinguish between different motivations, and address the associated benefits and harms. Applying a methodology based on factor analysis and cluster analysis, user profiles were characterised according to their specific features, gaming/viewing hours, self-perception of their skill level as a player, devices used, and type or genre of video game. Four subgroups of gamers/viewers were thus identified: casual, social, hobby, and problematic. The results showed that older users and female users feature more prominently in the first two groups, as do those spending less time on video games and live streaming platforms. Conversely, in the hobby and problematic groups, we observe just the opposite. The existence of profiles at possible risk of addiction underlines how, at a preventive level, there is a need for more in-depth research on these types of services and greater public awareness of the dangers of uncontrolled use.
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Lee SH, Choi I, Choi E, Lee M, Kwon Y, Oh B, Cole SW. Psychological well-being and gene expression in Korean adults: The role of age. Psychoneuroendocrinology 2020; 120:104785. [PMID: 32622293 DOI: 10.1016/j.psyneuen.2020.104785] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 06/17/2020] [Accepted: 06/22/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND Happiness has traditionally been thought to comprise two parts - pleasure (hedonia) and meaning (eudaimonia). Even though the two types of happiness are correlated, genomics studies have found distinct transcriptional correlates of hedonia and eudaimonia, particularly in the Conserved Transcriptional Response to Adversity (CTRA) marked by up-regulation of proinflammatory genes and down-regulation of interferon-related genes. Eudaimonia has been associated with reduced CTRA gene expression in several studies, whereas hedonia shows no consistent association with the CTRA. However, most of these social genomics studies have been conducted in Western cultures with Caucasian samples, so it is unclear if these findings extended to non-Western cultures with other ethnic groups. Moreover, it is unknown whether age might modify the association between CTRA gene expression and eudaimonia. To this end, we examined in a sample of Koreans the relationship between CTRA profiles and measures of hedonia and eudaimonia, as well as the role of age in modulating the strength of those relationships. METHODS Blood samples were collected from 152 healthy Korean adults (mean age = 44.64; 50 % female). Well-being was measured using the Mental Health Continuum short form (MHC-SF), Ryff Scales of Psychological Well-being (PWB), and subjective well-being (SWB) scales. RNA transcriptome profiles were obtained by RNA sequencing. Mixed effect linear model analyses examined the association between CTRA gene expression and measures of MHC-SF, SWB, PWB (total scores and six subscales) and additional analyses examined a possible moderating role of age. RESULTS CTRA gene expression was significantly downregulated in association with the MHC-SF eudaimonic scores as well as the PWB total scores. Among the six domains of PWB, autonomy showed the strongest inverse correlation with CTRA profiles. Moreover, the inverse association between CTRA and PWB was stronger for older participants. CONCLUSION Eudaimonia is associated with reduced CTRA gene expression in a Korean population, with particularly marked relationships for autonomy. Findings also suggest that aging with meaning may bring biological advantage in later life.
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Affiliation(s)
- Sung-Ha Lee
- Center for Happiness Studies, Seoul National University, Seoul, South Korea.
| | - Incheol Choi
- Center for Happiness Studies, Seoul National University, Seoul, South Korea; Department of Psychology, Seoul National University, Seoul, South Korea.
| | - Eunsoo Choi
- Department of Psychology, Korea University, Seoul, South Korea
| | - Minha Lee
- Department of Psychology, Seoul National University, Seoul, South Korea
| | - Yuri Kwon
- Department of Psychology, Seoul National University, Seoul, South Korea
| | - Bumjo Oh
- Department of Family Medicine, SMG- SNU Boramae Medical Center, South Korea
| | - Steven W Cole
- Department of Psychiatry and Biobehavioral Sciences, Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, United States
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