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Wang Y, Zhang L, Wang C, Lin M, Zheng L, Guo X. An Empirical Investigation of the Relationships Among Self-Esteem, Depression and Self-Serving Bias in People with Internet Gaming Disorder. Psychol Res Behav Manag 2024; 17:2557-2571. [PMID: 38973976 PMCID: PMC11227327 DOI: 10.2147/prbm.s462184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 06/25/2024] [Indexed: 07/09/2024] Open
Abstract
Introduction People are generally characterized by a self-serving bias which describes the tendency to ascribe positive outcomes or success to internal or personal causes (self-enhancement motivation) and ascribe negative outcomes or failure to external or situational causes (self-protection motivation). It has been found that the individuals with internet gaming disorder (IGD) who have low self-esteem and high depression exhibit an attenuated self-serving bias. However, the relationships among self-esteem, depression and self-serving bias are not clearly identified. Methods A sample of 138 IGD participants completed self-esteem and depression scales and a causal attribution task (Study 1) to examine the relationships among self-esteem, depression and self-serving bias (both self-enhancement and self-protection). In follow-up Study 2, 28 IGD participants were recruited to undertake self-affirmation intervention which can affirm one's sense of global self-view and bolster self-esteem to explore whether self-affirmation would trigger a reduction of depression and a raise of self-serving bias. Results The results of path analysis in Study 1 showed that the self-serving bias was predicted by self-esteem and depression, and the depression played a mediating role between self-esteem and self-serving bias. The results of Study 2 showed that the IGD participants reported higher self-esteem, lower depression and engaged in more self-protection motivation after affirming-self manipulation as compared with affirming-other manipulation. Conclusion These findings suggest that self-esteem predicts self-serving bias through depression and self-affirmation could trigger an increase of self-esteem, further decrease depression and improve self-serving bias for the individuals with IGD. The present article clearly identified the relationships among these factors and provided a new approach to promote positive self-concept in individuals with IGD. Future research is warranted to explore the lasting benefits of self-affirmation on domains of education, relationships and gaming withdrawal for the individuals with IGD among different populations.
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Affiliation(s)
- Yifan Wang
- Mental Health Education Center, Zhengzhou University, Zhengzhou, People’s Republic of China
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, People’s Republic of China
| | - Lei Zhang
- School of Physical Education (Main Campus), Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Chenggong Wang
- College of Science and Technology, Ningbo University, Ningbo, People’s Republic of China
| | - Min Lin
- Mental Health Education Center, Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Li Zheng
- Fudan Institute on Ageing, Fudan University, Shanghai, People’s Republic of China
- Ministry of Education (MOE) Laboratory for National Development and Intelligent Governance, Fudan University, Shanghai, People’s Republic of China
| | - Xiuyan Guo
- Fudan Institute on Ageing, Fudan University, Shanghai, People’s Republic of China
- Ministry of Education (MOE) Laboratory for National Development and Intelligent Governance, Fudan University, Shanghai, People’s Republic of China
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Narita Z, Ando S, Yamasaki S, Miyashita M, DeVylder J, Yamaguchi S, Hosozawa M, Nakanishi M, Hiraiwa-Hasegawa M, Furukawa TA, Kasai K, Nishida A. Association of Problematic Internet Use With Psychotic Experiences and Depression in Adolescents: A Cohort Study. Schizophr Bull 2024:sbae089. [PMID: 38825582 DOI: 10.1093/schbul/sbae089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2024]
Abstract
BACKGROUND AND HYPOTHESIS Problematic internet use (PIU) is prevalent among adolescents. Past research suggested cross-sectional associations between PIU and psychotic experiences, but little information is available on the longitudinal association. We hypothesized that PIU in adolescence may be longitudinally associated with psychotic experiences, adjusting for confounders. STUDY DESIGN We analyzed a random sample of adolescents in the Tokyo Teen Cohort to examine how PIU at ages 10 (2012-2015), 12 (2014-2017), and 16 (2019-2021) was associated with mental health issues at age 16. PIU was evaluated by the modified Compulsive Internet Use Scale, psychotic experiences by the Adolescent Psychotic-like Symptom Screener, and depression by the Short Mood and Feelings Questionnaire. We also examined the mediating role of social withdrawal. STUDY RESULTS We analyzed 3171 adolescents; 151 reported psychotic experiences and 327 reported depression at age 16. Compared with the lowest tertile PIU group, the highest tertile PIU group at age 12 showed an increased adjusted risk of psychotic experiences (RD 3.3%, 95% CI 2.9%-3.7%; RR 1.65, 95% CI 1.55-1.73) and depression (RD 5.9%, 95% CI 5.5%-6.3%; RR 1.61, 95% CI 1.55-1.68) at age 16. PIU at age 16 showed analogous results, while PIU at age 10 suggested a smaller impact. Social withdrawal mediated 9.4%-29.0% of the association between PIU and psychotic experiences. CONCLUSIONS PIU is longitudinally associated with psychotic experiences and depression in adolescents. Further longitudinal and intervention studies are warranted to provide robust public health implications and foster a safer digital future.
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Affiliation(s)
- Zui Narita
- Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Shuntaro Ando
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Syudo Yamasaki
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Mitsuhiro Miyashita
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Jordan DeVylder
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Silver School of Social Work, New York University, New York, New York City, USA
| | - Satoshi Yamaguchi
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Mariko Hosozawa
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Miharu Nakanishi
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- Department of Psychiatric Nursing, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Mariko Hiraiwa-Hasegawa
- School of Advanced Science, SOKENDAI (Graduate University for Advanced Studies), Kanagawa, Japan
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/ School of Public Health, Kyoto, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- The International Research Center for Neurointelligence (WPI-IRCN), University of Tokyo Institutes of Advanced Study (UTIAS), Tokyo, Japan
| | - Atsushi Nishida
- Unit for Mental Health Promotion, Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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Infanti A, Valls-Serrano C, Billieux J, Perales JC. Psychometric Properties of the Spanish Motives for Online Gaming Questionnaire in a Sample of College Students. THE SPANISH JOURNAL OF PSYCHOLOGY 2024; 27:e16. [PMID: 38801093 DOI: 10.1017/sjp.2024.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
This study investigates the psychometric properties of the Spanish version of the Motives for Online Gaming Questionnaire (MOGQ). We explored the factor structure and construct validity of the MOGQ through its relationships with gaming disorder symptoms (IGD-20) and impulsivity traits. We also analyzed if sociodemographic variables and gaming habits were related to gaming motives. An online cross-sectional survey was completed by 845 college students. Structure validity was examined using a combination of exploratory and confirmatory factor analyses, which supported a bifactor model composed of a general motivation factor and six uncorrelated factors (a mixed factor composed of escape and coping, competition, recreation, skill, social, and fantasy). Omega-hierarchical and omega coefficients were used to determine reliability of the MOGQ. The scale presented acceptable reliability for the general factor (ωh = .79) and the specific factor scores (social ω = .79, escape/coping ω = .81, competition ω = .79, skill ω = .84, fantasy ω = .82, and recreation ω = .70). Positive associations were observed between the MOGQ and the IGD-20 symptoms, with escape/coping (r = .48) and fantasy (r =.40) showing the strongest ones. Null or low correlations were observed with impulsivity traits. Motives to play varied significantly across genders. These findings provide evidence that the Spanish version of the MOGQ is a reliable and valid tool to assess motives to play online games.
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Dong W, Tang H, Wu S, Lu G, Shang Y, Chen C. The effect of social anxiety on teenagers' internet addiction: the mediating role of loneliness and coping styles. BMC Psychiatry 2024; 24:395. [PMID: 38802784 PMCID: PMC11129444 DOI: 10.1186/s12888-024-05854-5] [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: 10/02/2023] [Accepted: 05/17/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND & AIM There is a lack of understanding of how social anxiety may affect Internet addiction among adolescents. Based on several theories, the purpose of this study was to investigate the multiple mediating roles of loneliness and coping styles in the association between social anxiety and Internet addiction in Chinese adolescents. METHODS This study used the Social Anxiety Scale, Internet Addiction Test, Loneliness Scale, and Simple Coping Style Questionnaire to investigate 1188 students in two junior high schools and senior high schools in Henan Province, China. We adopted Pearson's correlation analysis and the PROCESS Macro Model 81 in regression analysis to explore the relationships among social anxiety, loneliness, coping styles, and Internet addiction. RESULTS We found that social anxiety not only directly affects teenagers' Internet addiction, but also affects teenagers' Internet addiction through loneliness and coping styles. CONCLUSIONS These results emphasize the importance of improving social anxiety to reduce Internet addiction among adolescents. At the same time, it also emphasizes the need to reduce adolescents' loneliness and cultivating positive coping styles. In addition, this study has certain theoretical significance for teenagers' mental health and intervention studies on Internet addiction.
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Affiliation(s)
- Wanglin Dong
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Henan, Kaifeng, China
| | - Haishan Tang
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Henan, Kaifeng, China
| | - Sijia Wu
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Henan, Kaifeng, China
| | - Guangli Lu
- Institute of Business Administration, School of Business, Henan University, Jinming Avenue, Henan, Kaifeng, 475004, China
| | - Yanqing Shang
- School of Basic Medical Science, Henan University, Jinming Avenue, Henan, Kaifeng, 475004, China.
| | - Chaoran Chen
- Institute of Nursing and Health, College of Nursing and Health, Henan University, Henan, Kaifeng, China.
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Jović J, Ćorac A, Stanimirović A, Nikolić M, Stojanović M, Bukumirić Z, Ignjatović Ristić D. Using machine learning algorithms and techniques for defining the impact of affective temperament types, content search and activities on the internet on the development of problematic internet use in adolescents' population. Front Public Health 2024; 12:1326178. [PMID: 38827621 PMCID: PMC11143794 DOI: 10.3389/fpubh.2024.1326178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 05/08/2024] [Indexed: 06/04/2024] Open
Abstract
Background By using algorithms and Machine Learning - ML techniques, the aim of this research was to determine the impact of the following factors on the development of Problematic Internet Use (PIU): sociodemographic factors, the intensity of using the Internet, different contents accessed on the Internet by adolescents, adolescents' online activities, life habits and different affective temperament types. Methods Sample included 2,113 adolescents. The following instruments were used: questionnaire about: socio-demographic characteristics, intensity of the Internet use, content categories and online activities on the Internet; Facebook (FB) usage and life habits; The Internet Use Disorder Scale (IUDS). Based on their scores on the scale, subjects were divided into two groups - with or without PIU; Temperament Evaluation of Memphis, Pisa, Paris, and San Diego scale for adolescents (A-TEMPS-A). Results Various ML classification models on our data set were trained. Binary classification models were created (class-label attribute was PIU value). Models hyperparameters were optimized using grid search method and models were validated using k-fold cross-validation technique. Random forest was the model with the best overall results and the time spent on FB and the cyclothymic temperament were variables of highest importance for these model. We also applied the ML techniques Lasso and ElasticNet. The three most important variables for the development of PIU with both techniques were: cyclothymic temperament, the longer use of the Internet and the desire to use the Internet more than at present time. Group of variables having a protective effect (regarding the prevention of the development of PIU) was found with both techniques. The three most important were: achievement, search for contents related to art and culture and hyperthymic temperament. Next, 34 important variables that explain 0.76% of variance were detected using the genetic algorithms. Finally, the binary classification model (with or without PIU) with the best characteristics was trained using artificial neural network. Conclusion Variables related to the temporal determinants of Internet usage, cyclothymic temperament, the desire for increased Internet usage, anxious and irritable temperament, on line gaming, pornography, and some variables related to FB usage consistently appear as important variables for the development of PIU.
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Affiliation(s)
- Jelena Jović
- Department of Preventive Medicine, Faculty of Medicine, University of Pristina in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | - Aleksandar Ćorac
- Department of Preventive Medicine, Faculty of Medicine, University of Pristina in Kosovska Mitrovica, Kosovska Mitrovica, Serbia
| | | | - Mina Nikolić
- Computer Science, Faculty of Electronic Engineering, University of Niš, Niš, Serbia
| | - Marko Stojanović
- Department of Epidemiology, Faculty of Medicine, University of Niš, Niš, Serbia
- Center for Control and Prevention of Communicable Diseases, Institute of Public Health Niš, Niš, Serbia
| | - Zoran Bukumirić
- Institute of Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Dragana Ignjatović Ristić
- Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
- Psychiatric Clinic, Clinical Centre "Kragujevac", Kragujevac, Serbia
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Mao P, Cai Z, Chen B, Sun X. The association between problematic internet use and burnout: A three-level meta-analysis. J Affect Disord 2024; 352:321-332. [PMID: 38302068 DOI: 10.1016/j.jad.2024.01.240] [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: 09/26/2023] [Revised: 01/17/2024] [Accepted: 01/26/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Burnout has received considerable attention in recent years because of the adverse consequences for people. Theoretical perspectives propose that problematic internet use is a significant potential risk for burnout. Despite a plethora of studies showing a positive association between problematic internet use and burnout, there remains a contentious debate regarding the extent and direction of this association. METHODS This study aims to perform a three-level meta-analysis to evaluate the strength of the relationship between problematic internet use and burnout through a quantitative synthesis of eligible studies published until April 2023. RESULTS A total of 42 studies with 54,121 participants and 103 effect sizes were identified. The results indicated a positive, moderate, and significant association between problematic internet use and burnout. Furthermore, the subgroup analysis found that this association was moderated by population, dimension of burnout, and the measure of burnout, however, some study features (i.e., region, type of problematic internet use, gender, and publication year) could not explain the heterogeneity across individual studies. LIMITATIONS Studies included in the current meta-analysis mainly used cross-sectional designs, which limited the potential to make inferences on the causal relationship between problematic internet use and burnout. CONCLUSIONS Individuals with problematic internet use have exhibited higher levels of burnout. Overall, these findings develop a deeper understanding of this association between problematic internet use and burnout and have implications for the direction of future research and interventions.
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Affiliation(s)
- Peipei Mao
- School of Psychology, Central China Normal University, Wuhan 430079, China; Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China
| | - Zhihui Cai
- School of Psychology, Central China Normal University, Wuhan 430079, China; Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China
| | - Bizhong Chen
- School of Psychology, Central China Normal University, Wuhan 430079, China; Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China
| | - Xiaojun Sun
- School of Psychology, Central China Normal University, Wuhan 430079, China; Key Laboratory of Adolescent Cyberpsychology and Behavior (CCNU), Ministry of Education, Wuhan 430079, China; Beijing Normal University Collaboration Innovation Center, Central China Normal University Branch, Wuhan 430079, China.
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Liu S, Wu P, Han X, Wang M, Kan Y, Qin K, Lan J. Mom, dad, put down your phone and talk to me: how parental phubbing influences problematic internet use among adolescents. BMC Psychol 2024; 12:125. [PMID: 38443976 PMCID: PMC10916140 DOI: 10.1186/s40359-024-01620-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/23/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND The positive association of parental phubbing with internalising and externalising problems among adolescents has gained academic traction. To date, limited research has investigated the association of parental phubbing and adolescents' Problematic Internet Use (PIU). Furthermore, the mechanism underlying this association is largely unknown. These gaps limit our understanding of family-related issues affecting PIU among adolescents. The present study explores whether there is a relation between parental phubbing and PIU and investigates the mechanisms underlying this relation among adolescents. METHODS The participants were 495 junior high schoolers aged 11-15 years. Participants completed questionnaires on their experiences with PIU, parental phubbing, parent-child relationships, and basic psychological needs satisfaction. RESULTS The results showed a direct and indirect positive association between parental phubbing and PIU. Furthermore, parental phubbing indirectly influenced PIU and was mediated by the parent-child relationship and basic psychological needs satisfaction, respectively. Moreover, the parent-child relationship and basic psychological needs satisfaction were sequentially mediated. CONCLUSIONS Our study highlights the crucial role of parents in the development of adolescent PIU and provides theoretical and practical guidelines for PIU prevention and intervention.
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Affiliation(s)
- Saifang Liu
- School of Psychology, Shaanxi Normal University, 199 South Chang'an Road, 710061, Xi'an, China
- Shaanxi Provincial Key Laboratory of Behavior and Cognitive Neuroscience, 710061, Xi'an, China
| | - Peiqian Wu
- School of Educational Science, Anhui Normal University, 241000, Wuhu, China
| | - Xiaoxi Han
- School of Psychology, Shaanxi Normal University, 199 South Chang'an Road, 710061, Xi'an, China
- Shaanxi Provincial Key Laboratory of Behavior and Cognitive Neuroscience, 710061, Xi'an, China
| | - Mengyun Wang
- School of Psychology, Shaanxi Normal University, 199 South Chang'an Road, 710061, Xi'an, China
- Shaanxi Provincial Key Laboratory of Behavior and Cognitive Neuroscience, 710061, Xi'an, China
| | - Yuecui Kan
- Department of Medical Psychology, Psychological Science and Health Management Center, Harbin Medical University, Harbin, China
| | - Kuiyuan Qin
- School of Psychology, Shaanxi Normal University, 199 South Chang'an Road, 710061, Xi'an, China
- Shaanxi Provincial Key Laboratory of Behavior and Cognitive Neuroscience, 710061, Xi'an, China
| | - Jijun Lan
- School of Psychology, Shaanxi Normal University, 199 South Chang'an Road, 710061, Xi'an, China.
- Shaanxi Provincial Key Laboratory of Behavior and Cognitive Neuroscience, 710061, Xi'an, China.
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Zhang C, Wu K, Wang W, Li Y, Zhao H, Lai W, Shi G, Guo L, Li L, Lu C. Mediation and interaction of problematic internet use in the relationship between sexual minority status and depressive symptoms: Gender-based analysis. J Affect Disord 2024; 346:174-181. [PMID: 37956827 DOI: 10.1016/j.jad.2023.11.024] [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: 06/27/2023] [Revised: 11/06/2023] [Accepted: 11/07/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Previous studies have demonstrated that sexual minorities are at a higher risk of experiencing depressive symptoms. However, few prior investigations have examined the potential mechanisms involved. This study aimed to employ the four-way decomposition approach that integrates the analysis of mediation and interaction to investigate the potential role of problematic internet use between sexual orientation and depressive symptoms. METHODS The participants were recruited through a multi-stage, stratified cluster, and random sampling method in China. Students who identified as "gay or lesbian" and "bisexual" were defined as "sexual minorities". The Young's Internet Addiction Test (IAT) was used to evaluate problematic internet use. The Center for Epidemiologic Studies Depression Scale (CESD-20) was used to evaluate depressive symptoms. RESULTS A total of 59,859 adolescents were included in this study, with 30,180 (53.25 %) boys and 29,679 (46.75 %) girls. Of these, 7263 (12.13 %) were identified as sexual minorities. Gender differences were observed in the association between sexual orientation, problematic internet use, and depressive symptoms. The mediating effect of problematic internet use was 28.80 % for boys and 36.84 % for girls, respectively. The interaction effect between problematic internet use and sexual minority status on depressive symptoms was 21.19 % and 9.65 % for boys and girls, respectively. LIMITATIONS The current study was limited by the cross-sectional design. CONCLUSION These findings suggest that prevention and intervention programs aimed at improving mental health outcomes among sexual minority adolescents should prioritize considering the impact of problematic internet use and potential gender differences.
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Affiliation(s)
- Caiyun Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Keying Wu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Yanzhi Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Hao Zhao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Wenjian Lai
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Guangduoji Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China
| | - Li Li
- Maternity and Children Health Care Hospital of Luohu District, Shenzhen, China.
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China; Guangdong Provincial Key Laboratory of Food, Nutrition and Health, Sun Yat-sen University, Guangzhou, China.
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