Development Of Evaluation Method For Problematic Mobile Phone Use(PMPU)and Neuropsychological Study On Relationships Between PMPU And Psychopathological Symptoms Among Medical Students

ObjectivesThe study aims to develop a self-rating questionnaire for adolescent problematic mobile phone use(PMPU)and apply it to describe the epidemiological status of PMPU,and to examine the potential underlying neuropsychological mechanisms in its associations with psychopathological symptoms among Chinese medical college students.MethodsA total of 2 376 students comprised of freshman,sophomore and junior from a medical university in Hefei were recruited by stratified sampling in our study.Two-independent samples t test,Pearson correlation coefficient analysis,factor analysis and other statistical methods were used to screen the items.Confirmatory factor analysis was applied to assess the construct validity of the questionnaire.Baseline data were collected in October 2013,with two follow-up surveys in June and December 2014.A total of 1 989 students were included and 589 students were lost to follow-up.Associations between demographic characteristics / social factors and PMPU / psychopathological symptoms were examined by χ2 test and logistic regression models.Event-related potentials(ERPs)was used to examine the role of neuropsychological mechanisms in the relationship between PMPU and psychopathological symptoms in 34 students.ResultsOn the basis of item analysis,the self-rating questionnaire for adolescent problematic mobile phone use(SQAPMPU)was suitable for the division of three dimensions with 13 items in total.Variance cumulative contribution rate was 59.13%;internal consistency test showed that the total questionnaire Cranach’s α coefficient was 0.87,Cronbach’s α coefficient of each dimension was between 0.58 and 0.83;all the indicators were at the significant level and have a great reliability and validity.Confirmatory factor analysis results showed that the value of RMSEA was 0.067,and the value of NFI,RFI,CFI,GFI,AGFI were above 0.9,with good fitting degree.The rates of PMPU were 27.3% at baseline、28.5% and 26.5% at follow-up;17.8%,15.5% and 10.2% for sub-health;12.9%,15.6% and 13.6% for anxiety,14.9%,17.0% and 13.7% for depression.The results of multivariable logistic regression showed that students with PMPU were more likely to be with psychopathological symptoms.However,after controlling some confounders like sex,age,BMI,any siblings,self-reported family economic status,smoking,drinking,self-harm,sleep disorder and Internet addiction,there was no a relationship between PMPU at baseline and the first follow-up anxiety(OR:1.31,95% CI: 0.98-1.76).Sustained PMPU was set as independent variable,and psychopathological symptoms were set as dependent variables.Multivariable logistic regression models indicated that sustained PMPU was related to psychopathological symptoms and reported a dose-response relationship after controlling confounding factors,such as sex,age,BMI,any siblings,self-reported family economic status,smoking,drinking,self-harm,sleep disorder and Internet addiction.A main effect of group indicated higher P2 amplitudes in PMPU group as compared to control group(4.45 vs.2.89 μV).An interaction between group and emotion reached significance,indicated higher P2 amplitudes in PMPU group,particularly for neutral-disgust pairs.However,the further analysis showed emotion did not individually modulate P2 amplitude both in PMPU group and control group.A main effect of group indicated higher P1 amplitudes to target onset in control group(2.22 vs.1.48μV).Interaction between group × emotion × validity,F=1.901,P = 0.019,η2p= 0.021,suggested that higher P1 amplitudes for valid targets in neutral–anger and neutral–happy pairs in control group,but enhanced responses for invalid targets in neutral–fear and neutral–disgust pairs in control group.Moreover,a group × emotion interaction,F=3.366,P = 0.001,η2p= 0.017 was highly significant,and indicated enhanced P1 amplitudes in control group for neutral–anger,neutral-disgust,neutral–fear,and neutral–happy pairs.Finally,interaction between group and validity,F = 8.059,P < 0.001,η2p= 0.018,logically indicated higher P1 amplitudes for valid trials in control group.ConclusionsThe SQAPMPU is consistent with the evaluation standard of psychometrics,and can be used to estimate PMPU in medical undergraduates.Logistic regression models indicate that students with PMPU can predict mental health in follow-up.Sustained PMPU has a dose-response effect on the occurrence of psychopathological symptoms.Attention bias plays a vital role in the relationships between PMPU and psychopathological symptoms.