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ARTICLE
More romantic or more realistic: trajectories and
influencing factors of romantic love among Chinese
college students from entering college to
graduation
Xinqiao Liu 1✉, Xinyu Ji1& Yifan Zhang1
College is a significant transition in the growth of individuals, and romantic relationships play
an important role in the future development of individuals. Understanding young people’s
attitudes toward love is helpful for formulating strategies to guide them to form correct
attitudes toward love, promote the formation of positive and healthy attitudes toward mar-
riage and life. This study aimed to explore the trajectories of college students’attitudes
toward love, reveal the development law of their attitudes toward love, and identify the
influencing factors that lead to changes in their attitudes toward love. Descriptive and cor-
relation analyses were performed on participants’attitudes toward love, followed by utili-
zation of a growth mixture model to explore latent trajectory classes and a multinomial
logistic regression model to analyze influencing factors across trajectories.The results indi-
cated that romantic attitudes could be divided into three groups: “high-increasing”,“low-
decreasing”and “low-increasing”, and realistic attitudes could be divided into three groups:
“high-increasing”,“low-increasing”and “high-decreasing”. Gender, major, extroversion, and
hometown location were factors influencing whether students fell into different trajectory
classes. Overall, society and colleges should pay more attention to changes in college stu-
dents’attitudes toward love, provide timely intervention and guidance, and prevent them
from suffering from behavioral, physical, and psychological problems.
https://doi.org/10.1057/s41599-024-03107-0 OPEN
1School of Education, Tianjin University, Tianjin 300350, China. ✉email: xinqiaoliu@pku.edu.cn
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Introduction
Love is generally regarded as the deepest and most mean-
ingful emotion, and it has been discussed in philosophy,
literature, and art (Rubin, 1970). College students are in a
significant transition from adolescence to adulthood (emerging
adulthood), which is a special stage for their physical and psy-
chological development (Fraley & Shaver, 2000; Trinke &
Bartholomew, 1997). At this stage, college students’demand for
love is particularly strong, and the exploration of love lays the
foundation for their attitudes toward love and their future mar-
riage (Arnett, 2000). Additionally, romantic relationships can
effectively reduce the risk of depression, antisocial behavior,
obesity, and other diseases among college students (Barr et al.,
2013; Braithwaite et al., 2010; Simon & Barrett, 2010). Therefore,
exploring college students’attitudes toward love not only is
beneficial for predicting their standards for choosing partners as
well as the development of love and marriage but also helps
society and schools take measures to prevent their mental health
problems. However, academic circles have paid little attention to
college students’attitudes toward love. Most of the existing stu-
dies have developed theories about attitudes toward love based on
Western culture and explored different types, trajectories, and
relationships between attitudes toward love and personality,
family factors, social environment, etc. However, there are few
studies on Eastern college students’attitudes toward love and no
in-depth analysis of its influence mechanism. Attitudes toward
love are affected by cultural background and social values, which
have cultural differences. Considering the influence of social and
cultural differences between Eastern and Western countries on
attitudes toward love (Dion & Dion, 1996; Neto, 2007; Sprecher
et al., 1994), we believe that against the background of Chinese
culture, exploring the overall trend of college students’attitudes
toward love, the developmental trajectories and influencing fac-
tors of their attitudes toward romantic love and realistic love can
provide more reference for the existing theories.
Based on the existing theoretical basis of attitudes toward love,
this study identified the trajectories of college students’attitudes
toward love to understand their changes from entering college to
graduation. On this basis, we also analyzed the factors that
influence the different trajectories of college students’attitudes
toward love. With the second demographic structure transition,
China’s marriage rate is experiencing a predicament decrease in
recent years (Xie & Hong, 2022). Late marriage or no marriage
will cause some social problems, such as a declining fertility rate,
an aging population, and a decreasing national economy. This
phenomenon occurs not only in China but also in countries such
as the United States and Northern Europe. Research on young
people’s attitudes toward love is helpful for understanding how
these attitudes and beliefs affect their marriage intentions, which
is highly important for helping college students form correct
views on love and marriage, promoting college students’marriage
intentions, and formulating policies and plans to improve the
marriage rate.
Literature review
Theories of love. Starting from Rubin’s distinction between “like”
and “love”(Rubin, 1970), discussion about love was increasingly
heated. For instance, Lee believed that love was not a single thing
but an entity that needed to be understood according to an
individual’s love “style”(Lee, 1977). Lee (1977) proposed six types
of love: Eros (passionate love), Ludus (game-playing love), Storge
(friendship love), Pragma (logical, “shopping list”love), Mania
(dependent love), and Agape (all-giving, selfless love). Shaver and
Hazan (1988) believed that loving styles could be integrated into
the attachment-theoretical framework, which might be secure,
anxious-ambivalent, or avoidant. Hatfield and Walster (1978)
proposed a dichotomy of love from the perspective of typology,
distinguished passionate love and companionate love, and
answered some questions about love, such as the best place to find
love, the differences between men and women in love, and the
ways to keep love. According to Sternberg’s(1986) triangular
theory of love, a combination of intimacy, passion, and com-
mitment defines eight different types of love, such as romantic
love (more intimacy, passion, and less commitment) and com-
panionate love (more intimacy, commitment, and less passion).
In 1997, Sternberg proposed the construct validation of a love
scale based on the triangular theory of love (Sternberg, 1997), but
the theory was not fully verified. Based on the views of Knox and
Sporakowski, the present study divided attitudes toward love into
two types: romantic love and realistic love. People with realistic
attitudes believe that love is regarded as a reliable, calm, and
comforting emotion, while people with romantic love believe that
love is the only reason for choosing a partner rather than other
realistic factors (Knox & Sporakowski, 1968).
There is a strong correlation between an individual’s attitude
toward love and cultural adaptation (Shooter, 1993), which is
strongly influenced by social and cultural background, especially
in China. The mainstream attitude toward love in ancient China
was associated with marriage, and love was not important in
marriage at that time. However, there were some stories about
nonmainstream attitudes toward love in ancient times, such as
“Cowher and Weaver Girl”,“Liang Shanbo and Zhu Yingtai”, and
the elopement of Zhuo Wenjun and Sima Xiaru. Since
monogamy was implemented in China in 1950, Chinese attitudes
toward love have changed substantially, the view of freedom of
love and marriage has gradually increased, and love is no longer
based only on the consideration of future marriage (Zeng et al.,
2016). In addition, Chinese scholars have gradually formed their
understanding of attitudes toward love. For instance, attitudes
toward love refer to people’s understanding of romantic relation-
ships in society (Zhang & Yang, 1999), which involves issues such
as what kind of love is meaningful, what kind of marriage is
happy, and what kind of marriage to choose (Huang & Zheng,
1999). Attitudes toward love reflect the values and internal
standards in the pursuit of love (Liao, 2006), which are critical
parts of attitudes toward life (Chen, 2012). According to these
scholars’interpretations of love, the connection between love and
marriage is still inseparable in contemporary China. Since the
reform and opening up, research on “love”in the Chinese context
has rapidly increased, and the research scope has expanded to the
campus, which was previously regarded as a forbidden area
(Wang, 2023). In the past, school education encouraged students
to take a serious attitude toward love, which influenced the
overall attitudes of Chinese college students toward love, which
tended to be more pragmatic. However, with changes in social
attitudes, not all Chinese students agree with pragmatic attitudes,
and further discussion on attitudes toward love among college
students in the new era is warranted.
Developmental trajectories. The developmental trajectory is a
mature framework in studies of attitudes toward love that cap-
tures both the time of love development and the sequence of
events. Connolly et al. (2013) conducted a longitudinal study on
the social development of youth with a sample range of 11 to 17
years old (8 waves of data from late primary school to the end of
high school). They were based on a group-based approach and
identified three developmental trajectories of romantic stages: on-
time, early starters, and late bloomers. The proportion of students
in the on-time group was the largest (52.3%), and their romantic
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activities gradually matured. Early-stage students (21.4%) started
dating and romantic relationships at an early age. Late-bloomer
students (26.4%) started ancillary activities in mid-adolescence
and dating at a late age. Meier and Allen (2009) studied the
relationship types of adolescents from 11 to 18 years old and
noted that the romantic relationships of adolescents gradually
developed as they grew up, and almost no binary or intimate
romantic relationships were observed in early adolescents. This
suggests that romantic relationships are characterized by stages,
and individuals show different attitudes toward romantic love at
different stages of development. Some studies have also suggested
that adolescents’romantic development is influenced by their
sociocultural background. Although the sequence of Asian ado-
lescents’developmental trajectories of romantic relationships is
similar to that of other adolescents (Connolly et al., 2004), their
romantic activity begins later than that of adolescents from North
American and European backgrounds (Carver et al., 2003;Li
et al., 2010). Generally, Chinese students are not allowed to have
romantic relationships before they enter college (although some
students still experience romantic relationships), and romantic
relationships in this period are regarded as “puppy love”.In
China, “puppy love”is believed to negatively affect students’
academic performance and is often not supported by school or
family, which causes Chinese students to start romantic rela-
tionships later than teenagers from North American and Eur-
opean backgrounds. Considering that college is an important
stage of individual emotional maturity and development, we
believe that it is necessary to separate this stage for trajectory
analysis to understand the changes and differences in college
students’attitudes toward love. According to the literature, few
studies have analyzed the developmental trajectories of attitudes
toward love (romantic love or realistic love) among college
teenagers.
Influencing factors. The factors influencing the developmental
trajectories of college students’attitudes toward love and the
factors influencing attitudes toward love within a group were
further explored. We believe that romantic and realistic attitudes
are correlated with gender, age, hometown location, extroversion,
major, ethnicity, siblings, body mass index (BMI), self-esteem,
parents’education levels, family economic status, family social
status, etc.
Gender differences in attitudes toward love are the most
prominent topic in the field. Brehm’s opinion is very representa-
tive: “Perhaps the different views on love among individuals
mainly exist between genders”(Brehm, 1992). Knox and
Sporakowski (1968) mentioned that women tended to have more
realistic attitudes than men, and a highly involved romantic
relationship could increase both men’s and women’s realistic
attitudes and reduce romantic differences. Contrary to popular
belief, studies have shown that men are more likely to be idealized
and romanticized than women (Kephart, 1967). According to a
survey of college students, men also had higher romantic scores
than women (Sprecher & Metts, 1999). A study of lovers and
newly married couples suggested that men were more likely to fall
in love (Kanin et al., 1970). Women were more realistic and
practical than men (Lester, 1985), more likely to agree that
“economic conditions should be carefully considered when
choosing a partner”, more cautious about love, and more able
to walk away from a romantic relationship (Hill et al., 1976).
Some studies have noted that gender differences in attitudes
toward love are related to the stage of a romantic relationship
(Fengler, 1974). At the beginning of a relationship, the difference
in attitudes between men and women was not significant, but
after engagement or marriage, men’s romantic attitudes
increased, and women’s realistic attitudes increased. Hobart
(1958) stated that the development and changes in attitudes
toward love differed by gender in a study of undergraduate
students’attitudes toward love. Men’s romantic attitudes
increased as their relationship continued, but women’s attitudes
did not.
Age is also a variable that can explain the differences in
attitudes toward love. In Yun and Young (2005) study of middle-
aged and elderly people, an increase in romantic love was
discovered among older men. Clemente et al. (2020) concluded
that adolescents scored low on the three components of the
Sternberg typology (passion, commitment, and intimacy),
commitment and unconditional love increased as they grew up,
and pragmatic love dominated in mid-adulthood (aged 20 to 32).
Although Reeder (1996) obtained the opposite finding, the
research conducted by Acker and Davis (1992) suggested that the
expected decline in passion only occurred for women.
Bartolac (2012) studied 503 students of different ages,
examining their romantic attitudes and their correlation with
sociodemographic variables. The results indicated that the
participants’romantic attitudes were correlated with their
hometown location, with students from rural areas being more
romantic. However, Bhana and Pattman (2011) conducted an
interview survey among young people (aged 16 to 17) from a
poor town in South Africa and discovered that the attitudes
toward love of young people in rural areas of South Africa were
closely related to material conditions. “Girls want money, boys
want virgins”, which is a materialistic love, and young people in
rural South Africa tended to have more realistic attitudes
toward love.
According to the study of Munro (1976), college-educated
introverted persons were less romantic than extroverted persons,
regardless of gender or life stage. Erevik et al. (2020) conducted a
large longitudinal study to investigate the relationship between
the use of Tinder and the formation of romantic relationships,
which included the differences between Tinder users and non-
Tinder users in personality traits (i.e., extroversion, agreeableness,
conscientiousness, neuroticism, and openness) and demographic
variables. The results revealed that Tinder users scored higher on
extroversion tasks than non-Tinder users. Extroversion has
always been considered one of the attractive characteristics of a
partner, and extroverted persons are more likely to fall into
romantic relationships (Botwin et al., 1997; Erevik et al., 2019;
Figueredo et al., 2006; Neyer & Lehnart, 2007).
The attitudes toward love reveal individuals’views toward love
issues, which also reflect their physical and mental health (Zhang,
1995). Through attitudes toward love, individuals can gain insight
into their spiritual world. Liu and Cao (2022) noted that
psychological and behavioral issues differed among college
students with different majors. Students majoring in the
humanities and social sciences had more careful thinking,
delicate and sensitive emotions, paid more attention to inner
experiences, and were easily affected by external factors. Students
majoring in science and engineering spent less time interacting
with others, were less communicative, dominated by rational
thinking, and less susceptible to external factors. These
differences indicate that students in the humanities and social
sciences are likely more inclined to romantic attitudes toward
love, while students in science and engineering may be more
realistic.
Crissey (2005) used data from the National Longitudinal Study
of Adolescent Health (Add Health) to examine racial/ethnic
differences in romantic relationships among adolescents of non-
Hispanic white (white), non-Hispanic black (black), Mexican
origin, and other races. White teens were more likely to date and
engage in serious romantic relationships with marriage
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expectations than teens from other racial/ethnic backgrounds. The
results in the study of Raley and Sullivan (2010) partially supported
Crissey’s claim, and they found that non-Hispanic white girls were
more likely to have romantic relationships than African American
girls, while African American boys were more likely to have
romantic relationships than non-Hispanic boys. Regardless of the
results, race/ethnicity is found to be correlated with attitudes
toward love.
The presence of siblings in childhood has a significant impact
on individuals’future interpersonal interactions (Parke et al.,
2002; Smith, Hart (2004)), and adolescents with siblings are more
mature and independent (Galambos et al., 2003). Some studies
have analyzed the correlation between siblings and attitudes
toward love. For instance, a family interview conducted by
Doughty et al. (2013) reported that intimate relationships with
siblings were positive predictors of romantic relationships. Chen
et al. (2006) discovered that the conflicts of partners from 19 to 25
years old first increased and then slightly decreased and stated
that being an only child and parents’low socioeconomic status
were associated with increased conflict. Based on existing research
on siblings, we suggest that this factor may be a potential
predictor of attitudes toward love.
In studies of romantic relationships, the correlation between
obesity and romantic relationships has also received extensive
attention. Studies have shown a significant negative correlation
between BMI and romantic relationships (Halpern et al., 2005):
for every 1-point increase in BMI, the probability of romantic
relationships decreases by 6%. Adolescent girls’pursuit of
thinness indicates increased expectations of romantic relation-
ships, and young women with lower BMIs are more likely to
develop new romantic relationships (Van Woerden et al., 2020).
According to the risk-regulation model, people usually seek a
balance between expressing love to promote intimacy and
avoiding emotional exposure to achieve self-protection (Knapp
et al., 2016; Luerssen et al., 2017). Individuals with high self-
esteem are more likely to feel an increase in romantic relation-
ships, while individuals with low self-esteem are more inclined
toward self-protection. Anxiety and avoidance behaviors in
romantic relationships are also associated with low self-esteem.
Moosmann and Roosa (2015) studied the characteristics of
romantic relationships among Mexican American adolescents
and noted that adolescents with higher-quality romantic relation-
ships reported higher self-esteem.
Studies of parents’education levels and families’socioeconomic
status have shown conflicting results. One view is that people with
less educated parents and poor family economic conditions tend to
be more realistic in choosing partners (Kasser et al., 1995; Kroh,
2009;Marks,1997). In contrast, people whose parents are highly
educated tend to pay more attention to their feelings and have
more romantic attitudes toward love. This phenomenon can be
explained by postmaterialist theory (Inglehart, 1971,2018), which
holds that individuals with comfortable economic conditions will
pursue quality of life and romantic love. The other view is that
when parents are more highly educated, the children are more
inclined to choose realistic attitudes toward love (Hu & Wu, 2019).
This view can be explained by the theory of social closure (Holton,
2013). As parents’education levels, families’social status, and
economic status increase, families are more likely to provide a rich
environment for children’s growth. Once children adapt to this
favorable environment, it is difficult for them to accept the decline
in class, so college students from wealthier families are more likely
to pursue realistic love.
Research gap. In summary, understanding the development
trajectories of college students’attitudes toward love and the
factors leading to their differences is of great value for society and
colleges to provide correct guidance for college students and
provide an empirical reference for solving current social problems
such as low marriage rates and aging. Although theories about
attitudes toward love have been proposed in previous studies,
several issues have not been fully explored. First, previous studies
lack further investigation of the developmental trajectories of
attitudes toward love, especially under certain cultural back-
grounds, such as Chinese college students influenced by Con-
fucian culture (Wan et al., 2000). Second, influenced by cultural
background, the Chinese have different attitudes toward love
from Western countries. Among Chinese college students, there
are two main attitudes toward love: one is to marry for the
purpose, and the other is to fill the spiritual gap through love
(Zeng et al., 2016). However, few studies have considered the
changes and differences in attitudes toward love among Chinese
college students. Third, most of the previous studies on the
influencing factors of attitudes toward love have focused on
gender differences and personality dimensions; the relationships
among other factors are still unclear, and the relationships
between these factors and attitudes toward love have not been
confirmed in Chinese population samples. Therefore, this study
analyses the developmental trajectories of college students’atti-
tudes toward love and the influencing factors of different
trajectories.
Methods
Participants and procedures. This study utilized a longitudinal
survey dataset spanning five consecutive years. Probability pro-
portionate to size sampling was adopted for the survey. Every
academic year, sociodemographic characteristics, psychological
status, and academic performance data were collected once.
Existing studies have described the sampling design of these
datasets in detail (Cao & Ji, 2024; Cao & Liu, 2024; Cao, 2023; Liu
et al., 2024; Liu et al., 2023a; Liu et al., 2023b; Liu et al., 2023c; Liu
et al., 2022), and this study used data from 2473 students (1166
females and 1307 males) who enrolled in 2008, spanning from
their freshman to senior years, which reflected the changes
throughout their college years from entering college to
graduation.
Measures. The core variable of this study is attitudes toward love
among college students. The survey of attitudes toward love
among college students adopted the 5-point Romantic Love Scale
with 23 questions. In this survey, college students were asked to
assign values to statements about attitudes toward love, with 1
point indicating “strongly disagree”and 5 point indicating
“strongly agree”. A higher score indicated that the student was
more consistent with the attitudes toward love reflected in the
items. Five important factors were extracted by principal com-
ponent analysis (oblique rotation principal component analysis,
OPCR), and they were romantic, realistic, unique, mysterious,
and resistant, among which two common factors were selected as
the analysis objects in this study: romantic attitudes and realistic
attitudes.
The romantic attitudes toward love include four items (“If I
love my partner, we will be able to get married, regardless of other
factors”,“If I break up with my partner, my world will become
boring and miserable”,“Love is the most important, and
everything else can be ignored”, and “My life will be meaningless
if I cannot be married to the person I love”), with a total score of
20 points. The Cronbach’s alpha of the romantic Index from
freshman to senior year was 0.68, 0.68, 0.73, and 0.76,
respectively. The realistic attitudes toward love also consisted of
four items (“Before committing to a relationship, I will consider
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the future development of my partner”,“An important
consideration when choosing a partner is the impact on my
career”,“Before committing to a relationship, I will consider the
genetic influence of my partner on our future children”, and
“When choosing a partner, I will seriously consider the financial
condition”). The total score is 20 points. The Cronbach’s alpha of
the realistic index from the freshman to senior year was 0.67,
0.67, 0.71, and 0.73, respectively.
Additionally, this study also added a series of variables that
might affect romantic and realistic attitudes, including gender
(the dichotomous variable: 1 for men and 0 for women), ethnicity
(the dichotomous variable: 1 for Han nationality and 0 for ethnic
minorities), hometown location (the dichotomous variable: 1 for
urban areas and 0 for rural areas), siblings (the dichotomous
variable: 1 for yes and 0 for no), major (dichotomous variable: 1
for engineering/science/agriculture/medicine, 0 for humanities/
social sciences), BMI (dummy variable: 0 for low, 1 for normal,
and 2 for high), extroversion (continuous variable, 1–9 points,
higher score indicates more extroversion), age (continuous
variable), father’s education level (continuous variable, unit:
year), mother’s education level (continuous variable, unit: year),
family economic status (continuous variable, 1–5 represents the
status from high to low) and family social status (continuous
variable, 1–5 represents the status from high to low). The self-
esteem scale compiled by Rosenberg (1965) was used to measure
self-esteem, including 10 items with a 5-point response, and the
total score ranged from 10–50. A higher score indicates a higher
level of self-esteem.
Data analysis. First, Stata 15.0 was used for descriptive analysis to
explore the changes in college students’romantic attitudes and
realistic attitudes toward love during their college years. Second,
for Pearson correlation analysis, Stata 15.0 was used. Third, for
the growth mixture model (GMM), Mplus 8.3 was used for the
GMM (Muthén, 2004) to explore the heterogeneity in the
population and the trajectories of romantic attitudes and realistic
attitudes toward love. The GMM is very flexible, can divide the
population into several latent classes, and can describe the tra-
jectories of the subgroups as well as the changes in individuals
within the group over time. Fourth, the optimal model was
determined according to the Akaike Information Criteria (AIC),
Bayesian Information Criteria (BIC), Sample Size Adjusted BIC
(SABIC), Lo Mendel-Rubin Likelihood Ratio Test (LMR-LRT),
Bootstrapped Likelihood Ratio Test (B-LRT), entropy values, and
theory of love. Fifth, for the multinomial logistic regression
analysis, Stata 15.0 was used to investigate the effects of various
factors on the different trajectories of romantic attitudes and
realistic attitudes toward love.
Results
Descriptive statistics. There were 1307 males in the survey,
accounting for 52.85%, and 1166 females, accounting for 47.15%,
with an average age of 19.6 years. Romantic attitude scores
increased from 9.12 in the freshman year to 9.695 in the junior
year before dropping to 9.622 in the senior year. The realistic
attitudes, which scored above 12 points, increased from 12.183
points in the freshman year to 12.794 points in the junior year but
decreased to 12.527 points in the senior year. Overall, realistic
attitudes scored higher than romantic attitudes.
Correlation analysis of romantic attitudes and realistic atti-
tudes among college students. Table 1shows the correlation
coefficients of romantic attitudes, realistic attitudes, and other
variables among college students. Romantic attitudes were sig-
nificantly negatively correlated with realistic attitudes
(r=−0.1492, p< 0.05); were significantly positively correlated
with gender (r=0.1886, p< 0.05), major (r=0.0791, p< 0.05),
age (r=0.0542, p< 0.05), and BMI (r=0.0608, p< 0.05); were
significantly negatively correlated with hometown location
(r=−0.0622, p< 0.05), father’s education levels (r=−0.0348,
p< 0.05), mother’s education levels (r=−0.0374, p< 0.05), and
self-esteem (r=−0.1240, p< 0.05); and were not significantly
correlated with ethnicity, siblings, extroversion, family economic
status, or family social status (p> 0.05). Realistic attitudes were
significantly positively correlated with age (r=0.0247, p< 0.05),
siblings (r=0.1606, p< 0.05), extroversion (r=0.0105, p< 0.05),
hometown location (r=0.1579, p< 0.05), father’s education
levels (r=0.1673, p< 0.05), mather’s education levels
(r=−0.1678, p< 0.05), and self-esteem (r=0.0348, p< 0.05);
were significantly negatively correlated with gender (r=−0.1886,
p< 0.05), major (r=−0.1325, p< 0.05), ethnicity (r=−0.0393,
p< 0.05), family economic status (r=−0.1487, p< 0.05), and
family social status (r=−0.1535, p< 0.05); and were not sig-
nificantly correlated with BMI (p> 0.05).
Trajectory classes of romantic attitudes among college stu-
dents. To clarify the heterogeneity and trajectory classes of
romantic attitudes among college students, based on previous
theoretical studies, fit tests were conducted on the growth mixture
models of classes 1–5, and the results are shown in Table 2. AIC,
BIC, and SABIC reflect the fitness of the models, and higher
values indicate greater fitness. According to the results, the 3-class
model is better than the others. The LMR-LRT and B-LRT also
exhibited significant differences between the 3-class model and
the adjacent model (p< 0.001), and the entropy was 0.68. Con-
sidering the test results of six indexes and the sample size pro-
portion of each group, this study states that the 3-class model best
fits.
Figure 1shows the trajectories of romantic attitudes. The first
class, accounting for 1.05%, showed an increasing trend from the
freshmen year (7.808) to the senior year (18.458), with a large
range of scores; thus, this class was named “high-increasing”. The
students in the second class accounted for 13.79%, and their
scores decreased from the freshman year (14.267) to the senior
year (10.54) within a small range, so we call them the “low-
decreasing”. In the third class, students accounted for 85.16%,
and their scores increased from the freshman year (8.305) to the
senior year (9.36) within a small range, which we call “low-
increasing”.
The slope and intercept of the 3-class model are included in
Table 3. For the “high-increasing”class, the increasing trend from
the freshman year to the senior year was significant
(slope =3.043, p< 0.001). For the “low-decreasing”class, the
scores slightly decreased from the freshman year to the senior
year, and the decreasing trend was significant (slope =−0.766,
p< 0.05). For the “low-increasing”class, there was a slight
increasing trend from the freshman year to the senior year, which
was also significant (slope =0.347, p< 0.001).
Trajectory classes of realistic attitudes among college students.
The fit tests of the development trajectories of college students’
realistic attitudes are shown in Table 4. The AIC, BIC, and SABIC
indicate that realistic attitudes are better divided into three clas-
ses, in which the LMR-LRT is significant (p< 0.05), the B-LRT is
also significantly different between the 3-class model and the
adjacent model (p< 0.001), and the entropy is 0.86. According to
the test results and considering the sample size proportion of each
group, this study considers that the 3-class model best fit.
Figure 2shows the trajectories of realistic attitudes. The scores
of students in the first class, accounting for 1.58%, increased from
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freshmen (7.564) to seniors (16.973) with a large range, so we call
this class “high-increasing”. Students in the second class
accounted for 96.97%, and their scores showed an increasing
trend from the freshman year (12.202) to the senior year (12.534)
with a small change in score, which we call “low-increasing”. The
third class, which accounted for 1.46%, decreased from the
freshman year (15.944) to the senior year (7.343) with relatively
large changes in scores, which is classified as “high-decreasing”.
The slope and intercept of the 3-class model are shown in
Table 5. For the “high-increasing”class, the increasing trend from
the freshman year to the senior year was significant
(slope =2.212, p< 0.001). The “low-increasing”class slightly
increased from freshmen to seniors, and the increasing trend was
significant (slope =0.124, p< 0.05). For the “high-decreasing”
class, the decreasing trend from the freshman year to the senior
year was significant (slope =−2.213, p< 0.001).
Influencing factors for latent classes of romantic attitudes. This
study further explored the factors leading to differences in the
trajectories of romantic attitudes among college students. A
multinomial logistic regression model was used to analyze the
categorical variables of high-increasing vs. low-increasing (refer-
ence group), low-decreasing vs. low-increasing (reference group),
and high-increasing vs. low-decreasing (reference group), and the
results are shown in Table 6.
Considering “low-increasing”as the reference group and
comparing the relative risk rate and pvalue with those of the
“high-increasing”group, the existing variables could not
significantly explain the difference in developmental trajectories
between the two groups (p> 0.05). The difference was small, or
more complex intermediate variables needed to be discovered.
Compared with the “low-decreasing”group, gender (RRR =1.92,
p=0.000) significantly affected the students who entered the
“low-increasing”group. In other words, men were more likely to
fall into the “low-decreasing”group than into the “low-
increasing”group of romantic attitudes.
The study also used the “low-decreasing”group as the
reference group and compared it with the “high-increasing”
group. The results indicated that the existing variables could not
significantly explain the difference in the developmental trajec-
tories between the two groups (p> 0.05).
Influencing factors for latent classes of realistic attitudes. This
study also explored the factors leading to the differences in the
developmental trajectories of college students’realistic attitudes
and used a multinomial logistic regression model to analyze the
categorical variables of high-increasing vs. high-decreasing
(reference group), low-increasing vs. high-decreasing (reference
group), and high-increasing vs. low-increasing (reference group),
and the results are shown in Table 7.
Using the “high-decreasing”group as the reference group, this
study compared the relative risk rate and pvalue with those of the
“high-increasing”group and found that the major (RRR =0.21,
p=0.007) significantly affected whether the students fell into the
“high-increasing”group. Compared with the “high-decreasing”
group, the major (RRR =0.42, p=0.036) significantly affected
whether they entered the “low-increasing”group. In conclusion,
students majoring in engineering/science/agriculture/medicine
were more likely to enter the “high-decreasing”group in realistic
attitudes than students majoring in humanities/social science.
By using “low-increasing”as the reference group and
comparing it with the “high-increasing”group, the results
showed that extroversion (RRR =0.76, p=0.009) and hometown
location (RRR =2.83, p=0.050) significantly affected whether
the students entered the “high-increasing”group, indicating that
Table 1 Correlation analysis of romantic attitudes and realistic attitudes among college students.
Variables 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1. Romantic attitudes 1
2. Realistic attitudes −0.1492* 1
3. Gender 0.1886* −0.1886* 1
4. Major 0.0791* −0.1325* 0.3853* 1
5. Age 0.0542* 0.0247* 0.0451* 0.0028 1
6. Ethnicity −0.0086 −0.0393* −0.02 −0.0248* 0.0093 1
7. Siblings −0.039 0.1606* −0.0447* −0.0816* −0.1342* −0.0863* 1
8. Extroversion −0.0105 0.0741* −0.0877* −0.0729* 0.1418* 0.0052 0.0417* 1
9. Hometown location −0.0622* 0.1579* −0.1113* −0.1219* −0.1354* −0.0067 0.5129* 0.0719* 1
10. Father’s education level −0.0348* 0.1673* −0.1074* −0.0874* −0.1410* −0.0369* 0.4725* 0.0736* 0.5573* 1
11. Mother’s education level −0.0374* 0.1678* −0.1184* −0.1146* −0.1213* −0.0253* 0.4993* 0.0848* 0.5795* 0.7035* 1
12. Family economic status 0.0172 −0.1487* 0.1026* 0.1153* 0.1516* 0.0279 −0.3050* −0.1003* −0.4378* −0.4644* −0.4367* 1
13. Family social status 0.0122 −0.1535* 0.0919* 0.1055* 0.1372* 0.0393 −0.2819* −0.1001* −0.3763* −0.4513* −0.4246* 0.6959* 1
14. BMI 0.0608* 0.0106 0.0936* 0.0713* 0.6290* −0.0129 0.0016 0.1869* −0.0159 0.0035 −0.0012 0.0011 0.0004 1
15. Self-esteem −0.1240* 0.0348* −0.0438* −0.0456* −0.1280* 0.0175 0.0847* 0.2060* 0.0755* 0.0934* 0.0910* −0.1285* −0.1631* −0.1209* 1
*5% significance level.
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Table 2 Determination of the number of trajectory subgroups of romantic attitudes.
Romantic attitudes 1-class model 2-class model 3-class model 4-class model 5-class model
AIC 46139.24 46100.87 46068.49 46053.43 46031.98
BIC 46191.56 46170.63 46155.69 46158.06 46154.05
SABIC 46162.96 46132.50 46108.03 46100.87 46087.33
LMR-LRT p< 0.001 p< 0.001 p=0.3355 p=0.1154
B-LRT p< 0.001 p< 0.001 p< 0.001 p< 0.001
Entropy 0.54 0.68 0.64 0.66
Mixture proportion (%) 100.00 15.57 1.05 5.01 2.67
84.43 13.79 1.17 49.70
85.16 46.62 4.97
47.19 1.46
41.21
AIC akaike information criterion, BIC Bayesian information criterion, SABIC sample size adjusted Bayesian information criterion, LMR-LRT Lo-Mendel-Rubin adjusted likelihood ratio test, B-LRT
bootstrapped likelihood ratio test.
0
2
4
6
8
10
12
14
16
18
20
4321
High-increasing(1.05%) Low-decreasing(13.79%) Low-increasing(85.16%)
Fig. 1 Growth mixture model of romantic attitudes. Trajectory classes of romantic attitudes.
Table 3 Intercept and slope of latent classes of romantic attitudes.
Romantic attitudes High-increasing (n=26) Low-decreasing (n=341) Low-increasing (n=2106)
Means SE pValue Means SE pValue Means SE pValue
Intercept 6.736 0.633 0.000 12.582 0.488 0.000 8.410 0.263 0.000
Slope 3.043 0.432 0.000 −0.766 0.23 0.001 0.347 0.061 0.000
SE standard error.
Table 4 Determination of the number of trajectory subgroups of realistic attitudes.
Realistic attitudes 1-class model 2-class model 3-class model 4-class model 5-class model
AIC 45225.01 45208.32 45190.61 45191.68 45192.23
BIC 45277.33 45278.08 45277.80 45296.31 45314.31
SABIC 45248.73 45239.95 45230.15 45239.12 45247.59
LMR-LRT p< 0.05 p< 0.05 p=0.6359 p=0.2839
B-LRT p< 0.001 p< 0.001 p=1.0000 p=0.5000
Entropy 0.96 0.86 0.59 0.63
Mixture proportion (%) 100.00 99.52 1.58 1.29 73.55
0.49 96.97 81.84 0.77
1.46 15.16 2.06
1.70 22.60
1.01
AIC akaike information criterion, BIC Bayesian information criterion, SABIC sample size adjusted Bayesian information criterion, LMR-LRT Lo Mendel-Rubin adjusted likelihood ratio test, B-LRT
bootstrapped likelihood ratio test.
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the more introverted and urban college students were more likely
to enter the “high-increasing”group of realistic attitudes.
Discussion
This study used the sample of Chinese college students to gain
insight into the development of college students’attitudes toward
love and analyzed the predictive factors, which not only provided
support for understanding Chinese attitudes toward love but also
provided practical insight for guiding college students to form
positive attitudes and values toward love. In this study, we
identified the developmental trajectories of Chinese college stu-
dents’romantic attitudes and realistic attitudes toward love and
explored the factors related to romantic attitudes and realistic
attitudes and the factors influencing college students’different
developmental trajectories of attitudes toward love.
Demographics and individual factors associated with romantic
and realistic attitudes. First, romantic attitudes are positively
correlated with gender, age, major, and BMI and negatively
correlated with hometown location, parents’education levels, and
0
2
4
6
8
10
12
14
16
18
4321
High-increasing(1.58%) Low-increasing(96.97%) High-decreasing(1.46%)
Fig. 2 Growth mixture model of realistic attitudes. Trajectory classes of realistic attitudes.
Table 5 Intercept and slope of latent classes of realistic attitudes.
Realistic attitudes High-increasing (n=39) Low-increasing (n=2398) High-decreasing (n=36)
Means SE pValue Means SE pValue Means SE pValue
Intercept 9.249 0.738 0.000 12.345 0.081 0.000 15.435 0.857 0.000
Slope 2.212 0.43 0.000 0.124 0.039 0.001 −2.213 0.422 0.000
Note: SE standard error.
Table 6 Multinomial logistic regression analyses of influencing factors for classes of romantic attitudes.
Romantic attitudes High-increasing
(vs Low-increasing)
Low-decreasing
(vs Low-increasing)
High-increasing
(vs Low-decreasing)
RRR 95% CIs pValue RRR 95% CIs pValue RRR 95% CIs pValue
Gender: Men (vs Women) 2.37 0.92–6.10 0.072 1.92 1.45–2.53 0.000 0.81 0.30–2.14 0.666
Age 1.00 0.64–1.58 0.995 1.01 0.88–1.15 0.924 1.01 0.63–1.60 0.983
Ethnicity: Minority (vs Han) 1.53 0.51–4.56 0.449 0.85 0.57–1.27 0.431 0.56 0.18–1.76 0.320
Siblings: No (vs Yes) 1.49 0.52–4.29 0.462 0.88 0.65–1.19 0.403 0.59 0.20–1.75 0.342
Extroversion 1.10 0.85–1.42 0.476 1.03 0.95–1.11 0.524 0.93 0.72–1.22 0.611
Hometown location: Urban (vs Rural) 1.23 0.37–4.10 0.730 0.91 0.64–1.30 0.613 0.74 0.21–2.54 0.631
Father’s education level 0.97 0.83–1.15 0.746 1.03 0.98–1.08 0.249 1.06 0.89–1.25 0.511
Mother’s education level 0.95 0.82–1.09 0.446 1.00 0.95–1.04 0.860 1.05 0.91–1.22 0.493
Family economic status 0.72 0.34–1.53 0.390 1.07 0.85–1.33 0.574 1.49 0.68–3.24 0.320
Family social status 1.07 0.52–2.21 0.856 0.99 0.81–1.22 0.946 0.93 0.44–1.96 0.846
BMI
Low (vs Normal) 0.68 0.20–2.36 0.546 1.08 0.78–1.48 0.649 1.58 0.44–5.64 0.481
High (vs Normal) 0.74 0.17–3.25 0.686 0.85 0.55–1.31 0.461 1.15 0.25–5.32 0.855
Self-esteem 1.00 0.93–1.08 0.925 1.00 0.98–1.02 0.744 0.99 0.92–1.07 0.855
Major: Engineering/science/agriculture/medicine
(vs Social sciences/Humanities)
0.62 0.26–1.47 0.275 0.92 0.71–1.19 0.521 1.49 0.61–3.67 0.384
RRR relative risk ratio, 95% CIs 95% confidence intervals.
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self-esteem. Realistic attitudes are positively correlated with age,
extroversion, self-esteem, siblings, hometown location, and par-
ents’education levels and negatively correlated with romantic
attitudes, gender, ethnicity, major, family social status, and family
economic status. Our correlation analysis results are consistent
with those of several previous studies (Bartolac, 2012; Bhana &
Pattman, 2011; Kephart, 1967; Knox & Sporakowski, 1968; Yun &
Young 2005). However, for age, we noticed that age had a sig-
nificant positive correlation with both romantic and realistic
attitudes. This result suggests that romantic and realistic attitudes
may exist simultaneously, and both romantic and realistic atti-
tudes can be high or low at the same time and are not necessarily
mutually exclusive (Driscoll et al., 1972). Inconsistent with many
studies (Botwin et al., 1997; Erevik et al., 2019; Munro, 1976), our
data showed a significant positive correlation between realistic
attitudes and extroversion, while romantic attitudes had no sig-
nificant correlation with extroversion. Yan (2010), an anthro-
pologist, proposed that individuals in modern society were no
longer willing to sacrifice themselves for the group and the family.
Instead, they seek their own interests and happiness through the
functioning of the family. We assume that the core of romantic
relationships among contemporary young people is no longer
about each other but points to themselves at all times. In modern
society, family background, concept of interests, bride price, and
other topics related to romantic relationships are widely dis-
cussed. Compared with introverts, extroverted people are more
likely to be influenced by the general environment, and their
attitudes toward love tend to be more realistic. In terms of major,
the study revealed that students majoring in science, engineering,
agriculture, and medicine were positively correlated with
romantic attitudes toward love and negatively correlated with
realistic attitudes toward love, which might be related to the
rational thinking of students majoring in science and engineering
(Liu & Cao, 2022). In terms of ethnicity/race, only a negative
correlation with realistic attitudes was detected. In contrast to the
conclusion of Doughty et al. (2013), we believe that siblings are
significantly positively correlated with realistic attitudes. The
positive correlation between BMI and romantic attitudes is also
inconsistent with previous research results (Halpern et al., 2005;
Van Woerden et al., 2020), and our results showed that an
increase of 1 point in BMI was associated with an increase of
0.0608 points in the scores of romantic attitudes. In addition, self-
esteem is negatively correlated with romantic attitudes and
positively correlated with realistic attitudes, which is completely
different from previous findings (Knapp et al., 2016; Luerssen
et al., 2017). Parents’education levels are positively correlated
with realistic attitudes and negatively correlated with romantic
attitudes. Family social status and family economic status are
negatively correlated with realistic attitudes. These findings
indicate that when parents have higher education levels, family
social status and economic status are greater, college students will
have more realistic attitudes toward love, which can be explained
by the theory of social closure (Holton, 2013). People with better
educated parents can be socialized, and to maintain a closed
social status, they usually take realistic attitudes.
Trajectories of romantic attitudes and realistic attitudes. Sec-
ond, according to the descriptive analysis, we noticed that the
overall trend of the romantic attitudes and realistic attitudes of
college students first increased and then decreased during the four
years of college. We believe that this trend reflects the special
cultural background in China; that is, the romantic relationships
of students before they enter college are often subject to social
constraints. To obtain higher scores on the college entrance
examination, most parents and teachers oppose their romantic
relationships. This phenomenon indicates that most Chinese
students do not begin to develop their atttudes toward love until
they enter college. Overall, realistic attitudes scored higher than
romantic attitudes. The results of the growth mixture model
further revealed that the development of romantic attitudes could
be divided into three groups. The first group is called “high-
increasing”(1.05%), which manifests a significant increase in
romantic attitudes from the freshman to the senior year. The
second group, known as the “low-decreasing”(13.79%), decreased
slightly from the freshman to the senior year. The third group is
“low-increasing”(85.16%), which was represented by a small
increase during the college years. The trajectories of realistic
attitudes fall into three groups: “high-increasing”(1.58%), “low-
increasing”(96.97%), and “high-decreasing”(1.46%). Most stu-
dents were in the “low-increasing”group in terms of both
romantic and realistic attitudes, indicating that both the romantic
Table 7 Multinomial logistic regression analyses of influencing factors for classes of realistic attitudes.
Realistic attitudes High-increasing
(vs High-decreasing)
Low-increasing
(vs High-decreasing)
High-increasing
(vs Low-increasing)
RRR 95% CIs pValue RRR 95% CIs pValue RRR 95% CIs pValue
Gender: Men (vs Women) 0.94 0.31–2.83 0.909 1.23 0.56–2.71 0.611 1.31 0.60–2.86 0.496
Age 0.92 0.53–1.61 0.776 0.99 0.66–1.49 0.970 1.08 0.73–1.58 0.711
Ethnicity: Minority (vs Han) 0.39 0.107–2.19 0.284 0.49 0.12–2.10 0.339 1.27 0.48–3.33 0.626
Siblings: No (vs Yes) 0.78 0.23–2.68 0.696 0.79 0.32–1.99 0.620 1.01 0.44–2.33 0.975
Extroversion 1.32 0.97–1.79 0.077 1.00 0.80–1.25 0.982 0.76 0.61–0.93 0.009
Hometown location: Urban (vs Rural) 0.37 0.08–1.72 0.207 1.06 0.34–3.28 0.923 2.83 1.00–7.99 0.050
Father’s education level 1.08 0.88–1.33 0.447 1.05 0.90–1.23 0.508 0.97 0.85–1.11 0.697
Mother’s education level 1.04 0.87–1.25 0.675 1.03 0.89–1.18 0.700 0.99 0.88–1.11 0.849
Family economic status 0.95 0.37–2.39 0.907 0.81 0.41–1.61 0.555 0.86 0.46–1.62 0.644
Family social status 1.05 0.43–2.55 0.913 1.45 0.75–2.79 0.265 1.38 0.75–2.53 0.297
BMI
Low (vs Normal) 1.07 0.29–3.88 0.920 0.96 0.38–2.42 0.936 0.90 0.36–2.25 0.824
High (vs Normal) 0.74 0.12–4.56 0.746 0.74 0.17–3.23 0.687 1.00 0.34–2.94 0.997
Self-esteem 1.04 0.96–1.14 0.316 1.04 0.97–1.11 0.252 1.00 0.94–1.05 0.876
Major: Engineering/science/agriculture/medicine (vs
Social sciences/Humanities)
0.21 0.07–3.65 0.007 0.42 0.18–0.94 0.036 1.95 0.90–4.21 0.090
RRR relative risk ratio, 95% CIs 95% confidence intervals.
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and realistic attitudes of college students increased slowly and
that they were not in conflict. From the perspective of evolu-
tionary theory (Ma et al., 2015), romantic love is a “commitment
device”that motivates individuals to maintain romantic rela-
tionships and contributes to long-term and stable relationships.
Although both attitudes show increasing trends, the overall scores
of realistic attitudes are higher than those of romantic attitudes,
and the proportion of the “low-decreasing”group in romantic
attitudes (13.79%) is higher. The realistic attitudes among Chi-
nese college students are likely related to cultural factors in the
collectivist society (Dion & Dion, 1993,1996), which is different
from individualism in Western countries (Bellah et al., 2007).
People in a collectivist society are more inclined to abide by social
norms and meet family expectations (Lamanna et al., 2020). In
China, love is the premise of marriage, but the selection of the
“partner”often involves the whole family (Day, 2002). As a result,
young Chinese should consider more realistic factors. Another
explanation is that college life is a transitional period for college
students before they enter their professional life. Engaging in an
ideal romantic relationship requires much energy for them, and
when they get closer to graduation, they will focus more on their
career choice (Gomez, 2019).
Influencing factors of latent classes of romantic attitudes and
realistic attitudes. Third, gender, major, extroversion, and
hometown location are the factors that lead to differences in the
developmental trajectories of college students’attitudes. Men are
more likely to fall into the “low-decreasing”group than into the
“low-increasing”group of romantic attitudes. Compared to the
“high-increasing”and “low-increasing”groups of realistic attitudes,
students majoring in science/engineering/agriculture/medicine are
more likely to belong to the “high-decreasing”group. Compared
with extroverted students and students from rural areas, introverted
students and students from urban areas are more likely to be in the
“high-increasing”group of realistic attitudes. There is much evi-
dence that males are more idealized and romantic than females
(Kanin et al., 1970; Kephart, 1967;Knox&Sporakowski,1968;
Sprecher & Metts, 1999), possibly because in Asia, the gender gap
in social status makes women more cautious about marriage and
more realistic toward love than men (Ra, 1994). Introverted stu-
dents’and urban students’attitudes toward love are becoming
more realistic, which is different from previous findings (Bartolac,
2012; Bhana & Pattman, 2011; Munro, 1976), and we speculate that
this may be caused by the particularity of the Chinese sample,
which needs further verification.
Limitations
First, since the samples were selective, the results from these data
should be used with caution when generalizing to other groups.
Given the differences in sociocultural background, whether our
results can be generalized to other countries is uncertain. Second,
the Romantic Love Scale in this study is a self-report scale, which
may lead to subjective biases, and the Cronbach’s alpha of the
scales was not high. Third, due to limitations in the existing data,
this study included only a few intervenable factors, and additional
intervenable variables should be considered in future studies.
Despite these limitations, this study on Chinese college students’
attitudes toward love supplements this field. It is not only valu-
able for understanding young Chinese people’s attitudes toward
love but also has implications for understanding attitudes toward
love in other similar societies.
Conclusions
This study focused on two typical attitudes toward love, romantic
love and realistic love, and deepened the psychological
understanding of college students’attitudes toward love. This study
revealed that attitudes toward love were correlated with gender,
major, age, BMI, self-esteem, ethnicity, siblings, extroversion,
hometown location, parents’education levels, family economic
status, and family social status. Moreover, attitudes toward love are
classified into three sub-trajectories. Gender, extroversion, and
major influence students into different sub-trajectories.
In general, Chinese college students’realistic scores on realistic
attitudes were higher than their romantic scores. It is a critical
task for society, colleges, and families to pay attention to the
problems of college students’romantic relationships and their
differences in gender, major, personality and hometown, and to
take measures to guide and shape college students’attitudes
toward love in time. The study suggests that colleges should be
based on mental health courses and guide students to form cor-
rect attitudes toward love. In the class or after class, positive
encouragement, micro-class science popularization, emotional
counseling, case simulation, and psychological empowerment
should be used to intervene and help students form mature
attitudes toward love to guide their future love behavior and life.
Data availability
The data of this study came from the “Beijing College Student
Panel Survey”(BCSPS), which is a follow-up survey for the five
consecutive years. The data ownership belongs to the National
Survey Research Center, Renmin University of China. For any
related questions about data, please reach the National Survey
Research Center, Renmin University of China. Since the dataset
has not been publicly released, the authors only obtained the right
to use the dataset and do not have the authority to publicly
distribute it. Therefore, a download link for the dataset cannot be
provided. However, descriptive statistical analysis results regard-
ing this dataset have been published in the appendix of the
author’s previously published paper. You can refer to the fol-
lowing paper for more information: https://doi.org/10.1057/
s41599-023-02252-2. The data that support the findings of this
study are available from the corresponding author upon reason-
able request.
Received: 2 June 2023; Accepted: 25 April 2024;
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Author contributions
Author XL designed the study and wrote the protocol. Authors XL and XJ undertook the
statistical analysis. Author XJ, XL and YZ wrote the first draft of the manuscript and
managed the literature analyses. All authors read and approved the final manuscript.
Competing interests
The authors declare no competing interests.
Ethical approval
Ethical approval was acquired from the Ethics Committee of Tianjin University (ethical
approval number: TJUE-2022-188; name of approval committee: Ethics Committee of
Tianjin University).
Informed consent
Before filling out the questionnaire, informed consent was obtained from all participants
in the study.
Additional information
Correspondence and requests for materials should be addressed to Xinqiao Liu.
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