Excessive reassurance-seeking and anxiety among Chinese new urban older adults: the role of attention to negative information and resilience.

Abstract

Background: Policy-driven relocation of older adults from rural to urban areas in China is a significant stressor that often exacerbates anxiety. The mechanisms through which excessive reassurance seeking (ERS) heightens anxiety in this population remain poorly understood.

Methods: A cross-sectional survey was conducted with 301 relocated older adults (aged 60-89 years; 52.5% women) in Jilin Province. Participants completed validated self-report measures assessing ERS, attention to negative information (ANI), resilience, and anxiety. Pearson correlations were used to assess bivariate relationships among the main variables. The PROCESS macro was employed to examine (a) the mediating role of ANI on the association between ERS and anxiety; (b) the moderating influence of resilience on the ERS-to-ANI path, thereby constituting a moderated-mediation model; and (c) the full-path robustness check of the model.

Results: Participants reported clinically meaningful levels of anxiety, which were positively associated with excessive reassurance seeking. The association between ERS and anxiety was mediated primarily through ANI. Further analysis found that the indirect effect of ERS on anxiety through ANI was more pronounced in the presence of higher levels of resilience.

Conclusion: ERS exacerbates anxiety mainly by amplifying negative attention bias. Even highly resilient individuals may experience more severe anxiety if they exhibit this attention bias. These findings emphasize that interventions should not only focus on fostering resilience, but also incorporate training to mitigate negative attention biases.