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The Cooper–Norcross Inventory of Preferences (C-NIP) is one of the most widely used measures of psychotherapy preferences. However, its psychometric properties have not been examined in non-Western samples. Research on disparities between the preferences of mental health professionals and their clients is also limited. We evaluated the C-NIP's psychometric properties and measurement invariance in Chinese lay clients and mental health professionals and evaluated the latent mean differences between clients' and professionals' scores on the C-NIP's four scales (preference for therapist vs. client directiveness, emotional intensity vs. emotional reserve, past vs. present orientation, and warm support vs. focused challenge). This cross-sectional investigation involved 301 lay clients and 856 mental health professionals who completed the Chinese version of the C-NIP. Confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were used to examine the factor structure of the C-NIP. ESEM provided stronger evidence than CFA for the four-factor model in both samples. The four scales had adequate internal consistency in both the lay clients (αs =.68–.89) and the mental health professionals (αs =.70–.80). Partial scalar invariance was established across these two populations. Chinese mental health professionals preferred less therapist directiveness, past orientation, and warm support—but more emotional intensity—than Chinese lay clients (ds = 0.25–0.90). Culture-specific cutoff values (norms) to identify strong therapy preferences were established. This study supports the application of the C-NIP to non-Western populations and suggests that discrepancies between the preferences of lay clients and mental health professionals are a cross-cultural phenomenon. Public Significance Statement: This study confirms the factor structure and measurement invariance of the Cooper–Norcross Inventory of Preferences (C-NIP) in Chinese psychotherapy populations. The study further reveals systematic differences between lay clients' and mental health professionals' treatment preferences in the Chinese clinical context. These disparities suggest that professionals should be cautious in projecting their therapy preferences onto their clients. [ABSTRACT FROM AUTHOR]

Background: More than 300 million people worldwide suffer from depression, which is a significant contributor to the global burden of disease. This study investigated the factors influencing psychological resilience and cognitive fusion in patients with depression and the relationships of psychological resilience and cognitive fusion with depression. Methods: This study enrolled 172 participants (65.8% of them were female). Psychological resilience, cognitive fusion, and depression were assessed with the psychological resilience scale, the cognitive fusion questionnaire, the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Zung Self-rating Depression Scale (SDS), respectively. Furthermore, the relationships of psychological resilience and cognitive fusion with depression were investigated. Results: The psychological resilience and cognitive fusion scores of patients with depression varied significantly among different education levels, and HAMA, HAMD, and SDS scores were significantly negatively correlated with psychological resilience but positively correlated with cognitive fusion. Conclusions: Depression levels in patients with depression are closely related to psychological resilience and cognitive fusion. Therefore, anxiety and depression could be alleviated by improving the psychological resilience or reducing the cognitive fusion of patients with depression. [ABSTRACT FROM AUTHOR]

Two different research traditions in the West see popularity defined either sociometrically, as being well-liked, or in a peer-perceived way as being publically visible and having social status and influence. Recent Q studies in Australia and England have supported the public prestige conception of popularity but we do not know how teenagers in Asian cultures view popularity. The current study used Q methodology and individual interviews to investigate the social constructions of popularity among 53 (16- to 19-year old) girls from two schools in Shanghai. Q factor analysis revealed one common perspective-popular girls were considered to be friendly and pro-social, while unpopular girls were characterized by relational aggression and self-centeredness. The interview data indicated that among Shanghai girls, the popularity concept was more related to peer acceptance than to social influence. The differences in the features of popular girls in this Shanghai-based study and teenage girls in Western studies are discussed. [ABSTRACT FROM AUTHOR]

AbstractAlthough many studies have attempted to validate grit scales because of the construct’s popularity, most have considered the shorter rather than the longer Original Grit Scale (Grit-O). We examined the Grit-O’s construct validity, longitudinal measurement invariance, incremental validity for academic performance, and longitudinal predictive validity for subjective well-being among young Chinese. We used a cross-sectional sample of 3,322 college students and a longitudinal sample of 1,884 college students, tested twice over 10 months. The first-order factor model fit the data better than other models and showed partial configural and metric measurement invariance over time. Grit and its two facets longitudinally predicted subjective well-being (i.e., life satisfaction, happiness, positive affect, negative affect, and depression) but had negligible incremental validity for two semesters’ grades after controlling for conscientiousness. So, while the Grit-O could be a useful construct for young adults, its predictive value overlaps with a better-established construct, conscientiousness. [ABSTRACT FROM AUTHOR]

Schizophrenia, as a stressful diagnosis, profoundly impacts the whole family, especially people with schizophrenia and their caregivers. This study tested the potential mediating role of expressed emotion in the association between mental health stigma and quality of life in caregiver‐patient dyads. Using a 2‐wave longitudinal design with a 6‐month interval between assessments, 161 dyads of patients with schizophrenia and their family caregivers (one patient and one caregiver) completed measures of mental health stigma, expressed emotion, and quality of life. The results showed that patients' self‐stigma had no significant actor or partner effect on expressed emotion or quality of life. In contrast, caregivers' stigmatizing attitudes toward patients had a significant partner effect on patients' perception of caregivers' expressed emotion and quality of life. The mediating effect of patients' perception of caregivers' expressed emotion in the association between caregivers' stigmatizing ideas toward patients and patients' quality of life was significant. By focusing on the interdependence of patients and their caregivers, this study highlights the role of caregivers' stigmatizing attitudes toward patients and patients' perception of caregivers' expressed emotion on patients' quality of life. Psychoeducation and interventions should not only aim to reduce the self‐stigma of people with schizophrenia but also their caregivers' stigmatizing ideas toward patients. Family interventions targeted at reducing the EE level of caregivers and patients' perception of caregivers' EE would also benefit the adaptation and quality of life of people with schizophrenia and their caregivers. [ABSTRACT FROM AUTHOR]

Happiness is the ultimate life goal for most people, and the pursuit of happiness serves as the fundamental motivation driving human behavior. Orientation to Happiness (OTH) represents the aspect that individuals seek when making decisions or engaging in activities, including values, priorities, motivations, ideals, and goals. Nevertheless, existing research has predominantly approached OTH from an individualistic perspective, emphasizing an individual's internal emotional state and personal goals, thereby neglecting the significant influence of a collectivist cultural background on the pursuit of happiness. To address this research gap, our study employs qualitative research methods, enabling us to delve deeply into the intricate interplay between cultural context, societal influences, and individual motivations that collectively shape OTH. Our research is dedicated to understanding the structure of OTH within the Chinese cultural context. Through semi-structured interviews with 26 Chinese adults and the utilization of an inductive style of thematic analysis, we have identified two core themes within the OTH of Chinese adults: Self-focused and Other-focused. Notably, the "Other-focused" theme emphasizes the pursuit of group harmony and the fulfillment of group responsibilities, highlighting the paramount role of "relationships" in the study of happiness within collectivist cultures. This insight forms a robust foundation for future research in this area. [ABSTRACT FROM AUTHOR]

Background: Social acknowledgment is a protective factor for survivors of trauma. However, the role of social acknowledgment in association with prolonged grief symptoms has not yet been established. Objectives: The current study aims to explore the relationship between social acknowledgment and prolonged grief via two beliefs foundational to how people think about grief-related emotions (1) goodness (i.e. whether emotions are desirable, useful, or unwanted and harmful), and (2) controllability (i.e. whether emotions are regulated according to our will or involuntary, arising of their own accord). These effects were explored in two different cultural samples of bereaved people. Methods: One hundred and fifty-four German-speaking and two hundred and sixty-two Chinese bereaved people who lost their loved ones completed questionnaires assessing social acknowledgment, beliefs about the goodness and controllability of grief-related emotions, and prolonged grief symptoms. Results: Correlation analyses showed that social acknowledgment was positively linked with stronger beliefs about the goodness and controllability of grief-related emotions and negatively related to prolonged grief symptoms. Beliefs about the goodness and controllability of grief-related emotions correlated negatively with prolonged grief symptoms. Multiple mediation analyses suggested that beliefs about the controllability and goodness of grief-related emotions mediated the link between social acknowledgment and prolonged grief symptoms. Cultural groups did not moderate the above model. Conclusion: Social acknowledgment may be related to bereavement adjustment consequences via the roles of beliefs about the goodness and controllability of grief-related emotions. These effects seem to be consistent cross-culturally. Social acknowledgment correlated positively with stronger beliefs about the goodness and controllability of grief-related emotions and negatively with prolonged grief symptoms. Beliefs about the goodness and controllability of grief-related emotions were negatively linked with prolonged grief symptoms. Beliefs about the controllability and goodness of grief-related emotions mediated the relationship between social acknowledgment and prolonged grief symptoms. The model presented cross-cultural consistency. [ABSTRACT FROM AUTHOR]

Due to different understandings of happiness, people adopt different tendencies to act, which is called orientation to happiness (OTH). Our previous study found that OTH had two core themes, Self-focused and Other-focused in Chinese culture, which was different from OTH structures in Western culture. However, no corresponding measurement tool has been developed or revised. The Hedonic and Eudaimonic Motives for Activities Scale (HEMA) was the most commonly used measurement tool of OTH in recent years. The present study aimed to develop a Chinese version of the HEMA. A total of 1729 Chinese adults participated in this study. The exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the underlying structure of the Chinese version of the HEMA. The results supported the 3-factor structure of the translation instrument, and the 15-item scale had good convergent and discriminant validity. The three dimensions were named Hedonism, Eudaimonism, and Otherism. Among them, Otherism is a new dimension, which means "the pursuit of the harmony of the group and achieving happiness by fulfilling their responsibilities in the group". The revised tool was named the Hedonic, Eudaimonic, and Otheristic Motives for Activities Scale-Chinese (HEOMA-C). The results showed that the HEOMA-C has good reliability and validity. Overall, the present study provided an effective tool to assess the OTH in Chinese culture. [ABSTRACT FROM AUTHOR]

Objective This study aimed to explore whether behavioral synchrony (BS) and inter-brain synchrony (IBS) could serve as potential biomarkers for alliance quality or outcomes among clients with different adult attachment styles. Method: We assessed the clients’ self-report working alliance and clinical outcomes as well as simultaneously measured BS using motion energy analysis (MEA) and IBS with functional near-infrared spectroscopy (fNIRS) among 37 secure (N = 21) or dismissing (N = 16) clients with their counselors during the first psychological counseling meeting. Results: Dismissing dyads manifested significantly higher late-stage counselor-led and client-led IBS (p = .018) than secure dyads. Adult attachment style served as the moderators in the correlation of both whole-stage client-led BS with bond dimension of alliance (p = .015) as well as in the correlation of both whole-stage no-lag IBS with CORE-10 score changes (p = .022). Moreover, increases in the whole-stage client-led BS were significantly associated with decreases in early-stage, late-stage and whole-stage no-lag IBS (all ps ≤ 0.01). Conclusion: These findings revealed the potentially impeding role of interpersonal synchrony in alliance quality for dismissing clients, at least during the first psychological counseling meetings. They also might partially validate the relationship between different modalities of interpersonal synchrony. [ABSTRACT FROM AUTHOR]

Cultural norms may dictate how grief is displayed. The present study explores the display behaviours and rules in the bereavement context from a cross-cultural perspective. 86 German-speaking Swiss and 99 Chinese bereaved people who lost their first-degree relative completed the adapted bereavement version of the Display Rules Assessment Inventory. Results indicated that the German-speaking Swiss bereaved displayed more emotions than the Chinese bereaved. The Chinese bereaved, but not the German-speaking Swiss bereaved, thought that bereaved people should display more emotions than they actually did when they were with their close others (but not when they were alone). Bereaved people endorsed more emotional expression "when alone" than "when with close others", demonstrating a social disconnection tendency, which was more evident in the Chinese sample. Bereaved people endorsed more expression of positive emotions (e.g. affection/love) and less expression of powerful negative emotions (e.g. blame/guilt, anger) across cultures. Compared to their Chinese counterparts, the German-speaking Swiss sample indicated more actual expressions for most emotion types (i.e. joy/happiness, affection/love, sadness, anger, and denial) but thought bereaved people should express more joy/happiness and less blame/guilt. The results suggest that bereaved people's display behaviours and rules are influenced by culture, situation, and type of emotion. [ABSTRACT FROM AUTHOR]

The Cooper-Norcross Inventory of Preferences (C-NIP) is a commonly used and psychometrically validated measure of client preferences in therapy. However, the C-NIP version for therapists (C-NIP-T) has not yet been validated. This study aimed to develop a Chinese version of the C-NIP-T and test its factor structure, reliability, and concurrent validity. A national sample of 1,054 Chinese mental health professionals completed the C-NIP-T and provided relevant demographic information. Confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were used to examine the factor structure of the C-NIP-T. ESEM provided stronger evidence than CFA for the hypothesized four-factor model. Internal consistency coefficients (Cronbach's α) of the four subscales ranged between.60 and.76. Full or partial scalar invariance was established across therapists' therapeutic orientations, gender, personal therapy, and clinical experience. There were significant differences in subscale scores among therapists who identified as cognitive/cognitive-behavioral, psychoanalytic/psychodynamic, and humanistic/client-centered, supporting the concurrent validity of the C-NIP-T. The C-NIP-T is a psychometrically sound measure that can be used to assess therapists' preferences about therapy. [ABSTRACT FROM AUTHOR]

Objective: Existential isolation refers to an individual's awareness of the unbridgeable gulf between oneself, other people and the world. This kind of isolation has been found to be higher in individuals with nonnormative experiences, such as racial or sexual minorities. Bereaved individuals may experience a stronger sense of existential isolation and feel that no one shares their feelings or perceptions. However, research on bereaved people's experiences of existential isolation and its effects on post‐loss adaptation is scarce. This study aims to validate the German and Chinese versions of the Existential Isolation Scale, investigate cultural and gender differences in existential isolation and explore the associations between existential isolation and prolonged grief symptoms in German‐speaking and Chinese bereaved individuals. Methods: A cross‐sectional study with 267 Chinese and 158 German‐speaking bereaved participants was conducted. The participants completed self‐report questionnaires assessing existential isolation, prolonged grief symptoms, social networks, loneliness and social acknowledgement. Results: The results indicated that the German and Chinese versions of the Existential Isolation Scale demonstrated adequate validity and reliability. No cultural or gender differences (or their interaction) were found for existential isolation. Higher existential isolation was associated with elevated prolonged grief symptoms, which was further moderated by the cultural group. The relationship between existential isolation and prolonged grief symptoms was significant for the German‐speaking bereaved people but not significant for those from China. Conclusion: The findings highlight the role of existential isolation in the adaptation to bereavement and how different cultural backgrounds moderate the effect of existential isolation on post‐loss reactions. Theoretical and practical implications are discussed. [ABSTRACT FROM AUTHOR]

The study aims to test the reliability and validity of the Chinese version of the Revised Spontaneity Assessment Inventory (SAI-R-C) and the correlation between spontaneity and mental health. Data were collected from various samples of Chinese college students and employees. The SAI-R-C, the Subjective Well-being Scale, and the Chinese version of the Outcome Rating Scale were simultaneously administered at a four-week interval to test the reliability and validity of the SAI-R-C. The results indicated that the SAI-R-C was unidimensional and its internal consistency coefficient was.96. The test-retest reliability of the SAI-R-C was.74 within a two-week interval. Significantly positive correlations were found between spontaneity and life satisfaction, positive emotions, overall well-being, and the Outcome Rating Scale, whereas a negative correlation was found between spontaneity and negative emotions. Overall, the SAI-R-C is a reliable and valid measure for assessing spontaneity in China. • The Chinese version of the SAI-R is an acceptable tool for assessing spontaneity. • Spontaneity is positively correlated with happiness. • Spontaneity is negatively correlated with psychological suffering. • No significant gender difference in Spontaneity was found in this study. • The participants' age positively predicts their spontaneity. [ABSTRACT FROM AUTHOR]

The threat of disease is associated with xenophobia, but limited research is available to shed light on the underlying processes that shape this relationship. Based on integrated threat theory and existing research, we tested a model in which the association between threat of disease and xenophobia is mediated by negative emotions, and how the process is moderated by empathic responding to others who are concerned about the disease threat. The research was conducted in China during the early phases of the COVID‐19 pandemic with the focus on Chinese unease about the people of Wuhan, the city where the pandemic began. A national sample of Chinese adults (N = 1697) completed a survey on their perceptions of risk due to COVID‐19, negative emotions experienced during the pandemic, empathic responses to others who were concerned about COVID‐19, and xenophobia expressed toward people from Wuhan. The results showed that negative emotions mediated the relationship between perceived COVID‐19 threat and xenophobia. However, contrary to expectation, empathic responding did not weaken the relation between perceived COVID‐19 threat and xenophobia; instead, it exacerbated the relationship. Specifically, empathic responding to help others in the context of concerns about COVID‐19 was related to greater xenophobia toward the out‐group (i.e., the people of Wuhan). [ABSTRACT FROM AUTHOR]

In China, bereaved parents who have lost their only child are known as Shidu parents, and they tend to present high levels of prolonged grief reactions. To date, a widespread focus has been placed on positive social support, while potential negative experiences have been relatively neglected. Additionally, the role of social support from different sources (i.e. close family members [partner, siblings, grandchildren], peers, and others [relatives, friends, colleagues]) has not been examined thoroughly. The present study investigated whether social support from different sources has a differential impact on postloss adaptation (i.e. prolonged grief and growth). The loss-orientated and restoration-orientated coping strategies of the dual process model were also tested for their mediating roles. A total of 277 Chinese Shidu parents were recruited to complete a series of questionnaires including social support from different sources, prolonged grief symptoms, posttraumatic growth, and dual process coping strategies. Correlation analyses, paired sample t tests and structural equation modelling were conducted. More positive support were related to less prolonged grief symptoms and more posttraumatic growth, while more negative support was only related to more prolonged grief. Positive support from close family members and others was significantly related to prolonged grief/growth, and negative support from these sources was significantly positively associated with prolonged grief. Positive or negative support from people who shared a similar experience was unrelated to prolonged grief/growth. Positive and negative support were related to prolonged grief and growth through loss-oriented coping strategies. Overall, the present study indicated that positive and negative support experiences from different sources functioned differently in the recovery of Chinese Shidu parents and that loss-oriented coping played a mediating role. These findings highlight the importance of differentiating social support by traits in coping with grief and the crucial mediating role of loss-oriented coping. More positive support correlated with less prolonged grief and more growth, while more negative support correlated with more prolonged grief. Support from family members and friends was more potent than that from peers. Social Support correlated with prolonged grief/growth through loss-oriented coping. [ABSTRACT FROM AUTHOR]

Introduction: Faced with surging infections and considering that 80% of cases were mild and moderate, the city government transformed stadiums and exhibition centers into the Fangcang shelter hospitals in Wuhan. The aims of this study were to evaluate mental health outcomes among patients with COVID‐19 treated in the Fangcang shelter hospitals and analyze potential risk factors associated with these symptoms, including PTSS, symptoms of anxiety, depression, insomnia, and perceived stress. Method: This cross‐sectional study used an online survey to assess mental health problems of 461 confirmed COVID‐19 patients in a Jianghan Fangcang shelter from February 15 to 22, 2020. A multivariable logistic regression analysis was performed to explore potential risk factors. Results: Overall, 25.2%, 50.1%, 54.4%, 10.2%, and 39.7% of all patients reported symptoms of posttraumatic stress, anxiety, depression, insomnia, and perceived stress, respectively. Multivariable logistic regression analysis showed that female sex was associated with all investigated outcomes except insomnia. Patients with lower education level were more likely to endorse anxiety, depression, and higher perceived stress, while patients' family members with other diseases were more likely to endorse severe insomnia. Patients with illness onset to admission less than 7 days were associated with higher perceived stress. Discussion: In this survey study, patients reported high rates of symptoms of posttraumatic stress, anxiety, depression, insomnia, and perceived stress. Combining with the special environment of the shelter hospitals and patient's psychological needs, the health care workers should give more effective interventions to relieve the patients' stress and improve their mental symptoms. [ABSTRACT FROM AUTHOR]

Research is sparse on who targets whom in peer aggression. In this study, we investigated the harm associated with the type of relationship between aggressed and aggressor with an international sample of over 5,000 students aged 11–16, living in 12 nations. Best friends and individuals with whom the respondent had no relationship were the least likely to engage in aggression, while one-third of peer aggression could be attributed to friends (not best friends), and classmates/peers. Greater harm was experienced between best friends only when it involved relational aggression, such as spreading rumors and being left out. Harm from aggression varied by world location and number of different experiences of aggression, while gender and age differences were inconsistent. Intervention programs could take advantage of the vital role that friends play as socializing agents during adolescence that focus on the harmfulness of aggression undertaken in the guise of a joke. [ABSTRACT FROM AUTHOR]

• A sample of college students were assessed at three time points over 22 months. • Narcissism at T1 was positively related to problematic SNS use at T3. • Ability comparison mediated the link between narcissism and problematic SNS use. • Opinion comparison did not mediate the narcissism-problematic SNS use relation. The present study aimed to explore whether the tendency to compare one's abilities and opinions to those of others (social comparison orientation) could longitudinally mediate the association between narcissism and problematic SNS use. A total of 1,196 college students were assessed at three time points over 22 months. The results showed that narcissism at time 1 was positively related to problematic SNS use at time 3 and that ability comparison at time 2 longitudinally mediated the association between narcissism at time 1 and problematic SNS use at time 3, whereas the longitudinal mediating effect of opinion comparison at time 2 was not significant. These findings suggest that narcissism more distally and ability comparison more proximally may be risk factors for engaging in problematic SNS use, and it is important to distinguish between types of social comparisons in problematic SNS use behaviors. [ABSTRACT FROM AUTHOR]

Introduction: Indirect reciprocity serves as a crucial component of how we interact with strangers. Two types of indirect reciprocity can be distinguished: pay-it-forward reciprocity and third party reciprocity. Pay-it-forward reciprocity refers to behaviors where people who have been treated well by others (either fairly or generously), extend that fairness or generosity to a stranger. Third-party reciprocity refers to behaviors where third-party bystanders altruistically punish those who transgress against others or kindly help the victims. The expansion of adolescents' social world increases opportunities to exercise indirect reciprocity yet very little research has focused on this topic in this age group. The current research addresses this lacuna and investigates how younger adolescents differ from older adolescents in pay-it-forward and third party reciprocity.Methods: With incentivized economic paradigms, we investigated both types of indirect reciprocity in younger (n = 50) and older adolescents (n = 46).Results: The pay-it-forward task revealed that receiving an equal (vs. unequal) distribution led both younger and older adolescents to become fairer to a third person. In the third-party task, older adolescents were more likely to devote their own resources to enforce fairness norms than younger adolescents.Conclusion: Our results shed light on how adolescents perceive and act in complex social settings where direct reciprocity is unrealistic. Both younger and older adolescents are capable of engaging in both forms of indirect reciprocity with older adolescents being more discriminative in their norm-enforcing behaviors. [ABSTRACT FROM AUTHOR]

Background: Compulsory drug detention is the most frequent way to control drug use in China; however, it has often been criticized. This qualitative study aimed to investigate abstinence self-efficacy and its sources of drug users in a compulsory male drug detention center in Shanghai, China, and the attitudes of the drug users to this form of rehabilitation.Methods: Thirty-six participants were interviewed (semi-structured, in depth) about their history of drug use and rehabilitation, self-evaluation of addiction, motivations to abstain, plans for the future and attitudes toward rehabilitation. A thematic analysis was undertaken of the transcripts with responses to interview questions being coded for content.Results: Two main types of self-efficacy were found - "overconfidence" (n = 16) and "helplessness" (n = 17). Overconfident participants underestimated their levels of addiction, overestimated their self-control and held external motivations and attributions. In contrast, helpless participants overestimated their levels of addiction, underestimated their self-control and had internal motivations and attributions. Compared to overconfident participants, helpless participants had more relapse history, and were more inclined to interpret relapse as a failure and attribute relapse to themselves. More helpless participants were abandoned by their family members, and received blame from the family members instead of encouragement, but their family members motivated them to abstain. Helpless participants experienced more negative emotions and had worse physical status. They said compulsory detention was a strong support for them and was the most effective way to abstain; while overconfident participants said compulsory detention was not necessary and not useful.Conclusion: It is important to increase the motivation of overconfident drug users and the perceived control of helpless drug users. Compulsory drug detention has strengths in supporting drug users who feel helpless to resist drug use. Adjustments and improvements of compulsory drug detention are suggested. [ABSTRACT FROM AUTHOR]

Background: In response to the COVID-19 pandemic, people in many countries have shown xenophobia toward China, where the pandemic began. Within China, xenophobia has also been observed toward the people of Wuhan, the city where the first cases were identified. The relationship between disease threat and xenophobia is well established, but the reasons for this relationship are unclear. This study investigated the mediation role of perceived protection efficacy and moderation role of support seeking in the relationship between perceived COVID-19 risk and xenophobia within China.Methods: An online survey was administered to a nationally representative sample (N = 1103; 51.7% women; ages 18 to 88) of Chinese adults during the early stage of the COVID-19 pandemic. Participants completed questionnaires about their perceived COVID-19 risk, perceived protection efficacy in reducing risk, support seeking, and xenophobic attitudes toward people of the Wuhan area.Results: Regression based analyses showed that the perceived COVID-19 risk positively predicted xenophobia. Low perceived protection efficacy partly mediated the relationship between perceived COVID-19 risk and xenophobic attitudes, and this indirect effect was moderated by support seeking. Specifically, the indirect effect was weaker among individuals who sought more social support.Conclusions: Under disease threat, xenophobia can appear within a country that otherwise seems culturally homogeneous. This study extends the extant research by identifying a possible psychological mechanism by which individuals' perception of disease threat elicits xenophobia, and by addressing the question of why this response is stronger among some people than others. Increasing the public's perceived efficacy in protecting themselves from infection, and encouraging support seeking, could reduce xenophobic attitudes. [ABSTRACT FROM AUTHOR]