Psychometric properties of the post-traumatic stress disorder checklist for DSM-5 (PCL-5) in Chinese stroke patients.

BACKGROUND: Stroke is a devastating disease and can be sufficiently traumatic to induce post-traumatic stress disorder (PTSD). Post-stroke PTSD is attracting increasing attention, but there was no study assessing the psychometric properties of the PCL-5 in stroke populations. Our study was conducted to examine the psychometric properties of the PTSD Checklist for DSM-5 (PCL-5) in Chinese stroke patients. METHODS: This was a cross-sectional observational study conducted at our hospital. Three hundred and forty-eight Chinese stroke patients came to our hospital for outpatient service were recruited. They were instructed to complete the PCL-5 scales and were interviewed for PTSD diagnosis with the Clinician Administered PTSD Scale for DSM-5 (CAPS-5). The cutoff scores, reliability and validity of the PCL-5 were analyzed. RESULTS: PCL-5 scores in our sample were positively skewed, suggesting low levels of PTSD symptoms. The reliability of PCL-5 was good. Exploratory and confirmatory factor analyses indicated acceptable construct validity, and confirmed the multi-dimensionality of the PCL-5. By CFA analysis, the seven-factor hybrid model demonstrated the best model fit. The PCL-5 also showed good convergent validity and discriminant validity. Receiver operating characteristic (ROC) analyses revealed a PCL-5 score of 37 achieved optimal sensitivity and specificity for detecting PTSD. CONCLUSIONS: Our findings supported the use of PCL-5 as a psychometrically adequate measure of post-stroke PTSD in the Chinese patients.

The influence of social pain experience on empathic neural responses: the moderating role of gender.

Empathy for pain, the ability to share and understand the pain of others, plays an important role in the survival and development of individuals. Previous studies have found that social pain experience affects empathy for pain, but potential gender differences have not been considered. The stage of information processing during which gender is most likely to play a moderating role has yet to be clarified. In the current study, we set up two groups (social pain experience priming: social exclusion group; positive social interaction experience priming: social inclusion group) with a Cyberball game paradigm. We recorded the electrophysiological responses when participants were completing an empathy task. An early frontal P2 and N2 differentiation between painful stimuli and neutral stimuli was observed and females showed larger P2 amplitudes than males. At the P3 stage, in the social exclusion group, males showed similar parietal P3 amplitudes for painful and neutral stimuli, while females showed smaller P3 amplitudes for painful stimuli. At the central-parietal late positive potential (LPP) stage, females in the social inclusion group showed larger LPP amplitudes for painful stimuli than males. Our results suggest that gender plays a significant moderating role in how social pain experience affects empathy for pain during the late cognitive processing stage. Experiment 2 was designed to investigate the cognitive mechanism behind the results for the P3 component in females and the results partially confirmed our speculation. This study provides a neurophysiological basis for the dynamic gender differences in the effects of social pain experience on empathy for pain.

Gender differences in empathic responses to others' economic payoffs: an event-related potentials study.

Although gender differences in empathy have been well established through measuring subjective outcomes, some studies of the neural mechanisms of pain empathy have not found gender differences. This inconsistent evidence may be caused by different research methods or different paradigms. The present study adopted a different approach from the pain empathy paradigm to examine gender differences in empathic responses to others' economic payoffs using event-related potentials. The results showed that the N2 amplitudes in female participants were more negative than those in male participants, indicating a greater female than male susceptibility to facial expressions at the early stage of empathy. The LPP amplitudes for male participants were found to be more positive in the observation condition (involving no self-interest) than in the participation condition (involving self-interest), but there was no significant difference in the LPP amplitudes for the female participants between the two conditions. The results suggest that females' empathic responses are more likely to be elicited automatically by the perception of others' emotional states. In contrast, males' empathic responses are more likely to be mediated by self-interest, which subsequently reduces their empathic responses.

Retrospective reversal of extinction of conditioned fear by instruction.

In the present study, we examined the impact of verbal instruction during extinction of human fear-conditioning. We extended the study of Raes, De Houwer, Verschuere, and De Raedt (2011) by controlling for context conditioning and recording unconditioned stimulus expectancy online in a within-subject design. We informed participants of an alternative reason for the absence of the aversive unconditioned stimulus after extinction had been carried out, to see if such instruction could induce retrospective protection from extinction. The results demonstrated that both the expectancy of an aversive outcome and conditioned skin conductance were significantly increased for the conditioned stimulus targeted by the instruction. Thus extinction was reversed by the concurrent presence of an alternative cause for the absence of the unconditioned stimulus.

[The influence of sex and menstrual cycle on conditioned acquisition and extinction: Event-related potential research].

Previous studies have indicated phase-related differences in conditioned acquisition and extinction. In recent years, many researchers used event-related potential (ERP) technology to assess the extent of the acquisition and extinction. Therefore, this study was aimed to assess the sex- and menstrual cycle-dependent effects on the conditioned acquisition and extinction using ERP technology. Thirty-two females at two phases (menses phase, FM, and luteal phase, FL) of their menstrual cycle and 16 males participated in the experiment. The experiment consisted of two stages: acquisition stage and extinction stage. In the acquisition stage, in the predictable context, a condition stimulus (CS) was always followed by the presentation of a negative picture or a neutral picture; but in the unpredictable context, a CS was paired with a negative picture or a neutral picture 20% of the time. In the extinction stage, only CS was presented. The results showed that at acquisition stage, significant larger P2 amplitudes were recorded in female subjects in FL and FM in comparison with those of males. The female subjects in FL may acquire the strongest CS-US conditional connection. At extinction stage, the female subjects in FL showed larger P2 amplitudes than males, but there were no significant differences in P2 amplitudes between the males and females in FM. The results suggest that the females in FL allocate more attention resources to the acquisition of a conditioned response and delayed extinction. In conclusion, we suggest that female menstrual cycle may modulate conditioned acquisition and extinction processes, and our ERP data may provide an explanation for the premenstrual dysphoric disorder.

Secure attachment priming inhibits the generalization of conditioned fear.

BACKGROUND: Fear overgeneralization constitutes a susceptibility factor contributing to the development and maintenance of anxiety spectrum disorders. Extant research has demonstrated that exposure to positive and supportive social relationships attenuates fear acquisition and promotes the extinction of conditioned fear responses. However, the literature lacks investigation into the effect of secure attachment priming on inhibiting the generalization of conditioned fear. METHODS: In this study, college students were recruited via online platforms to voluntarily engage in the experimental procedures, resulting in 57 subjects whose data were deemed suitable for analysis. The experimental protocol consisted of four consecutive phases: pre-acquisition, acquisition, priming, and generalization. The priming phase consisted of two experimental conditions: secure attachment priming (experimental group) and positive emotion priming (control group). This study adopted the perceptual discrimination fear conditioning paradigm, employing subjective expectancy of shock ratings and skin conductance responses as primary assessment indices. Individual difference variables were measured using corresponding psychological measurement scales. RESULTS: In terms of generalization degree, a notable divergence surfaced in the skin conductance responses across various generalization materials between the secure attachment priming group and the control group. Similarly, during generalization extinction, a significant disparity emerged in the skin conductance responses across different generalization phases between the secure attachment priming group and the control group. In addition, individual differences analyses revealed that the inhibitory effect of secure attachment priming on fear generalization was not affected by intolerance of uncertainty and attachment orientations. Conversely, slope analyses confirmed that as intolerance of uncertainty increased, the inhibitory effect of positive emotion priming on fear generalization was attenuated. CONCLUSION: The findings suggest that activating participants' representations of secure attachment via imagination effectively attenuates the generalization of perceptual fear at the physiological level. The inhibitory effect of secure attachment priming appears to be distinct from positive emotional modulation and remains unaffected by individual trait attachment styles. These results offer novel insights and avenues for the prevention and clinical intervention of anxiety spectrum disorders.

Novelty-retrieval-extinction paradigm to decrease high-intensity fear memory recurrence.

BACKGROUND: The retrieval-extinction paradigm based on memory reconsolidation can prevent fear memory recurrence more effectively than the extinction paradigm. High-intensity fear memories tend to resist reconsolidation. Novelty-retrieval-extinction can promote the reconsolidation of fear memory lacking neuroplasticity in rodents; however, whether it could effectively promote high-intensity fear memory reconsolidation in humans remains unclear. METHODS: Using 120 human participants, we implemented the use of the environment (novel vs. familiar) with the help of virtual reality technology. Novelty environment exploration was combined with retrieval-extinction in fear memory of two intensity levels (normal vs. high) to examine whether novelty facilitates the reconsolidation of high-intensity fear memory and prevents recurrence. Skin conductance responses were used to clarify novelty-retrieval-extinction effects at the behavioral level across three experiments. RESULTS: Retrieval-extinction could prevent the reinstatement of normal-intensity fear memory; however, for high-intensity fear memory, only the novelty-retrieval-extinction could prevent recurrence; we further validated that novelty-retrieval-extinction may be effective only when the environment is novel. LIMITATIONS: Although the high-intensity fear memory is higher than normal-intensity in this study, it may be insufficient relative to fear experienced in real-world contexts or by individuals with mental disorders. CONCLUSIONS: To some extent, these findings indicate that the novelty-retrieval-extinction paradigm could prevent the recurrence of high-intensity fear memory, and we infer that novelty of environment may play an important role in novelty-retrieval-extinction paradigm. The results of this study have positive implications for the existing retrieval extinction paradigm and the clinical treatment of phobia.

Contingency Reversal in Conditioned Fear Learning: The Moderated Mediation Model of Intolerance of Uncertainty and Instruction.

Objective: The study aimed to examine the roles of anxiety and intolerance of uncertainty (IU) in conditioned fear learning under an uncertain context induced by the contingency reversal of the association between the conditioned stimulus and the unconditioned stimulus (CS-US). Methods: The study sample comprised 53 participants, randomly divided into two groups: a non-instruction group and an instruction group. The experimental procedure encompassed five stages: pre-acquisition, acquisition, generalization, reversal acquisition, and reversal generalization. Our study primarily focused on analyzing a moderated mediation model. Results: In the instructed group, we observed that the reversed fear generalization response was directly influenced by the pre-reversal fear generalization response, while also being indirectly mediated by the IU factor. However, in the non-instructed group, we did not find a significant mediating effect of IU. Moreover, we noted that the mediation of IU was contingent on the instructional information. It is noteworthy that anxiety did not exhibit a discernible role in conditioned fear within the uncertainty condition in our study. Conclusion: The findings provide novel insights into fear-related phenomena, emphasizing the intricate interplay between individual traits and fear generalization under conditions of uncertainty. They contribute to understanding the mechanisms of emotional and cognitive interactions in uncertain conditions.

Effects of different forms of verbal processing on the formation of intrusions.

This study used the trauma film paradigm to investigate different forms of posttrauma verbal processing relevant to the formation of intrusive memories. We designed 3 experiments to investigate verbal processing that could help to reduce the formation of posttraumatic intrusions. Experiments 1 and 2 looked at the effect of several forms of verbal processing, varied in emotional foci and vantage points, on the formation of posttraumatic intrusions. Experiment 3 utilized event-related potential (ERP) technology to control emotional focus and to further examine the effect of verbal processing from different vantage points. Data produced by Experiment 1 showed that the "what-focus" group had fewer intrusions than the "why-focus" group. Experiment 2 produced no significant difference between first- and third-person vantage points. Results from the last experiment showed the what-focus group was faster to judge the colors of the words in the emotional Stroop task, and the amplitude and latency of P2 for negative words were greater than neutral words in the what-focus group. Based on the results of the experiments, participants who were led to verbalize their traumatic experiences using the what-focus and the first-person vantage point ended up with fewer intrusions.

[Auditory event-related potentials in children with functional articulation disorders].

OBJECTIVE: To investigate the central auditory processing function in children with functional articulation disorders (FAD), and possible causes of FAD. METHODS: Twenty-seven children with FAD were selected as the case group and 50 age-matched normal children were selected as the control group. The two groups were compared with respect to the following factors: percentage of individuals with a positive history of language development disorder, and the form, peak latency and peak amplitude of mismatch negativity (MMN) on auditory event-related potentials. RESULTS: Compared with the control group, the case group had a significantly higher percentage of individuals with a positive history of language development disorder (70% vs 8%; P<0.01), a significantly prolonged peak latency of MMN (209 ± 31 ms vs 175 ± 32 ms; P<0.01), and an insignificantly lower peak amplitude of MMN (P>0.05). CONCLUSIONS: Prolonged central auditory processing may be one of the causes of FAD in children.

The influence of word concreteness on acquired positive emotion association: An event-related potential study.

The ability to acquire positive emotions from words is essential to psychological well-being. How word concreteness affects the process of positive emotion acquisition remains unknown. Here, using an evaluation conditioning paradigm, participants learned the association between pseudowords and concrete/abstract and positive/neutral words. Behavior and event-related potential data were recorded while participants performed emotional recognition tasks. Behavioral results showed that, for neutral words, concrete words were more accurate than abstract words, whereas for positive words, abstract words were more accurate than concrete words. Moreover, N1 and P2 amplitudes in the pseudowords were modulated by interacting word emotion and concreteness. Specifically, pseudowords associated with neutral concrete words elicited larger N1 and P2 amplitudes than pseudowords associated with neutral abstract words. Conversely, N1 and P2 amplitudes in pseudowords associated with positive abstract words were not significant compared to those in positive concrete words. Additionally, an emotional effect was observed when pseudowords were associated with abstract words, showing higher P3 amplitude for the pseudowords associated with positive abstract words than neutral abstract words. No significant effects were found for the pseudowords associated with positive abstract or concrete words. These findings suggest that association learning may influence the early attention processing of emotion acquisition from words, and emotional information of positive abstract words might boost positive emotion acquisition, thereby eliminating the acquisition advantage from positive concrete words.

Effectiveness of repetitive transcranial magnetic stimulation combined with a brief exposure procedure for post-stroke posttraumatic stress disorder.

The incidence of posttraumatic stress disorder (PTSD) following stroke ranges from 6.5 % to 25 %. Presently few studies have focused on its treatment. Repetitive transcranial magnetic stimulation (rTMS) is often applied as a rehabilitation method after stroke, and it also represents a novel approach to PTSD. The aim of this study was to explore the effect of rTMS (or combined with a brief stroke re-exposure) on treating post-stroke PTSD. Sixty participants with post-stroke PTSD were randomly assigned into three groups (rTMS + brief exposure group, TMS + BE; rTMS alone group, TMS; sham treatment group, ST) and received 10 sessions of treatment accordingly over two weeks. Changes in PTSD symptoms (Impact of Event Scale-Revised, IES-R) were evaluated at pre-treatment (T1), the end of the first (T2), and the end of the second treatment week (T3). At the three-month follow-up (T4), a PTSD interview and IES-R assessment were given. Results showed that from T1 to T3, IES-R (and its intrusion subscale) scores of TMS + BE group and TMS group were significantly lower than the ST group, and the effect remained at three-month follow-up. The treatment effect was comparable between TMS + BE group and TMS group at T3, however, it was better for TMS + BE group than TMS group at T2, indicating a brief exposure promotes the effect of rTMS. At follow-up, the rates of PTSD were lower in TMS + BE group and TMS group than ST group. In conclusion, rTMS can effectively treat post-stroke PTSD and the effects may be accelerated by combining a brief exposure procedure. TRIAL REGISTRATION: Chinese Clinical Trial Registry, identifier: ChiCTR2100043444.

Game-matching background music has an add-on effect for reducing emotionality of traumatic memories during reconsolidation intervention.

Introduction: Hospital is a stressful place of employment, and a high proportion of healthcare workers, especially the ICU (Intensive Care Unit) nurses were found to be at risk of PTSD. Previous studies showed that taxing working memory through visuospatial tasks during the reconsolidation process of aversive memories can reduce the number of intrusions afterwards. However, the finds could not be replicated by some researches, indicating there may be some boundary conditions that are subtle and complex. Methods: We performed a randomized controlled trial (ChiCTR2200055921; URL: www.chictr.org.cn). In our study, a series of ICU nurses or probationers who performed a cardiopulmonary resuscitation (CPR) were enrolled and instructed to play a visuospatial music tapping game ("Ceaseless Music Note", CMN; Beijing Muyuan Technology Co., Ltd., Beijing, China) at the fourth day after CPR. The numbers of intrusions each day were recorded from the first to the seventh days (24 h×6 day), and the vividness and emotionality of CPR memories were rated at the 4th and 7th days. These parameters were compared between different groups (game with background sound; game with sound off; sound only; none). Results: The game-matching background music can have an add-on effect for single tapping game with no sound in reducing the emotionality of previous aversive memories. Discussion: We proposed that flow experience (the subjective experience of effortless attention, reduced self-awareness, and enjoyment, and may be induced by optimal skill-demands compatibility in challenging tasks) as a key boundary condition for successful reconsolidation intervention. Clinical trial registration: www.chictr.org.cn, identifier: ChiCTR2200055921.

Role of Cue Training, Context, and Stimulus Intensity on Fear Generalization in Humans.

Fear generalization is a crucial mechanism underlying maladaptive behavior, but factors influencing this process are not fully understood. We investigated the effects of cue training and context on fear generalization and how cognitive rules influence responses to different conditions. We also examined the role of stimulus intensity in fear generalization to provide insight into fear generalization mechanisms. Participants (n = 104) completed a fear emotion task with two stages: acquisition and generalization testing. Subjective fear expectancy ratings were used as outcome measures. Participants who received single threat cue training exhibited stronger fear generalization responses than those who received discrimination training with threat and safe cues. Participants who received discrimination training and used linear rules had the strongest fear response to the largest stimulus. Therefore, a safe cue may mitigate fear generalization but could increase fear responses to more intense stimuli. Altering context did not change the fear generalization response because fear generalization is mainly governed by the association between the conditioned stimulus and the unconditioned fear stimulus. The present study emphasizes the multifaceted nature of fear generalization and the importance of examining multiple factors to understand this phenomenon. These findings elucidate fear learning and provide insights needed for effective interventions for maladaptive behavior.

Effects of the retrieval-extinction paradigm with abstract reminders on fear memory extinction.

Reactivated fear memories may enter an unstable state that could be interrupted by behavioral interventions such as the retrieval-extinction procedure. Studies of pharmacological interventions have shown that retrieval cues are not necessarily an exact reduplication of initial conditioned stimuli (CSs); they can instead be abstract word cues. However, the effectiveness of using abstract reminder cues in behavioral intervention procedures remains unknown, as do the conditions under which they are effective. The typicality of CS and the abstraction level of reminders are also likely to be important in the paradigm but have not been investigated to date. Here, in three experiments (n = 107), we manipulate the fear conditioning process, including single CS-unconditioned stimulus (US) and multiple CS-US connections, as well as the CS typicality and abstraction level of reminder cues, to explore the conditions for adopting retrieval-extinction with abstract reminders. The results of Experiments 1 and 2 show that the abstract cue is ineffective for use as a reminder in the procedure; this is the case for single exemplar category learning and perceptual discriminative learning, independent of the typicality of CS+ or the abstraction level of reminder cues. Only the outcome of Experiment 3, which contains multiple CS-US connections, shows no indication of fear return. The limitations of the study and possible interpretations of the results are discussed.

Succinic Ester-Based Shape Memory Gelatin Sponge for Noncompressible Hemorrhage without Hindering Tissue Regeneration.

Shape memory sponges are very promising in stopping the bleeding from noncompressible and narrow entrance wounds. However, few shape memory sponges have fast degradable properties in order to not hinder tissue healing. In this work, based on cryopolymerization, a succinic ester-based sponge (Ssponge) is fabricated using gelatin and bi-polyethylene glycol-succinimidyl succinate (Bi-PEG-SS). Compared with the commercially available gelatin sponge (Csponge), Ssponge possesses better water/blood absorption ability and higher mechanical pressure over the surrounding tissues. Moreover, in the models of massive liver hemorrhage after transection and noncompressive liver wounds by penetration, Ssponge exhibits a better hemostasis performance than Csponge. Furthermore, in a liver regeneration model, Ssponge-treated livers shows higher regeneration speed compared with Csponge, including a lower injury score, more cavity-like tissues, less fibrosis and enhanced tissue regeneration. Overall, it is shown that Ssponge, with a fast degradation behavior, is not only highly efficient in stopping bleeding but also not detrimental for tissue healing, possessing promising clinical translational potential.

Immune characterization of mesenchymal stem cells in human umbilical cord Wharton's jelly and derived cartilage cells.

Mesenchymal stem cells derived from human umbilical cord Wharton's jelly (hWJMSCs) became prospective seed cell candidate for tissue engineering and cell-based therapy because of its variety source, easy procurement, robust proliferation, and high purity compared with bone marrow- and adipose-derived MSCs. Such neonatal stem cells can be isolated from a variety of extraembryonic tissues and appear to be more primitive and have greater multi-potentiality than their adult counterparts. In this study, we investigated the immune characters of hWJMSCs and its derived cartilage cells (hWJMSC-Cs) by detecting the expression of major histocompatibility complex I/I(MHC-I/II), costimulatory molecules (CD40, CD80 and CD86) and immune inhibitors including human leukocyte antigen G (HLA-G), indoleamine-2,3-dioxygenase (IDO), and prostaglandin E2 (PGE2). We found that hWJMSCs did not express MHC-II and costimulatory molecules, but moderately expressed MHC-I, and positively expressed immune inhibitors as HLA-G, IDO, PGE2, demonstrating their very low immunogenicity and potential to induce immune tolerance microenvironment in hosts. The results of chondrogenic differentiated hWJMSCs(hWJMSC-Cs) are similar to those of undifferentiated cells, except for the slightly elevated MHC-II and costimulators expression. Additionally, we detected cytokine profile of hWJMSCs through cytokine antibody array and verified by western blot the positive expression of immune suppression-related molecules, HGF, VEGF, TGF, and IL-10. Furthermore, to investigate the in vivo immune response of the cells, hWJMSCs-scaffold constructs were implanted into rabbits and rats, and the result showed that hWJMSCs did not elicit immune rejection in the animals. Their intermediate state between adult and embryonic stem cells makes them an ideal candidate for reprogramming to the pluripotent status. Additional studies are necessary to clarify the potential of hWJMSCs to be used in cartilage and other tissue regeneration and cell-based therapies.

The Effect of Parental Phubbing on Depression in Chinese Junior High School Students: The Mediating Roles of Basic Psychological Needs Satisfaction and Self-Esteem.

Objective: To reveal the relationship between parental phubbing, basic psychological needs satisfaction, self-esteem, and depression and to explore the impact of parental phubbing on depression. Methods: A total of 819 junior high school students responded to the parental phubbing scale, basic psychological needs satisfaction scale, self-esteem scale, and depression scale in combination. Results: (1) Parental phubbing was significantly correlated with satisfaction of basic psychological needs, self-esteem, and depression. (2) Parental phubbing can not only be used to directly predict depression in junior middle school students but also has an indirect impact on depression through three pathways: a separate mediating effect on basic psychological needs satisfaction, a separate mediating effect on self-esteem and a chain mediating effect on both. Conclusion: Parental phubbing is a risk factor for depression, which can negatively affect the mental health of junior high school students.

Early Safety Discrimination Under Uncertainty in Trait Anxiety: An Event-Related Potential Study.

Detection of safety-threat signals during uncertainty is an important mechanism of developmental anxiety disorder (AD). Although extensive research has focused on the detection of uncertain threat signals in anxious individuals, relatively little attention has been given to the identification of safety signals during uncertainty, which is an important way to relieve anxiety in individuals with AD. To investigate this phenomenon, 16 subjects with high trait anxiety (HTA) and 16 with low trait anxiety (LTA) completed a modified cue-target task in certain and uncertain stimulus blocks. In the uncertain block, the cue was followed by a threat picture or safety picture in 20% of trials, respectively; in the certain block, the cue could be followed by a threat picture or a safety picture on 100% of trials. Behavioral responses and event-related potentials (ERPs) were recorded. The ERP results demonstrated that LTA participants exhibited larger P2 amplitudes in the detection of safety cues than of threat cues during the uncertain block, whereas HTA participants showed significant P2 amplitudes between the safety and threat cues during the certain block, impairing the detection of safety stimuli during uncertainty. However, all participants exhibited greater N2 amplitudes following threat cues in certainty or uncertainty conditions. These findings pertaining to the P2 amplitude suggested distinctive attentional biases between HTA and LTA individuals, whereas the N2 amplitude showed association learning in uncertain conditions, compensating for safety-threat detection in HTA individuals.

Neuroticism and fear of COVID-19 during the COVID-19 pandemic: Testing the mediating role of intolerance of uncertainty and sense of control among Chinese high school students.

Since the COVID-19 pandemic broke out in 2019, neuroticism has been proven a predictor of fear of COVID-19 infection. However, only few studies have been conducted on the factors affecting the relationship between neuroticism and this kind of fear. The present study is aimed at analyzing the role intolerance of uncertainty (IU) and sense of control (SOC) play in relation to neuroticism and the fear of COVID-19. We conducted a cross-sectional study in Guangdong and Guangxi provinces, China, and we collected complete datasets from 792 high school students. The main results can be described as follows: (a) individuals with high neuroticism tended to have higher intolerance of uncertainty (IU) and a lower sense of control (SOC); (b) IU and SOC played a mediating role between neuroticism and fear of COVID-19, and a serial mediation effect was found between these factors; (c) after controlling for both IU and SOC, the effect of neuroticism on fear was no longer significant. The results suggested a critical role of IU and sense of control in the causal relationship between neuroticism and fear.