The impact of provider-patient communication skills on primary healthcare quality and patient satisfaction in rural China: insights from a standardized patient study.

OBJECTIVES: In middle-income countries, poor physician-patient communication remains a recognized barrier to enhancing healthcare quality and patient satisfaction. This study investigates the influence of provider-patient communication skills on healthcare quality and patient satisfaction in the rural primary healthcare setting in China. METHODS: Data were collected from 504 interactions across 348 rural primary healthcare facilities spanning 21 counties in three provinces. Using the Standardized Patient method, this study measured physician-patient communication behaviors, healthcare quality, and patient satisfaction. Communication skills were assessed using the SEGUE questionnaire framework. Multivariate linear regression models and multivariate logistic regression models, accounting for fixed effects, were employed to evaluate the impact of physicians' communication skills on healthcare quality and patient satisfaction. RESULTS: The findings indicated generally low provider-patient communication skills, with an average total score of 12.2 ± 2.8 (out of 24). Multivariate regression models, which accounted for physicians' knowledge and other factors, demonstrated positive associations between physicians' communication skills and healthcare quality, as well as patient satisfaction (P < 0.05). Heterogeneity analysis revealed stronger correlations among primary physicians with lower levels of clinical knowledge or more frequent training. CONCLUSION: This study emphasizes the importance of prioritizing provider-patient communication skills to enhance healthcare quality and patient satisfaction in rural Chinese primary care settings. It recommends that the Chinese government prioritize the enhancement of provider-patient communication skills to improve healthcare quality and patient satisfaction.

Parental involvement affects parent-adolescents brain-to-brain synchrony when experiencing different emotions together: An EEG-based hyperscanning study.

Parental involvement (PI) is a broad and multifaceted construct, which refers to the parental demonstration of interest in their child, caring, and warmth (Davis et al., 2021). Parental involvement affects parent-adolescent's relationship and communication. However, there was little research to examine the underlying neural mechanism. The present study aimed to explore how parental involvement is associated with the brain-to-brain synchronous activation between parent-adolescent dyads when sharing emotional experience together by using the electroencephalograph (EEG) hyperscanning. EEG was recorded simultaneously in a sample of 26 parent-adolescent dyads (Mparents'age=43.312, SD=5.468; Madolescents' age=12.077, SD=1.412) when completing the picture processing task. Phase locking values (PLVs) in beta band and gamma band were used to compare the differences in the parent-adolescent dyads' induced brain-to-brain synchrony between the high parental involvement group (HPI) and the low parental involvement group (LPI). Results showed that greater beta brain-to-brain synchrony was observed in the HPIs than in the LPIs when experiencing positive emotions together in the central region. However, there was no significant difference between the HPIs and the LPIs in the negative and neutral condition. Moreover, greater gamma brain-to-brain synchrony was observed when viewing negative emotional stimuli together than viewing positive emotional stimuli together in the LPIs in the central region. However, there was no significant difference between different emotional conditions in the HPIs. Findings of the present study provide neuroscientific evidence that parental involvement may strengthen parent-adolescent's emotional interaction and communication.

Psychological needs satisfaction and smartphone addiction among Chinese adolescents: The mediating roles of social anxiety and loneliness.

Objectives: Although previous studies have initially noted that psychological needs satisfaction (PNS) might be a significant risk factor for technology addiction (e.g. online gaming addiction and Internet addiction), specific mechanisms involved in the association between PNS and adolescent smartphone addiction are largely unknown. Based on self-determination theory, this cross-sectional study constructed a multiple mediation model to examine whether PNS will influence adolescent smartphone addiction through the mediating roles of social anxiety and loneliness. Methods: Eight hundred and ninety-nine Chinese adolescents answered the questionnaire including measures of PNS, social anxiety, loneliness, and smartphone addiction. SPSS 24.0 was used for common method bias test, reliability test, and correlation analysis, and Mplus 7.4 was used to examine the mediating roles of social anxiety and loneliness in the multiple mediation model. Results: This study found that (1) PNS was negatively associated with adolescent smartphone addiction; (2) loneliness significantly mediated the association between PNS and smartphone addiction while the mediating role of social anxiety in this association was nonsignificant; and (3) social anxiety and loneliness also sequentially mediated this association. Conclusion: This study further enriched potential mechanisms linking PNS and smartphone addiction among adolescents, which may contribute to intervention and prevention programs for adolescent smartphone addiction from the perspective of improving both PNS and negative emotions including social anxiety and loneliness.

Children's emotional intelligence and aggressive behavior: The mediating roles of positive affect and negative affect.

Objective: Although previous studies have noted that emotional intelligence (EI) might be a significant protective factor for aggressive behavior, the specific mechanisms involved is largely unknown. Based on the General Aggressive Model, this cross-sectional study aims to investigate whether EI will influence aggressive behavior through the mediating roles of positive affect (PA) and negative affect (NA). Methods: A total of 410 primary school students (45.4% females; Mage = 10.35, SD = 0.48, range from 10 to 11 years) from Shenzhen, China, completed questionnaires on EI, aggressive behavior, PA, and NA. SPSS 22.0 was used for reliability test and correlation analysis, and (Hayes, 2013) [1] PROCESS macro (Model 6) was used to examine the multiple mediation model. Results: The results show that (a) EI was negatively associated with children's aggressive behavior; (b) NA partially mediated the link between EI and aggressive behavior in children, and (c) PA and NA sequentially mediated the above link. Conclusion: This study would not only deepen our understanding of how EI is associated with aggressive behavior but also provide valuable suggestions for teachers and parents to more effectively prevent and intervene children's aggressive behavior.

Trait Mindfulness and Physical Health among Chinese Middle-Older Adults: The Mediating Role of Mental Health.

Few studies have focused on the specific effects of trait mindfulness on physical health status, especially from a resilient aging perspective. This study examined the mediating role of mental health in the association between trait mindfulness and physical health status among middle-older adults in urban China. The participants included 188 individuals who were recruited from a community senior university and five community senior care centers. The findings reveal: (1) trait mindfulness has a strong effect on two physical health indicators (self-rated physical health and subjective sleep quality); (2) mental health is a significant mediator in the relationship between trait mindfulness and physical health status; and (3) the mediation role of mental health is more evident in the self-rated physical health model (24.15%) than subjective sleep quality (18.10%). This study improves our knowledge of how trait mindfulness can lead to a better physical health in middle-older adults and can lead to the development of social value communication and effective prevention.

Perceived Parental Monitoring of Smartphones and Problematic Smartphone Use in Adolescents: Mediating Roles of Self-Efficacy and Self-Control.

Adolescents are vulnerable for problematic smartphone use (PSU), which is associated with adverse psychological and physical health outcomes. Prior studies have debated whether the association between parental monitoring of smartphones and PSU is positive, negative, or nonsignificant. The present study investigated the relationship between parental monitoring of smartphones and PSU and the potential mediation mechanism involving self-efficacy and self-control. Eight hundred ninety-nine middle- and high-school students from a metropolitan city in China completed a questionnaire containing measurements of demographic information, perceived parental monitoring of smartphones, self-control, self-efficacy, and PSU. The results showed that (a) perceived parental monitoring of smartphones was negatively related to adolescent PSU; (b) self-control partially mediated the link between perceived parental monitoring of smartphones and adolescent PSU; and (c) self-efficacy and self-control sequentially mediated the link between parental monitoring of smartphones and PSU. The current study highlights the mediating mechanisms linking perceived parental monitoring of smartphones and adolescent PSU, and this may contribute to the development of family-based prevention and intervention strategies for adolescent PSU.

Relations between family cohesion and adolescent-parent's neural synchrony in response to emotional stimulations.

BACKGROUND: The interaction between parent and adolescent is more challenging than in other age periods. Family cohesion seriously impacts parent-adolescent emotional interactions. However, the underlying neural mechanism has not been fully examined. This study examined the differences in the neural synchrony in response to emotional film clips between high and low family cohesion adolescent-parent dyads by using the electroencephalograph (EEG) hyperscanning. RESULTS: Simultaneously electroencephalograph (EEG) was recorded while 15 low family cohesion parent-adolescent dyads (LFCs)and 14 high family cohesion parent-adolescent dyads (HFCs)received different emotional induction when viewing film clips. Interbrain phase-locking-value (PLV) in gamma band was used to calculate parent-adolescent dyads' interbrain synchrony. Results showed that higher gamma interbrain synchrony was observed in the HFCs than the LFCs in the positive conditions. However, there was no significant difference between the HFCs and LFCs in other conditions. Also, the HFCs had significantly higher gamma interbrain synchrony in the positive conditions than in the negative conditions. CONCLUSION: Interbrain synchrony may represent an underlying neural mechanism of the parent-adolescent emotional bonding, which is the core of family cohesion.

Adolescent social anxiety undermines adolescent-parent interbrain synchrony during emotional processing: A hyperscanning study.

Social anxiety severely impacts adolescents' social interactions with others; however, the underlying neural mechanism has not been revealed. This study examined how adolescent's social anxiety level influences the interbrain synchrony within adolescent-parent dyads during emotional processing by using electroencephalograph (EEG) hyperscanning. A sample of 25 adolescent-parent dyads completed the picture processing task. Adolescents' ages ranged from 10 to 14 years old. The results showed that (1) at parietal areas, greater gamma interbrain synchrony was observed in the high social anxiety adolescent-parent dyads (HSAs) than the low social anxiety adolescent-parent dyads (LSAs) in the positive conditions. However, greater gamma interbrain synchrony of the picture processing task was observed in the LSAs than the HSAs in the negative conditions. (2) Compared with the neutral condition, LSAs induced greater interbrain synchronization in the negative condition than in the neutral condition at central and parietal areas. However, HSAs induced greater interbrain synchronization in the positive condition than in the negative condition at parietal areas. (3) HSAs induced greater interbrain synchronization at parietal areas than in the central areas in positive conditions. The results provide neurological evidence that the way parent and adolescent process different emotions in the same emotional episode could be affected by the adolescent's anxiety level.

Patient satisfaction and its health provider-related determinants in primary health facilities in rural China.

BACKGROUND: Patient satisfaction is an important outcome measure of health service and is one of the main reasons for the gradual deterioration of doctor-patient relationships in China. This study used the standardized patient (SP) method to explore patient satisfaction and its health provider-related determinants among primary health facilities in rural China. METHODS: The dataset comprised 1138 clinic cases in 728 rural primary health facilities in 31 counties, spread across four provinces. Information regarding the consultation interaction between the unannounced SPs and primary physicians was recorded. Patient satisfaction was gathered from the feedback of SPs after the visit. RESULTS: The overall average score of SP satisfaction with rural primary health facilities was only 13.65 (SD = 3.22) out of 20. The SP scores were found to be consistent with those of real patients. After controlling variances in patient population via the SP method, the regression analysis demonstrated that health provider-related factors, such as physician-level characteristics, consultation process, affordability, and convenience, have a significant correlation with patient satisfaction among primary physicians. Among factors relating to physician-level characteristics, affordability, convenience and the consultation process of the visit, the quality of the consultation process (e.g., consultation time, proactively providing necessary instructions and other crucial information) were found to be the prominent determinants. CONCLUSIONS: This study revealed the need to improve patient satisfaction in primary health facilities in rural China. To solve this issue, we recommend that policies to increase medical service quality be implemented in rural primary healthcare systems.

Parent-adolescent relationships, peer relationships, and adolescent mobile phone addiction: The mediating role of psychological needs satisfaction.

INTRODUCTION: Prior studies have shown that parent-adolescent relationships and peer relationships may be important factors associated with adolescent mobile phone addiction (MPA). The present study aims to further explore the direct effects of parent-adolescent and peer relationships on adolescent MPA as well as the indirect effects through the mediating roles of autonomy, competence, and relatedness needs satisfaction. METHODS: Our sample consisted of 1766 Chinese adolescents (53.10% male; Mage = 13.33, SD = 1.94, range from 10 to 18 years) who completed questionnaires regarding parent-adolescent relationships, peer relationships, psychological needs satisfaction, and MPA. SPSS 24.0 was used to analyze correlations among variables and Mplus 7.4 was used to test the structural equation model in this study. RESULTS: (1) positive parent-adolescent relationships were negatively associated with adolescent MPA, while peer relationships did not show a significant association with MPA; (2) autonomy and competence needs satisfaction significantly mediated the effects of parent-adolescent and peer relationships on MPA, while the mediating role of relatedness need satisfaction between parent-adolescent and peer relationships and MPA was not significant; (3) the mediating effect of competence need satisfaction between peer relationships and MPA was significantly stronger than that between parent-adolescent relationships and MPA. CONCLUSIONS: This study explored the different mechanisms by which parent-adolescent and peer relationships influence adolescent MPA. These discoveries may contribute to intervention and prevention programs for adolescent MPA.

Differences in Reward Sensitivity between High and Low Problematic Smartphone Use Adolescents: An ERP Study.

BACKGROUND: Problematic smartphone use is highly prevalent in adolescent populations compared to other age groups (e.g., adults and young children). Previous studies suggested that higher levels of reward sensitivity were associated with problematic smartphone use. Therefore, the current study investigated the neural processing of monetary and social reward and punishment feedbacks between high and low problematic smartphone use adolescents. METHODS: 46 adolescents participated in the current study and they were categorized into two groups based on their level of problematic smartphone use: those who obtained low scores on the measure of problematic smartphone use were categorized as Low Problematic Smartphone Use (LPSU), and those who obtained high scores on the measure of problematic smartphone use were categorized as High Problematic Smartphone Use (HPSU). Electrocortical activities were recorded during the processing of monetary and social reward and punishment feedback. RESULTS: (1) LPSUs evoked larger P3 in the social punishment condition than in the monetary punishment condition. HPSUs evoked larger P3 in the social reward condition than in the monetary condition. (2) The feedback-related negativity (FRN) amplitudes in the reward condition were significantly larger than those in the punishment condition. (3) HPSUs induced larger reward positivity in social feedback conditions than in monetary feedback conditions, while there were no significant differences between the two types of conditions in the LPSUs. DISCUSSION: The results provide neural underpinning evidence that high sensitivity to social rewards may be related to problematic smartphone use in adolescence.

What links to psychological needs satisfaction and excessive WeChat use? The mediating role of anxiety, depression and WeChat use intensity.

BACKGROUND: Excessive online social network sites (SNSs) use, such as Facebook or WeChat overuse, has become a severe problem and have caused negative consequences. It is especially important to examine what causes excessive WeChat use in the Chinese population. This study explored the critical role of affective states and WeChat use intensity in the relationship between psychological needs satisfaction and excessive WeChat use based on the self-determination theory and the emotional motivation theory. METHODS: 952 Chinese college students aged 18 to 25 completed an online survey that measured psychological needs satisfaction, depression, anxiety, WeChat use intensity, and excessive WeChat use. RESULTS: Path analysis demonstrated that anxiety, depression, and WeChat use intensity mediated the effect of psychological needs satisfaction on excessive WeChat use. More importantly, the chain mediation model indicated that psychological needs satisfaction could influence excessive WeChat use through the "anxiety-WeChat use intensity" path, but not the "depression-WeChat use intensity" path. CONCLUSION: The current study could not only contribute to theoretical development, but also guide mental health practice by showing that improving psychological needs satisfaction may restrain excessive WeChat use through regulating affective states and Wechat use intensity.

Regularity of Clinical Visits and Medication Adherence of Patients with Hypertension or Diabetes in Rural Yunnan Province of China.

Chronic diseases can be controlled through effective self-management. The purpose of this study is to explore the regularity of clinical visits and medication adherence of patients with hypertension or diabetes (PWHD), and its association with the first experience with care and individual factors in rural Southwestern China. This cross-sectional study was carried out in Yunnan province in 2018 and recruited 292 PWHD and 122 village clinics from 122 villages in 10 counties. Participants were interviewed using a structured questionnaire. Results show around 39% of hypertensive and 25% of diabetic patients neither visited physicians nor took medicine regularly during the preceding three months of the interview date. The regression results further indicated that individual characteristics of the PWHD, including patient age, health status, and economic level, as well as their first experience with care, were significantly associated with their regular healthcare behavior. In addition to providing medical services, on average each sample village clinic, with around two physicians, simultaneously managed 180 hypertensive and 45 diabetic patients. This study revealed the need for further reforms in terms of improving self-management and thus recommends an increase in the quantity and the quality of human resources in the primary healthcare realm in rural China.

What Can Children Learn from a Free Trial of Eyeglasses Use? Evidence from a Cluster­Randomized Controlled Trial in Rural China.

Free trial is a widely used business strategy that takes advantage of information asymmetry. However, evidence on what we can learn and how rapidly we can learn from a free trial of health care is limited. This study evaluates the effect of a free trial of eyeglasses on children's 8 items of perception related to eyeglasses use. An evaluation was conducted alongside a cluster-randomized controlled trial involved 832 myopic children from northwest rural China. A total of 428 myopic children from 42 schools were randomized to receive free eyeglasses, and 404 myopic children from 42 schools were randomized as control group. We find that the perceived costs and benefits of eyeglasses use and the perceived timing of wearing eyeglasses at the appropriate time can be learned from a free trial of eyeglasses. Compared with the control group in the long run, 5.6 percentage points more children in treatment group agreed that wearing eyeglasses was attractive, 16.5 percentage points more children agreed that wearing eyeglasses is helpful to academic performance, and 7.9 percentage points more children agreed that children with vision problems should wear eyeglasses. Due to the effects of a free product and the time to learning from experience, the magnitude of the impact of a free trial changed over time. We also find that the indirect experience, such as a vision protection course, cannot change children' perceptions about the cost or benefits of eyeglasses use. The findings imply that children can learn significantly from the experience of a free trial of eyeglasses. A free trial is an effective strategy to solve the information asymmetry problem for health care. The first pair of eyeglasses of children can be one-off subsidized to trigger demand for eyeglasses use.

Analysing the preferences for family doctor contract services in rural China: a study using a discrete choice experiment.

BACKGROUND: Preliminary evaluations have found that family doctor contract services (FDCSs) have significantly controlled medical expenses, better managed chronic diseases, and increased patient satisfaction and service compliance. In 2016, China proposed the establishment of a family doctor system to carry out contract services, but studies have found the uptake and utilization of these services to be limited. This study aimed to investigate rural residents' preferences for FDCSs from the perspective of the Chinese public. METHODS: A discrete choice experiment (DCE) was performed to elicit the preferences for FDCSs among rural residents in China. Attributes and levels were established based on a literature review and qualitative methods. Five attributes, i.e., cost, medicine availability, the reimbursement rate, family doctor competence, and family doctor attitude, were evaluated using a mixed logit model. RESULTS: A total of 609 residents were included in the main DCE analysis. The respondents valued the high competence (coefficient 2.44, [SE 0.13]) and the good attitude (coefficient 1.42, [SE 0.09]) of family doctors the most. Cost was negatively valued (coefficient - 0.01, [SE 0.01]), as expected. Preference heterogeneity analysis was conducted after adjusting the interaction terms, and we found that rural residents with higher educational attainment prefer a good attitude more than their counterparts with lower educational attainment. The estimated willingness to pay (WTP) for "high" relative to "low" competence was 441.13 RMB/year, and the WTP for a provider with a "good" attitude relative to a "poor" attitude was 255.77 RMB/year. CONCLUSION: The present study suggests that strengthening and improving the quality of primary health care, including the competence and attitudes of family doctors, should be prioritized to increase the uptake of FDCSs. The contract service package, including the annual cost, the insurance reimbursement rate and individualized services, should be redesigned to be congruent with residents having different health statuses and their stated preferences.

Parent-child relationship and smartphone use disorder among Chinese adolescents: The mediating role of quality of life and the moderating role of educational level.

The present study explored the effect of parent-child relationship on Smartphone Use Disorder (SUD) and the mediating role of quality of life (QOL). In addition, we explored the role of educational level from the developmental psychology perspective. Our results indicate that: (1) parent-child relationship could negatively predict SUD among adolescents; (2) QOL played a partial mediator role in the relationship between parent-child relationship and SUD; (3) As educational level increased from elementary school to middle school to high school, the effect of parent-child relationship on QOL weakened. This study showed that adolescents with good parent-child relationship had a higher QOL thus exhibiting a lower extent of SUD. Moreover, the link between parent-child relationship and SUD weakened as the educational level increased.

A configurational investigation of smartphone use disorder among adolescents in three educational levels.

INTRODUCTION: Smartphone use disorder in youth was associated with severe physical, psychological, and financial problems. Based on the ecological system theory of child development, this study examined a wide range of psychosocial characteristics in elementary-, middle-, and high-school adolescents with high scores on smartphone use disorder. METHODOLOGY: Existing research, which mainly adopted regression-based analytical techniques, found that gender, self-control, sensation seeking, loneliness, anxiety, perceived parent-adolescent relationship, and perceived parental monitoring are associated with smartphone use disorder. To complement traditional variable-centered approaches, the current study adopted a person-centered approach, fuzzy-set Qualitative Comparative Analysis (fsQCA) procedures, to examine adolescents with smartphone use disorder. RESULTS: The fsQCA procedure revealed four, nine, and thirteen distinct configurations that contributed to smartphone use disorder in adolescents for elementary school students, middle school students, and high school students respectively. A comparison across the three educational levels revealed four differences and two similarities. The results suggest that different groups of adolescents might be at risk for smartphone use disorder across the three educational levels. CONCLUSIONS: The fsQCA procedures generated solutions with satisfactory coverage and consistency. This demonstrates the promising value of fsQCA for researching smartphone use disorder and other behavior problems in adolescents. The results suggest that educators and mental health practitioners should consider educational level when helping adolescents with smartphone use disorder.

Inhibitory Control in Excessive Social Networking Users: Evidence From an Event-Related Potential-Based Go-Nogo Task.

Inhibitory control is a core executive function module that monitors and suppresses inappropriate behavior. Inhibitory deficits have been observed in different addiction types (e.g., smoking, alcohol, drug and gambling). The excessive use of social networking sites (SNSs) has attracted increasing attention; however, it is unknown whether inhibitory control is impaired in excessive SNS users. This study used event-related potentials in an SNS-related Go-Nogo task to investigate inhibitory control in excessive SNS users. Although the behavioral data did not show any significant differences between groups, the N1 amplitude was larger following SNS images than control images in excessive SNS users. Furthermore, excessive users showed larger N2 amplitude and smaller Nogo-P3 amplitude than non-excessive users irrespective of stimuli. These findings suggested that excessive SNS users are inefficient in allocating monitoring resources in the Go-Nogo task (reflected by enhance N2) and show difficulty in late inhibitory control procedure (reflected by reduced Nogo-P3) compared to non-excessive users. Also, excessive SNS users pay more attention to SNS-related images compared to non-SNS-related images (reflected by the N1). Interventions for this specific population should focus on limiting exposure to SNS cues and enhancing inhibitory control.

Medical waste management in three areas of rural China.

OBJECTIVE: The purpose of this paper is to describe current practices of medical waste management, including its generation, investments, collection, storage, segregation, and disposal, and to explore the level of support from upper tiers of the government and health care system for medical waste management in rural China. METHODS: The authors draw on a dataset comprised of 209 randomly selected rural township health centers (THCs) in 21 counties in three provinces of China: Anhui, Shaanxi and Sichuan. Surveys were administered to health center administrators in sample THCs in June 2015. RESULTS: The results show that the generation rate of medical waste was about 0.18 kg/bed, 0.15 kg/patient, or 0.13 kg/person per day on average. Such per capita levels are significant given China's large rural population. Although investments of medical waste facilities and personnel in THCs have improved, results show that compliance with national regulations is low. For example, less than half of hazardous medical waste was packed in sealed containers or containers labeled with bio-hazard markings. None of the THCs segregated correctly according to the categories required by formal Chinese regulations. Many THCs reported improper disposal methods of medical waste. Our results also indicate low levels of staff training and low rates of centralized disposal in rural THCs. CONCLUSIONS: Medical waste is a serious environmental issue that is rising on the agenda of policymakers. While a large share of THCs has invested in medical waste facilities and personnel, it appears that actual compliance remains low. Using evidence of low rates of training and centralized disposal, we surmise that a lack of support from upper tiers of management is one contributing factor. Given these findings, we recommend that China's policymakers should enhance support from upper tiers and improve monitoring as well as incentives in order to improve medical waste management.

Trait anxiety and probabilistic learning: Behavioral and electrophysiological findings.

Anxiety is a negative emotion that affects various aspects of people's daily life. To explain why individuals with high anxiety tend to make suboptimal decisions, we suggest that their learning ability might play an important role. Regarding that anxiety modulates both outcome expectation and attention allocation, it is reasonable to hypothesize that the function of feedback learning should be sensitive to individual level of anxiety. However, previous studies that directly examined this hypothesis were scarce. In this study, forty-two Chinese participants were assigned to a high-trait anxiety (HTA) group or a low-trait anxiety (LTA) group according to their scores in the Trait form of Spielberger's State-Trait Anxiety Inventory (STAI-T). Both groups finished a reward learning task in which two options were associated with different winning probabilities. The event-related potential (ERP) elicited by outcome feedback during the task was recorded and analyzed. Behavioral results revealed that, when the winning probability was 80% for one option and 20% for another, the HTA group chose the 80% winning option less often than the LTA group at the initial stage (i.e., first 20 trials) of the task, but there was no between-group difference in total number of choice. In addition, HTA participants took more time to make decisions in the 80/20 condition than in the 50/50 condition, but this effect was insignificant in the LTA group. ERP results indicated that anxiety affects learning in two ways. First, compared to their LTA counterparts, HTA participants showed a smaller feedback-related negativity (FRN) in response to negative feedback, indicating the impact of anxiety on outcome expectation. Second, HTA participants showed a larger P3 component in the 80/20 condition than in the 50/50 condition, indicating the impact of anxiety on attention allocation. Accordingly, we suggest that individuals' ability of feedback learning could be negatively modulated by anxiety.