Mindfulness and anxiety among medicine college students: a moderated mediation model of intolerance of uncertainty and neuroticism

Anxiety is commonly present in medical students. Mindfulness can effectively treat anxiety, but the mechanisms are poorly understood. This study aimed to investigate the association between mindfulness and anxiety, and the mediation roles of intolerance of uncertainty (IU) and neuroticism. This cross-sectional study enrolled medical students from the Army Medical University in April 2023. The Mindfulness Attention Awareness Scale, Intolerance of Uncertainty Scale, the 7-Item Generalized Anxiety Disorder Scale, and the Eysenck Personality Scale-Neurotic Dimension were used. The moderated mediation model was examined using SPSS PROCESS models 1, 4, 7, 14, and 58. A total of 314 participants (212 males and a mean age of 19.67 ± 1.61 years old) were included. Neuroticism was significantly negatively correlated with anxiety (r = -0.453, p < 0.01). IU played a mediating role in the relationship between mindfulness and anxiety, with a total standardized mediation effect value of −0.1348 (95% CI: −0.2071, −0.0760, P). When neuroticism was low, IU had a positive effect on anxiety (neuroticism = M-1SD) (B = 0.2887, t = 5.2043, p < 0.001). When neuroticism was moderate (B = 0.1244, t = 0.0479, p < 0.01), IU had a positive effect on anxiety. When neuroticism was high, the moderation effect was not significant (B = -0.0399, t = -0.6247, p > 0.050). Among medical college students, mindfulness influences anxiety through the mediating effect of IU. Neuroticism moderates this mediating pathway in the second stage.