The COVID-19 pandemic was accompanied by an "infodemic," an overwhelming flood of information, both accurate and inaccurate, related to the virus. This study addresses the concern that overexposure to COVID-19-related information may negatively impact mental health, leading to increased emotional distress. Previous research has shown similar negative psychological effects from excessive media exposure following other major events, such as 9/11, the Boston Marathon bombings, and various disease outbreaks. While social media provides crucial information dissemination, particularly during social isolation, overexposure is linked to negative emotions. The mechanisms behind these effects, specifically the roles of risk perception and psychological resilience, are not fully understood. This study aims to explore these mechanisms and offer theoretical and practical insights for healthcare professionals, governments, and the public in managing the psychological consequences of the infodemic. The research specifically focuses on the mediating role of risk perception and the moderating role of psychological resilience in the relationship between COVID-19 information exposure and emotional distress.

Existing literature highlights the detrimental effects of overexposure to information during public health crises. Studies have shown a clear link between increased exposure to COVID-19 information (both frequency and duration) and heightened anxiety and depression. The impact is significant, with excessive exposure accounting for a notable percentage of the variance in anxiety levels. Furthermore, research emphasizes the importance of risk perception in influencing mental health outcomes. Risk perception, encompassing both cognitive and affective processes, is shaped by mass media exposure and plays a crucial role in determining individual responses to health threats. While the relationship between media exposure and risk perception in disease outbreaks has been explored, the specific context of the COVID-19 infodemic and its interaction with resilience needs further investigation. Finally, the literature acknowledges the role of psychological resilience in mediating stress responses. Resilience, a multidimensional concept encompassing stable and changeable attributes, is associated with better mental health outcomes during crises. However, research examining the interplay between risk perception, resilience, and the impact of COVID-19 information exposure remains limited.

This study employed a cross-sectional design with cluster sampling, surveying undergraduate and graduate students at two Beijing universities from February 2nd to March 3rd, 2020 – a period encompassing the peak and decline of COVID-19 cases in China. 1313 participants were included after applying exclusion criteria (participants infected with COVID-19, those failing attention checks, and those completing the survey in under 5 minutes). The survey utilized validated scales to measure key variables: * **COVID-19 Information Exposure:** Assessed frequency (times per day) and duration (hours per day) of exposure to COVID-19 information across legacy and social media. * **Perceived Risk:** Measured using two items assessing the perceived likelihood of personal and family/friend infection. * **Emotional Distress:** Measured using the GAD-7 (Generalized Anxiety Disorder 7-item scale) and PHQ-9 (Patient Health Questionnaire 9-item scale) to assess anxiety and depressive symptoms respectively. * **Psychological Resilience:** Measured using the Connor-Davidson Resilience Scale (CD-RISC), which also allows for the assessment of five factors: tenacity, tolerance, acceptance, control, and spirituality. Data analysis involved descriptive statistics, correlation analysis (to check for common method bias), a latent mediation model (examining the mediating effect of risk perception), and a latent moderated mediation model (investigating the moderating effect of resilience on the mediation). Demographic variables (age, sex, ethnicity, education level) were controlled as covariates in all models. Model fit was assessed using established indices (χ²/df, CFI, TLI, RMSEA, SRMR).

The study yielded several key findings: 1. **Positive Correlation:** A positive correlation was found between COVID-19 information exposure and emotional distress. Descriptive analysis revealed thresholds for moderate anxiety (7 times or 2 hours daily exposure) and moderate depression (6 times or 38 minutes daily exposure). These thresholds were lower than those reported in other studies, potentially suggesting a higher sensitivity among the Chinese population. 2. **Mediating Effect of Risk Perception:** Risk perception significantly mediated the relationship between COVID-19 information exposure and emotional distress. Increased information exposure predicted higher risk perception, which in turn predicted increased emotional distress. 3. **Moderating Effect of Resilience:** Psychological resilience significantly moderated the mediating effects of risk perception. High resilience buffered the negative effects of risk perception on emotional distress. Specifically, the mediating effect of risk perception was significantly weaker at high resilience levels compared to low resilience levels. 4. **Differential Effects of Resilience Factors:** Further analysis of the five resilience factors revealed that tenacity, acceptance, control, and spirituality significantly moderated the mediating effects of risk perception. Tolerance, however, did not show a significant moderating effect. This suggests that active coping mechanisms and positive outlook are particularly important in mitigating the negative impact of perceived risk.

The findings of this study provide strong support for the hypothesis that overexposure to COVID-19 information significantly increases emotional distress. The mediation analysis clearly demonstrates the role of risk perception in this relationship. Excessive and potentially inaccurate information can lead to an inflated perception of risk, thus triggering anxiety and depression. The moderating effect of resilience highlights the crucial role of individual coping mechanisms in mitigating the negative impact of the infodemic. The differential effects observed across the five resilience factors underscore the complexity of resilience as a construct and suggest that interventions should target specific aspects of resilience, such as the cultivation of tenacity, acceptance, control, and spirituality. The lower thresholds for moderate anxiety and depression compared to studies in other countries may reflect cultural differences in information processing and social sensitivity. The collectivistic nature of Chinese society and reliance on situational cues may contribute to a heightened emotional response to pandemic-related information.

This study provides novel insights into the relationship between COVID-19 information exposure, risk perception, resilience, and emotional distress. It emphasizes the detrimental impact of information overload, the mediating role of inaccurate risk perception, and the crucial protective role of resilience, particularly its distinct factors. Future research could explore the influence of information content, beyond frequency and duration, on mental health outcomes. Investigating the interplay of other factors, such as perceived self-efficacy and information processing modes, would provide a more comprehensive understanding of the mechanisms involved. Longitudinal studies employing both self-reported and objective biological indicators would further enhance the robustness and generalizability of findings. The implications of this study extend to public health initiatives, clinical interventions, and policy recommendations aimed at mitigating the negative psychological effects of infodemics.

This study has some limitations. The sample consisted primarily of university students proficient in using mobile phones, potentially limiting the generalizability of the findings to older populations or those who primarily rely on traditional media. The study focused solely on the quantity of information exposure; future research should incorporate qualitative assessments of information content and its impact. The cross-sectional design limits causal inferences; longitudinal studies would provide stronger evidence of the causal relationships between variables. The reliance on self-reported data introduces the possibility of subjective bias and response styles. Finally, although the study covered different stages of the pandemic in China, further research focusing specifically on post-peak periods is warranted.