From stigma to support: the mediating role of sympathy between nurses’ perceived stigma and helping behavior tendency for alcohol use disorder

BackgroundThe detrimental effect of stigma on healthcare for individuals with alcohol use disorders (AUDs) is well-established, often resulting in social distance and diminished helping behavior tendencies. However, contemporary neuroscience reconceptualizes addiction as a brain disease, potentially altering emotional responses to stigma. This study examines a seemingly paradoxical possibility: that under specific conditions, perceived stigma is primarily associated with sympathy (rather than anger or fear), which in turn is linked to helping behavior tendencies among nurses.MethodsA cross-sectional survey was administered to 348 clinical nurses from tertiary hospitals in China. Participants completed standardized scales assessing perceived stigma of patients with AUDs, causal attributions, emotional responses (including sympathy, anger, and fear), and helping behavior tendencies. Data were analyzed using Pearson correlation and mediation analysis (PROCESS macro, Model 4) with 5,000 bootstrap samples to test the mediating role of sympathy.ResultsPerceived stigma showed a significant positive correlation with sympathy (r= .160, p<.05), which was in turn positively correlated with helping behavior tendencies (r= .269, p<.05). Critically, mediation analysis revealed that sympathy fully mediated the relationship between perceived stigma and helping behavior tendencies. The standardized indirect effect was significant (β= 0.15, 95% CI [0.08, 0.23]), accounting for the total observed relationship, as the direct effect was non-significant. Additionally, compared to non-psychiatric nurses, psychiatric nurses perceived patients as significantly less dangerous and reported lower levels of fear and anger, along with a stronger intention to help and a lower tendency to avoid patients.ConclusionChallenging conventional perspectives, this study supports a dual-pathway model in which perceived stigma can indirectly associated with professional helping behavior tendencies through the elicitation of sympathy. While other emotions like anger and fear were also measured, the findings highlight the pivotal role of cognitive-affective processes, shaped by neurobiological understandings of addiction, in determining nursing care. Specifically, sympathy, but not anger or fear, was found to mediate the stigma-helping relationship. Enhancing neuroscience-informed education and targeted empathy training, particularly for general nurses, could transform stigmatizing attitudes into supportive care, ultimately improving outcomes for patients with AUDs.

The temporal stability of core symptoms of social media addiction and their comorbidity with anxiety and depression in adolescents: a longitudinal network analysis

IntroductionSocial media addiction (SMA) is often comorbid with anxiety and depression. This study examined the temporal stability of core SMA symptoms and the bridging symptoms with anxiety and depression.MethodsA total of 1,240 adolescents (179 males, 1,061 females; mean age = 15.46 ± 0.63 years, age range: 14 – 18) completed the Bergen Social Media Addiction Scale (BSMAS), the Patient Health Questionnaire–9 (PHQ–9), and the Generalized Anxiety Disorder–7 (GAD–7) on two separate occasions in 2023 (T1) and 2024 (T2). The four symptom networks, including the BSMAS networks, two comorbidity networks (the BSMAS–GAD and the BSMAS–PHQ), and the integrated BSMAS–GAD–PHQ network, were estimated using Gaussian graphical models. Core symptom centrality was assessed using Expected Influence (EI), whereas bridge symptoms were identified using Bridge Expected Influence (BEI).Results1) Although SMA, anxiety, and depression levels of respondents rose significantly over the year, all four networks showed strong temporal stability, with the edge weights (r = .892 –.973, p < .001), the EI (r = .806 – .961, p ≤ .002), and the BEI (r = .699 – .804, p ≤ .008) highly correlated between T1 and T2; network comparison tests showed no significant changes in overall structures of all four networks, with most edges showing stable weights. 2) Within the BSMAS network, BSMAS2 (tolerance) and BSMAS6 (conflict) exhibited the highest EI at both time points. 3) In the comorbidity networks, BSMAS3 (mood modification), BSMAS5 (withdrawal), and BSMAS6 (conflict) consistently served as bridge symptoms on the SMA side at both T1 and T2. 4) Across both time points, PHQ1 (anhedonia) and PHQ7 (concentration problems) exhibited the highest BEI on the depression side, whereas GAD1 (nervousness) and GAD5 (restlessness) did so on the anxiety side. 5) These bridge symptoms were also confirmed in the integrated network.DiscussionThese findings illuminate the temporal persistence and development of symptom relationships, offering a more dynamic understanding of SMA–depression–anxiety comorbidity in adolescents.

Group CBT targeting hostile attribution bias in adolescents and young adults with ASD traits

BackgroundAdolescence is characterized by heightened self-consciousness and sensitivity to social evaluations. During this period, hostile attribution bias—interpreting ambiguous social cues as hostile—can lower quality of life (QOL) and contribute to future mental health problems. Adolescents with autism spectrum disorder (ASD) show similar difficulties, often more pronounced due to their cognitive style and interpersonal vulnerabilities. Group cognitive behavioral therapy (CBT) aims to correct such biases through structured cognitive and social experiences. This study evaluated the psychological effects of group CBT on hostile attribution bias, social functioning, and QOL in adolescents and young adults with ASD traits.MethodsWe conducted an 8-session group CBT program focusing on hostile attribution bias and suspiciousness in 21 adolescents and young adults with ASD traits attending a hospital psychiatric outpatient department. The 15 participants who completed the program were included in analyzes. Psychological indices included hostile attribution bias (Ambiguous Intentions Hostility Questionnaire), social functioning (Social Responsiveness Scale, Second Edition [SRS-2]), and subjective QOL. Pre–post changes were quantified as change rates ((post − pre)/pre × 100). Group-level changes were tested with paired analyzes; exploratory associations among change rates were examined using Spearman correlations.ResultsGroup CBT significantly improved hostile attribution bias (effect size [ES] = 0.698, p = 0.017), social communication and interaction (SRS-2; ES = 0.780, p = 0.012), and subjective QOL (ES = 0.752, p = 0.011). Exploratory individual-level analyzes showed a discordant pattern: smaller reductions in hostile attribution bias (less negative change rates) were associated with greater increases in subjective QOL (ρ = 0.597, p = 0.019).ConclusionsThis pilot study suggests that group CBT may reduce hostile attribution bias and improve QOL and social functioning in adolescents and young adults with ASD traits. Notably, the positive correlation between hostile attribution bias change rates and QOL change rates suggests that greater QOL gains were not necessarily accompanied by larger reductions in hostile attribution bias, indicating that improvements in cognitive bias and perceived well-being may arise through partly distinct or non-linear pathways rather than a simple one-to-one relationship.Clinical trial registryUniversity Hospital Medical Information Network (UMIN000030140).

The ghost of tuberculosis past

Nature Medicine, Published online: 22 April 2026; doi:10.1038/s41591-026-04356-z

The analysis of the 100 Million Brazilian database reveals that a past tuberculosis diagnosis increases the risk of death up to 14 years later regardless of treatment outcome, which should prompt urgent prioritization of global prevention efforts.