Clinical Neuropsychiatry最新文献

{"title":"Links Between Externalizing And Internalizing Symptoms And Peer Victimization: The Role Of Rumination And Self-Efficacy.","authors":"Julia El Kallassi, Raymond Bou Nader, Martine Bouvard","doi":"10.36131/cnfioritieditore20260108","DOIUrl":"10.36131/cnfioritieditore20260108","url":null,"abstract":"<p><strong>Objective: </strong>Bullying is a serious problem among school-age children, contributing to both internalizing and externalizing difficulties. The existing literature does not place much emphasis on the factors explaining the link between victimization and psychological difficulties. This study looked into the roles of rumination and self-efficacy in this relationship.</p><p><strong>Method: </strong>Data was collected from 362 children (202 girls; <i>Mage</i> = 13.1, <i>SD</i> = 1.16) over two points in time, separated by 6 months.</p><p><strong>Results: </strong>Findings revealed a main effect of bullying status (being a victim of bullying vs. being non-involved) on rumination, self-efficacy, and internalizing/externalizing symptoms. Additional analyses explored different existing profiles (non-involved who stayed non-involved, new victims, escaped victims, and continuous victims) in terms of their psychological difficulties, ruminative responses, and self-efficacy. Mediation analyses show that victimization at Time 1 predicts internalizing difficulties at Time 2, but this effect is not mediated by rumination or self-efficacy. Conversely, victimization indirectly predicts externalizing symptoms at Time 2 via rumination. Moreover, internalizing symptoms at Time 1 predict victimization at Time 2 through both rumination and self-efficacy, while externalizing symptoms at Time 1 predict victimization at Time 2 via self-efficacy.</p><p><strong>Conclusions: </strong>The findings provide practical insights for those working with victims of bullying and also lay the foundation for future research.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"77-89"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating Peer Inclusion And Exclusion: Pathological Narcissism, Reflective Functioning, And Rejection-Related Emotions In Adolescents.","authors":"Andrea Fontana, Lucia Sideli, Beatrice Cianfanelli, Antonella Somma, Andrea Fossati","doi":"10.36131/cnfioritieditore20260109","DOIUrl":"10.36131/cnfioritieditore20260109","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the interplay between pathological narcissism, reflective functioning (RF), and peer exclusion (vs. inclusion) among adolescents. The study hypothesizes that peer exclusion (vs. inclusion) is associated with greater post-task difficulties in reflective functioning and higher rejection-related emotions, and tests whether these associations vary as a function of pathological narcissism.</p><p><strong>Method: </strong>A sample of 204 adolescents (aged 14-18) participated in an experimental task simulating social media interactions using the Social Media Ostracism Paradigm (SMOP). Participants were assigned to one of three experimental conditions: Over-Inclusion (OI), Neutral (N), and Over-Exclusion (OE). Pathological narcissism was assessed using the Pathological Narcissism Inventory (PNI), and reflective functioning and rejection-related emotions were evaluated post-task.</p><p><strong>Results: </strong>High-risk narcissistic adolescents exhibited significantly lower RF scores than their low-risk peers (F(1, 198) = 13.72, p < .001), particularly in the OE condition (F(2, 198) = 6.76, p < .001). Low-risk adolescents in the OI condition demonstrated better RF. Social exclusion significantly impacted rejection-related emotions (F(2, 198) = 13.890, p < .001), with OE participants reporting higher distress than N and OI groups. However, narcissism did not significantly moderate emotional responses.</p><p><strong>Conclusions: </strong>Pathological narcissism was associated with greater RF difficulties, which were most evident under exclusion. However, rejection distress appears to be a broadly shared response in adolescence and may function as a normative signal of threatened belongingness, relatively independent of narcissism levels. These results emphasize the importance of targeted interventions focusing on mentalization and peer dynamics, particularly for adolescents with high-risk narcissism traits.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"90-99"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glycemic Control, Quality Of Life, And Social Determinants Of Sleep Quality In Newly Diagnosed Type 2 Diabetes Mellitus.","authors":"Nguyen Quang Bay, Duong Thi Mai Phuong, Phan Hoang Hiep, Lam My Hanh, Pham Tran Anh Khoa, Nguyen Thi Thuy Hanh, Nguyen Dang Vung, Vu Minh Tuan, Tran Thi Thanh Thuy, Le Anh Tuan, Nguyen Hoang Thanh","doi":"10.36131/cnfioritieditore20260104","DOIUrl":"10.36131/cnfioritieditore20260104","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence of poor sleep quality and identify associated factors among patients newly diagnosed with T2DM.</p><p><strong>Method: </strong>A cross-sectional study was conducted at the National Hospital of Endocrinology, Vietnam, from August 2024 to July 2025. A total of 106 patients with newly diagnosed T2DM were recruited. Data on sociodemographics, lifestyle, clinical and biochemical measures, social support (MSPSS), and quality of life (WHOQOL-BREF) were collected. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Logistic regression was applied to identify predictors of sleep disorder (PSQI ≥5), and Tobit regression was used to examine determinants of the total PSQI score.</p><p><strong>Results: </strong>The mean PSQI global score was 6.86 ± 4.63, and 67.9% of participants experienced at least mild sleep disturbance. Logistic regression showed that elevated HbA1c (OR = 7.66, 95% CI: 2.81-20.86, p < 0.001) and female sex (OR = 0.13, 95% CI: 0.02-0.82, p = 0.029) were significant predictors of poor sleep. Tobit regression further identified HbA1c (Coef. = 1.45, p < 0.001), female sex (Coef. = -3.40, p < 0.001), economic stress (Coef. = -3.42, p < 0.001), WHOQOL physical (Coef. = -0.07, p = 0.027), and WHOQOL environment (Coef. = 0.11, p = 0.012) as significant determinants of PSQI score. Lifestyle factors and family support showed weaker or non-significant associations.</p><p><strong>Conclusions: </strong>These findings suggest that sleep should be routinely assessed at diagnosis, with integrated management strategies addressing biomedical, psychosocial, and environmental determinants to improve outcomes.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"49-55"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When A Critique Becomes Untenable: A Scholarly Response To Grossman Et Al.'S Evaluation Of Polyvagal Theory.","authors":"Stephen W Porges","doi":"10.36131/cnfioritieditore20260111","DOIUrl":"10.36131/cnfioritieditore20260111","url":null,"abstract":"<p><p>A recent critique advanced by Grossman et al. (2026, this issue) argues that Polyvagal Theory is scientifically untenable, asserting that its core claims regarding autonomic organization, respiratory sinus arrhythmia (RSA), and evolutionary framing are inconsistent with established neurophysiology. The present paper evaluates these assertions not by disputing individual claims in isolation, but by examining whether the critique engages Polyvagal Theory as it is articulated in the peer-reviewed literature and whether it meets the epistemic standards required for scientific refutation. Rather than responding sequentially to individual objections, the analysis clarifies the theory's conceptual foundations, scope, and explicit conditions of falsifiability as a systems-level, pathway-specific framework of autonomic state regulation. It demonstrates that the critique repeatedly evaluates a reconstructed proxy of the theory shaped by persistent category errors, including conflation of neuroanatomy with neurophysiology, reduction of theory to measurement, and substitution of phylogenetic continuity for functional organization. These structural misrepresentations propagate across methodological, neurophysiological, evolutionary, and developmental domains, precluding meaningful empirical adjudication. Across these domains, the paper shows that disagreements concerning RSA metrics, comparative anatomy, or evolutionary framing do not engage the theory's specified mechanisms or demonstrate conditions under which its predictions would fail. Where disagreement exists, it reflects differences in measurement preference, level of analysis, or theoretical framing rather than evidence against the theory's organizing principles. An appendix presents a historical audit showing that several central claims reiterated in the critique were identified in the literature nearly two decades earlier as mischaracterizations of Polyvagal Theory. Their continued repetition without substantive modification reflects a persistent failure of representational uptake rather than unresolved empirical controversy. It is concluded that the charge of scientific untenability does not apply to Polyvagal Theory as formulated, but instead reflects a critique that fails to engage the theory on its own terms. Productive scientific discourse requires representational fidelity, appropriate alignment of levels of analysis, and responsiveness to theoretical and empirical clarification ‒ criteria essential to theory evaluation but not met in the critique under review.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"23 1","pages":"113-128"},"PeriodicalIF":3.8,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12937496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacological Interventions for Excoriation Behaviors in Alzheimer's Disease: An Empty Systematic Review of Clinical Trials.","authors":"Victor Linking Magalhães Campos, Antonio de Pádua Serafim","doi":"10.36131/cnfioritieditore20250607","DOIUrl":"10.36131/cnfioritieditore20250607","url":null,"abstract":"<p><strong>Objective: </strong>skin-picking behaviors are often maintained in association with mood changes, but can also manifest as separate manifestations particularly in Alzheimer's disease (AD). Verifying the effect of interventions on its remission may contribute to reducing stress in patients and caregivers. This systematic review sought to evaluate the eficacy of pharmacological interventions for skin-picking behaviors in elderly individuals with AD.</p><p><strong>Method: </strong>according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA 2020), searches were conducted in ClinicalTrials.gov,Embase, Lilacs, Open Science Framework, PsycNET, PubMed, Scopus, SciELO, SciELO Preprints and Web of Science, with no language or date restrictions. Inclusion criteria were clinical trials with participants aged ≥ 40 years with AD, evaluating pre/ post-test outcomes with standardized instruments.</p><p><strong>Results: </strong>of the 87 records found, none met the eligibility criteria, configuring an empty review. Two studies related to the topic were excluded because they were not clinical trials (a single case report and a case series), involving five patients treated with antipsychotics (risperidone, pimozide and thioridazine) and antidepressants (paroxetine). The absence of eligible studies suggests a gap in the literature and the lack of robust evidence on the pharmacological efficacy on these behavioral symptoms in this population.</p><p><strong>Conclusions: </strong>future clinical trials are needed to support specific therapeutic recommendations, since the evidence suggested by studies that are not clinical trials, evaluated in addition to the main objective of this review, is primary and limited.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 6","pages":"498-506"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Preliminary Validation of a Pakistani Neuropsychological Test Assessment Battery-Pantab.","authors":"Shameem Fatima, Tehmina Zubair","doi":"10.36131/cnfioritieditore20250606","DOIUrl":"10.36131/cnfioritieditore20250606","url":null,"abstract":"<p><strong>Objective: </strong>the main objective of present research project was to develop and validate a neuropsychological test assessment battery to evaluate the neuropsychological profiles of healthy and clinical populations from Pakistani.</p><p><strong>Method: </strong>the battery was developed in two languages, URDU and non-native English, to assess neuropsychological functioning of illiterate to highly literate Urdu Speaking and bilingual Pakistani populations. It was named as Pakistani Neuropsychological Test Assessment Battery (PANATB). The PANTAB assessed neuropsychological functioning from six domains namely orientation, attention and concentration, language, visuo-spatial & perceptual ability, memory, and executive functions. It included items most relevant to Pakistani norms and culture. Its administration time is 35 to 40 minutes. The project was completed in two phases of development and validation. Validation was done in two studies.</p><p><strong>Results: </strong>the first study evaluated and established the retest reliability and concurrent validity on a sample of adolescents and adults (n1=216). Age and educational differences were also observed in performance. Clinical and convergent validities were established in the second study (n=122) by comparing the performance of two clinical subgroups of patients with traumatic brain injury and stroke with healthy participants.</p><p><strong>Conclusions: </strong>the PANTAB is a valid measure of neuropsychological assessment and is sensitive to identifying cognitive impairment associated with clinical conditions and aging. It may fulfill the need for brief, reliable, and objective evaluation of a broad range of neurocognitive functions in the Pakistani clinical and non-clinical populations.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 6","pages":"485-497"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of the Climate Change Anxiety Scale-Short Form.","authors":"Maria Mirandi, Giorgio Ghizzoni, Carlo Garofalo, Elisa Delvecchio, Giacomo Rettori, Susan Clayton, Claudia Mazzeschi","doi":"10.36131/cnfioritieditore20250604","DOIUrl":"10.36131/cnfioritieditore20250604","url":null,"abstract":"<p><strong>Objective: </strong>this study aimed to provide preliminary validity evidence for an 8-item short form of the Climate Change Anxiety Scale (CCAS-SF) in a sample of Italian emerging adults. Specifically, it tested the factor structure, measurement invariance across sex, and construct validity of the CCAS-SF.</p><p><strong>Method: </strong>the study involved 891 Italian emerging adults (32.40% male; Mage = 23.00, SD = 2.50; age range: 19-29 years). The researchers conducted a Confirmatory Factor Analysis (CFA) to evaluate the factor structure of the CCAS-SF. Measurement invariance across sex was tested through configural, metric, and scalar invariance. Internal consistency of the subscales was assessed, and correlations with anxiety and depression symptoms were examined to assess construct validity.</p><p><strong>Results: </strong>the CFA supported a two-factor structure for the CCAS-SF, cognitive-emotional and functional impairment. Measurement invariance was confirmed across sex (configural, metric, and scalar invariance). The internal consistency of both subscales was good. Analysis revealed that females had higher levels of cognitive-emotional impairment compared to males, but there were no significant sex differences in functional impairment. Both subscales showed positive correlations with anxiety and depression symptoms.</p><p><strong>Conclusions: </strong>the Italian CCAS-SF is a brief, valid, and reliable tool for assessing climate change anxiety. It is particularly useful for time-constrained research and as a resource for mental health professionals working with emerging adults.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 6","pages":"465-473"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiological and Personality Measures as Potential Factors Associated with Cardiac Coherence Training Effects on Symptoms Reduction: A Pilot Study on Healthcare Workers.","authors":"Sara Guidotti","doi":"10.36131/cnfioritieditore20250609","DOIUrl":"10.36131/cnfioritieditore20250609","url":null,"abstract":"<p><strong>Objective: </strong>High cardiovascular risk (i.e., increased heart rate (HR) and reduced HR variability (HRV)) is common among healthcare workers. HRV biofeedback (HRVB) and cardiac coherence training (CCT) aim to minimize cardiac reactivity through breathing and cognitive exercises. Despite the numerous evidence, there are no studies that have investigated the potential role of psychological and psychophysiological factors on its efficacy.</p><p><strong>Method: </strong>Twenty healthcare workers (i.e., doctors, nurses, psychologists, etc.) employed at the San Giacomo Hospital of Physical Medicine and Rehabilitation in Ponte dell'Olio (Piacenza, Italy) completed the Symptom Checklist-90-Revised (SCL-90-R) and the 16 Personality Factors Questionnaire (16PF). Then, skin conductance (SC), HR, and HRV, with frequency domain analysis (i.e., LF-HRV, HF-HRV, LF/HF ratio), were recorded at baseline and under induced stressors through a Psychophysiological Stress Profile (PPS). Following CCT, its efficacy was measured through a comparison of psychological symptoms (i.e., SCL-90-R) and baseline, reactivity, and recovery psychophysiological values (i.e., SC, HR, and HRV). Additionally, the coherence index (CI), corresponding to the cardiac coherence (CC) score, as well as its cumulative score, the achievement score (AS), were collected. Nonetheless, the percentage of CI (%INITIAL-CI) and AS (%INITIAL-AS) variation compared to the initial session was calculated.</p><p><strong>Results: </strong>Lower levels of somatizations, depression, obsessions and compulsions, and hostility were observed, as well as lower reactivity to HR and better recovery of SC at T1. On the other hand, an increase in LF-HRV and a higher HRV (LF/HF ratio) in general were appreciated. Furthermore, the value of %INITIAL-CI of the last CCT session positively correlated with the post-stress recovery SC value at T0, as well as with some personality traits connected to self-regulation capability. Specifically, emotional stability positively correlated with %INITIAL-CI and %INITIAL-AS. Furthermore, the latter was also significantly associated with perseverance.</p><p><strong>Conclusions: </strong>Although the absence of the control group should be noted as a limitation, the purpose is to emphasize the correlations between CI and AS at the end of the intervention and the psychophysiological and personality measures.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 6","pages":"517-528"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Risk, Self-Harm, and Violence in Schizophrenia: A Narrative Review of Implications for Early Identification and Intervention.","authors":"Ela Doruk Korkmaz, Elif Everest","doi":"10.36131/cnfioritieditore20250601","DOIUrl":"10.36131/cnfioritieditore20250601","url":null,"abstract":"<p><strong>Objective: </strong>This narrative review examines clinical, genetic, and epidemiological evidence on schizophrenia (SCZ) to identify predictors of self-harm and violence, summarize genetic contributors to SCZ including pleiotropy and links between polygenic burden and negative/disorganized symptoms, and evaluate implications for early identification and predictive tools.</p><p><strong>Method: </strong>We synthesized findings from large-scale genome-wide association studies, rare variant and polygenic risk research, gene-environment interplay, epidemiological studies on suicide and violence, and clinical trials of early-intervention programs for SCZ.</p><p><strong>Results: </strong>SCZ involves a complex genetic architecture that includes hundreds of common risk variants and rarer coding and structural mutations. These genetic factors interact with environmental exposures, particularly childhood adversity and substance use, to shape vulnerability trajectories. Suicidality is a leading cause of excess mortality in SCZ, especially in early disease phases. Violence risk is modest overall but elevated in individuals with untreated psychosis or comorbid substance misuse. Emerging findings suggest that polygenic burden is linked to negative and disorganized symptoms, which in turn associate with worse clinical outcomes. Early, sustained, multicomponent intervention improves symptoms, functioning, and treatment adherence and may reduce self-harm and indirectly mitigate violence by addressing modifiable risk factors. Emerging machine learning models, though not yet widely validated, show promise in identifying individuals at higher risk of suicide or aggression by integrating clinical, demographic, and biological features.</p><p><strong>Conclusions: </strong>Integrating genetic, clinical, and environmental data can enhance risk stratification and support precision prevention in SCZ. Polygenic risk scores are not yet clinically predictive alone but may add value when combined with symptom profiles and early-life adversity for early identification and detecting susceptibility to negative/disorganized symptoms. Near-term priorities include externally validating prediction tools, standardizing screening for trauma exposure and substance use within early-psychosis services to guide monitoring intensity and relapse-prevention planning, and scaling coordinated specialty care.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 6","pages":"439-446"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145878722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Algorithmic Entrapment the Silent Erosion of User Autonomy and Mental Health.","authors":"Leon Donadoni, Donatella Marazziti, Federico Mucci","doi":"10.36131/cnfioritieditore20250602","DOIUrl":"10.36131/cnfioritieditore20250602","url":null,"abstract":"<p><p>Recent developments in the study of highly visual social media have highlighted that, far from being neutral conduits, adolescents' online environments might be curated by recommender systems that learn from behaviour. On this view, risk and benefit may depend less on time spent online than on patterns of exposure ‒ what reaches young people, how they meet it, and when in development contact occurs. For instance, in large adolescent cohorts, only 10-15% of users account for most of the association between use and distress, underscoring the relevance of heterogeneity. Similar feeds might support connection and care while, in susceptible users, amplifying appearance-centred comparison, compulsive use and contact with harmful material. A public-health perspective treats personalisation as an upstream determinant and invites proportionate responsibilities, namely transparency, independent audit and safety-by-design. Clinically, brief assessments that separate time from type of engagement, paired with low-burden, mechanism-focused interventions, could offer practical steps. Taken together, a precautionary and balanced stance should aim at keeping what is valuable online while reducing foreseeable harm through accountable design.</p>","PeriodicalId":46700,"journal":{"name":"Clinical Neuropsychiatry","volume":"22 6","pages":"447-453"},"PeriodicalIF":2.4,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12752921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145879301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}