Svetla N. Petrova, Violeta R. Manolova and Stoyan R. Vezenkov
Center for applied neuroscience Vezenkov, BG-1582, Sofia, e-mail: info@vezenkov.com
For citation: Petrova, S.N., Manolova V.R. and Vezenkov, S.R. (2025) Reintroducing Screens: Severe Regression and Symptom Aggravation in Children with ASD/Screen Addiction. Nootism 1(1), 59-65, ISSN 3033-1765
*This paper was presented by Svetla Petrova at the Second Science Conference "Screen Children" on November 23, 2024, in Sofia, Bulgaria.
Abstract
This study analyzes the impact of repeated or unregulated screen exposure on children with screen addiction during a therapeutic program incorporating screen detoxification. The research examines the neurological, cognitive, and socio-emotional development of these children, focusing on the relationship between screen addiction and developmental regressions. The research includes seven clinical cases of children diagnosed with autism spectrum disorder (ASD) or exhibiting autistic traits, who underwent therapy involving screen time restriction (screen detox). Additionally, the study investigates behavioral and cognitive changes following re-exposure to screen devices.
The results indicate significant improvements in social engagement, language development, and adaptive behavior, including the elimination of autistic traits, in children whose screen exposure was completely eliminated during therapy. Conversely, re-exposure to screens leads to a marked regression in symptomatology, including increased irritability, stereotypical behaviors, reduced concentration, and sleep disturbances. These effects suggest a substantial negative impact of screen activity on the recovery of neurophysiological mechanisms related to neuroplasticity, mirror neuron functioning, and social attachment processes.
The report highlights the need for systematic studies on the effects of early-age screen exposure, particularly in children with screen addiction or those undergoing rehabilitation from screen addiction. It also emphasizes the importance of developing effective intervention strategies to minimize potential risks. Additionally, the report recommends stricter monitoring of screen time in educational institutions and the implementation of alternative methods for cognitive and social stimulation tailored to the individual needs of children.
Keywords: screen addiction, ASD, screen detox, screen reintroducing, regression, autistic traits
Introduction
Over the past decades, a significant body of research has highlighted the increasing influence of screen technologies on children's cognitive and emotional development. (Li et al., 2024; Huang et al., 2024; Wu et al., 2023) In this context, a concerning trend has emerged: a growing number of children exhibiting autism-like symptoms, raising the need for an in-depth analysis of the potential causal links between screen addiction
and neuropsychological development. In children with autism-like symptoms, screen addiction has been identified as a contributing factor to stereotypical behaviors, reduced social engagement, impaired eye contact, and communication difficulties. (Dong et al., 2021)
Child development is a complex and multifaceted process influenced by various biological, social, and psychological factors. In the process of initial assessment and symptom tracking, the study examines key differences between children with typical development and those affected by screen addiction. (Koob et al., 2016; Huang et al., 2024)
Comparative Analysis of Cognitive, Social, and Behavioral Development in Children with and without Screen Addiction
- Perception of the World
A child with typical cognitive functioning perceives the world through all sensory modalities, which contributes to a comprehensive and integrated understanding of the surrounding environment. In contrast, a child with screen addiction primarily experiences reality through digital screens, with other sensory stimuli being significantly diminished. This limited sensory engagement results in difficulties in developing spatial awareness, tactile sensitivity, and essential social skills.
- Learning Abilities
Children with normal development acquire new skills through active practice, observation, and interaction with their surroundings. They adapt to diverse situations, honing problem-solving abilities. Conversely, a child with screen addiction tends to engage in ritualistic behaviors, characterized by repetitive actions that provide immediate gratification without fostering genuine cognitive development.
- Social Relationships
Typically developing children value relationships with parents, teachers, and other significant figures, which facilitates socialization and fosters a sense of responsibility and belonging. In contrast, a child with screen addiction prioritizes the immediate pleasure or comfort derived from screen devices, failing to establish a stable emotional connection with caregivers as a source of social support.
- Adaptation to the Environment
A child with normal development makes efforts to adapt to the world of adults and peers, supporting personal growth and social integration. In contrast, a child with screen addiction attempts to adapt others to their screen-dependent, fantasy-driven world, actively avoiding situations that require social interaction or cognitive flexibility.
- Attention and Task Execution
Children with normal development are capable of initiating and completing tasks, demonstrating the ability to concentrate and follow through with commitments. In contrast, children with screen addiction struggle to maintain attention, are easily distracted, and exhibit a dependence on continuous novel stimuli. This results in an inability to focus on sustained, non-screen-based, and non-compulsive activities.
- Sources of Satisfaction
For typically developing children, satisfaction is derived from successfully completing tasks, achieving goals, and engaging in competitive or collaborative activities that yield appropriate social recognition. Conversely, children with screen addiction exhibit a lack of interest in activities outside the digital environment, with alternative sources of stimulation failing to elicit a meaningful emotional response.
- Response to Environmental Changes
A child with normal development demonstrates behavioral flexibility in adapting to changes in their surroundings. In contrast, a child with screen addiction experiences significant distress when attempting to deviate from stereotypical behaviors, often responding with irritability, anxiety, or outright refusal to participate in new activities.
- Nervous System Functioning and Sleep Patterns
Sleep plays a critical role in childhood development, supporting the consolidation of newly acquired knowledge. Typically developing children achieve sufficient and restful sleep, which enhances cognitive functioning. In contrast, children with screen addiction frequently experience fragmented and insufficient sleep due to excessive stimulation of the nervous system, which impairs their ability to concentrate, regulate emotions, and maintain cognitive efficiency.
- Cognitive and Social Integration
A child with normal development constructs a well-integrated perception of the world and self, fostering a natural inclination for social engagement and participation in group activities. In contrast, a child with screen addiction may experience developmental stagnation, remaining at the cognitive and social level they were at before the onset of addiction. Many such children become deeply immersed in their fantasy-driven screen environment, which serves as a substitute for real-world social interactions. (Firth et al., 2024)
Scope and Objectives of the Study
The present study examines cases in which children were exposed to screens and subsequently developed specific symptomatology. Following this initial observation, a clinical assessment was conducted, confirming the presence of screen addiction. The children then underwent a therapeutic intervention, including treatment for screen addiction and a structured screen detox program. However, at a later stage, instances of re-exposure to screens were identified, allowing for the systematic observation of changes in symptomatology.
The research encompasses seven cases of children aged 4 to 11, each presenting varying degrees of symptom severity. All participants underwent therapy for screen addiction, which involved a controlled screen detox process. Through comparative analysis, patterns of behavioral and cognitive changes were identified, particularly those occurring upon reintroduction to screen exposure. The study specifically examines symptom regression following renewed screen exposure, as well as the time required to restore progress after such setbacks. Special attention is given to cases in which external factors—whether institutional or familial—unintentionally led to the resumption of screen activity and the corresponding symptom regression. The observed cases strongly support the hypothesis that screen addiction has a significantly negative impact on children's neurological development, particularly in early childhood.
The primary objective of this report is to analyze the effects of screen addiction on children's nervous systems and to present empirical data on the dynamics of their cognitive, behavioral, and emotional responses under conditions of reduced or increased screen exposure during screen addiction therapy. A key focus is placed on the neurophysiological mechanisms through which screen activity influences neuroplasticity, mirror neuron function, and attachment processes, all of which play a crucial role in early childhood development.
Another aim of the report is to contribute to the ongoing scientific discourse on screen addiction in children by presenting specific observations and empirical evidence regarding the effects of screen addiction, screen detox, and re-exposure to screens on children undergoing rehabilitation from screen addiction. Additionally, the study seeks to emphasize the need for greater awareness and intervention strategies that can support parents, therapists, and institutions in fostering an environment conducive to healthy child development.
Study Design
The present study employs a longitudinal case-tracking methodology to analyze the impact of screen addiction exposure on children's neurological and cognitive development. The study includes seven children between the ages of 4 and 11, all diagnosed with varying degrees of autism-like symptomatology. Each child underwent an initial assessment to determine the severity and duration of their screen addiction, followed by a systematic therapy program designed to address screen addiction, explicitly incorporating a screen detox phase. The therapeutic program consisted of weekly sessions with a screen addiction therapist, each lasting 50 minutes. Additionally, parents received weekly guidelines for at-home exercises and lifestyle adjustments tailored to the child's recovery progress. The study documents symptom dynamics throughout therapy, evaluating changes in relation to adherence to the screen detox protocol or instances of recurrent or concurrent screen exposure during therapy.
Symptoms of Screen Addiction
During the therapeutic program, children were systematically monitored for changes in the following symptoms:
- Stereotypical behaviors, compulsions, self-stimulation, and sensation-seeking tendencies
- Involuntary movements, tics, hand-flapping, toe-walking, and other motor anomalies
- Irritability and increased excitability
- Sleep disturbances, including difficulty falling asleep, fragmented sleep, and lack of deep sleep
- Restricted diet and selective eating habits
- Hypo- or hyper-retention of bowel movements, incontinence, or urinary retention
- Lack of eye contact or lazy eye syndrome
- Impaired attention and focus
- Absence of emotional attachment
- Disinterest in social interactions
- Inability to complete tasks
Research Methodology
The study adopts a quasi-experimental design with repeated measures to track behavioral, cognitive, and emotional changes. Data were collected through multiple methodologies:
- Behavioral Observation: Systematic tracking of cognitive, emotional, and behavioral changes before, during, and after therapy.
- Parental Questionnaires and Interviews: Assessing changes in social interactions, sleep patterns, language development, and attachment levels.
- Symptom Severity Assessment: Measuring symptom intensity and frequency on a 10-point scale, where 10 represents the most severe manifestation and 0 indicates complete absence.
- External Factor Analysis: Recording cases where children were re-exposed to screens due to institutional or familial circumstances.
The study compares cases where screen exposure was entirely eliminated, partially restricted, or not regulated during the therapeutic program. Each child underwent weekly therapy sessions of 50 minutes, with continuous interaction with a screen addiction therapist. During these sessions, the therapist assessed the child's behavior, symptom progression, and recovery rate across sensory-neural, cognitive, emotional, and social domains.
Additionally, parental input was systematically collected in parallel sessions conducted by a second therapist in an adjacent consultation room. This secondary therapist gathered detailed reports on the child's weekly symptom fluctuations, behavioral patterns, and recovery trajectory. At the end of each session, both therapists reviewed and discussed their findings with the parents. This dual-therapist approach enabled a comprehensive examination of symptom regression triggered by recurrent or unregulated screen exposure.
Results
Case Studies on the Impact of Screen Exposure on Therapeutic Progress
Cases of Screen-Free Periods Followed by Unauthorized Screen Exposure
Two children of the same age, a girl (A.) and a boy (B.), both four years old, began therapy and completely ceased screen use at the start of the intervention. Their initial condition was characterized by low adaptability, a lack of interest in social activities, absence of attention or expectation toward others, avoidance of structured activities and assigned tasks, and the presence of stereotypical behaviors. Any attempt to prevent these repetitive behaviors resulted in intense negative reactions or tantrums, with B. also displaying aggressive behavior.
After three months of therapy, B. exhibited a 6/10 reduction in stereotypical behaviors and showed increased interest in social activities, attentively responding to others and anticipating their reactions. He also began using his first words in context. Similarly, A. showed a 4/10 reduction in stereotypical behaviors, demonstrated attention toward others, and differentiated behavior based on interactions—displaying compliance and interest when adults provided assistance. Aggressive behavior had disappeared, and she also began using words when necessary.
By the sixth month, B.’s progress remained stable until a significant environmental change occurred: in his preschool, the group sizes were increased, and television was introduced as a behavioral management tool. Within just seven days of this re-exposure to screens, both A. and B. experienced a complete regression to their initial state. A similar deterioration was observed in B. when family members, disregarding parental instructions, secretly provided him with screen device. Following one specific episode of prolonged exposure to video content on a smartphone, B.’s parents noted redness and swelling around his eyes, resembling an allergic reaction. From that point onward, his condition worsened drastically, with a resurgence of tantrums, stereotypical behaviors, and near-complete intolerance to any non-screen-related activities.
Both children also exhibited severe sleep disturbances upon reintroduction to screens. Additionally, regressions in physiological regulation were observed, including difficulties with bowel and bladder control. The recovery time for B. to regain his prior progress was twice as long, requiring six months. In contrast, A.'s parents decided to discontinue therapy following the incident at the preschool, preventing further recovery assessment.
Case of Screen Reintroduction in a Partially Verbal Child
Child V., a six-year-old boy, initially presented with verbal abilities, hyperactivity, nervous tics, and echolalic speech (repetitive or "parroted" language use). Over six months of therapy, significant progress was observed, particularly in hyperactivity reduction and attention span improvement. By the fourth month, his ability to follow rules in both group and individual activities improved by 9/10, and his communicative engagement increased by 8/10. Additionally, his nervous tics significantly decreased to 2/10.
His parents reported a drastic behavioral transformation, with V. voluntarily refraining from screen use by the fifth month, actively choosing outdoor play over digital content due to a past promise made to his mother. However, by the sixth month, regression was noted. His echolalic speech resurfaced, with automatic repetitions of phrases from children’s television shows. Upon investigation, it was discovered that family members had secretly allowed him access to screen devices over several days. Following this exposure, V. exhibited deteriorated concentration, and his nervous tics increased in frequency by 7/10.
Although his regression did not reach the severity of his initial condition, his anxiety and nervousness doubled, indicating a direct negative effect of screen exposure on his behavioral stability.
Case of Therapy Without Screen Restrictions
Child G., a four-year-old boy diagnosed with ADHD and autism, initially presented as nonverbal, unresponsive, and engaged in stereotypical behaviors, such as singing familiar English-language cartoon melodies repetitively (his native language is Bulgarian). He showed no interest in social activities, exhibited severe distress when deprived of specific objects associated with his repetitive behaviors, and displayed rigid food selectivity, consuming only fried chicken and French fries in a specific form.
After nine months of therapy without screen restrictions, no progress was observed. Instead, his behavioral crises intensified, particularly in response to object removal, and he began displaying aggressive behaviors. At this point, his parents discovered that, despite prior agreements with school officials, television had been used daily in his preschool classroom for several hours per day. Following this revelation, they decided to withdraw G. from preschool and take full responsibility for his care at home.
Three months later (by the twelfth month of therapy), G. demonstrated significant improvements. He began trying and enjoying new foods, including fruits and vegetables, showing interest in people around him, responding appropriately to verbal instructions, and actively participating in group activities. Additionally, he exhibited turn-taking behaviors, laughed in social interactions, and spoke his first words.
This case strongly illustrates that screen exposure directly inhibits development and exacerbates symptoms, emphasizing the necessity of strict screen regulation in therapeutic settings.
Case Studies on Partial or Unrestricted Screen Use During Therapy
Cases of Therapy with Partial Screen Reduction in Verbal Children
Two additional cases involve boys, D. (11 years old) and E. (9 years old), who are verbal but present with other cognitive and behavioral deficits. D. exhibits difficulties in understanding jokes, contextual conversations, and emotions, as well as balance issues, memory deficits, learning difficulties, and poor concentration. E., while facing fewer challenges, struggles with hyperactivity, memory and learning difficulties, resistance to task completion, tantrums during conflicts, and extreme reactions when deprived of his phone.
Despite therapists prescribing a complete screen detox, D.’s screen use was never fully eliminated due to parental inconsistency, as he continued using screens for social media communication and occasional gaming. Over a three-month period, he experienced crises accompanied by aggressive outbursts related to his desire to play video games.
- lived in two separate households due to his parents' divorce, experiencing entirely different approaches to screen regulation. One parent fully restricted screen access, while the other allowed unlimited screen time. This discrepancy resulted in a cyclical pattern of increased hyperactivity following periods of screen exposure and subsequent calming when screens were removed. The weekly fluctuation of his symptoms was clearly observable, demonstrating a direct correlation between screen exposure and behavioral instability.
Both D. and E. exhibited crises when screens were removed, including aggressive behaviors and manipulative tactics, such as threats of self-harm to regain access to screen digital devices. These cases suggest that maintaining any level of screen exposure during therapy results in persistent symptoms, preventing substantial improvement.
Case of Therapy Without Screen Restrictions
The final case concerns J., a six-year-old boy diagnosed with autism, who was nonverbal, engaged in stereotypical behaviors, avoided new places and people, and rarely made eye contact. Despite the dedicated involvement of his parents, his symptoms persisted for several months, with increased irritability and worsening sleep patterns by the fifth month.
Suspecting potential screen exposure at preschool, the parents inquired but were repeatedly assured that no screens were used. Over the next two months, J.’s condition gradually improved, though he still had not developed speech.
However, during a three-week summer break, during which he neither attended therapy nor preschool but remained solely in the care of his parents, his sleep quality significantly improved (reaching 10 hours per night), stereotypical behaviors diminished, and he spoke his first contextual sentences. The progress was striking.
Upon returning to preschool, his ritualistic behaviors immediately intensified on the first day. Further investigation revealed that an interactive board was used daily in the classroom for approximately 90 minutes, displaying educational videos, songs, and animated content. The preschool administration justified the screen use by stating that such screen activities were mandated as part of the educational curriculum. In response, J.’s parents decided to pick him up early each day to prevent his exposure to screens.
This case highlights three critical factors contributing to J.’s improvement during the summer break:
- Complete absence of screen exposure for three weeks
- High-quality sleep and overall rest
- Continuous interaction with parents in a screen-free environment
Following these adjustments, therapy continued for three more months, during which J. remained entirely protected from screens. By the end of this period, his stereotypical behaviors and anxieties had disappeared, he engaged in social interactions, listened with comprehension, and spoke in simple yet contextually appropriate sentences.
Notably, individuals unfamiliar with his earlier condition, including dance instructors and his mother’s new colleagues, perceived him as a typically developing child, and J. responded to them in a socially appropriate manner.
Summary of Results
The findings of this study reveal significant differences in children's cognitive and behavioral functioning based on the duration and nature of their exposure to screen devices during a screen addiction therapy program. Several key conclusions can be drawn supported by other studies (Zamfir, 2018; Heffler et al., 2022):
- Positive effects of screen restriction – In all cases where screen time was drastically reduced or completely eliminated, significant improvements were observed in social interaction, attention span, and speech development.
- Regression upon re-exposure – Even brief reintroduction of screens led to clear regressions in cognitive and behavioral functioning, including a return to stereotypical behaviors and increased irritability.
- Long-term effects – The time required to recover progress after re-exposure varied significantly, with some children needing months to regain their initial improvements.
These results highlight the need for further studies to assess the long-term neurological effects of screen addiction in children. Additionally, they emphasize the importance of implementing stricter policies to limit screen exposure during early childhood to optimize cognitive and social development. (Firth et al., 2024)
Discussion
The Impact of Screen Time on School- and Preschool-Aged Children
Observations in kindergartens and schools indicate increasing difficulty in limiting children’s exposure to screens in their daily activities. Despite regulatory measures such as Ordinance No. 3 of February 5, 2007 (Ministry of Health, Bulgaria), which restricts the use of electronic display devices strictly for educational purposes and within set time limits, in practice, children in preschools are exposed to screens far more frequently and for longer durations than recommended.
Reports from parents and child development specialists indicate that in many early childhood institutions, children are regularly exposed to digital content—such as presentations, animations, and videos—far exceeding the recommended screen time. While this exposure may not pose a significant risk for neurotypical children, for children prone to screen addiction, even 15 minutes per day can trigger a return to previous negative behavioral patterns.
This raises several critical questions about the effects of screen activity on child development and strategies for minimizing potential harm. More specifically, how can children who are particularly vulnerable to screens be protected? Is it possible, in today’s technological environment, to raise children without significant screen exposure?
Another challenge is the lack of alternative support structures for children with screen addiction. Current educational and social policies do not provide specialized rehabilitation measures for these children, leaving parents to independently seek solutions and adapt caregiving strategies on their own.
These findings highlight the need for further discussions and research in the following areas:
- What policies and regulations can be introduced or adapted to minimize children's exposure to screen devices in early childhood institutions?
- What alternative educational approaches can be developed to reduce the reliance on screen devices?
- How can society create a supportive environment for children already affected by screen addiction, ensuring their successful social integration?
The urgency of finding effective solutions in this area is evident (Firth et al., 2024), as the increasing accessibility of screen devices in early childhood could have long-term implications for cognitive, social, and emotional development.
Conclusions
This report examines the impact of screen exposure on children diagnosed with screen addiction during their therapy, providing empirical evidence of cascading negative effects and worsening symptoms. While the triggers leading to relapse in substance addiction have been extensively studied, there is a lack of research on relapse triggers in screen addiction. (Sinha et al., 2007, 2008, 2009, 2018, 2024; George, 1989; Larimer et al., 2004; Viera et al., 2025; Lomas, 2024)
Based on the studied cases, several key conclusions can be drawn:
- Screen restriction leads to significant improvements
The data clearly demonstrate that completely eliminating screen exposure during therapy results in significant developmental progress. Improvements were observed in social interactions, speech development, attention span, self-regulation, and environmental adaptation. - Re-exposure to screens triggers symptom regression
Children who, after initial progress, were reintroduced to screen activity—whether at home, in preschool, or by relatives—showed clear behavioral regression. In some cases, the loss of progress occurred within days, with the return of stereotypical behaviors, irritability, inability to concentrate, and withdrawal from social engagement. - Recovery from screen re-exposure takes longer than initial progress
Regaining improvements after screen re-exposure required significantly more therapy time than the original period of progress. In some cases, the recovery phase took twice as long as the initial improvement phase, highlighting the persistent nature of screen addiction and the challenges of reversing its effects. - Screen exposure affects not only cognition but also physiological functioning
Beyond behavioral symptoms, some children exhibited physiological disturbances, including sleep disorders, increased anxiety, tics, and digestive issues. These symptoms were particularly pronounced in children with a longer history of screen addiction and were closely linked to neurological mechanisms of addiction and overstimulation. - Institutional environments contribute to the problem
In several cases, screen time was reintroduced in preschools and schools despite existing regulations. This suggests a lack of effective monitoring and enforcement of screen exposure policies in institutional settings, underscoring the need for stricter measures and guidelines to limit digital activities in educational environments. - Greater awareness and prevention strategies are necessary
The findings emphasize the need for increased awareness among parents, educators, and healthcare professionals about the negative effects of early screen use. Preventative strategies should be developed, alongside therapeutic interventions aimed at minimizing screen addiction’s impact on child development.
Final Conclusion
The results of this study confirm that screen addiction is a critical factor influencing children's neurological and psychosocial development, contributing to autism-like symptoms. Even after successful therapy and screen detox, re-exposure to screens during childhood leads to significant regression, underscoring the need for stricter control over the use of screen technologies in early childhood.
These findings highlight the necessity of further research and policy development to regulate screen exposure in kindergartens and schools, as well as to establish rehabilitation programs for children affected by screen addiction. Addressing this issue requires collaborative efforts from educators, healthcare providers, policymakers, and families to ensure that children’s cognitive and emotional development is not compromised by excessive screen exposure.
References
Dong, H. Y., Wang, B., Li, H. H., Yue, X. J., & Jia, F. Y. (2021). Correlation between screen time and autistic symptoms as well as development quotients in children with autism spectrum disorder. Frontiers in psychiatry, 12, 619994. https://doi.org/10.3389/fpsyt.2021.619994
Firth, J., Torous, J., López‐Gil, J. F., Linardon, J., Milton, A., Lambert, J., ... & Firth, J. A. (2024). From “online brains” to “online lives”: understanding the individualized impacts of Internet use across psychological, cognitive and social dimensions. World Psychiatry, 23(2), 176-190. https://doi.org/10.1002/wps.21188
George, W. H. (1989). Marlatt and Gordon's relapse prevention model: A cognitive-behavioral approach to understanding and preventing relapse. Journal of Chemical Dependency Treatment.
Heffler, K. F., Frome, L. R., & Gullo, D. F. (2022). Changes in autism symptoms associated with screen exposure: case report of two young children. Psychiatry Research Case Reports, 1(2), 100059. https://doi.org/10.1016/j.psycr.2022.100059
Huang, P., Chan, S. Y., Ngoh, Z. M., et al. (2024). Screen time, brain network development, and socio-emotional competence in childhood: Moderation of associations by parent–child reading. Psychological Medicine, 54(9), 1992-2003. https://doi.org/10.1017/S0033291724000084
Koob, G. F., & Volkow, N. D. (2016). Neurobiology of addiction: a neurocircuitry analysis. The Lancet Psychiatry, 3(8), 760–773. doi:10.1016/s2215-0366(16)00104-8
Larimer, M. E., Palmer, R. S., & Marlatt, G. A. (2004). Relapse prevention: An overview of Marlatt's cognitive-behavioral model. Psychosocial treatments, 1-18.
Li, M., Zhao, R., Dang, X., Xu, X., Chen, R., Chen, Y., ... & Wu, D. (2024). Causal relationships between screen use, reading, and brain development in early adolescents. Advanced Science, 11(11), 2307540. https://doi.org/10.1002/advs.202307540
Lomas, C. (2024). Neurobiology, psychotherapeutic interventions, and emerging therapies in addiction: a systematic review. Journal of Addictive Diseases, 1–19. https://doi.org/10.1080/10550887.2024.2440184
Sinha, R. (2007). The role of stress in addiction relapse. Current Psychiatry Reports, 9(5), 388–395. https://doi.org/10.1007/s11920-007-0050-6
Sinha, R. (2008). Chronic Stress, Drug Use, and Vulnerability to Addiction. Annals of the New York Academy of Sciences, 1141(1), 105–130. doi:10.1196/annals.1441.030
Sinha, R. (2009). Stress and Addiction: A Dynamic Interplay of Genes, Environment, and Drug Intake. Biological Psychiatry, 66(2), 100–101. doi:10.1016/j.biopsych.2009.05.003
Sinha, R. (2018). Role of addiction and stress neurobiology on food intake and obesity. Biological Psychology, 131, 5–13. doi:10.1016/j.biopsycho.2017.05.001
Sinha, R. (2024). Stress and substance use disorders: risk, relapse, and treatment outcomes. The Journal of Clinical Investigation, 134(16). https://doi.org/10.1172/JCI172883.
Viera, A., Jadovich, E., Lauckner, C., Muilenburg, J., & Kershaw, T. (2025). Responding to location-based triggers of cravings to return to substance use: A qualitative study. Journal of Substance Use and Addiction Treatment, 168, 209534. https://doi.org/10.1016/j.josat.2024.209534
Vezenkov, S.R. and V.R Manolova (2022) A Central Role of Biofeedback in а Complex Therapy of Screen Devices Usage Addiction. BFE 21tst Meeting Montesilvano, Italy, 21-22 September 2022, https://www.researchgate.net/publication/363861767_A_Central_Role_of_Biofeedback_in_a_Complex_Therapy_of_Screen_Devices_Usage_Addiction
Vezenkov, S.R. and V.R. Manolova (2024) Rethinking Autism: The Screen Addiction Paradigm. Conference Paper: BFE 22nd Meeting, 8-13 April 2024, Ljubljana, Slovenia https://www.researchgate.net/publication/379911282_Rethinking_Autism_The_Screen_Addiction_Paradigm
Wu, D., Dong, X., Liu, D., & Li, H. (2023). How Early Digital Experience Shapes Young Brains During 0-12 Years: A Scoping Review. Early Education and Development, 35(7), 1395–1431. https://doi.org/10.1080/10409289.2023.2278117
Zamfir, M. T. (2018). The consumption of virtual environment more than 4 hours/day, in the children between 0-3 years old, can cause a syndrome similar with the autism spectrum disorder. Journal of Romanian literary studies, (13), 953-968.