Understanding Vulnerability and Clinical Heterogeneity in Addiction: From Risk Factors to Clinical Management

Dear Colleagues,

Addiction is often described through relatively stable characteristics, including diagnostic categories, personality traits, impulsivity, or average levels of craving and reward sensitivity. However, the transition from reward seeking to loss of control is inherently dynamic. It unfolds over time, fluctuates within individuals, and emerges from the interaction between personal vulnerability and changing environmental conditions. A central challenge for contemporary addiction research is therefore not only to identify who is vulnerable, but also to understand when, how, and under which conditions rewarding experiences become increasingly difficult to regulate, contributing to clinically relevant impairment, persistence, or relapse.

Recent methodological and conceptual advances provide new opportunities to investigate these processes with greater temporal, ecological, and clinical resolution. Ecological momentary assessment, digital phenotyping, psychophysiology, computational modeling, multimodal assessment, and longitudinal designs can capture fluctuations in craving, affect, decision-making, and behavioral control that are often obscured by cross-sectional and group-level approaches. These approaches may also help identify markers associated with symptom severity, clinical trajectories, and treatment response. At the same time, contemporary reward environments—including digital gambling, gaming, social media, and other highly accessible and intermittently reinforcing contexts—raise new questions about how individual vulnerabilities interact with repeated exposure, cue reactivity, and habit formation in the development and maintenance of problematic and addictive behaviors.

This Special Issue aims to advance a dynamic and clinically informed understanding of addiction by examining how individual vulnerability, and context interact over time to produce different pathways toward, or away from, loss of control. We welcome contributions addressing emotion regulation, cognitive control, personality, psychophysiological mechanisms, and their associations with symptom severity, functional impairment, relapse, recovery, and treatment outcomes. Studies adopting longitudinal, ecological, computational, transdiagnostic, multimodal, or personalized approaches are especially encouraged.

Topics of interest for publication include, but are not limited to, the following:

• Substance-related and behavioral addictions;
• Impulsivity, compulsivity, and inhibitory control;
• Emotion regulation and affective processes in addiction;
• Personality traits and individual differences in vulnerability and clinical trajectories;
• Neurocognitive and psychophysiological markers;
• Clinical heterogeneity and addiction phenotypes;
• Comorbidity and transdiagnostic mechanisms;
• Vulnerability, maintenance, relapse, and recovery;
• Prediction of clinical outcomes and treatment response;
• Personalized assessment, prevention, and intervention;
• Clinically meaningful outcomes and functional impairment.

The scope of this Special Issue is therefore to complement categorical diagnostic perspectives by examining the processes that may explain why individuals differ in their vulnerability to, clinical expression of, course of, and recovery from addictive behaviors. Researchers are invited to submit original research articles, clinical studies, systematic reviews, meta-analyses, and theoretically informed reviews addressing these questions and their implications for the assessment, prevention, and treatment of addiction.

Dr. Alessandro Quaglieri
Dr. Emanuela Mari
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.