International Neuropsychiatric Disease Journal

The TEND Model: A Prefrontal Cortex Scaffold for Accelerating Adolescent Neurodevelopment and Mitigating the Legion Effect

Dhally M. Menda — 2025-11-03

Background: Adolescence is characterized by a neurodevelopmental mismatch between a mature, hyper-reactive limbic system and an immature prefrontal cortex (PFC). This imbalance predisposes adolescents to impulsivity, emotional dysregulation, and vulnerability to maladaptive internal states, conceptualized here as the Legion Effect—a condition of internal fragmentation where semi-autonomous "voices" (e.g., Judge, Teacher, Clown, Photographer, and Baby) operate without integrative PFC control. Current interventions often manage symptoms without directly exercising the PFC to accelerate its maturation.

Methods: This theoretical synthesis integrates neuroscience, cognitive-behavioural frameworks, and neuroimaging findings to conceptualize the TEND Model (Track, Examine, Nurture, Direct) as an external Prefrontal Cortex Scaffold (ePFC). The framework is designed to engage underdeveloped PFC regions through structured, repeated practice, leveraging activity-dependent neuroplasticity.

Results: The four sequential phases of TEND are mapped to distinct neural circuits:

Track → Anterior cingulate cortex and insula (interoception and salience).
Examine → Dorsolateral PFC (cognitive labeling and meta-cognition).
Nurture → Ventromedial PFC (self-compassion and emotional regulation).
Direct → Integrated PFC and motor cortex (goal-directed behaviour).

Through Hebbian learning, this practice is hypothesized to accelerate top-down control, rebalance Default Mode Network (DMN) hyperactivity, and mitigate the Legion Effect. A key innovation is the Voice Influence Score (VIS), a quantitative tool for meta-cognitive assessment during the Examine phase. Future research and potential applications of the TEND Model in clinical settings and educational programmes are highlighted, underscoring its promise as a scalable, evidence-based intervention for adolescent mental health.

Conclusion: The TEND Model provides a structured neurocognitive exercise to build executive function capacity in adolescents. It shifts the intervention paradigm from symptom management to targeted neural exercise, demystifies inner conflict, and integrates multiple therapeutic traditions into a neurobiologically-sequenced scaffold. Empirical validation is recommended to confirm its efficacy and scalability in public health practice.

Psychosocial and Demographic Correlates of Non-Suicidal Self-Injury among In-School Adolescents in Gboko LGA, Benue State

ZAR, Vershima Daniel — 2025-12-02

Background: Non-suicidal self-injury (NSSI) is a significant public health issue prevalent during adolescence, serving primarily as a maladaptive coping mechanism for psychological distress. While its correlates are well-documented in Western contexts, a critical gap exists in understanding these factors within specific Nigerian socio-cultural settings. This study investigates the under-researched psychosocial and demographic correlates of NSSI among in-school adolescents in Gboko LGA, Benue State, Nigeria.

Methods: To achieve its stated goals, this study used a correlational research methodology. All secondary school pupils enrolled in Gboko LGA made up the target population. The Psychosocial and Demographic Correlates of Non-Suicidal Self-Injury Among In-School Adolescents Questionnaire (PDCNSAIAQ) was used to gather information from 420 in-school adolescents. Descriptive statistics were used to analyze the data. Point-biserial correlation was used to analyze research question one, and frequencies and percentages were used to analyze research question two. Hypotheses were analysed using the multivariable logistic regression analysis.

Results: Findings showed that in-school adolescents aged ≥20years (19.3%) engaged in NSSI behaviours than those aged 15 -19years (9.7%). The Table also shows that male in-school adolescents (12.1%) engaged in NSSI behaviours more than females (11.8%). In addition, in-school adolescents in JSS 2 (13.3%) engaged in NSSI behaviours more than those in JSS 1 (11.6%), SS 2 (10.5%) and SS 1 (9.8%).

Conclusion: This study provided a roadmap for public health education to address NSSI behaviours among adolescents. By focusing on mental health literacy, family support, gender-sensitive approaches, and socio-environmental interventions, public health educators can play a pivotal role in reducing the prevalence of NSSI and improving the mental health outcomes of adolescents in Gboko LGA and beyond. The study recommended that schools should ensure that health education and counselling services are developed to specifically address the emotional suppression often expected of males and the unique pressures faced by females in single-gender settings

A Comprehensive Review of the Impact of MRI on Physical Health

Thota Deepika Roy — 2025-11-04

Magnetic Resonance Imaging (MRI) is a critical diagnostic tool offering detailed visualization of soft tissues without ionizing radiation. Despite its widespread use in high-income countries, access remains limited in low- and middle-income countries (LMICs) due to high costs, infrastructure deficits, and a shortage of trained personnel. This article explores the utility, safety, and accessibility of MRI, emphasizing conditions requiring repeated imaging such as gliomas, metastases, and spinal disorders and patient populations for whom MRI is contraindicated, including those with certain implants or severe renal impairment. While MRI is generally safe and repeatable, caution is warranted with gadolinium-based contrast agents due to potential tissue retention and nephrogenic systemic fibrosis. Safety concerns also extend to device-related risks and acoustic noise exposure. Technological advancements including ultra-high-field scanners (3T and 7T), silent MRI, helium-free systems, and AI-driven enhancements are improving scan precision, patient comfort, and system sustainability. India’s growing role in MRI research and manufacturing is accelerating global access to cost-effective imaging solutions. This review underscores the importance of safe, equitable, and innovative MRI deployment to meet rising diagnostic demands across diverse healthcare settings.

Neurocognitive Deficits in Attention Deficit/Hyperactive Disorder (ADHD): Role of Sensory Processing, Visual Perception and Attention

Prakat Karki — 2025-11-12

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders characterized by symptoms of inattention and/or hyperactivity and impulsivity, and it affects mostly children and adolescents by causing significant impairment in their development and daily functioning. ADHD is associated with various neurobiological abnormalities and deficits, and this review article examines the current research evidence on the role of three neurocognitive domains in ADHD, namely sensory processing, visual perception and attention. Atypical sensory processing in terms of increased or reduced neural thresholds for sensory modulation can explain the distinct symptoms of the various ADHD subtypes. In visual perception, structural and functional deficits in visual processing and perception can account for the vision related problems commonly found in ADHD. Finally, deficits in selective and sustained attention observed in ADHD can indicate underlying dysfunctions in other bottom-up and top-down processes. The interaction of sensory processing, visual perception and attention has also been discussed alongside other neurobiological processes and mechanisms implicated in ADHD. Although evidence of the role of these three neurocognitive domains has significant clinical implications, the wide range of experiences and symptom manifestations in ADHD warrants further research of these and other neurocognitive and neurobiological mechanisms, as well as reconsideration of current ADHD diagnostic protocols. The article highlights the need and further scope of better understanding the psychosocial, cognitive and biological underpinnings and mechanisms of ADHD, in order to formulate more effective diagnostic and treatment approaches.