Are the rivers sentient or do they just appear that way. A Spot check should be required to notice this effect either way.

What happens if you fail your first save at the River Styx in Avernus. Do you just not get the +2 bonus or should something bad happen?

What happens to you if you fail the Will save when you try to move closer to the river?

What is the effect of paranoia damage? Not everyone has access to The Call of Cthulhu Campaign setting book.

You really need to edit and proofread this and add breaks between paragraphs.