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I just increased the 20fps lock to 120 (probably overkill, but it helped)

I just tried some other resolutions because the graphics where still very wrong(I was getting extra blur on higher resolutions except 4k etc.) , it was just that last thing I did before I quit that version of the game. 

You seem to be having a different issue then, and the settings I messed around with wouldn't matter. 

When you have the black screen you could try just going in/out of full screen mode with Alt+Enter to see if something happens (more than the black box being full-screen or smaller/windowed).

I have a Switch-pro-style controller and it wasn't seen by the game so I mapped the keyboard to the controller via steam-big-picture...
TIL that is why I still need to give the doll the anti-social-cold-shoulder or shoot her in the face while menuing. 

I (think I) had this issue with the first version I downloaded I think that was 1.0.0, it was gone when I tried 1.03.1 today. (it could be another issue related to what was running on my PC and was fixed by a reboot tho.) 

A while after starting 1.0.0 and hearing the audio, i pressed enter (and might have clicked other things) I got a glitchy mess of a screen, but I was able to go into settings and try to change setting there etc.  (just added this part to see if it was truly the same issue you're having.) 

TL:DR; if you're not on 1.0.3.1 or later I would try to update the game.