Cognitive bias modification for paranoia (CBM-pa): A randomised controlled feasibility study in patients with distressing paranoid beliefs

Jenny Yiend; Charlene L.M. Lam; Nora Schmidt; Bryony Crane; Margaret Heslin; Thomas Kabir; Philip McGuire; Christopher Meek; Elias Mouchlianitis; Emmanuelle Peters; Daniel Stahl; Antonella Trotta; Sukhwinder Shergill

doi:10.1017/S0033291722001520

Cognitive bias modification for paranoia (CBM-pa): A randomised controlled feasibility study in patients with distressing paranoid beliefs

Jenny Yiend^*, Charlene L.M. Lam, Nora Schmidt, Bryony Crane, Margaret Heslin, Thomas Kabir, Philip McGuire, Christopher Meek, Elias Mouchlianitis, Emmanuelle Peters, Daniel Stahl, Antonella Trotta, Sukhwinder Shergill

^*Corresponding author for this work

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Abstract

Background Cognitive Bias Modification for paranoia (CBM-pa) is a novel, theory-driven psychological intervention targeting the biased interpretation of emotional ambiguity associated with paranoia. Study objectives were (i) test the intervention's feasibility, (ii) provide effect size estimates, (iii) assess dose-response and (iv) select primary outcomes for future trials. Methods In a double-blind randomised controlled trial, sixty-three outpatients with clinically significant paranoia were randomised to either CBM-pa or an active control (text reading) between April 2016 and September 2017. Patients received one 40 min session per week for 6 weeks. Assessments were given at baseline, after each interim session, post-treatment, and at 1- and 3-months post-treatment. Results A total of 122 patients were screened and 63 were randomised. The recruitment rate was 51.2%, with few dropouts (four out of 63) and follow-up rates were 90.5% (1-month) and 93.7% (3-months). Each session took 30-40 min to complete. There was no statistical evidence of harmful effects of the intervention. Preliminary data were consistent with efficacy of CBM-pa over text-reading control: patients randomised to the intervention, compared to control patients, reported reduced interpretation bias (d = -0.48 to -0.76), improved symptoms of paranoia (d = -0.19 to -0.38), and lower depressed and anxious mood (d = -0.03 to -0.29). The intervention effect was evident after the third session. Conclusions CBM-pa is feasible for patients with paranoia. A fully powered randomised control trial is warranted.

Original language	English
Pages (from-to)	4614-4626
Number of pages	13
Journal	Psychological Medicine
Volume	53
Issue number	10
DOIs	https://doi.org/10.1017/S0033291722001520
Publication status	Published - 14 Jul 2023

Keywords

Cognitive bias modification
interpretation bias
paranoia
psychosis
RCT

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YIEND-ET-AL-22-Cognitive bias modification for paranoia (CBM-pa) A randomised controlled feasibility study in patients with distressing paranoid beliefsFinal published version, 631 KB

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Yiend, J., Lam, C. L. M., Schmidt, N., Crane, B., Heslin, M., Kabir, T., McGuire, P., Meek, C., Mouchlianitis, E., Peters, E., Stahl, D., Trotta, A., & Shergill, S. (2023). Cognitive bias modification for paranoia (CBM-pa): A randomised controlled feasibility study in patients with distressing paranoid beliefs. Psychological Medicine, 53(10), 4614-4626. https://doi.org/10.1017/S0033291722001520

@article{a0bc6461421f42fcba6ffac7074e4435,

title = "Cognitive bias modification for paranoia (CBM-pa): A randomised controlled feasibility study in patients with distressing paranoid beliefs",

abstract = "Background Cognitive Bias Modification for paranoia (CBM-pa) is a novel, theory-driven psychological intervention targeting the biased interpretation of emotional ambiguity associated with paranoia. Study objectives were (i) test the intervention's feasibility, (ii) provide effect size estimates, (iii) assess dose-response and (iv) select primary outcomes for future trials. Methods In a double-blind randomised controlled trial, sixty-three outpatients with clinically significant paranoia were randomised to either CBM-pa or an active control (text reading) between April 2016 and September 2017. Patients received one 40 min session per week for 6 weeks. Assessments were given at baseline, after each interim session, post-treatment, and at 1- and 3-months post-treatment. Results A total of 122 patients were screened and 63 were randomised. The recruitment rate was 51.2%, with few dropouts (four out of 63) and follow-up rates were 90.5% (1-month) and 93.7% (3-months). Each session took 30-40 min to complete. There was no statistical evidence of harmful effects of the intervention. Preliminary data were consistent with efficacy of CBM-pa over text-reading control: patients randomised to the intervention, compared to control patients, reported reduced interpretation bias (d = -0.48 to -0.76), improved symptoms of paranoia (d = -0.19 to -0.38), and lower depressed and anxious mood (d = -0.03 to -0.29). The intervention effect was evident after the third session. Conclusions CBM-pa is feasible for patients with paranoia. A fully powered randomised control trial is warranted.",

keywords = "Cognitive bias modification, interpretation bias, paranoia, psychosis, RCT",

author = "Jenny Yiend and Lam, {Charlene L.M.} and Nora Schmidt and Bryony Crane and Margaret Heslin and Thomas Kabir and Philip McGuire and Christopher Meek and Elias Mouchlianitis and Emmanuelle Peters and Daniel Stahl and Antonella Trotta and Sukhwinder Shergill",

note = "Publisher Copyright: Copyright {\textcopyright} The Author(s), 2022. Published by Cambridge University Press.",

year = "2023",

month = jul,

day = "14",

doi = "10.1017/S0033291722001520",

language = "English",

volume = "53",

pages = "4614--4626",

journal = "Psychological Medicine",

issn = "0033-2917",

publisher = "Cambridge University Press",

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Yiend, J , Lam, CLM, Schmidt, N, Crane, B , Heslin, M, Kabir, T, McGuire, P, Meek, C, Mouchlianitis, E , Peters, E , Stahl, D, Trotta, A & Shergill, S 2023, 'Cognitive bias modification for paranoia (CBM-pa): A randomised controlled feasibility study in patients with distressing paranoid beliefs', Psychological Medicine, vol. 53, no. 10, pp. 4614-4626. https://doi.org/10.1017/S0033291722001520

TY - JOUR

T1 - Cognitive bias modification for paranoia (CBM-pa)

T2 - A randomised controlled feasibility study in patients with distressing paranoid beliefs

AU - Yiend, Jenny

AU - Lam, Charlene L.M.

AU - Schmidt, Nora

AU - Crane, Bryony

AU - Heslin, Margaret

AU - Kabir, Thomas

AU - McGuire, Philip

AU - Meek, Christopher

AU - Mouchlianitis, Elias

AU - Peters, Emmanuelle

AU - Stahl, Daniel

AU - Trotta, Antonella

AU - Shergill, Sukhwinder

PY - 2023/7/14

Y1 - 2023/7/14

N2 - Background Cognitive Bias Modification for paranoia (CBM-pa) is a novel, theory-driven psychological intervention targeting the biased interpretation of emotional ambiguity associated with paranoia. Study objectives were (i) test the intervention's feasibility, (ii) provide effect size estimates, (iii) assess dose-response and (iv) select primary outcomes for future trials. Methods In a double-blind randomised controlled trial, sixty-three outpatients with clinically significant paranoia were randomised to either CBM-pa or an active control (text reading) between April 2016 and September 2017. Patients received one 40 min session per week for 6 weeks. Assessments were given at baseline, after each interim session, post-treatment, and at 1- and 3-months post-treatment. Results A total of 122 patients were screened and 63 were randomised. The recruitment rate was 51.2%, with few dropouts (four out of 63) and follow-up rates were 90.5% (1-month) and 93.7% (3-months). Each session took 30-40 min to complete. There was no statistical evidence of harmful effects of the intervention. Preliminary data were consistent with efficacy of CBM-pa over text-reading control: patients randomised to the intervention, compared to control patients, reported reduced interpretation bias (d = -0.48 to -0.76), improved symptoms of paranoia (d = -0.19 to -0.38), and lower depressed and anxious mood (d = -0.03 to -0.29). The intervention effect was evident after the third session. Conclusions CBM-pa is feasible for patients with paranoia. A fully powered randomised control trial is warranted.

AB - Background Cognitive Bias Modification for paranoia (CBM-pa) is a novel, theory-driven psychological intervention targeting the biased interpretation of emotional ambiguity associated with paranoia. Study objectives were (i) test the intervention's feasibility, (ii) provide effect size estimates, (iii) assess dose-response and (iv) select primary outcomes for future trials. Methods In a double-blind randomised controlled trial, sixty-three outpatients with clinically significant paranoia were randomised to either CBM-pa or an active control (text reading) between April 2016 and September 2017. Patients received one 40 min session per week for 6 weeks. Assessments were given at baseline, after each interim session, post-treatment, and at 1- and 3-months post-treatment. Results A total of 122 patients were screened and 63 were randomised. The recruitment rate was 51.2%, with few dropouts (four out of 63) and follow-up rates were 90.5% (1-month) and 93.7% (3-months). Each session took 30-40 min to complete. There was no statistical evidence of harmful effects of the intervention. Preliminary data were consistent with efficacy of CBM-pa over text-reading control: patients randomised to the intervention, compared to control patients, reported reduced interpretation bias (d = -0.48 to -0.76), improved symptoms of paranoia (d = -0.19 to -0.38), and lower depressed and anxious mood (d = -0.03 to -0.29). The intervention effect was evident after the third session. Conclusions CBM-pa is feasible for patients with paranoia. A fully powered randomised control trial is warranted.

KW - Cognitive bias modification

KW - interpretation bias

KW - paranoia

KW - psychosis

KW - RCT

UR - http://www.scopus.com/inward/record.url?scp=85156091094&partnerID=8YFLogxK

U2 - 10.1017/S0033291722001520

DO - 10.1017/S0033291722001520

M3 - Article

C2 - 35699135

AN - SCOPUS:85156091094

SN - 0033-2917

VL - 53

SP - 4614

EP - 4626

JO - Psychological Medicine

JF - Psychological Medicine

IS - 10

ER -

Cognitive bias modification for paranoia (CBM-pa): A randomised controlled feasibility study in patients with distressing paranoid beliefs

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