STOP Project: Successful Treatment of Paranoia
Persecutory delusions—characterised by paranoid thinking—are the most frequent and clinically significant symptoms of psychosis. Over one-third of all UK psychiatric patients suffer from persecutory delusions, often appearing in a range of psychopathologies. New directions in treatments for delusions emphasize briefer, targeted interventions, with a focus on putative causal factors such as cognitive biases. Cognitive bias refers to the selective processing of information that matches the core content of the pathology of a disorder. For example, individuals with threat-related persecutory delusions may consistently interpret emotionally ambiguous information in one (maladaptive) direction (i.e., interpretation bias). In theoretical models of psychosis, such biases are proposed as contributors to the formation and maintenance of positive symptoms, including paranoia. Cognitive Bias Modification for paranoia (CBM-pa) uses a computerised task to manipulate biased interpretations and promote more adaptive processing. Feasibility testing of a six-session CBM-pa has shown positive results.
In the STOP ('Successful Treatment of Paranoia’) project, we aim to build on CBM-pa by testing a novel, entirely self-administered digital therapeutic for paranoia. We will conduct a four year, two-site double-blind randomised controlled trial (RCT) with patients who experience clinical levels of paranoia. The trial comprises a three arm RCT, comparing two doses of therapy (6-sessions and 12-sessions, + Treatment-as-usual) with a 12-session text reading control. We will randomly allocate participants into one of the three trial arms, with assessments given at baseline, 6, 12, 18, and 24 weeks; the primary outcome (severity of paranoid symptoms as measured by the Paranoia Scale) set at 24 weeks.
STOP Trial: https://www.stoptrial.co.uk/
CSI Lab Researchers: Sukhwinder Shergill, Che-Wei Hsu, Carolina Fialho, Rayan Taher
Collaborators: Jenny Yiend, Thomas Kabir, Jeroen Keppens, Philip McGuire, Elias Mouchlianitis, Emmanuelle Peters, Tanya Ricci Daniel Stahl, George Vamvakas, Pamela Jacobsen
Start date: 2021 [3 year project]