A Digital Mental Health Intervention for Paranoia (the STOP App): Qualitative Study on User Acceptability

Area of Science:

• Psychology
• Digital Health
• Clinical Interventions

Background:

• Cognitive bias modification for interpretation (CBM-I) targets negative biases, particularly in anxiety disorders.
• Interpretation bias plays a role in maintaining paranoia.
• The Successful Treatment of Paranoia (STOP) app is a CBM-I tool developed for paranoia.

Purpose of the Study:

• To involve service users in the design, development, and testing of the STOP app.
• To assess the acceptability of the STOP app among individuals with paranoia.
• To evaluate the STOP app against NICE standards for Digital Health Technologies (DHTs).

Main Methods:

• 12 participants with mild to moderate paranoia completed 6 weekly STOP sessions.
• Qualitative feedback was gathered through semi-structured interviews.
• Interviews were analyzed using framework analysis, combining deductive and inductive approaches.

Main Results:

• Six key themes emerged: independent use, digital vs. traditional methods, user reactions, impact on cognition and well-being, design/usability, and intervention relevance.
• The STOP app was broadly acceptable and positively received by most participants.
• Findings aligned with NICE DHT standards, with user involvement in development and testing.

Conclusions:

• The STOP app is a broadly acceptable digital intervention for individuals experiencing paranoia.
• User involvement in the design and testing process contributed to positive reception and satisfaction.
• Findings will inform the ongoing iterative development of the STOP app for targeting interpretation bias.