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The Cyber Paranoia and Fear Scale-Updated (CPFS-U): development and implications for digital health engagement
Frances T Greenway1,2, Mark Weal2, Emma Palmer-Cooper3
1Southampton Psychosis and Bipolar Research and Innovation Group, Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK f.t.greenway@soton.ac.uk.
BMJ Open
|July 6, 2026
Summary
The updated Cyber Paranoia and Fear Scale-Updated (CPFS-U) effectively measures digital technology fears. This tool helps understand user mistrust in digital health, promoting inclusive system design.
Area of Science:
- Psychology
- Digital Health
- Technology Acceptance
Background:
- Cyber paranoia and fear are increasingly relevant due to rapid technological advancements.
- Existing scales may not fully capture contemporary concerns related to artificial intelligence (AI) and digital dependence.
Purpose of the Study:
- To update and revalidate the Cyber Paranoia and Fear Scale (CPFS).
- To assess the scale's relevance to digital health readiness and engagement.
- To ensure the scale reflects current technological contexts.
Main Methods:
- Exploratory factor analysis on an online community sample (n=433).
- Item refinement through Patient and Public Involvement and Engagement groups.
- Assessment of internal consistency and construct validity.
Main Results:
- A four-factor structure emerged: AI and digital dependence, technological risk awareness, perceived data vulnerability, and surveillance-related mistrust.
- The updated Cyber Paranoia and Fear Scale-Updated (CPFS-U) showed good internal consistency and construct validity.
- Cyber-paranoia and fear were distinct from general paranoia and anxiety, specific to digital technologies.
Conclusions:
- The CPFS-U is a psychometrically sound, modernized measure for digital and AI technology responses.
- It can inform risk communication and user engagement in digital health.
- The scale aids in designing trustworthy digital interventions and inclusive health systems by identifying disengaged users.
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