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BMC Psychiatry
Published in: BMC Psychiatry 1/2019

Open Access 01-12-2019 | Delusional Disorder | Research article

A qualitative study of the acceptability of cognitive bias modification for paranoia (CBM-pa) in patients with psychosis

Authors: C. J. Leung, A. Fosuaah, J. Frerichs, M. Heslin, T. Kabir, T. M. C. Lee, P. McGuire, C. Meek, E. Mouchlianitis, A. S. Nath, E. Peters, S. Shergill, D. Stahl, A. Trotta, J. Yiend

Published in: BMC Psychiatry | Issue 1/2019

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Abstract

Background

Cognitive Bias Modification (CBM) has been used successfully as a computer-based intervention in disorders such as anxiety. However, CBM to modify interpretations of ambiguous information relevant to paranoia has not yet been tested. We conducted a qualitative investigation of a novel intervention called CBM for paranoia (CBM-pa) to examine its acceptability in patients with psychosis.

Methods

Eight participants with psychosis who completed CBM-pa were identified by purposive sampling and invited for a semi-structured interview to explore the facilitators and barriers to participation, optimum form of delivery, perceived usefulness of CBM-pa and their opinions on applying CBM-pa as a computerised intervention. The interviews were transcribed and analysed using thematic analysis by researchers working in collaboration with service users.

Results

Themes emerged relating to participants’ perception about delivery, engagement, programme understanding, factors influencing experience, perceived impact and application of CBM-pa. CBM-pa was regarded as easy, straightforward and enjoyable. It was well-accepted among those we interviewed, who understood the procedure as a psychological intervention. Patients reported that it increased their capacity for adopting alternative interpretations of emotionally ambiguous scenarios. Although participants all agreed on the test-like nature of the current CBM-pa format, they considered that taking part in sessions had improved their overall wellbeing. Most of them valued the computer-based interface of CBM-pa but favoured the idea of combining CBM-pa with some form of human interaction.

Conclusions

CBM-pa is an acceptable intervention that was well-received by our sample of patients with paranoia. The current findings reflect positively on the acceptability and experience of CBM-pa in the target population. Patient opinion supports further development and testing of CBM-pa as a possible adjunct treatment for paranoia.

Trial registration

Current Controlled Trials ISRCTN: 90749868. Retrospectively registered on 12 May 2016.
Appendix
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Literature
1.
Freeman D, Garety P, Kuipers E, Fowler D, Bebbington P. A cognitive model of persecutory delusions. Br J Clin Psychol. 2002;41(4):331–47.PubMedCrossRef
2.
Savulich G, Shergill S, Yiend J. Biased cognition in psychosis. J Exp Psychopathol. 2012;3(4):514–36.CrossRef
3.
Savulich G, Shergill SS, Yiend J. Interpretation biases in clinical paranoia. Clin Psychol Sci. 2017;5(6):985–1000.CrossRef
4.
Savulich G, Freeman D, Shergill S, Yiend J. Interpretation biases in paranoia. Behav Ther. 2015;46(1):110–24.PubMedCrossRef
5.
Koster EHW, Fox E, Macleod C. Introduction to the special section on cognitive bias modification in emotional disorders. J Abnorm Psychol. 2009;118(1):1–4.PubMedCrossRef
6.
Beard C, Weisberg RB, Primack J. Socially anxious primary care patients’ attitudes toward cognitive bias modification (CBM): a qualitative study. Behav Cogn Psychother. 2012;40:618–33.PubMedCrossRef
7.
Brosan L, Hoppitt L, Shelfer L, Sillence A, MacKintosh B. Cognitive bias modification for attention and interpretation reduces trait and state anxiety in anxious patients referred to an out-patient service: results from a pilot study. J Behav Ther Exp Psychiatry. 2011;42(3):258–64.PubMedCrossRef
8.
Lysaker PH, Davis LW, Buck KD, Outcalt S, Ringer JM. Negative symptoms and poor insight as predictors of the similarity between client and therapist ratings of therapeutic alliance in cognitive behavior therapy for patients with schizophrenia. J Nerv Ment Dis. 2011;199(3):191–5.PubMedCrossRef
9.
Malla AK, Takhar JJ, Norman RMG, Manchanda R, Cortese L, Haricharan R, et al. Negative symptoms in first episode non-affective psychosis. Acta Psychiatr Scand. 2002;105(6):431–9.PubMedCrossRef
10.
Menne-Lothmann C, Viechtbauer W, Höhn P, Kasanova Z, Haller SP, Drukker M, et al. How to boost positive interpretations? a meta-analysis of the effectiveness of cognitive bias modification for interpretation. PLoS One. 2014;9(6):1–26.CrossRef
11.
Turner R, Hoppitt L, Hodgekins J, Wilkinson J, Mackintosh B, Fowler D. Cognitive bias modification in the treatment of social anxiety in early psychosis: a single case series. Behav Cogn Psychother. 2011;39(3):341–7.PubMedCrossRef
12.
Steel C, Wykes T, Ruddle A, Smith G, Shah DM, Holmes EA. Can we harness computerised cognitive bias modification to treat anxiety in schizophrenia? A first step highlighting the role of mental imagery. Psychiatry Res. 2010;178(3):451–5.PubMedCrossRef
13.
Yiend J, Trotta A, Meek C, Dzafic I, Baldus N, Crane B, et al. Cognitive bias modification for paranoia (CBM-pa): study protocol for a randomised controlled trial. Trials. 2017;18(1):1–13.CrossRef
14.
Dixon LB, Holoshitz Y, Nossel I. Treatment engagement of individuals experiencing mental illness: review and update. World Psychiatry. 2016;15(2):189.CrossRef
15.
16.
Beard C, Weisberg RB, Amir N. Combined cognitive bias modification treatment for social anxiety disorder: a pilot trial. Depress Anxiety. 2011;28(11):981–8.PubMedPubMedCentralCrossRef
17.
Kuckertz JM, Schofield CA, Clerkin EM, Primack J, Boettcher H, Weisberg RB, et al. Attentional bias modification for social anxiety disorder: what do patients think and why does it matter? Behav Cogn Psychother. 2019;47:16–38.PubMedCrossRef
18.
First MB, Williams JBW, Karg RS, Spitzer RL. Structured clinical interview for DSM-5—research version (SCID-5 for DSM-5, research version; SCID-5-RV). Arlington: American Psychiatric Association; 2015.
19.
Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull. 1987;13(2):261–76.PubMedCrossRef
20.
Lehman AF, Lieberman JA, Dixon LB, McGlashan TH, Miller AL, Perkins DO, et al. Practice guideline for the treatment of patients with schizophrenia, second edition. Am J Psychiatry. 2004;161(2 Suppl):1–56.PubMed
21.
22.
23.
Guba EG, Lincoln YS. Competing paradigms in qualitative research. Handbook of qualitative research. Thousand Oaks: Sage Publications, Inc; 1994. p. 105–17.
24.
Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13(1):117.PubMedPubMedCentralCrossRef
25.
Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77–101.CrossRef
26.
27.
28.
Tong A, Sainsbury P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. Int J Qual Heal Care. 2007;19(6):349–57.CrossRef
29.
30.
Mitchell N, Gordon PK. Attitudes towards computerized CBT for depression amongst a student population. Behav Cogn Psychother. 2007;35(4):421–30.CrossRef
31.
Hoppitt L, Matthews A, Yiend J, Mackintosh B. Cognitive mechanisms underlying the emotional effects of bias modification. Appl Cogn Psychol. 2010;24:312–25.CrossRef
32.
33.
34.
Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68–78.PubMedCrossRef
35.
Bakker D, Kazantzis N, Rickwood D, Rickard N. Mental Health smartphone apps: review and evidence-based recommendations for future developments. JMIR Ment Health. 2016;3(1):e7.PubMedPubMedCentralCrossRef
36.
Donkin L, Glozier N. Motivators and motivations to persist with online psychological interventions: a qualitative study of treatment completers. J Med Internet Res. 2012;14(3):e91.PubMedPubMedCentralCrossRef
37.
Darvell MJ, Kavanagh DJ, Connolly JM. A qualitative exploration of Internet-based treatment for comorbid depression and alcohol misuse. Internet Interv. 2015;2(2):174–82.CrossRef
38.
Gearing RE, Schwalbe CSJ, Lee R, Hoagwood KE. The effectiveness of booster sessions in CBT treatment for child and adolescent mood and anxiety disorders. Depress Anxiety. 2013;30(9):800–8.PubMedCrossRef
Metadata
Title
A qualitative study of the acceptability of cognitive bias modification for paranoia (CBM-pa) in patients with psychosis
Authors
C. J. Leung
A. Fosuaah
J. Frerichs
M. Heslin
T. Kabir
T. M. C. Lee
P. McGuire
C. Meek
E. Mouchlianitis
A. S. Nath
E. Peters
S. Shergill
D. Stahl
A. Trotta
J. Yiend
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2019
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/s12888-019-2215-3

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