Abstract
Elevated paranoia is common in the general population, particularly in young adults, and can cause significant distress and issues in social functioning. Paranoia often co-occurs with low mood, and so flexible interventions that can help with a range of experiences would be well suited to the needs of
this group. Acceptance and commitment therapy (ACT) is a transdiagnostic behaviour therapy which may be able to fill this gap. The current study used a multiple baseline single case experimental design (SCED) to investigate the impact of a six-session ACT intervention with eleven university students experiencing elevated paranoia and low mood. Half the participants were randomised to complete the ENGAGE module first (focused on personal values and goals) and the OPEN modules second (focused on mindfulness skills), and the other half completed the intervention in the reverse order. Participants completed daily measures of paranoia, positive and negative affect, and ACT
processes which were evaluated using visual and Tau-U analysis. They also completed standardised questionnaires on paranoia, depression, anxiety, stress and psychological flexibility at four time points which were analysed using reliable and clinically significant change. A two week follow up period was used to assess whether improvements were maintained. Both groups showed a reliable improvement on trait paranoia, however the ENGAGE-first group showed larger improvements on depression and stress. Neither group significantly improved for anxiety. Only the ENGAGE-first group showed significant improvements on state paranoia and negative affect, while the OPEN-first group
showed no change. The study provides tentative evidence that a full ACT intervention is effective for young people experiencing elevated paranoia and low mood particularly when the ENGAGE sessions are delivered first, however results were not consistent across participants. Study limitations and recommendations are discussed.
this group. Acceptance and commitment therapy (ACT) is a transdiagnostic behaviour therapy which may be able to fill this gap. The current study used a multiple baseline single case experimental design (SCED) to investigate the impact of a six-session ACT intervention with eleven university students experiencing elevated paranoia and low mood. Half the participants were randomised to complete the ENGAGE module first (focused on personal values and goals) and the OPEN modules second (focused on mindfulness skills), and the other half completed the intervention in the reverse order. Participants completed daily measures of paranoia, positive and negative affect, and ACT
processes which were evaluated using visual and Tau-U analysis. They also completed standardised questionnaires on paranoia, depression, anxiety, stress and psychological flexibility at four time points which were analysed using reliable and clinically significant change. A two week follow up period was used to assess whether improvements were maintained. Both groups showed a reliable improvement on trait paranoia, however the ENGAGE-first group showed larger improvements on depression and stress. Neither group significantly improved for anxiety. Only the ENGAGE-first group showed significant improvements on state paranoia and negative affect, while the OPEN-first group
showed no change. The study provides tentative evidence that a full ACT intervention is effective for young people experiencing elevated paranoia and low mood particularly when the ENGAGE sessions are delivered first, however results were not consistent across participants. Study limitations and recommendations are discussed.
| Original language | English |
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| Publication status | Unpublished - 2024 |