Self-Concept in Young People with Paranoia - Version 1.0
Research type
Research Study
Full title
Self-Concept in Young People with Paranoia: Development of an Assessment Tool
IRAS ID
291160
Contact name
Miriam Kirkham
Contact email
Sponsor organisation
University of Oxford, Clinical Trials and Research Governance
Duration of Study in the UK
1 years, 2 months, 1 days
Research summary
Research Summary
Trust is the decision to depend on others in the face of vulnerability and uncertainty, comprised of an emotional response towards others and a judgement about another’s intentions. The ability to trust others exists on a spectrum, with some feeling excessively mistrustful of others. Excessive mistrust is termed ‘paranoia’ in psychiatry and is defined as the unfounded belief that others are intentionally trying to harm you.
Approximately 75% of mental health problems have an onset before the age of 25. Paranoia is a prevalent and distressing experience in adolescence and has a negative impact on young people’s social relationships, development of identity, and successful transition into adulthood. Research shows that negative beliefs about oneself (e.g. I am worthless) are involved in causing and maintaining paranoia, and that targeting negative thoughts about oneself in treatment reduces paranoia and increases wellbeing. This may be particularly important in adolescence, when key developmental tasks include the formation of identity, social groups, and independence.
A large proportion of individuals experiencing paranoia report negative self-beliefs and identify a wish for treatment focused on improving self-confidence. However, little is known about what beliefs young people experiencing paranoia hold about themselves, and no measure exists to accurately capture these experiences.
In this study we aim to create and validate a questionnaire for young people aged 14 to 25 experiencing paranoia, to measure how they evaluate themselves. This will help to develop tailored treatments for young people experiencing paranoia. In future, helping people to challenge specific negative thoughts about themselves, and develop positive thoughts about themselves, may be a way to reduce paranoia and improve trust, relationships and wellbeing. To develop the measure we will recruit and interview adolescents accessing mental health services who experience paranoia, and test the new measures properties with a general population sample of adolescents.
Summary of Results
Short Title: Self-Confidence in Young People with Mistrust of Others.
Why did we run this study?
Research shows that approximately 75% of mental health problems have an onset before the age of 25. Paranoia, an over-generalised or unfounded mistrust of others, is a prevalent and distressing experience in adolescence shown to have a negative impact on young people’s social relationships, development of identity, and transition into adulthood.Research shows that negative beliefs about oneself (e.g. I am worthless) may be involved in causing and maintaining paranoia, and that targeting negative beliefs about oneself in treatment can reduce paranoia, increase wellbeing, and help people develop trusting relationships.
A large proportion of individuals experiencing paranoia report negative self-beliefs and identify a wish for treatments to focus on improving self-confidence. However, little is known about what beliefs young people experiencing paranoia hold about themselves, and no measure exists to accurately capture these experiences.
In this study, we aimed to create and validate a questionnaire for young people aged 14 to 25 experiencing paranoia, to measure negative self-beliefs. This will help to develop tailored treatments for young people experiencing paranoia. In future, helping people to challenge specific negative thoughts about themselves, and develop positive thoughts about themselves, may be a way to reduce paranoia and improve trust, relationships and wellbeing.
Who carried out the research?
The study was run by Miriam Kirkham, who was a Trainee Clinical Psychologist at Oxford University. Miriam was supervised by Clinical Psychologists Dr Felicity Waite and Dr Ciorsdan Anderson. The research was part of a Doctoral University course and sponsored by the University of Oxford. The study was looked at and approved by an NHS Ethics Committee.What happened in the study?
Experts by experience were involved from the McPin Young People's Advisory Group to help develop the study in terms of the design, methods, and materials used. This involved a focus group with five young people who had experienced paranoia.To develop the measure, the researchers interviewed 12 young people (aged 14 to 25) who felt overly mistrustful, unsafe, or under threat from others. Questions were asked about these young people's self-beliefs. Participants at interview stage were recruited from Oxfordshire and Berkshire Healthcare NHS Foundation Trusts.
From the interviews, the researchers developed a measure of negative beliefs people had about themselves. A second measure was created to assess how people came to have these beliefs.
Next, the researchers tested the new measures properties and compared them to existing measures of self-esteem and related mental health difficulties (e.g. paranoia, low mood). This was done by recruiting a larger group of 937 young people, aged 14 to 25 and from the general population, in an online survey that was advertised on social media.
What did we find?
New measures: The researchers collected a range of negative beliefs people had about themselves. From this, a questionnaire was created with thoughts representing four themes. Themes included beliefs one is: Not good enough, a bad person, broken, and an outcast. The researchers asked participants to describe how they came to have these beliefs about themselves and created a second questionnaire. Participants spoke about their thought processes, types of achievement, their impact on others, others impact on them, avoidance of others, reliance on others, and changing themselves in different ways to fit with social groups.In the online survey, the researchers found the two new measures were reliable over time when participants completed them at two different time-points. The new measures were related to existing measures of self-esteem and mental health difficulties. As people held more negative beliefs about themselves, they reported lower self-esteem, more experiences of low mood, and a greater mistrust of others.
What happens next?
The researchers developed the new questionnaires to identify specific negative beliefs young people hold about themselves, when feeling mistrustful of others. Also, to better understand how young people came to hold these beliefs. The researchers aims are for the measures to be used in therapy and mental health services, to measure changes in negative beliefs over time, and support open conversations about difficult and personal topics. The study is currently being written as a research report, with the aim to publish in an academic journal.REC name
South West - Frenchay Research Ethics Committee
REC reference
21/SW/0100
Date of REC Opinion
7 Sep 2021
REC opinion
Further Information Favourable Opinion