Exploring internet- and technology-related suspicious delusions and their impact on online engagement in OCD populations. A mixed methods study

Abstract

Background: many individuals with obsessive-compulsive disorder (OCD) do not receive adequate mental health support, and treatment is not always effective for those who do. Digital mental health interventions offer potential to address this gap, but their success may depend on factors such as paranoia and trust. This study examines the relationships among OCD symptoms, cyber paranoia and fear, and trust in technology, focusing on how these factors affect individuals with OCD and their engagement with digital systems.

Methods: this mixed-methods approach included quantitative data from 199 non-clinical control participants and 122 individuals diagnosed with OCD. Statistical analyses examined group differences. Additionally, participants with OCD completed open-ended qualitative questions regarding perceptions of trust, safety, and technology use.

Results: individuals with OCD scored significantly higher on the Cyber Paranoia and Fear Scale, Paranoia Scale, and Prodromal Questionnaire compared to controls, supporting prior associations between paranoia and OCD symptoms. However, trust-related beliefs and cyber paranoia fears showed no significant group differences. Qualitative responses revealed that technological familiarity, perceptions of safety, and personal trust shaped participants’ comfort and willingness to engage with digital platforms.

Conclusion: the qualitative and quantitative results of this study underscore the relationship between OCD symptoms, paranoia, and cyber-related paranoia and fear. These results contribute to the growing understanding of what makes interventions trustworthy, particularly for groups that may face additional barriers to access or trust. Promoting technological competence and fostering trust in online systems may help mitigate distress, therefore better supporting individuals with OCD in digital contexts.

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Identifiers

ORCID for Mark Weal: orcid.org/0000-0001-6251-8786

ORCID for Emma Claire Palmer-Cooper: orcid.org/0000-0002-5416-1518

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