ArticleBMJ open2026
The Cyber Paranoia and Fear Scale-Updated (CPFS-U): development and implications for digital health engagement.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo update and revalidate the Cyber Paranoia and Fear Scale to reflect current technological contexts and examine its relevance to digital health readiness and engagement.
methodsUsing an online community sample (n=433), exploratory factor analysis was conducted to examine the factor structure of the revised item pool. Items were refined through consultation with Patient and Public Involvement and Engagement groups to ensure contemporary relevance and clarity.
resultsAnalysis supported a four-factor structure representing artificial intelligence (AI) and digital dependence, technological risk awareness, perceived data vulnerability and surveillance-related mistrust. The updated Cyber Paranoia and Fear Scale-Updated (CPFS-U) demonstrated good internal consistency and supported construct validity. Cyber-paranoia and fear were conceptually and empirically distinct from general paranoia and anxiety, highlighting the specific cognitive and emotional responses elicited by digital technologies.
conclusionsThe CPFS-U offers a psychometrically robust, modernised measure for understanding individuals' responses to digital and AI-based technologies. Its application in digital health research and practice can inform risk communication, user engagement strategies and the design of trustworthy digital interventions. By identifying individuals who may disengage due to online mistrust, the CPFS-U has the potential to inform more inclusive and psychologically informed digital health systems.
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