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Psycho-Education and Group Cognitive-Behavioural Therapy for Clinical Perfectionism: A Case-Series Evaluation

Published online by Cambridge University Press:  14 August 2012

Anna L. Steele
Affiliation:
Adelaide Health Service, Australia
Sue Waite
Affiliation:
Adelaide Health Service, Australia
Sarah J. Egan*
Affiliation:
Curtin University, Australia
Janelle Finnigan
Affiliation:
Curtin University, Australia
Alicia Handley
Affiliation:
Curtin University, Australia
Tracey D. Wade
Affiliation:
Flinders University, Australia
*
Reprint requests to Sarah Egan, School of Psychology and Speech Pathology and Curtin Health Innovation Research Institute, Curtin University, GPO Box U1987, Perth, Western Australia, Australia6847. E-mail: [email protected]

Abstract

Background: Research indicates that psycho-education and cognitive behavioural interventions can reduce perfectionism but to date no group treatments have been examined. Aims: The current study utilized a case series design to compare psycho-education materials and subsequent eight-week group cognitive behaviour therapy (CBT) to a baseline waitlist in an outpatient community psychiatry sample (n = 21). Method: Participants were assessed on five occasions: baseline, 4 weeks later (waitlist), 4 weeks after receiving psycho-education material, post-treatment (8 weeks after receiving the group intervention), and 3-month follow-up. Results: There was a main effect of time for perfectionism and negative affect from baseline to post-group (effect sizes ranging from 1.46 to 1.91) that were maintained at 3-month follow-up. Conclusions: These results suggested that group CBT for clinical perfectionism may be beneficial, but that psycho-education alone is not effective for reducing perfectionism or negative affect.

Type
Empirically Grounded Clinical Interventions
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012

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References

Aldea, M., Rice, K., Gormley, B. and Rojas, A. (2010). Telling perfectionists about their perfectionism: effects of providing feedback on emotional reactivity and psychological symptoms. Behaviour Research and Therapy, 48, 11941203.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, Text Revision, 4th ed. Washington, DC: American Psychiatric Association.Google Scholar
Anderson, R. A. and Rees, C. S. (2007). Group versus individual cognitive-behavioural treatment for obsessive-compulsive disorder: a controlled trial. Behaviour Research and Therapy, 45, 123137.Google Scholar
Antony, M., Bieling, P., Cox, B., Enns, M. and Swinson, R. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression, Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10, 176181.Google Scholar
Antony, M. M., Purdon, C. L., Huta, V. and Swinson, R. P. (1998). Dimensions of perfectionism across the anxiety disorders. Behaviour Research and Therapy, 36, 11431154.Google Scholar
Beevers, C. G. and Miller, I. W. (2004). Perfectionism, cognitive bias and hopelessness as prospective predictors of suicidal ideation. Suicide and Life-Threatening Behavior, 34, 126137.Google Scholar
Bieling, P. J., Israeli, A. L. and Antony, M. M. (2004). Is perfectionism good, bad, or both? Examining models of the perfectionism construct. Personality and Individual Differences, 36, 13731385.CrossRefGoogle Scholar
Blatt, S. J. and Zuroff, D. (2005). Empirical evaluation of the assumptions in identifying evidence based treatments in mental health. Clinical Psychology Review, 25, 459486.CrossRefGoogle ScholarPubMed
Chang, E. C. and Sanna, L. J. (2012). Evidence for the validity of the Clinical Perfectionism Questionnaire in a nonclinical population: more than just negative affectivity. Journal of Personality Assessment, 94, 102108.Google Scholar
Cohen, J. (1988). Statistical Power for the Behavioural Sciences, 2nd ed. Hillsdale, NJ: Erlbaum.Google Scholar
Dickie, L., Surgenor, L. J., Wilson, M. and McDowall, J. (2012). The structure and reliability of the Clinical Perfectionism Questionnaire. Personality and Individual Differences, doi:10.1016/j.paid.2012.02.003.CrossRefGoogle Scholar
Dunkley, D., Sanislow, C., Grilo, C. and McGlashan, T. (2006). Perfectionism and depressive symptoms three years later: negative social interactions, avoidant coping and perceived social support as mediators. Comprehensive Psychiatry, 47, 106115.Google Scholar
Dunkley, D., Zuroff, D. C. and Blankstein, K. R. (2006). Specific perfectionism components versus self-criticism in predicting maladjustment. Personality and Individual Differences, 40, 665676.CrossRefGoogle Scholar
Egan, S. J. and Hine, P. (2008). Cognitive behavioural treatment of perfectionism: a single case experimental design series. Behaviour Change, 25, 245258.Google Scholar
Egan, S. J. and Stout, S. (2007). Group Cognitive Behavioural Treatment of Perfectionism. Invited paper presented in symposium, OCD and related cognitive styles: outcomes and treatment (Chair: Mike Kyrios, Discussant: Paul Salkovskis). World Psychiatric Association International Congress, Melbourne, Australia, November.Google Scholar
Egan, S. J., Wade, T. D. and Shafran, R. (2011). Perfectionism as a transdiagnostic process: a clinical review. Clinical Psychology Review, 31, 203212.Google Scholar
Fairburn, C. G., Cooper, Z., Doll, H. A., O'Connor, M. E., Bohn, K., Hawker, D. M., et al. (2009). Transdiagnostic cognitive-behavioral therapy for patients with eating disorders: a two-site trial with 60-week follow-up. American Journal of Psychiatry, 166, 311319.Google Scholar
Finn, S. and Tonsager, E. (1992). Therapeutic effects of providing MMPI-2 test feedback to college students awaiting therapy. Psychological Assessment, 4, 278287.Google Scholar
Frost, R., Marten, P., Lahart, C. and Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449468.CrossRefGoogle Scholar
Frost, R. O., Novara, C. and Rhéaume, J. (2002). Perfectionism in obsessive-compulsive disorder. In Frost, R. O. and Steketee, G. (Eds.), Cognitive Approaches to Obsessions and Compulsions (pp. 91105). New York: Pergamon.CrossRefGoogle Scholar
Frost, R. O. and Steketee, G. (1997). Perfectionism in obsessive-compulsive disorder patients. Behaviour Research and Therapy, 35, 291296.Google Scholar
Glover, D., Brown, G., Fairburn, C. and Shafran, R. (2007). A preliminary evaluation of cognitive behaviour therapy for perfectionism: a case series. Journal of British Clinical Psychology, 46, 8594.Google Scholar
Hamachek, D. E. (1978). Psychodynamics of normal and neurotic perfectionism Psychology: A Journal of Human Behaviour, 15, 2733.Google Scholar
Hawley, L. L., Ho, M. R., Zuroff, D. C. and Blatt, S. J. (2006). The relationship of perfectionism, depression and therapeutic alliance during treatment for depression: latent difference score analysis. Journal of Consulting and Clinical Psychology, 74, 930942.CrossRefGoogle ScholarPubMed
Hewitt, P. L. and Flett, G. L. (1991). Perfectionism in the self and social contexts: conceptualisation, assessment and association with psychopathology. Journal of Personality and Social Psychology, 60, 456470.Google Scholar
Himle, J. A., Van Etten, M. and Fischer, D. J. (2003). Group cognitive behavioral therapy for obsessive-compulsive disorder (OCD): a controlled study. International Journal of Psychiatry in Clinical Practice, 9, 257263.Google Scholar
Holden, J. E., Kelley, K. and Agarwal, R. (2008). Analysing change: a primer on multilevel models with applications to nephrology. American Journal of Nephrology, 28, 792801.Google Scholar
Juster, H. R., Heimberg, R. G., Frost, R. O., Holt, C. S., Mattia, J. I. and Faccenda, K. (1996). Social phobia and perfectionism. Personality and Individual Differences, 21, 403410.Google Scholar
Lecrubier, Y., Sheehan, D. V., Weiller, E., Amorim, P., Bonora, I., Sheehan, K., et al. (1997). The mini international neuropsychiatric interview (MINI). A short diagnostic structured interview: reliability and validity according to the CIDI. European Psychiatry, 12, 224231.CrossRefGoogle Scholar
Lovibond, P. F. and Lovibond, S. H. (1995). The structure of negative emotional states: comparison of the depression and anxiety inventories. Behaviour Research and Therapy, 33, 335343.CrossRefGoogle ScholarPubMed
Lundh, L. G. and Ost, L. G. (2001). Attentional bias, self-consciousness and perfectionism in social phobia before and after cognitive-behaviour therapy. Scandinavian Journal of Behaviour Therapy, 30, 416.Google Scholar
Newman, M. and Greenway, P. (1997). Therapeutic effects of providing MMPI-2 test feedback to clients at a university counseling service: a collaborative approach. Psychological Assessment, 9, 122131.Google Scholar
Oliver, J. M. and Baumgart, E. P. (1985). The Dysfunctional Attitude Scale: psychometric properties and relation to depression in an unselected adult population. Cognitive Therapy and Research, 9, 161167.Google Scholar
Pleva, J. and Wade, T. (2006). Guided self-help versus pure self-help for perfectionism: a randomised controlled trial. Behaviour Research and Therapy, 45, 849861.Google Scholar
Rashbash, J., Steele, F., Browne, W. and Prosser, B. (2004). A User's Guide to MLwiN. University of Bristol: Centre for Multilevel Modelling.Google Scholar
Riley, C., Lee, M., Cooper, Z., Fairburn, C. and Shafran, R. (2007). A randomised controlled trial of cognitive-behaviour therapy for clinical perfectionism: a preliminary study. Behaviour Research and Therapy, 45, 22212231.CrossRefGoogle ScholarPubMed
Rosenberg, M. (1965). Society and the Self-Image. Princeton, NJ: Princeton University Press.Google Scholar
Sassaroli, S., Lauro, L. J., Ruggiero, G. M., Mauri, M. C., Vinai, P. and Frost, R. (2008). Perfectionism in depression, obsessive compulsive disorder and eating disorders.Behaviour Research and Therapy, 46, 757765.Google Scholar
Shafran, R., Cooper, Z. and Fairburn, C. (2002). Clinical perfectionism: a cognitive behavioural analysis. Behaviour Research and Therapy, 40, 773791.Google Scholar
Shafran, R., Egan, S. and Wade, T. (2010). Overcoming Perfectionism: a self-help manual using cognitive-behavioural techniques. London: Robinson.Google Scholar
Sheehan, D. V., Janavs, J., Baker, R., Sheehan, K. H., Knapp, E. and Sheehan, M. (1998). Mini International Neuropsychiatric Interview. Tampa: University of South Florida.Google Scholar
Steele, A. L., O'Shea, A., Murdock, A. and Wade, T. D. (2011). Perfectionism and its relation to over-evaluation of weight and shape and depression in an eating disorder sample. International Journal of Eating Disorders, 44, 459464.Google Scholar
Steele, A. and Wade, T. (2008). A randomised trial investigating guided self-help to reduce perfectionism and its impact on bulimia nervosa: a pilot study. Behaviour Research and Therapy, 46, 13161323.Google Scholar
Stoeber, J. and Otto, K. (2006). Positive conceptions of perfectionism: approaches, evidence, challenges. Personality and Social Psychology Review, 10, 295319.CrossRefGoogle ScholarPubMed
Thiels, C., Schmidt, U., Troop, N., Treasure, J. and Garthe, R. (2001). Compliance with a self-care manual in guided self-change for bulimia nervosa. European Eating Disorders Review, 9, 115122.Google Scholar
Tykra, A. R., Waldron, I., Graber, J. A. and Brooks-Gunn, J. (2002). Prospective predictors of the onset of anorexic and bulimic syndromes. International Journal of Eating Disorders, 32, 282290.Google Scholar
Vohs, K. D., Bardone, A. M., Joiner, T. E., Abramson, L. Y. and Heatherton, T. F. (1999). Perfectionism, perceived weight status, and self-esteem interact to predict bulimic symptoms: a model of bulimic symptom development. Journal of Abnormal Psychology, 108, 695700.Google Scholar
Weissman, A. N. and Beck, A. T. (1978). Development and Validation of the Dysfunctional Attitudes Scale: a preliminary investigation. Paper presented at the Annual Meeting of the American Educational Research Association, Toronto, Canada.Google Scholar
Zimmerman, M. and Chelminski, I. (2006). A scale to screen for DSM-IV axis I disorders in psychiatric outpatients: performance of the Psychiatric Diagnostic Screening Questionnaire. Psychological Medicine, 36, 16011611.Google Scholar
Zimmerman, M. and Mattia, J. (2001) A self-report scale to help make psychiatric diagnoses. Archives of General Psychiatry, 58, 787794.Google Scholar
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