A randomized controlled trial of unguided internet cognitive–behavioral treatment for perfectionism in individuals who engage in regular exercise

Valentine, Emily; Bodill, Kate; Watson, Hunna J.; Hagger, Martin S.; Kane, Robert; Anderson, Rebecca

doi:10.1002/eat.22888

Cited by 20 publications

(14 citation statements)

References 22 publications

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“…The panel also agreed on a number of aspects of the construct of compulsive exercise that are consistent with the current literature in the field. For example, negative affect regulation, weight and shape concerns, rigidity, perfectionism and a compulsive drive to exercise were all endorsed as part of compulsive exercise behaviour [13,24,53,54,[56][57][58][59][60]. This further supports the notion that compulsive exercise is a multidimensional construct, as suggested by previous studies [12] (Table 3).…”

Section: Construct Of Compulsive Exercisesupporting

confidence: 84%

Measuring exercise in eating disorder patients: a Delphi study to aggregate clinical and research knowledge

et al. 2022

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Background Exercise is a prominent feature of most eating disorders, and has been shown to have a number of detrimental effects on treatment outcome. There is some disagreement in the literature regarding the construct of compulsive exercise, and assessment and treatment varies significantly. This study therefore aimed to aggregate expert clinicians’ and researchers’ views on how to define and measure compulsive exercise in eating disorder patients. The expert panel was also asked about questionnaire design, and possible problems when measuring compulsive exercise. Method This study used the Delphi method to establish consensus amongst an expert panel. Three successive rounds of questionnaires were distributed to the panel over a period of six months. The first round consisted of four open-ended questions regarding the definition and measurement of compulsive exercise in eating disorder patients. For Round 2, 70 statements were derived from the answers, and panelists were asked to rate each item on a Likert-based scale. An 85% consensus level was chosen. In Round 3, 44 statements were re-rated by the panel. Results Seventeen of 24 participants completed all three rounds of the study. Consensus was achieved for 63% of the items, while 18.5% reached near consensus, and 18.5% did not reach consensus after Round 3. The panel agreed on a number of important aspects of compulsive exercise. Several suggestions regarding the format of a questionnaire assessing this behavior were also endorsed. The panel further identified common difficulties when assessing compulsive exercise in eating disorder patients, notably a lack of consensus still apparent in the literature. Conclusion The current findings constitute a further step towards a unified definition of compulsive exercise, and contribute important suggestions to the measurement of this behavior.

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Section: Construct Of Compulsive Exercisesupporting

confidence: 84%

Measuring exercise in eating disorder patients: a Delphi study to aggregate clinical and research knowledge

et al. 2022

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“…These results are consistent with the effect sizes found for perfectionism and psychological symptoms in previous meta-analyses (Lloyd et al, 2015;Robinson & Wade, 2021;Suh et al, 2019), suggesting that CBT for perfectionism has efficacy as a transdiagnostic intervention. A strength of this meta-analysis was of the 15 studies we included, there were eight studies that were not included in Suh et al (2019) which were , Lowndes et al (2019), Shu et al (2019), Steele and Wade (2008), Valentine et al (2018), ), Grieve et al (2021 and one unpublished study. Of these eight studies, only one was included in the Lloyd et al (2015) review.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of randomised controlled trials of cognitive behaviour therapy for perfectionism: a systematic review and meta-analysis

Galloway

Watson

Greene

et al. 2021

Cognitive Behaviour Therapy

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Perfectionism is a transdiagnostic process across anxiety, depression, and eating disorders.The aim of this systematic review was to examine the efficacy of self-help and face to face CBT for perfectionism in reducing perfectionism and anxiety, depression, and eating disorders. A total of 15 randomised controlled trials of CBT for perfectionism were identified (N = 912 participants; mean pooled age = 23 years) which met inclusion criteria. There were medium or large effect sizes found on perfectionism measures; personal standards (g = 0.57, 95% CI = 0.43-0.72), concern over mistakes (g = 0.89, 95% CI = 0.71-1.08) and clinical perfectionism (g = 0.87, 95% CI = 0.70-1.04). There were medium effects for symptoms of eating disorders (g = 0.61, 95% CI = 0.36-0.87) and depression (g = 0.60, 95% CI = 0.28-0.91), and a small-medium effect on anxiety (g = 0.42, 95% CI = 0.21-0.62). There was no publication bias found. Limitations included the small number of trials included and lack of active treatment comparisons. Results suggested that CBT for perfectionism is efficacious in reducing perfectionism and symptoms of depression, anxiety and eating disorders. Future research should examine comparisons of CBT for perfectionism with other psychological treatments.

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“…Another 10 studies were excluded for one of the following reasons: did not focus on testing effectiveness of interventions (rather, focused on therapeutic relationship, participant adherence), did not assess perfectionism (despite having both “perfectionism” and “intervention” in the abstract, some studies examined self-criticism or self-compassion, rather than perfectionism), had no intervention component, or were case studies. Also, given our interest in comparing delivery modalities (face-to-face vs. online), we also excluded four studies that adapted a self-help modality, which were therefore neither face-to-face nor online (Lowndes, Egan, & McEvoy, 2019; Steele & Wade, 2008; Valentine et al, 2018; Wimberley et al, 2016). Last, we excluded one study that did not report information to calculate effect sizes.…”

Section: Methodsmentioning

confidence: 99%

A review and meta-analysis of perfectionism interventions: Comparing face-to-face with online modalities.

Suh

Sohn

Kim

et al. 2019

Journal of Counseling Psychology

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Extending Lloyd, Schmidt, Khondoker, and Tchanturia (2015), this review and meta-analysis evaluated the effectiveness of randomized controlled trials aimed at reducing perfectionism and associated symptoms of depression and anxiety. Of particular interest was the examination of a moderator of delivery method (face-to-face vs. online) in testing the effectiveness of psychological interventions. Also examined is the effect of two structural moderators (control condition type, sample characteristic). A total of 10 studies were identified (65 perfectionism effect sizes, 8 depression effect sizes, and 8 anxiety effect sizes). Psychological interventions were effective in decreasing perfectionism dimensions, depression, and anxiety with medium effect sizes. There were no significant differences in delivery modality, control condition type, and sample characteristic on effect sizes. Findings suggest that psychological interventions are generally effective in reducing perfectionism, although there is no apparent delineation in increasing "adaptive" perfectionism and decreasing "maladaptive" perfectionism. Although comparable benefits were shown in face-to-face and online intervention delivery modes, we suggest prudently incorporating online interventions into clinical practice. Public Significance StatementThis review and meta-analysis found empirical support for using psychological interventions to reduce perfectionistic tendencies among individuals. Using either face-to-face or online delivery mode yielded comparable benefits in decreasing perfectionism. Incorporating online interventions into clinical practice should be done with prudence and simply substituting face-to-face interventions with online interventions is not recommended.

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A randomized controlled trial of unguided internet cognitive–behavioral treatment for perfectionism in individuals who engage in regular exercise

Abstract: The results indicate unguided ICBT for perfectionism can have a significant impact on perfectionism, compulsive exercise, and ED symptomatology.

Cited by 20 publications

References 22 publications

Measuring exercise in eating disorder patients: a Delphi study to aggregate clinical and research knowledge

Measuring exercise in eating disorder patients: a Delphi study to aggregate clinical and research knowledge

The efficacy of randomised controlled trials of cognitive behaviour therapy for perfectionism: a systematic review and meta-analysis

A review and meta-analysis of perfectionism interventions: Comparing face-to-face with online modalities.

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