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

Abstract

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.

A protocol for unguided internet self-help cognitive behaviour therapy for perfectionism in adolescents at-risk of eating disorders

“…The FMPS is a well-validated measure of perfectionism that contains 35 questions across six subscales; Concern Over Mistakes, Doubts About Actions, Personal Standards, Parental Expectations, Organization, and Parental Criticism ( Frost et al, 1990 ). In this study only the 9-item concern over mistakes (CM; negative reactions to mistakes) and 7-item personal standards (PS; setting high standards) will be used as an additional outcome measure of perfectionism as these scales are the most clinically relevant subscales of the measure ( Shafran et al, 2002 ) and widely used as outcomes measures in RCTs of CBT-P ( Galloway et al, 2022 ). The FMPS has excellent internal consistency (α = 0.90) ( Frost et al, 1990 ).…”

“…Perfectionism is a risk and perpetuating factor for eating disorder symptoms in adults ( Fairburn et al, 2003b ; Limburg et al, 2017 ) and adolescents ( Johnston et al, 2018 ; Vacca et al, 2021 ). Cognitive behaviour therapy for perfectionism (CBT-P) has been demonstrated in recent meta-analyses to have medium effects on eating disorder symptoms ( g = 0.61 ( Galloway et al, 2022 ); g = 0.64 ( Robinson and Wade, 2021 )) and transdiagnostic impacts on anxiety ( g = 0.42) and depressive ( g = 0.60) symptoms ( Galloway et al, 2022 ). Numerous studies have demonstrated the efficacy of CBT-P on reducing perfectionism and psychopathology, delivered via the internet in unguided (e.g., Egan et al, 2014 ; Grieve et al, 2022 ; Shu et al, 2019 ; Valentine et al, 2018 ; Wade et al, 2019 ) and guided formats ( Rozental et al, 2017 ; Shafran et al, 2017 ).…”

“…The utility of targeting perfectionism is valuable, as a transdiagnostic process ( Egan et al, 2011 ) which has demonstrated the ability to treat a range of symptoms of eating disorders, anxiety and depression ( Galloway et al, 2022 ; Robinson and Wade, 2021 ). Consequently, CBT-P holds promise as an intervention to prevent eating disorders and associated anxiety and depression in young people.…”

No perfect sleep! A systematic review of the link between multidimensional perfectionism and sleep disturbance

“…Hence, understanding its detrimental health consequences has become an increasingly relevant concern (e.g., Limburg et al, 2017; Smith et al, 2021). Third, interventions exist that reduce perfectionism (for meta‐analyses see Galloway et al, 2021; Lloyd et al, 2015). Thus, perfectionism may be a modifiable risk factor for sleep disturbance.…”

Examining and enhancing the reliability of the Arabic version of the Clinical Perfectionism Questionnaire

“…The present study aimed to translate the CPQ into Arabic and to examine its psychometric properties using the Rasch methodology, a robust statistical approach increasingly becoming a gold standard in rehabilitation medicine [ 36 ]. The CPQ was chosen over the other multidimensional measures due to its appropriate fit within the cognitive-behavioral therapy model, which is considered the gold standard for treating clinical perfectionism [ 14 ].…”