A randomized controlled trial of internet-based cognitive behavior therapy for perfectionism including an investigation of outcome predictors
Open accessAbstract
Being highly attentive to details can be a positive feature. However, for some individuals, perfectionism can lead to distress and is associated with many psychiatric disorders. Cognitive behavior therapy has been shown to yield many benefits for those experiencing problems with perfectionism, but the access to evidence-based care is limited. The current study investigated the efficacy of guided Internet-based Cognitive Behavior Therapy (ICBT) and predictors of treatment outcome. In total, 156 individuals were included and randomized to an eight-week treatment or wait-list control. Self-report measures of perfectionism, depression, anxiety, self-criticism, self-compassion, and quality of life were distributed during screening and at post-treatment. Intention-to-treat were used for all statistical analyses. Moderate to large between-group effect sizes were obtained for the primary outcome measures, Frost Multidimensional Perfectionism Scale, subscales Concerns over Mistakes and Personal Standards, Cohen's d = 0.68-1.00, 95% Confidence Interval (CI) [0.36-1.33], with 35 (44.9%) of the patients in treatment being improved. Predictors were also explored, but none were related to treatment outcome. In sum, guided ICBT can be helpful for addressing problems with clinical perfectionism, but research of its long-term benefits is warranted.
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The lack of mediational analyses and consistent predictors of outcome with CBT-P should be considered limitations.
“The lack of mediational analyses and consistent predictors of outcome with CBT-P should also be considered as limitations (Rozental et al., 2017).”
From Coming of age: A reflection of the first 21 years of cognitive behaviour therapy for perfectionism (2023) · cites this paper as Rozental et al., 2017
The Predictors of treatment outcome section reports that none of the examined predictors was associated with post-treatment perfectionism scores, and the Discussion calls for research on other predictors. The Discussion also says that what contributed to treatment efficacy needs closer investigation, but it does not identify a lack of mediational analyses as a limitation. (LLM, conf=0.82)
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- Authors
- Rozental, A., Shafran, R., Wade, T., Egan, S., Nordgren, L. B., Carlbring, P., Landström, A., Roos, S., Skoglund, M., Thelander, E., Trosell, L., Örtenholm, A., & Andersson, G.
- Affiliations
- Stockholm University (SE)
- University College London (GB)
- Flinders University (AU)
- Curtin University (AU)
- Linköping University (SE)
- Corresponding author
- Rozental, Alexander
- ORCID
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2017-08
- Volume
- 95
- Pages
- 79-86
- ISSN
- 0005-7967 (ISSN-L)
- OpenAlex
- W2617253031
- Cited by
- 76
- References
- 41
- Citations by year
- 2026: 1 · 2025: 8 · 2024: 5 · 2023: 6 · 2022: 10 · 2021: 13 · 2020: 11 · 2019: 12 · 2018: 8 · 2017: 2
- FWCI
- 11.17
- Type
- journal article
- Language
- en
- Open access
- green
- discovery.ucl.ac.uk
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- Funders
- Great Ormond Street Hospital for Children
- Linköpings Universitet
- NIHR Biomedical Research Centre, Royal Marsden NHS Foundation Trust/Institute of Cancer Research
- University College London
- Topics
- Social Sciences › Psychology › Clinical Psychology › Perfectionism, Procrastination, Anxiety Studies
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- perfectionism, internet-based cognitive behavioral therapy, treatment outcome predictors, self-criticism, self-compassion, personal standards, depression, anxiety, quality of life, Frost Multidimensional Perfectionism Scale
- MeSH terms
- Perfectionism, Adult, Anxiety, Anxiety Disorders, Depression, Female, Humans, Male, Middle Aged, Prognosis, Psychiatric Status Rating Scales, Quality of Life, Cognitive Behavioral Therapy, Treatment Outcome, Internet, Young Adult
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