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Perfectionism as a transdiagnostic process: A clinical review
Abstract
Perfectionism is a risk and maintaining factor for eating disorders, anxiety disorders and depression. The objective of this paper is to review the four bodies of evidence supporting the notion that perfectionism is a transdiagnostic process. First, a review of the literature was conducted that demonstrates the elevation of perfectionism across numerous anxiety disorders, depression, and eating disorders compared to healthy controls. Data is presented that shows perfectionism increases vulnerability for eating disorders, and that it maintains obsessive-compulsive disorder, social anxiety and depression as it predicts treatment outcome in these disorders. Second, evidence is examined showing that elevated perfectionism is associated with co-occurrence of psychopathology. Third, the different conceptualisations of perfectionism are reviewed, including a cognitive-behavioural conceptualisation of clinical perfectionism that can be utilised to understand this transdiagnostic process. Fourth, evidence that treatment of perfectionism results in reductions in anxiety, depression and eating pathology is reviewed. Finally, the importance of clinicians considering the routine assessment and treatment of perfectionism is outlined.
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“Perfectionism is a transdiagnostic risk and maintaining process across anxiety, depression, and eating disorders (Egan et al., 2011; Limburg 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 Egan et al., 2011
In the citing paper
“Some examples of transdiagnostic mechanisms that have been found to play a fundamental role in EDs are intolerance to uncertainty [104], rumination [105], perfectionism [106], or thought suppression [107].”
From Negative and positive affect regulation in a transdiagnostic internet-based protocol for emotional disorders: Randomized controlled trial (2021) · cites this paper as [106]
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Hartmann, A. S., Thomas, J. J., Greenberg, J. L., Matheny, N. L., & Wilhelm, S. (2014) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0000000000000215 · Cited by 61
Metadata
- Authors
- Egan, S. J., Wade, T. D., & Shafran, R.
- Affiliations
- Curtin University (AU)
- Flinders University (AU)
- University of Reading (GB)
- Corresponding author
- Egan, Sarah J.
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2011-03
- Volume
- 31
- Issue
- 2
- Pages
- 203-212
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W2092825860
- Cited by
- 961
- References
- 126
- Citations by year
- 2026: 60 · 2025: 73 · 2024: 65 · 2023: 64 · 2022: 81 · 2021: 94 · 2020: 59 · 2019: 83 · 2018: 64 · 2017: 76 · 2016: 52 · 2015: 59 · 2014: 48 · 2013: 30 · 2012: 32
- FWCI
- 3.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- CentAUR (University of Reading) (acceptedVersion)
- UCL Discovery (University College London) (submittedVersion)
- eSpace (Curtin University) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Perfectionism, Procrastination, Anxiety Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
- Keywords
- perfectionism, transdiagnostic mechanisms, eating disorders, anxiety disorders, depression, obsessive-compulsive disorder, social anxiety, co-occurring psychopathology, treatment outcomes
- MeSH terms
- Anxiety, Anxiety Disorders, Feeding and Eating Disorders, Depression, Humans, Personality, Cognitive Behavioral Therapy
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