A pilot randomised controlled trial of guided self-help cognitive behaviour therapy for perfectionism: Impact on diagnostic status and comorbidity
Abstract
Background and objectives Perfectionism is associated with the development and maintenance of anxiety, mood, and eating disorders. Cognitive behaviour therapy (CBT) results in significant reductions in perfectionism and psychological symptoms however, the majority of studies have not examined clinical samples or impact on diagnostic status and comorbidity.Methods Forty participants with elevated perfectionism, of whom 80% had a range of psychological disorders, were randomised to CBT for perfectionism or waitlist control.Results The treatment group reported significant large effect size reductions in perfectionism measures of personal standards and concern over mistakes (d = 1.1-1.6), dichotomous thinking (d = 1.2), and medium effect size reductions in depression (d = 0.55) and increases in quality of life (d = 0.73), which were maintained at 4 month follow-up. The participants in the treatment group were significantly less likely to present with comorbid psychological disorders at post-treatment than the control group.Limitations The sample size was small, and there was no control condition at follow-up.Conclusions Findings lend further support for CBT for perfectionism as an efficacious transdiagnostic treatment for perfectionism and related psychopathology.
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The efficacy of CBT for perfectionism has been demonstrated via statistical significance in all 15 RCTs included in the Galloway et al. (2022) meta-analysis, in addition to reliable and clinically significant change.
“The efficacy of treatment has been demon strated via statistical significance (all 15 RCTs included in the Galloway et al., 2022 meta-analysis), in addition to reliable and clinically signif icant change (e.g., Handley et al., 2015; Hoiles et al., 2022; Riley et al., 2007; Shu et al., 2019).”
From Coming of age: A reflection of the first 21 years of cognitive behaviour therapy for perfectionism (2023) · cites this paper as Hoiles et al., 2022
Cites
Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007) · Behavior Research Methods · doi:10.3758/bf03193146 · Cited by 65,971 · see citing works
Lovibond, P. F., & Lovibond, S. H. (1995) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)00075-u · Cited by 14,523 · see citing works
Henry, J. D., & Crawford, J. R. (2005) · British Journal of Clinical Psychology · doi:10.1348/014466505x29657 · Cited by 5,801 · see citing works
The dimensions of perfectionism
Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R. (1990) · Cognitive Therapy and Research · doi:10.1007/bf01172967 · Cited by 4,279 · see citing works
Moher, D., Schulz, K. F., & Altman, D. G. (2001) · BMC Medical Research Methodology · doi:10.1186/1471-2288-1-2 · Cited by 2,755 · see citing works
Sheehan, D., Lecrubier, Y., Harnett Sheehan, K., Janavs, J., Weiller, E., Keskiner, A., Schinka, J., Knapp, E., Sheehan, M., & Dunbar, G. (1997) · European Psychiatry · doi:10.1016/s0924-9338(97)83297-x · Cited by 2,149 · see citing works
Clinical perfectionism: A cognitive behavioural analysis
Shafran, R., Cooper, Z., & Fairburn, C. G. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00059-6 · Cited by 984 · see citing works
Perfectionism as a transdiagnostic process: A clinical review
Egan, S. J., Wade, T. D., & Shafran, R. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.04.009 · Cited by 961 · see citing works
Perfectionism and psychopathology: a review of research and treatment
Shafran, R., & Mansell, W. (2001) · Clinical Psychology Review · doi:10.1016/s0272-7358(00)00072-6 · Cited by 664 · see citing works
The Relationship between Perfectionism and Psychopathology: A Meta-analysis
Limburg, K., Watson, H. J., Hagger, M. S., & Egan, S. J. (2017) · Journal of Clinical Psychology · doi:10.1002/jclp.22435 · Cited by 602 · see citing works
The Anxiety Disorders Interview Schedule for DSM-IV (ADIS-IV).
Grisham, J. R., Brown, T. A., & Campbell, L. (2004) · Cited by 430 · see citing works
STEVANOVIC, D. (2011) · Journal of Psychiatric and Mental Health Nursing · doi:10.1111/j.1365-2850.2011.01735.x · Cited by 278 · see citing works
Ritsner, M. S., Kurs, R., Gibel, A., Ratner, Y., & Endicott, J. (2005) · Quality of Life Research · doi:10.1007/s11136-005-2816-9 · Cited by 214 · see citing works
Cognitive-Behavioral Treatment for Perfectionism
Egan, S. J., & Shafran, R. (2017) · The Psychology of Perfectionism · doi:10.4324/9781315536255-19 · Cited by 181 · see citing works
Self-citationRiley, C., Lee, M., Cooper, Z., Fairburn, C. G., & Shafran, R. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2006.12.003 · Cited by 142 · see citing works
The role of dichotomous thinking and rigidity in perfectionism
Egan, S. J., Piek, J. P., Dyck, M. J., & Rees, C. S. (2007) · Behaviour Research and Therapy · doi:10.1016/j.brat.2007.02.002 · Cited by 130 · see citing works
Self-citationSteele, A. L., & Wade, T. D. (2008) · Behaviour Research and Therapy · doi:10.1016/j.brat.2008.09.006 · Cited by 126 · see citing works
Galloway, R., Watson, H., Greene, D., Shafran, R., & Egan, S. J. (2022) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2021.1952302 · Cited by 115 · see citing works
Egan, S. J., van Noort, E., Chee, A., Kane, R. T., Hoiles, K. J., Shafran, R., & Wade, T. D. (2014) · Behaviour Research and Therapy · doi:10.1016/j.brat.2014.09.009 · Cited by 101 · see citing works
A Randomised Controlled Trial of Group Cognitive Behavioural Therapy for Perfectionism
Handley, A. K., Egan, S. J., Kane, R. T., & Rees, C. S. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.02.006 · Cited by 99 · see citing works
Overcoming perfectionism: A self-help guide using cognitive behavioural techniques
Shafran, R., Egan, S. J., & Wade, T. D. (2010) · Cited by 89 · see citing works
Rozental, A., Shafran, R., Wade, T., Egan, S., Nordgren, L. B., Carlbring, P., Landström, A., Roos, S., Skoglund, M., Thelander, E., et al. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.05.015 · Cited by 76 · see citing works
Perfectionism as an Explanatory Construct in Comorbidity of Axis I Disorders
Bieling, P., Summerfeldt, L. J., Israeli, A. L., & Antony, M. M. (2004) · Journal of Psychopathology and Behavioral Assessment · doi:10.1023/b:joba.0000022112.27186.98 · Cited by 74 · see citing works
Shafran, R., Wade, T. D., Egan, S. J., Kothari, R., Allcott-Watson, H., Carlbring, P., Rozental, A., & Andersson, G. (2017) · Behaviour Research and Therapy · doi:10.1016/j.brat.2017.05.014 · Cited by 72 · see citing works
The reliability and validity of the dichotomous thinking in eating disorders scale
Byrne, S. M., Allen, K. L., Dove, E. R., Watt, F. J., & Nathan, P. R. (2008) · Eating Behaviors · doi:10.1016/j.eatbeh.2007.07.002 · Cited by 69 · see citing works
Shu, C. Y., Watson, H. J., Anderson, R. A., Wade, T. D., Kane, R. T., & Egan, S. J. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.103429 · Cited by 59 · see citing works
Cognitive Behavioural Treatment of Perfectionism: A Single Case Experimental Design Series
Egan, S. J., & Hine, P. (2008) · Behaviour Change · doi:10.1375/bech.25.4.245 · Cited by 52 · see citing works
Lowndes, T. A., Egan, S. J., & McEvoy, P. M. (2018) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2018.1490810 · Cited by 29 · see citing works
Valentine, E., Bodill, K., Watson, H. J., Hagger, M. S., Kane, R. T., Anderson, R., & Egan, S. J. (2018) · International Journal of Eating Disorders · doi:10.1002/eat.22888 · Cited by 19 · see citing works
Sadri, S. K., Anderson, R., McEvoy, P. M., Kane, R. T., & Egan, S. J. (2017) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465816000618 · Cited by 11 · see citing works
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Coming of age: A reflection of the first 21 years of cognitive behaviour therapy for perfectionism
Shafran, R., Egan, S. J., & Wade, T. D. (2023) · Behaviour Research and Therapy · doi:10.1016/j.brat.2023.104258 · Cited by 30 · see citing works
Egan, S. J., Johnson, C., Wade, T. D., Carlbring, P., Raghav, S., & Shafran, R. (2024) · Internet Interventions · doi:10.1016/j.invent.2024.100711 · Cited by 28 · see citing works
O'Brien, A., Anderson, R., Mazzucchelli, T., & Egan, S. J. (2022) · Internet Interventions · doi:10.1016/j.invent.2022.100565 · Cited by 14 · see citing works
Egan, S. J., Neal, J., Ure, S., Callaghan, T., Ho, P., Shafran, R., & Wade, T. D. (2023) · Journal of Eating Disorders · doi:10.1186/s40337-023-00860-6 · Cited by 13 · see citing works
Egan, S. J., Munro, C., Pauley-Gadd, S. B., O’Brien, A., Callaghan, T., Payne, N., Raghav, S., MYERS, B. J., Hall, C., Wilson, H., et al. (2024) · Internet Interventions · doi:10.1016/j.invent.2024.100771 · Cited by 8 · see citing works
A clinician’s quick guide to evidence-based approaches: perfectionism
Egan, S. J., Shafran, R., & Wade, T. D. (2022) · Clinical Psychologist · doi:10.1080/13284207.2022.2108315 · Cited by 6 · see citing works
Ahmed, F., Wu, C., Li, L., Ye, Q., Ksebe, W., & Wang, K. (2025) · IntechOpen eBooks · doi:10.5772/intechopen.1009601 · Cited by 4 · see citing works
Catling, J. C., Kelly, P., Walsh, E., Yeung, C., Gomez, N., & Catling, I. (2026) · International Journal of Adolescence and Youth · doi:10.1080/02673843.2026.2618696
- Authors
- Hoiles, K. J., Rees, C. S., Kane, R. T., Howell, J., & Egan, S. J.
- Affiliations
- Curtin University (AU)
- Corresponding author
- Egan, Sarah J.
- Venue
- Journal of Behavior Therapy and Experimental Psychiatry
- Publisher
- Elsevier BV
- Published
- 2022-09
- Volume
- 76
- Pages
- 101739
- ISSN
- 0005-7916 (ISSN-L)
- OpenAlex
- W4281775039
- Cited by
- 8
- References
- 30
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 2 · 2022: 2
- FWCI
- 1.60
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Behavior Therapy and Experimental Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- 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 › Obsessive-Compulsive Spectrum Disorders
- Keywords
- perfectionism, guided self-help, transdiagnostic treatment, comorbidities, diagnostic status, depression, quality of life, dichotomous thinking, concern over mistakes, personal standards, anxiety, eating disorders, mood disorders
- MeSH terms
- Perfectionism, Humans, Pilot Projects, Quality of Life, Comorbidity, Cognitive Behavioral Therapy, Treatment Outcome
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