A pilot randomised controlled trial of guided self-help cognitive behaviour therapy for perfectionism: Impact on diagnostic status and comorbidity

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.