Perfectionism in Intensive Residential Treatment of Obsessive-Compulsive Disorder

Perfectionism is frequently noted in obsessive-compulsive disorder (OCD) and some data suggest that treatment outcomes with cognitive behavioral therapy (CBT) are poorer for OCD patients with higher levels of perfectionism. However, this literature includes inconsistent findings and has thus far been limited to outpatient samples. Existing studies have also not utilized measures of perfectionism in-line with the multidimensional nature of this construct, which includes both adaptive and maladaptive forms of perfectionism. This study administered measures of multidimensional perfectionism and OCD severity at admission and discharge in a large sample (N = 154) of adult OCD patients undergoing intensive residential treatment (IRT). Results indicated that more perfectionistic patients had slightly longer treatment duration. Adjusting for treatment duration and baseline severity, pre-treatment perfectionism did not significantly predict OCD outcomes. However, all domains of perfectionism significantly improved following treatment, and changes in perfectionism significantly predicted OCD outcomes. In particular, greater reduction in maladaptive perfectionism uniquely predicted better OCD symptom outcomes. These results suggest that high initial levels of perfectionism may not prevent OCD patients from benefitting from IRT, and that reduction in perfectionism significantly accounts for OCD treatment gains. Limitations and avenues for future research are discussed.