Hostname: page-component-89b8bd64d-sd5qd Total loading time: 0 Render date: 2026-05-09T04:59:19.328Z Has data issue: false hasContentIssue false
  • English
  • Français

Can Psychological Interventions Reduce Perfectionism? A Systematic Review and Meta-analysis

Published online by Cambridge University Press:  13 May 2014

Samantha Lloyd ,
Ulrike Schmidt ,
Mizanur Khondoker  and
Kate Tchanturia
Samantha Lloyd
Affiliation:
King's College London, Institute of Psychiatry, UK
Ulrike Schmidt
Affiliation:
King's College London, Institute of Psychiatry, UK
Mizanur Khondoker
Affiliation:
King's College London, Institute of Psychiatry, UK
Kate Tchanturia*
Affiliation:
King's College London, Institute of Psychiatry, UK
*
Reprint requests to Kate Tchanturia, PO59, King's College London, Institute of Psychiatry, Department of Psychological Medicine, De Crespigny Park, London SE5 8AF, UK. E-mail: kate.tchanturia@kcl.ac.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Perfectionism is implicated in a range of psychiatric disorders, impedes treatment and is associated with poorer treatment outcomes. Aims: The aim of this systematic review and meta-analysis was to summarize the existing evidence for psychological interventions targeting perfectionism in individuals with psychiatric disorders associated with perfectionism and/or elevated perfectionism. Method: Eight studies were identified and were analysed in meta-analyses. Meta-analyses were carried out for the Personal Standards and Concern over Mistakes subscales of the Frost Multi-Dimensional Perfectionism Scale (FMPS) and the Self Orientated Perfectionism and Socially Prescribed Perfectionism subscales of the Hewitt and Flett MPS (HMPS) in order to investigate change between pre and postintervention. Results: Large pooled effect sizes were found for the Personal Standards and Concern over Mistakes subscales of the FMPS and the Self Orientated Perfectionism subscale of the HMPS, whilst a medium sized effect was found for change in Socially Prescribed Perfectionism. Medium pooled effect sizes were also found for symptoms of anxiety and depression. Conclusions: There is some support that it is possible to significantly reduce perfectionism in individuals with clinical disorders associated with perfectionism and/or clinical levels of perfectionism. There is also some evidence that such interventions are associated with decreases in anxiety, depression, eating disorder and obsessive compulsive symptoms. Further research is needed in order to investigate the optimal dosage and format of such interventions as well as into specific disorders where there is a lack of evidence for their effectiveness.

Keywords

Perfectionismsystematic reviewmeta-analysiscognitive behavioural therapy

Information

Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 43 , Issue 6 , November 2015 , pp. 705 - 731
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Aldea, M. A., Rice, K. G., Gormley, B. and Rojas, A. (2010).Telling perfectionists about their perfectionism: effects of providing feedback on emotional reactivity and psychological symptoms. Behaviour Research and Therapy, 48, 1194–1203.Google Scholar
Antony, M. and Swinson, R. (2009).When Perfect isn't Good Enough: strategies for coping with perfectionism. Oakland, CA: New Harbinger Publications.Google Scholar
Arpin-Cribbie, C., Irvine, J. and Ritvo, P. (2012). Web-based cognitive-behavioral therapy for perfectionism: a randomized controlled trial. Psychotherapy Research, 22, 194–207.CrossRefGoogle ScholarPubMed
Beck, A. T., Epstein, N., Brown, G. and Steer, R. A. (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56, 893.Google Scholar
Beck, A.T., Steer, R.A. and Brown, G.K. (1996). Manual for Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation.Google Scholar
Bieling, P. J., Israeli, A. L. and Antony, M. M. (2004). Is perfectionism good, bad, or both? Examining models of the perfectionism construct. Personality and Individual Differences, 36, 1373–1385.Google Scholar
Bieling, P. J., Israeli, A., Smith, J. and Antony, M. M. (2003). Making the grade: the behavioural consequences of perfectionism in the classroom. Personality and Individual Differences, 35, 163–178.Google Scholar
Blatt, S. J., Quinlan, D. M., Pilkonis, P. A. and Shea, M. T. (1995). Impact of perfectionism and need for approval on the brief treatment of depression: the National Institute of Mental Health Treatment of Depression Collaborative Research Program revisited. Journal of Consulting and Clinical Psychology, 63, 125.CrossRefGoogle ScholarPubMed
Burns, G. L., Keortge, S. G., Formea, G. M. and Sternberg, L. G. (1996). Revision of the Padua Inventory of obsessive compulsive disorder symptoms: distinctions between worry, obsessions, and compulsions. Behaviour Research and Therapy, 34, 163–173.CrossRefGoogle ScholarPubMed
Bradburn, M. J., Deeks, J. J. and Altman, D. G. (1998). Metan: an alternative meta-analysis command. Stata Technical Bulletin, 44, 4–15. Reprinted in Stata Technical Bulletin Reprints, 8, pp. 86–100. College Station, TX: Stata Press.Google Scholar
Chik, H. M., Whittal, M. L. and O’Neill, M. P. (2008). Perfectionism and treatment outcome in obsessive compulsive disorder. Cognitive Therapy and Research, 32, 376–388.CrossRefGoogle Scholar
Cox, B. J., Enns, M. W. and Clara, I. P. (2002). The multidimensional structure of perfectionism in clinically distressed and college student samples. Psychological Assessment, 14, 365.Google Scholar
Dunkley, D. M., Zuroff, D. C. and Blankstein, K. R. (2003). Self-critical perfectionism and daily affect: dispositional and situational influences on stress and coping. Journal of Personality and Social Psychology, 84, 234.Google Scholar
Egan, S. J. and Hine, P. (2008). Cognitive behavioural treatment of perfectionism: a single case experimental design series. Behaviour Change, 25, 245–258.CrossRefGoogle Scholar
Egan, S. J., Wade, T. D. and Shafran, R. (2011). Perfectionism as a transdiagnostic process: a clinical review. Clinical Psychology Review, 31, 203–212.CrossRefGoogle ScholarPubMed
Egan, S. J., Piek, J. P., Dyck, M.J., Rees, C.S. and Hagger, M.S. (2013). A clinical investigation of motivation to change standards and cognitions about failure in perfectionism. Behavioural and Cognitive Psychotherapy, 41, 565–578.Google Scholar
Egger, M., Smith, G. D., Schneider, M. and Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. British Medical Journal, 315 (7109), 629–634.Google Scholar
Enns, M. W. and Cox, B. J. (1999). Perfectionism and depression symptom severity in major depressive disorder. Behaviour Research and Therapy, 37, 783–794.Google Scholar
Fairburn, C. G. and Beglin, S. J. (1994). Assessment of eating disorders: interview or self‐report questionnaire? International Journal of Eating Disorders, 16, 363–370.3.0.CO;2-#>CrossRefGoogle ScholarPubMed
Fairburn, C. G., Cooper, Z. and Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41, 509–528.Google Scholar
Ferguson, K. L. and Rodway, M. R. (1994). Cognitive behavioral treatment of perfectionism: initial evaluation studies. Research on Social Work Practice, 4, 283–308.Google Scholar
Flett, G. L., Hewitt, P. L., Blankstein, K. R. and Gray, L. (1998). Psychological distress and the frequency of perfectionistic thinking. Journal of Personality and Social Psychology, 75, 1363–1381.CrossRefGoogle ScholarPubMed
Frost, R. O., Heimberg, R. G., Holt, C. S., Mattia, J. I. and Neubauer, A. L. (1993). A comparison of two measures of perfectionism. Personality and Individual Differences, 14, 119–126.CrossRefGoogle Scholar
Frost, R., Marten, P., Lahart, C. and Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449–468.Google Scholar
Frost, R. O. and Steketee, G. (1997). Perfectionism in obsessive-compulsive disorder patients. Behaviour Research and Therapy, 35, 291–296.CrossRefGoogle ScholarPubMed
Glover, D. S., Brown, G. P., Fairburn, C. G. and Shafran, R. (2007). A preliminary evaluation of cognitive behaviour therapy for clinical perfectionism: a case series. British Journal of Clinical Psychology, 46, 85–94.CrossRefGoogle ScholarPubMed
Harris, R., Bradburn, M., Deeks, J., Harbord, R., Altman, D. and Sterne, J. (2008). Metan: fixed- and random-effects meta-analysis. Stata Journal, 8, 3–28.Google Scholar
Hedges, L.V. (1981). Distribution theory for Glass's estimator of effect size and related estimators. Journal of Educational Statistics, 6, 107–128.CrossRefGoogle Scholar
Hewitt, P. L. and Flett, G. L. (1991). Perfectionism in the self and social contexts: conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456–470.CrossRefGoogle ScholarPubMed
Hewitt, P. L., Flett, G. L., Turnbull-Donovan, W. and Mikail, S. F. (1991). The Multidimensional Perfectionism Scale: reliability, validity, and psychometric properties in psychiatric samples. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3, 464–468.CrossRefGoogle Scholar
Higgins, J. P., Thompson, S. G., Deeks, J. J. and Altman, D. G. (2003). Measuring inconsistency in meta-analyses. British Medical Journal, 327 (7414), 557–560.CrossRefGoogle ScholarPubMed
Hodgson, R. and Rachman, S. (1977). Obsessional compulsive complaints. Behaviour Research and Therapy, 15, 389–395.CrossRefGoogle ScholarPubMed
Jacobs, R. H., Silva, S. G., Reinecke, M. A., Curry, J. F., Ginsburg, G. S., Kratochvil, C. J., et al. (2009). Dysfunctional attitudes scale perfectionism: a predictor and partial mediator of acute treatment outcome among clinically depressed adolescents. Journal of Clinical Child & Adolescent Psychology, 38, 803–813.Google Scholar
Juster, H. R., Heimberg, R. G., Frost, R. O., Holt, C. S., Mattia, J. I. and Faccenda, K. (1996). Social phobia and perfectionism. Personality and Individual Differences, 21, 403–410.Google Scholar
Kearns, H., Forbes, A. and Gardiner, M. (2007). A cognitive behavioural coaching intervention for the treatment of perfectionism and self-handicapping in a nonclinical population. Behaviour Change, 24, 157.CrossRefGoogle Scholar
Kutlesa, N. and Arthur, N. (2008). Overcoming negative aspects of perfectionism through group treatment. Journal of Rational-Emotive & Cognitive-Behaviour Therapy, 26, 134–150.CrossRefGoogle Scholar
Lovibond, P. F. and Lovibond, S. H. (1995). The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33, 335–343.CrossRefGoogle ScholarPubMed
Moher, D., Liberati, A., Tetzlaff, and Altman, D.G. (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. British Medical Journal, 339: b2535.CrossRefGoogle ScholarPubMed
Nunnally, J. C. and Bernstein, I. H. (1994). Psychometric Theory (3rded.). New York: McGraw-Hill.Google Scholar
O’Connor, R. C., Rasmussen, S. and Hawton, K. (2010). Predicting depression, anxiety and self-harm in adolescents: the role of perfectionism and acute life stress. Behaviour Research and Therapy, 48, 52–59.CrossRefGoogle ScholarPubMed
Pleva, J. and Wade, T. D. (2007). Guided self-help versus pure self-help for perfectionism: a randomised controlled trial. Behaviour Research and Therapy, 45, 849–861.CrossRefGoogle ScholarPubMed
Radhu, N., Daskalakis, Z. J., Guglietti, C. L., Farzan, F., Barr, M. S., Arpin-Cribbie, C. A., et al. (2012).Cognitive behavioral therapy-related increases in cortical inhibition in problematic perfectionists. Brain Stimulation, 5, 44–54.CrossRefGoogle ScholarPubMed
Radloff, L. S. (1977). The CES-D Scale: a self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.CrossRefGoogle Scholar
Rice, K. and Ashby, J. (2007). An efficient method for classifying perfectionists. Journal of Counselling Psychology, 54, 1, 72–85.CrossRefGoogle Scholar
Rice, K. G., Ashby, J. S. and Slaney, R. B. (1998). Self-esteem as a mediator between perfectionism and depression: a structural equations analysis. Journal of Counseling Psychology, 45, 304.Google Scholar
Riley, C., Lee, M., Cooper, Z., Fairburn, C. and Shafran, R. (2007). A randomised controlled trial of cognitive-behaviour therapy for clinical perfectionism: a preliminary study. Behaviour Research and Therapy, 45, 2221–2231.CrossRefGoogle ScholarPubMed
Riley, C. and Shafran, R. (2005). Clinical perfectionism: a preliminary qualitative analysis. Behavioural and Cognitive Psychotherapy, 33, 369–374.Google Scholar
Salkovskis, P. M., Wroe, A. L., Gledhill, A., Morrison, N., Forrester, E., Richards, C., et al. (2000). Responsibility attitudes and interpretations are characteristic of obsessive compulsive disorder. Behaviour Research and Therapy, 38, 347–372.Google Scholar
Shafran, R., and Mansell, W. (2001). Perfectionism and psychopathology: a review of research and treatment. Clinical Psychology Review, 21, 879–906.Google Scholar
Shafran, R., Cooper, Z. and Fairburn, C. (2002). Clinical perfectionism: a cognitive behavioural analysis. Behaviour Research and Therapy, 40, 773–791.CrossRefGoogle ScholarPubMed
Shafran, R., Egan, S. J. and Wade, T. (2010). Overcoming Perfectionism: a self-help guide using cognitive-behavioural techniques. London: Constable & Robinson.Google Scholar
Slaney, R. B., Rice, K. G., Mobley, M., Trippi, J. and Ashby, J. S. (2001). The Revised Almost Perfect Scale. Measurement and Evaluation in Counseling and Development, 34, 130–145.CrossRefGoogle Scholar
Steele, A. L. and Wade, T. D. (2008). A randomised trial investigating guided self-help to reduce perfectionism and its impact on bulimia nervosa: a pilot study. Behaviour Research and Therapy, 46, 1316–1323.CrossRefGoogle ScholarPubMed
Steele, A. L., Waite, S., Egan, S.J., Finnigan, J., Handley, H. and Wade, T.D. (2013). Psycho-education and group cognitive-behavioural therapy for clinical perfectionism: a case series evaluation. Behavioural and Cognitive Psychotherapy, 41, 129–143.Google Scholar
Stoeber, J. and Otto, K. (2006). Positive conceptions of perfectionism: approaches, evidence, challenges. Personality and Social Psychology Review, 10, 295–319.Google Scholar
Sutandar-Pinnock, K., Woodside, D. B., Carter, J. C., Olmsted, M. P. and Kaplan, A. S. (2003). Perfectionism in anorexia nervosa: a 6–24-month follow-up study. International Journal of Eating Disorders, 33, 225–229.Google Scholar
Vincent, N. K. and Walker, J. R. (2000). Perfectionism and chronic insomnia. Journal of Psychosomatic Research, 49, 349–354.CrossRefGoogle ScholarPubMed
Wilksch, S. M., Durbridge, M. R. and Wade, T. D. (2008). A preliminary controlled comparison of programs designed to reduce risk of eating disorders targeting perfectionism and media literacy. Journal of the American Academy of Child & Adolescent Psychiatry, 47, 939–947.Google Scholar
Wilksch, S. M., and Wade, T. D. (2013). Life smart: a pilot study of a school-based program to reduce the risk of both eating disorders and obesity in young adolescent girls and boys. Journal of Pediatric Psychology, 38, 1021–1029.CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.