Biased interpretation in perfectionistic concerns: an experimental investigation

Cognitive bias modification for perfectionism and intolerance of uncertainty: A randomized controlled trial

This study investigated the efficacy of combined cognitive bias modification (CBM) on perfectionism and intolerance of uncertainty. Fifty-four university students scoring over 70.5 on the Brief Symptom Measure were randomly assigned to experimental and placebo control groups. The CBM intervention was administered online for 4 weeks. Assessments were given at baseline, after the 4-week intervention, and 1 month post-intervention. Results showed a statistically significant decrease in two dimensions of perfectionism, concern over mistakes and parental criticism, and intolerance of uncertainty of those in the experimental group, compared to those in the control group. The findings related to the interpretation of perfectionism revealed a significant interaction effect of time and direction of sentences for the experimental group. Lastly, the experimental group's interpretation bias scores for intolerance of uncertainty showed a statistically significant increase after the intervention compared to those in the control group. The study's findings provide preliminary support for the effectiveness of CBM on perfectionism and intolerance of uncertainty.

Coming of age: A reflection of the first 21 years of cognitive behaviour therapy for perfectionism

It has been 21 years since the publication of the cognitive behavioural model of clinical perfectionism that underpins cognitive behaviour therapy (CBT) for perfectionism. The notion of clinical perfectionism and CBT for perfectionism has been controversial. Despite 15 randomised controlled trials which have demonstrated the efficacy of CBT for perfectionism in reducing perfectionism and symptoms of anxiety, depression and eating disorders, strong responses to this work continue to appear in the literature. In this article, we examine the evolution and controversy surrounding clinical perfectionism, the efficacy of CBT for perfectionism, and future directions for the concept of perfectionism and its treatment. Future research should aim to provide independent evaluations of treatment efficacy, compare CBT for perfectionism to active treatments, conduct dismantling trials to examine the effective components of treatment, and examine the causal processes involved in perfectionism. We provide recommendations for future pathways to support innovation in theory, understanding, and treatment of perfectionism with a view towards improving clinical outcomes.

A Randomized Test of Interpretation Bias Modification for Perfectionism Versus Guided Visualization Relaxation Among High Perfectionistic Undergraduate Students

Clinical perfectionism contributes to the onset and maintenance of multiple psychological concerns. We conducted a randomized, longitudinal test of the efficacy of a web-based intervention for perfectionism (specifically, cognitive bias modification, interpretation retraining; CBM-I), compared to an active treatment comparison condition (specifically, guided visualization relaxation training) for reducing perfectionism and related psychopathology. College students (N = 167) with elevated perfectionism were randomized to one of the two study conditions and were asked to complete their assigned intervention twice weekly for 4 weeks. Participants completed measures of perfectionism and psychological symptoms at baseline, 2 weeks (midway through the intervention period), 4 weeks (at the conclusion of the intervention period), and 8 weeks (1 month follow-up). CBM-I was rated as acceptable overall, though relaxation training was rated slightly more favorably. CBM-I outperformed relaxation training on improving perfectionism-relevant interpretation biases (i.e., increasing nonperfectionistic interpretations and decreasing perfectionistic interpretations), though with small effect sizes and inconsistency across study timepoints. Self-reported perfectionism showed small decreases across time in both intervention conditions. Support was found for a key hypothesized mechanism of CBM-I, such that randomization to CBM-I had a longitudinal, indirect effect on decreasing psychopathology symptom scores through improving perfectionism-relevant interpretation biases. However, in light of small effect sizes, the present study failed to provide compelling evidence that CBM-I for perfectionism contributes meaningfully to the treatment of perfectionism.