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Background: Mindfulness-based cognitive therapy (MBCT) has evidence of efficacy in a range of populations, but few studies to date have reported on MBCT for treatment of anxious and depressive symptoms in Parkinson's disease (PD). Aims: The aim of this study was to examine the efficacy of modified MBCT in reducing symptoms of anxiety and depression and improving quality of life in PD. Method: Thirty-six individuals with PD were randomly assigned to either modified MBCT or a waitlist control. Changes in symptoms of anxiety, depression and quality of life were compared at group level using generalized linear mixed models and at individual level using reliable change analysis. Results: At post-treatment, there was a significant reduction in depressive symptoms for people undertaking modified MBCT at both group and individual levels compared with controls. There was no significant effect on anxiety or quality of life at the group level, although significantly more people had reliable improvement in anxiety after modified MBCT than after waitlist. Significantly more waitlist participants had reliable deterioration in symptoms of anxiety and depression than those completing modified MBCT. Most participants stayed engaged in modified MBCT, with only three drop-outs. Discussion: This proof-of-concept study demonstrates the potential efficacy of modified MBCT as a treatment for depressive symptoms in Parkinson's disease and suggests further research is warranted.
Background: The evidence regarding whether co-morbid obsessive compulsive personality disorder (OCPD) is associated with treatment outcomes in obsessive compulsive disorder (OCD) is mixed, with some research indicating that OCPD is associated with poorer response, and some showing that it is associated with improved response. Aims: We sought to explore the role of OCPD diagnosis and the personality domain of conscientiousness on treatment outcomes for exposure and response prevention for OCD. Method: The impact of co-morbid OCPD and conscientiousness on treatment outcomes was examined in a clinical sample of 46 participants with OCD. Results: OCPD diagnosis and scores on conscientiousness were not associated with poorer post-treatment OCD severity, as indexed by Yale-Brown Obsessive Compulsive Scale (YBOCS) scores, although the relative sample size of OCPD was small and thus generalizability is limited. Conclusion: This study found no evidence that OCPD or conscientiousness were associated with treatment outcomes for OCD. Further research with larger clinical samples is required.
Background: Perfectionism is strongly associated with obsessive compulsive disorder (OCD). Cognitive behavioural therapy for perfectionism (CBT-P) has been found to result in reductions in a range of symptoms in individuals with anxiety disorders, depression and eating disorders. Aim: To pilot-test the efficacy of group CBT for perfectionism in participants with OCD and elevated perfectionism. Method: Participants were randomized to receive immediate 8-week group CBT-P (n = 4) or an 8-week waitlist followed by CBT-P (n = 7). Results: Reliable reductions and a large effect size indicated that CBT-P was associated with improvements in perfectionism and OCD severity at post-test. However, these changes were not clinically significant and drop-out was high, resulting in a small final sample. Conclusions: CBT-P may be effective in reducing perfectionism and disorder-specific OCD symptoms. However, the high drop-out rate and lack of clinically significant findings suggest that further research needs to be conducted to determine the efficacy of CBT for perfectionism in OCD.
Perfectionism is a risk and maintaining factor across psychopathology and has been proposed to be a transdiagnostic process. The aim of this study was to examine the reliability and validity of the Clinical Perfectionism Questionnaire (CPQ) in 32 adults (75% female, M age = 35.54 years, SD = 9.71) with a range of psychological disorders, presenting for treatment of clinical perfectionism. There was evidence that the CPQ was correlated with established measures of perfectionism and theoretically related constructs including self-criticism and dichotomous thinking. The CPQ was also able to predict treatment outcome. The internal consistency was not adequate in the current study; however, the sample size was small. Future studies should examine the psychometric properties of the CPQ in a larger sample of individuals with a range of psychological disorders.
Perfectionism has been argued to have both positive and negative aspects. Negative perfectionism has a robust positive correlation with psychopathology. This study explored the personality pattern of a group of clinical participants and a group of athletes in relation to positive and negative perfectionism. The results indicated negative perfectionism is related to neuroticism and agreeableness in both clinical and non-clinical groups. Negative perfectionism was most strongly associated with low agreeableness but had no significant relationship with conscientiousness or extraversion in the clinical sample. In the athlete sample, higher negative perfectionism was most strongly related to higher neuroticism but was also associated with lower extraversion and conscientiousness. In order to more fully understand these relationships and their clinical implications, more studies using validated measures of positive and negative perfectionism with larger samples are required. It would be useful to determine if personality factors of agreeableness and competence could be increased in order to ameliorate the distress associated with negative perfectionism.
Background: Clinical perfectionism is a risk and maintaining factor for anxiety disorders, depression and eating disorders. Aims: The aim was to examine the psychometric properties of the 12-item Clinical Perfectionism Questionnaire (CPQ). Method: The research involved two samples. Study 1 comprised a nonclinical sample (n = 206) recruited via the internet. Study 2 comprised individuals in treatment for an eating disorder (n = 129) and a community sample (n = 80). Results: Study 1 factor analysis results indicated a two-factor structure. The CPQ had strong correlations with measures of perfectionism and psychopathology, acceptable internal consistency, and discriminative and incremental validity. The results of Study 2 suggested the same two-factor structure, acceptable internal consistency, and construct validity, with the CPQ discriminating between the eating disorder and control groups. Readability was assessed as a US grade 4 reading level (student age range 9–10 years). Conclusions: The findings provide evidence for the reliability and validity of the CPQ in a clinical eating disorder and two separate community samples. Although further research is required the CPQ has promising evidence as a reliable and valid measure of clinical perfectionism.
Background: Improving mental health literacy in the general population is important as it is associated with early detection and treatment-seeking for mental health problems. Target areas for mental health literacy programs should be guided by research that tests the impact of improving knowledge of psychological constructs associated with the development of mental health problems. Aims: This study investigated the impact of providing corrective information about the nature of intrusive thoughts on their subsequent appraisal in a community sample. Method: In an online, experimental design, 148 community participants completed measures of obsessive-compulsive symptoms and appraisals (Obsessive Compulsive Inventory-Revised [OCI-R]; Intrusions Inventory [III]). Individuals were instructed to read either a brief informational text about the nature of intrusive thoughts or a control text. All participants then completed post-test measurements of appraisals. Intervention effectiveness was analysed using hierarchical multiple regression. Results: Individuals in the intervention group reported significantly lower levels of maladaptive appraisals than those in the control group (α = .05). Conclusions: The results of this study support the efficacy of provision of brief written information in reducing negative appraisals of intrusive thoughts in a community sample. It suggests a possible role for education about intrusive thoughts as a prevention strategy for obsessive-compulsive disorder.
Background: To date no research has investigated the link between Post Traumatic Stress Disorder (PTSD) and perfectionism in a clinical sample. Aims: The aim of the current study was to examine whether there is a relationship between PTSD and perfectionism. This is important to address as many studies have demonstrated a link between other anxiety disorders, eating disorders, depression and perfectionism. The research also aimed to examine whether rumination was a mediator of the relationship between PTSD and perfectionism. Method: The sample consisted of 30 participants who were currently in treatment for PTSD. Results: The results suggest that perfectionism and PTSD symptoms were significantly correlated. In addition, rumination was a significant mediator of the relationship between Concern over Mistakes and PTSD. Conclusions: These findings help increase understanding about the relationships of perfectionism and rumination in PTSD and have implications for the treatment of PTSD.
Background: Clinical perfectionism is a transdiagnostic process that has been found to maintain eating disorders, anxiety disorders and depression. Cognitive behavioural models explaining the maintenance of clinical perfectionism emphasize the contribution of dichotomous thinking and resetting standards higher following both success and failure in meeting their goals. There has been a paucity of research examining the predictions of the models and motivation to change perfectionism. Motivation to change is important as individuals with clinical perfectionism often report many perceived benefits of their perfectionism; they are, therefore, likely to be ambivalent regarding changing perfectionism. Aims: The aim was to compare qualitative responses regarding questions about motivation to change standards and cognitions regarding failure to meet a personal standard in two contrasting groups with high and low negative perfectionism. Negative perfectionism refers to concern over not meeting personal standards. Method: A clinical group with a range of axis 1 diagnoses who were elevated on negative perfectionism were compared to a group of athletes who were low on negative perfectionism. Results: Results indicated that the clinical group perceived many negative consequences of their perfectionism. They also, however, reported numerous benefits and the majority stated that they would prefer not to change their perfectionism. The clinical group also reported dichotomous thinking and preferring to either keep standards the same or reset standards higher following failure, whilst the athlete group reported they would keep standards the same or set them lower. Conclusions: The findings support predictions of the cognitive behavioural model of clinical perfectionism.
This study investigated if clinical perfectionism leads to resetting standards higher following both success and failure. A sample of 206 participants (74% female) completed an online experiment consisting of three sets of a nonverbal reasoning task and were asked before each set to select how many of the trials they aimed to get correct. Each set was followed by feedback regarding performance. Half of the participants received ‘difficult’ items for set 2, to allow investigation of failure effects. There was a significant relationship between clinical perfectionism and the standards that were set for the first set; however, there was no relationship with standard setting following success or failure. Instead, previous actual success or failure was the best predictor of goal setting. Consequently, clinical perfectionism was associated with setting higher standards in general, but not resetting standards higher following success or failure. Findings suggest that while clinical perfectionism plays a role in standard setting prior to performance, following performance actual success or failure becomes the best indicator. The implications of these findings for the cognitive behavioural model of clinical perfectionism are discussed.
Background: Research indicates that psycho-education and cognitive behavioural interventions can reduce perfectionism but to date no group treatments have been examined. Aims: The current study utilized a case series design to compare psycho-education materials and subsequent eight-week group cognitive behaviour therapy (CBT) to a baseline waitlist in an outpatient community psychiatry sample (n = 21). Method: Participants were assessed on five occasions: baseline, 4 weeks later (waitlist), 4 weeks after receiving psycho-education material, post-treatment (8 weeks after receiving the group intervention), and 3-month follow-up. Results: There was a main effect of time for perfectionism and negative affect from baseline to post-group (effect sizes ranging from 1.46 to 1.91) that were maintained at 3-month follow-up. Conclusions: These results suggested that group CBT for clinical perfectionism may be beneficial, but that psycho-education alone is not effective for reducing perfectionism or negative affect.
Background: Magical thinking has been proposed to have an aetiological role in obsessive compulsive disorder (OCD). Aims: To address the limitations of existing measures of magical thinking we developed and validated a new 24-item measure of magical thinking, the Illusory Beliefs Inventory (IBI). Method: The validation sample comprised a total of 1194 individuals across two samples recruited via an Internet based survey. Results: Factor analysis identified three subscales representing domains relevant to the construct of magical thinking: Magical Beliefs, Spirituality, and Internal State and Thought Action Fusion. The scale had excellent internal consistency and evidence of convergent and discriminant validity. Evidence of criterion-related concurrent validity confirmed that magical thinking is a cognitive domain associated with OCD and is largely relevant to neutralizing, obsessing and hoarding symptoms. Conclusions: It is important for future studies to extend the evidence of the psychometric properties of the IBI in new populations and to conduct longitudinal studies to examine the aetiological role of magical thinking.
Perfectionism has been suggested as a risk factor for the development of stress and burnout in psychotherapists, but this has not been extensively investigated. This study examined the relationship between perfectionism, stress and burnout in 87 Australian clinical psychologists. Stress had significant influences on the relationship between perfectionism and burnout. Specifically, stress was found to be a partial intervening variable in the relationship between perfectionism and personal burnout. In addition, stress was also found to completely mediate the influence of perfectionism on work-related and client-related burnout. The results indicated that perfectionism was both directly and indirectly related through stress to various types of burnout in clinical psychologists. Implications of the findings for research in to the utility of intervention for high levels of perfectionism in clinical psychologists are discussed.
Perfectionism can maintain depression, anxiety and eating disorders, yet few studies have evaluated treatments for perfectionism. This study examined the effectiveness of individual cognitive behaviour therapy (CBT) in treating perfectionism in four adults with a diagnosis of either an anxiety disorder or depression. The study used an A-B single case experimental design series with follow-up, and a 3-week pre- and postbaseline phase. Treatment involved 8 sessions and a 2-week follow-up session. Visual inspection of data revealed downward trends in overall perfectionism and clinically significant decreases in perfectionism for two participants. No clinically significant reductions were observed in depressive or anxious symptomatology. CBT for perfectionism warrants further investigation.
Although there has been a long interest in the personality traits associated with obsessive-compulsive disorder (OCD), few studies have examined differences on normal, dimensional personality traits for individuals with OCD compared with other clinical disorders. The purpose of this study was to replicate and extend upon the work of Rector et al. (2002) who found unique associations between OCD and trait domains and facets of the five-factor model of personality (FFM) when compared with a clinical sample of depressed individuals. The current study compared individuals with a current diagnosis of OCD (n=21) with individuals with a current diagnosis of anxiety or depression but no OCD symptoms (n=39) on the Revised NEO Personality Inventory (NEO PI-R Form S). Of particular interest was whether individuals with OCD would differ from other clinically anxious/depressed individuals on the actions facet of the FFM, as this facet is known to be related to harm and risk avoidance, and previous research suggests specific relationships between these forms of avoidance and OCD. Individuals with OCD were found to have lower scores on the actions, competence and self-discipline facets. These results add further support to previous research that suggests unique associations between trait domains and facets of the FFM and OCD.
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