| Popis: |
Clinical perfectionism - having a sense of self-worth that is overly dependent on striving and achievement - is problematic for mental wellbeing and contributes to the onset and maintenance of multiple psychological disorders. The present study is a randomized, longitudinal test of a web-based intervention for perfectionism (cognitive bias modification, interpretation retraining; CBM-I), relative to an active treatment comparison condition (relaxation training). College students (N = 167) with elevated perfectionism were randomized to either CBM-I for perfectionism, or relaxation training via guided visualization audio recordings. Participants were asked to complete their assigned intervention twice weekly for four weeks. Participants also completed measures of perfectionism (perfectionism-relevant interpretation biases; self-report perfectionism; perfectionistic performance concerns on behavioral tasks) and psychological symptoms (depression, anxiety, eating disorder pathology, negative self-perceptions). These measures were completed at baseline, two weeks (mid-way through the intervention period), four weeks (at the conclusion of the intervention period), and eight weeks (follow-up visit). Participants also reported on their demographics, prior and concurrent psychological treatments, and perceived acceptability of their assigned intervention. The baseline assessment was an in-person lab visit; all other study visits were completed online. Results were mixed. The CBM-I intervention was rated as acceptable overall, though relaxation training was rated slightly more favorably. Participants in both conditions showed small reductions in perfectionism over the course of the study. Contrary to hypotheses, results suggest that CBM-I was not significantly better than relaxation training at improving perfectionism-relevant interpretation biases, though there were marginal effects in expected directions. Results indicated no benefit of CBM-I over relaxation training on reducing perfectionism self-report scores or perfectionistic performance concerns on behavioral tasks. Longitudinal mediation analyses found that randomization to CBM-I predicted less strong perfectionistic interpretations of ambiguous scenarios, which in turn predicted lower eating disorder pathology, anxiety symptoms, and self-criticism (controlling for corresponding baseline scores). In the present longitudinal, randomized trial, both CBM-I for perfectionism and relaxation training led to slight decreases in perfectionism in a nonclinical sample of perfectionistic college students. Contrary to hypotheses, CBM-I did not outperform relaxation training. However, support was found for a key hypothesized mechanism of CBM-I: randomization to CBM-I had a longitudinal, indirect effect on decreasing psychopathology symptom scores through decreasing perfectionistic interpretations (though effect sizes were small). The present study aligns with recent research and clinical efforts to conceptualize and treat psychopathology on the basis of underlying mechanisms for symptom improvement, as opposed to on the basis of disorder status. |
