The comparison between CBT focused on perfectionism and CBT focused on emotion regulation for individuals with depression and anxiety disorders and dysfunctional perfectionism: a randomized controlled trial

• Published in: Behavioural and cognitive psychotherapy 2021-07, Vol.49 (4), p.454-471
• Main Authors: Mahmoodi, Mohammad, Bakhtiyari, Maryam, Masjedi Arani, Abbas, Mohammadi, Abolfazl, Saberi Isfeedvajani, Mohsen
• Format: Article
• Language: English
• Subjects: Anxiety; Anxiety disorders; Behavior modification; Cognitive ability; Cognitive therapy; Eating disorders; Emotional disorders; Emotions; Main; Mental depression; Mental disorders; Morbidity; Psychopathology; Quality of life; Research methodology
• ISSN: 1352-4658; 1469-1833
• DOI: 10.1017/S1352465820000909

There is considerable evidence indicating that similar aetiological and maintenance processes underlie depressive and anxious psychopathology. According to the literature, perfectionism and emotion regulation are two transdiagnostic constructs associated with symptoms of emotional disorders. This study is the first randomized controlled trial comparing the efficacy of cognitive behavioural therapy for perfectionism (CBT-P) and the unified protocol for the transdiagnostic treatment of emotional disorders (UP). Seventy-five participants with a range of depressive and anxiety disorders and elevated perfectionism were randomized to three conditions: CBT-P, UP or a waitlist control (WL). Repeated measures ANOVA indicated that the treatment groups reported a significantly greater pre-post reduction in the severity of symptoms of disorders, as well as a significantly greater pre-post increase in quality of life, all with moderate to large effect sizes compared with the WL group. Treatment gains were maintained at 6-month follow-up. The CBT-P group reported a significantly greater pre-post reduction in perfectionism compared with UP, and the UP group reported a significantly greater pre-post improvement in emotion regulation compared with CBT-P. Findings support CBT for perfectionism and regard UP as efficacious treatments for individuals with depression and anxiety disorders who also have dysfunctional perfectionism. It appears that perfectionism cannot be a serious obstacle to UP. As this is a preliminary study and has some limitations, it is recommended that further research be conducted.