Guided web-based cognitive behavior therapy for perfectionism: Results from two different randomized controlled trials
© 2018 The authors. Background: Perfectionism can become a debilitating condition that may negatively affect functioning in multiple areas, including mental health. Prior research has indicated that internet-based cognitive behavioral therapy can be beneficial, but few studies have included follow-u...
| Main Authors: | , , , , , , , , |
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| Format: | Journal Article |
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Journal of Medical Internet Research
2018
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| Online Access: | http://hdl.handle.net/20.500.11937/68849 |
| _version_ | 1848761904992878592 |
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| author | Rozental, A. Shafran, R. Wade, T. Kothari, R. Egan, Sarah Ekberg, L. Wiss, M. Carlbring, P. Andersson, G. |
| author_facet | Rozental, A. Shafran, R. Wade, T. Kothari, R. Egan, Sarah Ekberg, L. Wiss, M. Carlbring, P. Andersson, G. |
| author_sort | Rozental, A. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | © 2018 The authors. Background: Perfectionism can become a debilitating condition that may negatively affect functioning in multiple areas, including mental health. Prior research has indicated that internet-based cognitive behavioral therapy can be beneficial, but few studies have included follow-up data. Objective: The objective of this study was to explore the outcomes at follow-up of internet-based cognitive behavioral therapy with guided self-help, delivered as 2 separate randomized controlled trials conducted in Sweden and the United Kingdom. Methods: In total, 120 participants randomly assigned to internet-based cognitive behavioral therapy were included in both intention-to-treat and completer analyses: 78 in the Swedish trial and 62 in the UK trial. The primary outcome measure was the Frost Multidimensional Perfectionism Scale, Concern over Mistakes subscale (FMPS CM). Secondary outcome measures varied between the trials and consisted of the Clinical Perfectionism Questionnaire (CPQ; both trials), the 9-item Patient Health Questionnaire (PHQ-9; Swedish trial), the 7-item Generalized Anxiety Disorder scale (GAD-7; Swedish trial), and the 21-item Depression Anxiety Stress Scale (DASS-21; UK trial). Follow-up occurred after 6 months for the UK trial and after 12 months for the Swedish trial. Results: Analysis of covariance revealed a significant difference between pretreatment and follow-up in both studies. Intention-to-treat within-group Cohen d effect sizes were 1.21 (Swedish trial; 95% CI 0.86-1.54) and 1.24 (UK trial; 95% CI 0.85-1.62) for the FMPS CM. Furthermore, 29 (59%; Swedish trial) and 15 (43%; UK trial) of the participants met the criteria for recovery on the FMPS CM. Improvements were also significant for the CPQ, with effect sizes of 1.32 (Swedish trial; 95% CI 0.97-1.66) and 1.49 (UK trial; 95% CI 1.09-1.88); the PHQ-9, effect size 0.60 (95% CI 0.28-0.92); the GAD-7, effect size 0.67 (95% CI 0.34-0.99); and the DASS-21, effect size 0.50 (95% CI 0.13-0.85). Conclusions: The results are promising for the use of internet-based cognitive behavioral therapy as a way of targeting perfectionism, but the findings need to be replicated and include a comparison condition. |
| first_indexed | 2025-11-14T10:39:05Z |
| format | Journal Article |
| id | curtin-20.500.11937-68849 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T10:39:05Z |
| publishDate | 2018 |
| publisher | Journal of Medical Internet Research |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-688492018-09-27T03:36:04Z Guided web-based cognitive behavior therapy for perfectionism: Results from two different randomized controlled trials Rozental, A. Shafran, R. Wade, T. Kothari, R. Egan, Sarah Ekberg, L. Wiss, M. Carlbring, P. Andersson, G. © 2018 The authors. Background: Perfectionism can become a debilitating condition that may negatively affect functioning in multiple areas, including mental health. Prior research has indicated that internet-based cognitive behavioral therapy can be beneficial, but few studies have included follow-up data. Objective: The objective of this study was to explore the outcomes at follow-up of internet-based cognitive behavioral therapy with guided self-help, delivered as 2 separate randomized controlled trials conducted in Sweden and the United Kingdom. Methods: In total, 120 participants randomly assigned to internet-based cognitive behavioral therapy were included in both intention-to-treat and completer analyses: 78 in the Swedish trial and 62 in the UK trial. The primary outcome measure was the Frost Multidimensional Perfectionism Scale, Concern over Mistakes subscale (FMPS CM). Secondary outcome measures varied between the trials and consisted of the Clinical Perfectionism Questionnaire (CPQ; both trials), the 9-item Patient Health Questionnaire (PHQ-9; Swedish trial), the 7-item Generalized Anxiety Disorder scale (GAD-7; Swedish trial), and the 21-item Depression Anxiety Stress Scale (DASS-21; UK trial). Follow-up occurred after 6 months for the UK trial and after 12 months for the Swedish trial. Results: Analysis of covariance revealed a significant difference between pretreatment and follow-up in both studies. Intention-to-treat within-group Cohen d effect sizes were 1.21 (Swedish trial; 95% CI 0.86-1.54) and 1.24 (UK trial; 95% CI 0.85-1.62) for the FMPS CM. Furthermore, 29 (59%; Swedish trial) and 15 (43%; UK trial) of the participants met the criteria for recovery on the FMPS CM. Improvements were also significant for the CPQ, with effect sizes of 1.32 (Swedish trial; 95% CI 0.97-1.66) and 1.49 (UK trial; 95% CI 1.09-1.88); the PHQ-9, effect size 0.60 (95% CI 0.28-0.92); the GAD-7, effect size 0.67 (95% CI 0.34-0.99); and the DASS-21, effect size 0.50 (95% CI 0.13-0.85). Conclusions: The results are promising for the use of internet-based cognitive behavioral therapy as a way of targeting perfectionism, but the findings need to be replicated and include a comparison condition. 2018 Journal Article http://hdl.handle.net/20.500.11937/68849 10.2196/jmir.9823 http://creativecommons.org/licenses/by/4.0/ Journal of Medical Internet Research fulltext |
| spellingShingle | Rozental, A. Shafran, R. Wade, T. Kothari, R. Egan, Sarah Ekberg, L. Wiss, M. Carlbring, P. Andersson, G. Guided web-based cognitive behavior therapy for perfectionism: Results from two different randomized controlled trials |
| title | Guided web-based cognitive behavior therapy for perfectionism: Results from two different randomized controlled trials |
| title_full | Guided web-based cognitive behavior therapy for perfectionism: Results from two different randomized controlled trials |
| title_fullStr | Guided web-based cognitive behavior therapy for perfectionism: Results from two different randomized controlled trials |
| title_full_unstemmed | Guided web-based cognitive behavior therapy for perfectionism: Results from two different randomized controlled trials |
| title_short | Guided web-based cognitive behavior therapy for perfectionism: Results from two different randomized controlled trials |
| title_sort | guided web-based cognitive behavior therapy for perfectionism: results from two different randomized controlled trials |
| url | http://hdl.handle.net/20.500.11937/68849 |