Overcoming Perfectionism: A Randomised Controlled Trial of an Online CBT Based Guided Self-help Intervention

November 9, 2017 updated by: Institute of Child Health
The purpose of this study is to assess the effectiveness of CBT based online guided self-help intervention for perfectionism at reducing symptoms of perfectionism and Axis I disorders post-treatment and at six-month follow-up.

Study Overview

Status

Completed

Conditions

Detailed Description

Perfectionism is elevated across, and increases risk for a range of Axis I disorders, as well as having a direct negative effect on day to day function. A growing body of evidence shows that cognitive behavioural therapy (CBT) reduces perfectionism and Axis I disorders, with medium to large effect sizes. Given the increased desire for online interventions to facilitate access to evidence-based therapy, web-based CBT self-help interventions for perfectionism have been designed. Existing interventions have not included personalised guidance which has been shown to improve outcome rates.

The purpose of this study is to assess the effectiveness of CBT based online guided self-help intervention for perfectionism at reducing symptoms of perfectionism and Axis I disorders post-treatment and at six-month follow-up.

A randomised controlled trial method is employed, comparing the treatment arm (online guided self-help) with a waiting list control group. Outcomes are examined at three time points, T1 (baseline), T2 (post-intervention at 12 weeks), T3 (follow-up at 24 weeks). Participants will be recruited through universities, online platforms, and social media, and if eligible will be randomised using an online automatic randomiser.

Study Type

Interventional

Enrollment (Actual)

120

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • London, United Kingdom, WC1N 1EH
        • UCL Institute of Child Health

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Be 18 or over, with no upper age limit.
  • Score one standard deviation above published norms on the 'Concern over mistakes' subscale of the Frost Multidimensional Perfectionism Scale (Frost, Marten, Lahart, & Rosenblate, 1990), i.e. a score of ≥ 29 (Flett, Sawatzky, & Hewitt, 1995).
  • Be fluent in English.

Exclusion Criteria:

- They report suicidal thoughts or intent prior to commencement of the intervention.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Online guided self-help intervention
CBT based online guided self-help intervention. Intervention can be found at www.overcomingperfectionism.co.uk
CBT based online guided self-help intervention for perfectionism based on CBT manual for treatment of perfectionism, "Cognitive Behavioural Treatment of Perfectionism" by Sarah Egan, Tracy Wade, Roz Shafran and Martin Antony
Other Names:
  • Overcoming Perfectionism
No Intervention: Control
No intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Frost Multidimensional Perfectionism Scale (Frost et al., 1990)
Time Frame: 6 months
This self-report measure consists of 36 items grouped into six subscales. Participants respond on a five point scale ranging from 1 = "strongly disagree" to 5 = "strongly agree". The measure has been found to be both reliable and valid for use with non-clinical and clinical populations (Frost et al., 1990; Hewitt & Flett, 1991; Hewitt, Flett, Turnbull-Donovan, & Mikail, 1991). Participants will be considered eligible for inclusion in the study if they score one standard deviation above published norms on the Concern over Mistakes subscale, i.e. a score of ≥ 29. This measure has been amended to reflect participants experience over the past month allowing us to measure change.
6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Obsessive-Compulsive Inventory - Revised (OCI-R) (Foa et al., 2002)
Time Frame: 6 months
The OCI-R, a shortened version of the Obsessive-Compulsive Inventory, assesses symptoms of OCD. The measure consists of 18 items (e.g. "I frequently have get nasty thoughts and have difficulty in getting rid of them"). On a five point scale, respondents rate how distressed or bothered they have been in the past month by the symptom described, with responses ranging from "Not at all" to "Extremely." It has been found to have good validity and reliability in both clinical and non-clinical samples (Abramowitz & Deacon, 2006; Foa et al., 2002; Hajcak, Huppert, Simons, & Foa, 2004; Huppert et al., 2007).
6 months
Eating Disorder Examination-Questionnaire (EDE-Q) (C. G. Fairburn, 1994)
Time Frame: 6 months
The EDE-Q assesses for symptoms of the eating disorders: Anorexia Nervosa (AN), Bulimia Nervosa (BN), Binge Eating Disorder (BED) and sub-threshold variants. The measure consists of 28 items rated on a seven point scale appropriate to the item: number of days a symptom has been experienced over the past month, ranging from no days to every day; and for remaining questions (e.g. "How dissatisfied have you been with your weight?") responses ranging from "Not at all" to "Markedly." It has been found to have good reliability, and has been validated for use among clinical and community samples (Aardoom, Dingemans, Op't Landt, & Van Furth, 2012; Carter, Stewart, & Fairburn, 2001; J. M. Mond, Hay, Rodgers, Owen, & Beumont, 2004; Jonathan M Mond et al., 2008; Reas, Grilo, & Masheb, 2006).
6 months
Depression, Anxiety and Stress Scales (DASS) (Lovibond & Lovibond, 1996)
Time Frame: 6 months
The DASS is a 42 item self-report measure of depression, anxiety and stress (e.g. "I found myself getting upset by quite trivial things"), rated on a four point scale ranging from "Did not apply to me at all" to "Applied to me very much or most of the time." It has been shown to be reliable and has been validated for use among clinical and community samples (Brown, Chorpita, Korotitsch, & Barlow, 1997; Crawford & Henry, 2003; Page, Hooke, & Morrison, 2007).
6 months
Vancouver Obsessional Compulsive Inventory - Mental Contamination Scale (VOCI-MC) (Radomsky, Rachman, Shafran, Coughtrey, & Barber, 2014)
Time Frame: 6 months
The VOCI-MC is a self-report measure that assesses symptoms of mental contamination. The measure consists of 20 items (e.g. "Often I look clean but feel dirty), rated on a five point scale ranging from "Not at all" to "Very much." It has been shown to be reliable and valid for use among clinical and community samples (Coughtrey, Shafran, Knibbs, & Rachman, 2012; Coughtrey, Shafran, & Rachman, 2013; Radomsky et al., 2014).
6 months
Clinical Perfectionism Questionnaire (CPQ; C. Fairburn et al., 2003a)
Time Frame: 6 months
This self-report measure consists of 12 items (e.g. "Have you pushed yourself really hard to meet your goals?" and "Have you raised your standards because you thought they were too easy?"). Participants respond on a four point scale ranging from 1 = "not at all" to 4 = "all the time". This measure of clinical perfectionism was created by Fairburn, Cooper and Shafran at the University of Oxford, and has been found to have good reliability and validity in two community samples and an ED sample; participants will be considered eligible for inclusion if they score similarly to this psychiatric population (i.e. a score of ≥ 29) (Egan, Shafran, et al., 2014). This measure has been amended to reflect participants experience over the past week, allowing us to monitor change on a weekly basis.
6 months

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Fears of Compassion Scales (FCS; (Paul Gilbert, McEwan, Matos, & Rivis, 2011)
Time Frame: 6 months
This measure consists of three scales which assess fear of compassion for self (e.g. "I worry that if I start to develop compassion for myself I will become dependent on it"), fear of compassion from others (e.g. "I try to keep my distance from others, even if I know they are kind"), and fear of compassion for others (e.g. "Being too compassionate makes people soft and easy to take advantage of"). The FCS is made up of 38 items in total which are rated on a four point scale ranging from 0 = "Don't agree at all" to 4 = "Completely agree." It has been shown to be reliable, and valid for use among clinical and community samples (P Gilbert et al., 2012; Paul Gilbert et al., 2011).
6 months
Rosenberg Self-esteem Scale (Rosenberg, 1965)
Time Frame: 6 months
This measure of self-esteem consists of 10 items (e.g. "On the whole I am satisfied with myself" and "I wish I could have more respect for myself") and is rated on a four point scale ranging from 1 = "strongly disagree" to 4 = "strongly agree" It has been found to be reliable, and been validated for use among clinical and community samples (Bagley & Mallick, 2001; Ferring & Filipp, 1996; Martín-Albo, Núñez, Navarro, & Grijalvo, 2007; Phillips, Pinto, & Jain, 2004; Schmitt & Allik, 2005; Shaw-Zirt, Popali-Lehane, Chaplin, & Bergman, 2005).
6 months
Intolerance of Uncertainty Scale (IoU; (Freeston, Rhéaume, Letarte, Dugas, & Ladouceur, 1994)
Time Frame: 6 months
The IoU consists of 27 items (e.g. "Uncertainty stops me from having a firm opinion" and "It's unfair not having any guarantees in life"), and is rated on a five point scale ranging from 1 = "Not at all characteristic of me" to 5 = "Entirely characteristic of me." It has been found to be reliable, and has been validated for use among clinical and community samples (Kristine Buhr & Dugas, 2002; Kristin Buhr & Dugas, 2006; Jacoby, Fabricant, Leonard, Riemann, & Abramowitz, 2013).
6 months
Warwick-Edinburgh Mental Well-Being Scale (WEMWBS; (Tennant et al., 2007)
Time Frame: 6 months
The WEMWBS is a 14 item self-report measure of mental well-being that focuses on positive aspects of mental health, including subjective well-being, psychological functioning (including autonomy, competence, self-acceptance, and personal growth), and interpersonal relationships. Examples of items include, "I have been feeling optimistic about the future," "I have been feeling confident," and "I have been dealing with problems well." Participants respond on a five point scale, ranging from 1 = "none of the time" to 5 = "all of the time." The WEMWBS has shown good reliability (0.83) and has been validated for use among student and population samples (Clarke et al., 2011; Maheswaran, Weich, Powell, & Stewart-Brown, 2012; Tennant et al., 2007).
6 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Roz Shafran, PhD, UCL Institute of Child Health

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

July 1, 2015

Primary Completion (Actual)

February 1, 2017

Study Completion (Actual)

February 1, 2017

Study Registration Dates

First Submitted

April 27, 2016

First Submitted That Met QC Criteria

April 27, 2016

First Posted (Estimate)

April 29, 2016

Study Record Updates

Last Update Posted (Actual)

November 13, 2017

Last Update Submitted That Met QC Criteria

November 9, 2017

Last Verified

April 1, 2016

More Information

Terms related to this study

Other Study ID Numbers

  • 14PP31

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

Undecided

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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