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

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ClinicalTrials.gov Identifier: NCT02756871
Recruitment Status : Completed
First Posted : April 29, 2016
Last Update Posted : November 13, 2017
Sponsor:
Information provided by (Responsible Party):
Institute of Child Health

Brief Summary:
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.

Condition or disease Intervention/treatment Phase
Perfectionism Other: online guided self-help intervention for perfectionism Not Applicable

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  (Clinical Trial)
Actual Enrollment : 120 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: Overcoming Perfectionism: A Randomised Controlled Trial of an Online CBT Based Guided Self-help Intervention
Study Start Date : July 2015
Actual Primary Completion Date : February 2017
Actual Study Completion Date : February 2017

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
Other: online guided self-help intervention for perfectionism
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 Name: Overcoming Perfectionism

No Intervention: Control
No intervention.



Primary Outcome Measures :
  1. 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.


Secondary Outcome Measures :
  1. 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).

  2. 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).

  3. 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).

  4. 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).

  5. 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.


Other Outcome Measures:
  1. 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).

  2. 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).

  3. 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).

  4. 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).



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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

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.


Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02756871


Locations
United Kingdom
UCL Institute of Child Health
London, United Kingdom, WC1N 1EH
Sponsors and Collaborators
Institute of Child Health
Investigators
Principal Investigator: Roz Shafran, PhD UCL Institute of Child Health

Publications of Results:
Bagley, C., & Mallick, K. (2001). Normative data and mental health construct validity for the Rosenberg Self-Esteem Scale in British Adolescents. International Journal of Adolescence and Youth, 9(2-3), 117-126.
Coughtrey, A. E., Shafran, R., Knibbs, D., & Rachman, S. J. (2012). Mental contamination in obsessive-compulsive disorder. Journal of Obsessive-Compulsive and Related Disorders, 1(4), 244-250.
Coughtrey, A. E., Shafran, R., & Rachman, S. (2013). Imagery in mental contamination: A questionnaire study. Journal of Obsessive-Compulsive and Related Disorders, 2(4), 385-390.
Fairburn, C., Cooper, C., & Shafran, R. (2003a). Clinical Perfectionism Questionnaire. Department of Psychiatry. University of Oxford, United Kingdom.
Ferring, D., & Filipp, S. (1996). Measurement of self-esteem: findings on reliability, validity, and stability of the Rosenberg Scale. Diagnostica, 42(3), 284-292.
Hewitt, P. L., Flett, G. L., Turnbull-Donovan, W., & Mikail, S. F. (1991). The Multidimensional Perfectionism Scale: Reliability, validity, and psychometric properties in psychiatric samples. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 3(3), 464.
Radomsky, A. S., Rachman, S., Shafran, R., Coughtrey, A. E., & Barber, K. C. (2014). The nature and assessment of mental contamination: A psychometric analysis. Journal of Obsessive-Compulsive and Related Disorders, 3(2), 181-187.

Other Publications:
Egan, S. J., Wade, T. D., Shafran, R., & Anthony, M. M. (2014). Cognitive-Behavioural Treatment of Perfectionism. New York: Guilford.

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):
Responsible Party: Institute of Child Health
ClinicalTrials.gov Identifier: NCT02756871     History of Changes
Other Study ID Numbers: 14PP31
First Posted: April 29, 2016    Key Record Dates
Last Update Posted: November 13, 2017
Last Verified: April 2016
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: Undecided