A randomized controlled trial of self-help acceptance and commitment therapy and cognitive behavioral therapy for perfectionism

IF 4.2 2区心理学 Q1 PSYCHOLOGY, CLINICAL

Behaviour Research and Therapy Pub Date : 2025-06-17 DOI:10.1016/j.brat.2025.104806

Emily M. Bowers , Michael E. Levin , Clarissa W. Ong , Michael P. Twohig

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Abstract

The prevalence of perfectionism is increasing in undergraduate students, highlighting the need to expand accessible treatment options for this population. Acceptance and commitment therapy (ACT) and cognitive behavioral therapy (CBT) are effective interventions for perfectionism, but have yet to be examined when delivered in a bibliotherapy format. This randomized controlled trial (NCT06057740) assessed the efficacy of ACT and CBT self-help books for perfectionism compared to a waitlist control. University students with high perfectionism (N = 110) were randomized to ACT (n = 37), CBT (n = 37), or waitlist (n = 36). Participants completed self-report assessments at pre-, mid-, post-intervention, and 1-month follow-up. Analyses were run with multilevel linear modeling with the intent-to-treat sample. Participants assigned to ACT and CBT showed significantly improved perfectionism, psychological inflexibility, cognitive reappraisal, well-being, and stress, compared to the waitlist participants. There were no significant differences between ACT and CBT on total perfectionism scores, cognitive reappraisal, well-being, and stress, except for psychological inflexibility scores, where ACT demonstrated stronger improvements in evaluative concerns and psychological inflexibility scores compared to the CBT and waitlist conditions over time. No intervention effects were found for anxiety or depression. The high adherence rates and satisfaction ratings indicate bibliotherapy for individuals with perfectionism is a feasible intervention. Bibliotherapy for perfectionism may be effective in reducing perfectionistic symptoms, potentially increasing access to evidence-based interventions for perfectionism among undergraduate students.

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自我接纳与承诺疗法与完美主义认知行为疗法之随机对照试验

大学生中完美主义的患病率正在上升，这突出了为这一人群扩大可获得的治疗选择的必要性。接受与承诺疗法（ACT）和认知行为疗法（CBT）是治疗完美主义的有效干预手段，但如果以阅读疗法的形式进行治疗，则尚未得到检验。这项随机对照试验（NCT06057740）评估了ACT和CBT自助书籍与等待列表对照相比对完美主义的疗效。高度完美主义的大学生（N = 110）被随机分为ACT组（N = 37）、CBT组（N = 37）和候补组（N = 36）。参与者在干预前、干预中、干预后和1个月的随访中完成自我报告评估。使用意向治疗样本的多水平线性模型进行分析。与候补组相比，ACT组和CBT组的参与者表现出明显改善的完美主义、心理僵化、认知重评、幸福感和压力。ACT和CBT在总完美主义得分、认知再评估、幸福感和压力方面没有显著差异，除了心理不灵活性得分，随着时间的推移，ACT在评估性关注和心理不灵活性得分方面比CBT和候补名单条件有更大的改善。没有发现干预对焦虑或抑郁的影响。高依从率和满意度表明阅读疗法对完美主义个体是一种可行的干预手段。完美主义的阅读疗法可能有效地减少完美主义症状，潜在地增加本科生对完美主义的循证干预。

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来源期刊

Behaviour Research and Therapy PSYCHOLOGY, CLINICAL-

CiteScore

7.50

自引率

7.30%

发文量

148

期刊介绍： The major focus of Behaviour Research and Therapy is an experimental psychopathology approach to understanding emotional and behavioral disorders and their prevention and treatment, using cognitive, behavioral, and psychophysiological (including neural) methods and models. This includes laboratory-based experimental studies with healthy, at risk and subclinical individuals that inform clinical application as well as studies with clinically severe samples. The following types of submissions are encouraged: theoretical reviews of mechanisms that contribute to psychopathology and that offer new treatment targets; tests of novel, mechanistically focused psychological interventions, especially ones that include theory-driven or experimentally-derived predictors, moderators and mediators; and innovations in dissemination and implementation of evidence-based practices into clinical practice in psychology and associated fields, especially those that target underlying mechanisms or focus on novel approaches to treatment delivery. In addition to traditional psychological disorders, the scope of the journal includes behavioural medicine (e.g., chronic pain). The journal will not consider manuscripts dealing primarily with measurement, psychometric analyses, and personality assessment.