Kothari, Radha;
(2017)
Guided Internet-based Cognitive Behavioural Therapy for Perfectionism, and its Impact on Self-esteem and Intolerance of Uncertainty: A Randomised Controlled Trial.
Doctoral thesis (D.Clin.Psy), UCL (University College London).
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Abstract
Perfectionism, low self-esteem, and intolerance of uncertainty are transdiagnostic processes, elevated across, and implicated in the aetiology and maintenance of, a number of mental health disorders. The present research explores the relationship between these transdiagnostic processes, and whether a change in one (perfectionism), can effect a change in the others (self-esteem and intolerance of uncertainty). Part one is a meta-analytic review of 21 studies investigating the relationship between perfectionism and self-esteem. A negative association was found between self-esteem and perfectionism, particularly the unhelpful or maladaptive aspects of perfectionism known as perfectionistic concerns. Part two presents the findings of a randomised controlled trial (RCT) of a guided internet-based cognitive behaviour therapy (ICBT) for perfectionism, which was conducted jointly with Professor Roz Shafran and her research team. A total of 120 participants took part (experimental = 62, control = 58). Negative associations were observed between perfectionism and self-esteem, and self-esteem and intolerance of uncertainty. A positive association was observed between perfectionism and intolerance of uncertainty. ICBT for perfectionism significantly reduced levels of perfectionism and intolerance of uncertainty, and increased self-esteem, post-intervention (12 weeks). Changes in perfectionism and intolerance of uncertainty, but not self-esteem, were maintained at follow-up (24 weeks). Part three considers the broader challenges of internet-based interventions, treating perfectionism, conducting RCTs, and the advantages and disadvantages of being a clinician-researcher.
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