A randomized controlled trial of unguided internet cognitive behaviour therapy for perfectionism in adolescents: Impact on risk for eating disorders

Shu, Chloe; Watson, Hunna J.; Anderson, Rebecca; Wade, Tracey D.; Kane, Robert; Egan, Sarah J.

doi:10.1016/j.brat.2019.103429

Cited by 44 publications

(76 citation statements)

References 43 publications

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“…A 3‐ to 4‐month follow‐up was chosen in the current study. This time frame is consistent with past treatment and prevention research (e.g., McCabe et al, 2017; McMillan et al, 2011; Rohde et al, 2014; Shu et al, 2019; Wade et al, 2017), the window assessed for diagnoses (e.g., binge eating in bulimia and traditionally amenorrhea in anorexia; American Psychological Association, 2013). It was also utilized to maximize participant retention by allowing completion of the study within‐one school term.…”

Section: Discussionsupporting

confidence: 76%

“…Data collection at T1 occurred during one class period (80–120 min) and T2 data collection occurred 3.5–4 months later in accordance with school availability. A 3‐month follow‐up period was selected to match the time frame used to assess for diagnoses of bulimia nervosa (and historically in anorexia nervosa; American Psychological Association, 2013) as well as to be consistent with past literature (e.g., McCabe, Connaughton, Tatangelo, Mellor, & Busija, 2017; McMillan, Stice, & Rohde, 2011; Rohde et al, 2014; Shu et al, 2019; Wade, Byrne, & Allen, 2017). Adolescents who provided written informed consent completed a questionnaire package that assessed sociodemographic data as well as body checking and eating pathology at T1 and T2 (in addition to other measures included as part of two independent research questions on self‐compassion and body checking in patients with eating and obsessive–compulsive disorders; Coelho et al, 2019; Pullmer, Coelho, & Zaitsoff, 2019).…”

Section: Methodsmentioning

confidence: 99%

“…literature (e.g.,McCabe, Connaughton, Tatangelo, Mellor, & Busija, 2017;McMillan, Stice, & Rohde, 2011;Rohde et al, 2014;Shu et al, 2019;Wade, Byrne, & Allen, 2017). Adolescents who provided written informed consent completed a questionnaire package that assessed sociodemographic data as well as body checking and eating pathology at T1 and T2 (in addition to other measures included as part of two independent research questions on self-compassion and body checking in patients with eating and obsessive-compulsive disorders;Coelho et al, 2019;.…”

mentioning

confidence: 99%

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A longitudinal examination of body‐checking behaviors and eating disorder pathology in a community sample of adolescent males and females

Zaitsoff

Pullmer

Coelho

2020

Intl J Eating Disorders

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Objective: Related to the cognitive-behavioral theory of eating disorders, body checking has gained increasing recognition as both a maintaining factor for eating disorders and an important target for treatment. However, it is unclear whether bodychecking behaviors contribute to the development of disordered eating, or if these behaviors develop as a response to experiencing eating disorder thoughts and behaviors. This study aims to examine the relationships between body-checking behaviors and eating disordered thoughts and behaviors in adolescent females and males in the community over time. Methods: Participants included 238 adolescents (n = 104 males, n = 134 females, M age = 16.5 years) recruited from high schools in British Columbia, Canada, who completed the Eating Disorder Examination Questionnaire and Body Checking Questionnaire at baseline (T1) and again approximately 4 months later (T2). Results: After controlling for baseline levels of eating pathology and body mass index (BMI), body checking at T1 predicted increases in eating pathology for both males and females. In contrast, after controlling for baseline levels of body checking and BMI, eating pathology at T1 did not predict changes in body checking for females, but it did for males. Findings suggest that, among adolescents, engaging in bodychecking behaviors may increase risk for disordered eating. Discussion: If supported by further research, targeting body-checking behaviors in prevention programs may be warranted.

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Section: Discussionsupporting

confidence: 76%

Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

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A longitudinal examination of body‐checking behaviors and eating disorder pathology in a community sample of adolescent males and females

Zaitsoff

Pullmer

Coelho

2020

Intl J Eating Disorders

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“…The several studies examining ICBT-P have yielded promising results, with significant reductions in levels of perfectionism, as well as symptoms of associated disorders, with reductions being maintained at 12-month follow-up ( Rozental et al, 2017 ). To date, only one study has examined the efficacy of ICBT-P in a sample of adolescents ( Shu et al, 2019 ). Researchers examined the efficacy of unguided ICBT-P compared to an active treatment condition, and a waitlist control group in preventing eating disorder onset in a sample of adolescent females ( Shu et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

“…To date, only one study has examined the efficacy of ICBT-P in a sample of adolescents ( Shu et al, 2019 ). Researchers examined the efficacy of unguided ICBT-P compared to an active treatment condition, and a waitlist control group in preventing eating disorder onset in a sample of adolescent females ( Shu et al, 2019 ). Results showed that unguided ICBT-P was efficacious in reducing clinical perfectionism, and that reductions were maintained at 6-month follow-up ( Shu et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Guided Internet-delivered cognitive behaviour therapy for perfectionism in a non-clinical sample of adolescents: A study protocol for a randomised controlled trial

Jones

Howell

Tonta

et al. 2020

Internet Interventions

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Background Perfectionism is elevated across a range of psychopathologies and has been shown to impede treatment outcomes. There is also evidence suggesting elevated perfectionism may contribute to the onset and maintenance of non-suicidal self-injury. There is a growing body of evidence suggesting that Internet-delivered cognitive-behavioural therapy for perfectionism reduces perfectionism and symptoms of psychological disorders and that reductions are maintained at 3-month and 6-month follow-up. There may also be reductions in non-suicidal self-injury, although no study has investigated this potential benefit. Given that associations between perfectionism and psychopathology are observed across both adults and adolescents, the need for the development of interventions targeting adolescents is essential for early intervention and prevention. Methods The present study will employ a randomised controlled trial to examine the efficacy of 8-week guided Internet-delivered cognitive-behavioural therapy for perfectionism in adolescents compared to a waitlist control group. The primary outcome is perfectionism, and secondary outcomes include symptoms of psychological disorders, well-being, and non-suicidal self-injury. Outcomes will be assessed at pre-intervention, post-intervention, 1-month follow-up, 3-month follow-up, and 6-month follow-up. A minimum of 240 participants will be recruited online through social media, Australian universities, and schools across Australia. Generalised linear mixed models will be used to test for changes in outcomes between the intervention group and the waitlist control. Discussion The outcomes of this trial will contribute to the literature on perfectionism and psychopathology in adolescents, as well as the efficacy of guided Internet-delivered interventions for adolescents. Trial registration The trial was registered on the 20th of June 2019 at the Australia New Zealand Clinical Trials Registry (ACTRN12619000881134). Trial status This is protocol version 1.0. Participant recruitment began on 31 July 2019 and is still actively running with an anticipated completion date in the fourth quarter of 2020.

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Perfectionism, anorexia nervosa, and family treatment: How perfectionism changes throughout treatment and predicts outcomes

Welch

Agras

Lock

et al. 2020

Intl J Eating Disorders

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Objective: This study uses data from a multisite randomized clinical trial to study the role of perfectionism in family-based treatment (FBT) for adolescent anorexia nervosa (AN). The main aim is to examine the role of baseline perfectionism in treatment response. Method: Adolescents (N = 158; ages 12-18; 89.2% female) and their families were randomized to receive either FBT or systemic family treatment for AN. Eating disorder (ED) pathology, obsessive-compulsive symptoms, and perfectionism were assessed at baseline, end of treatment, and 6-and 12-month follow-up. Linear regression analyses were used to test whether perfectionism and obsessivecompulsive symptoms at baseline predict ED pathology at all timepoints. An independent samples t test was used to test whether there was a significant difference in the change in perfectionism in either treatment group. Results: Baseline maladaptive perfectionism significantly predicted ED pathology but not ideal body weight at all timepoints. The model that included obsessivecompulsive symptoms also predicted ED pathology at all timepoints except 12-month follow-up. Perfectionism scores did not change during treatment regardless of treatment type. Discussion: Baseline perfectionism predicted treatment response in this study. Interventions might target perfectionism to improve treatment response in AN.

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A randomized controlled trial of unguided internet cognitive behaviour therapy for perfectionism in adolescents: Impact on risk for eating disorders

Cited by 44 publications

References 43 publications

A longitudinal examination of body‐checking behaviors and eating disorder pathology in a community sample of adolescent males and females

A longitudinal examination of body‐checking behaviors and eating disorder pathology in a community sample of adolescent males and females

Guided Internet-delivered cognitive behaviour therapy for perfectionism in a non-clinical sample of adolescents: A study protocol for a randomised controlled trial

Perfectionism, anorexia nervosa, and family treatment: How perfectionism changes throughout treatment and predicts outcomes

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