UBC Theses and Dissertations

UBC Theses Logo

UBC Theses and Dissertations

Perfect patients, perfect results? evaluating negative effect of trait perfectionism in psychotherapy Deng, Xiaolei


Evidence has suggested that components of perfectionism are associated with poor treatment outcome in individual therapy for depression. (e.g., Blatt et al., 1995; Jacobs et al., 2009). However, most studies conceptualized and measured perfectionism as attitudes; few studies have examined the mechanism through which perfectionism contributed to poor treatment outcome, and no study examined potential gender differences in the perfectionism and treatment literature. Hewitt and Colleagues developed and extended the Perfectionism Social Disconnection Model (PSDM; 2006, 2017) to the treatment context. According to the model, perfectionism can lead to both subjective and objective social disconnections, which can impede therapeutic alliance and therapy processes, resulting in poor treatment outcome. There is also evidence that quality of social relationships outside therapy can have an impact on therapy outcome (Miller et al., 1997). Hence, the purpose of this paper was to examine: (1) whether trait perfectionism, captured with a broad conceptualization and multidimensional measure, is associated with poor treatment outcome; (2) whether quality of extratherapeutic relationships mediate the association between perfectionism traits and poor treatment outcome; (3) whether men and women react to disruption in social relationships differently in leading to poor treatment outcome. The current study measured perfectionism traits, quality of life, depression, and anxiety among 263 community adults who participated in a 10-week group CBT treatment program for residual depressive symptoms. The study found that other oriented perfectionism and socially prescribed perfectionism were associated with poor treatment outcome. The overall quality of social relationships and quality of friendship mediated the relationships between perfectionism traits and poor treatment outcome. Finally, perfectionistic men reacted to disruption in relative relationships more than perfectionistic women did in leading to poor treatment outcome. Together, the current findings support the notion that certain perfectionism traits can impede treatment by hindering social relationships outside of therapy. Implications of the present findings for understanding the link between perfectionism and treatment outcome are discussed.

Item Media

Item Citations and Data


Attribution-NonCommercial-NoDerivatives 4.0 International