What this Trial Is About

Over the past three decades, perfectionism has received increasing theoretical and empirical attention as a cognitive-personality factor that increases vulnerability to a wide range of psychological problems, including depression and anxiety. Although mediators and moderators of the link between perfectionism and well-being have been identified, the direct clinical utility of these findings has not been a focus. The Perfectionism and Coping Processes Model - Explanatory Feedback Intervention (PCPM-EFI) draws on previous findings and individually analyzes participant responses to perfectionism measures and online daily questionnaires of stress, coping, and mood over 7 days. The EFI provides an individualized slideshow presentation that is delivered in a single 45-60 minute session by a student research assistant to address how stress and coping patterns trigger and maintain negative affect and (lower) positive affect in the participant's daily life. A recent waitlist controlled feasibility trial compared the PCPM-EFI condition with a waitlist control condition over 4 weeks in 176 university students with higher SC perfectionism, with individualized feedback delivered one-on-one by student trainees in-person or remotely through videoconferencing. The feasibility of the individualized analyses of each participant's daily data was supported by identifying daily trigger patterns, maintenance tendencies, strengths, common triggers, and best targets for reducing negative mood and increasing positive mood across several stressors for each participant. Participant ratings indicated that the comprehensive feedback was coherent and functional. Participants in the EFI condition, compared to those in the control condition, reported increases in empowerment, coping self-efficacy, and problem-focused coping, as well as decreases in depressive and anxious symptoms. Between-group effect sizes were moderate-to-large. There were reliable improvements in empowerment and depressive symptoms for 56% and 36%, respectively, of participants in the EFI condition. These findings demonstrate the broad applicability, conceptual utility, and effectiveness of the PCPM-EFI for self-critical perfectionistic individuals. Given these promising findings, research is needed to examine the utility of customizing daily emotion regulation findings, and the complementary effects of providing meaningful feedback on well-being. The present study will build on the promising findings of the PCPM-EFI by using a 7-day daily diary methodology to test a complementary EFI on perfectionism and emotion regulation processes (e.g., self-compassion, mindfulness, experiential avoidance, rumination, reappraisal) delivered online through videoconferencing in a sample of university students with higher self-critical perfectionism. Based on the Perfectionism and Emotion Regulation Processes Model (PERPM), the PERPM-EFI follows the same structure as the PCPM-EFI to provide individualized analyses drawn from previous findings. The results of a pilot study of 12 university students with higher SC perfectionism suggest that the PERPM-EFI is broadly applicable, conceptually useful, and effective. Specifically, despite the small sample size, participants reported increases in empowerment, mindfulness, self-compassion, and emotional self-awareness, as well as decreases in depressive and anxious symptoms. The present study will use a randomized control design to examine whether the PCPM-EFI plus PERPM-EFI can better improve well-being, relative to providing no feedback, the PERPM-EFI alone, or PCPM-EFI alone in the context of a 4-week longitudinal study with three time points in a sample of 180 university students. The four conditions will be: (a) waitlist control condition, (b) PCPM-EFI, (c) PERPM-EFI, and (d) PCPM-EFI plus PERPM-EFI. It is hypothesized that all three EFI conditions will yield better outcomes than the waitlist control condition. It is also hypothesized that the combined PCPM-EFI plus PERPM-EFI condition will be superior to the PCPM-EFI condition and PERPM-EFI condition on empowerment (primary outcome) and secondary symptom outcomes (i.e., depressive symptoms, anxious symptoms, negative affect, positive affect). It is also expected that participants in the PCPM-EFI plus PERPM-EFI condition and PCPM-EFI condition will exhibit larger increases in coping self-efficacy and problem-focused coping than participants in the PERPM-EFI condition. On the other hand, it is hypothesized that participants in the PCPM-EFI plus PERPM-EFI condition and PERPM-EFI condition will exhibit larger increases in self-compassion, mindfulness, and emotional self-awareness than participants in the PCPM-EFI condition. If the feedback interventions are shown to be efficacious, the interventions could be offered to universities, work places, clinical settings, and other organizations.

Perfectionism and Daily Coping and Emotion Regulation Processes: A Trial of Two Explanatory Feedback Interventions