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Title: Perfectionism in Anorexia Nervosa : performance based evidence, the relationship with other features of the disorder, familial and treatment aspects
Author: Lloyd, Samantha
ISNI:       0000 0004 5923 272X
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2015
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This thesis explores perfectionism in Anorexia Nervosa (AN) using a series of discrete but inter-related studies: Study 1: A pilot study of a group intervention targeting perfectionism in adults with AN (N=21). Reductions in self-reported perfectionism were observed between pre- and post-intervention. Study 2: A systematic review and meta-analysis of interventions targeting perfectionism. Support was found for the efficacy of cognitive behavioural therapy in reducing perfectionism and psychopathology. Study 3: An investigation of performance based perfectionism in participants with AN (N=81) compared with healthy controls (HC; N=72). Evidence was found for elevated performance based and cognitive aspects of perfectionism in the AN group. Study 4: An investigation of associations between perfectionism and cognitive style (rigidity, attention to detail) using self-report and behavioural measures in adults and adolescents with AN (N=82) and HCs (N=84). Strong associations were found between perfectionism and self-reported cognitive style but not between perfectionism and performance on tasks of set-shifting and central coherence. Study 5: An investigation of self-reported and performance based perfectionism in unaffected AN mothers (N=21) compared with HC mothers (N=20). AN mothers did not differ from HC mothers on performance based or self-reported perfectionism. This thesis provides pilot evidence that it is possible to significantly reduce perfectionism in adults with Anorexia Nervosa using a specific group based cognitive behavioural intervention. It also provides wider evidence of the efficacy/effectiveness of cognitive behavioural interventions in reducing perfectionism in those with psychiatric disorders associated with perfectionism and/or those with clinical levels of perfectionism and outlines available evidence based interventions. The thesis contributes to knowledge of perfectionism in AN. It provides behavioural evidence of performance based perfectionism in AN compared to HCs on novel practical tasks. The findings of this thesis suggest that whilst perfectionism is associated with everyday self-reported difficulties with rigidity and excessive detail focus, it is not related to performance on neuropsychological tasks of set-shifting and central coherence. Neither self-reported nor performance based perfectionism was found to be elevated in unaffected mothers of those with AN. The findings have implications for the way in which perfectionism is targeted in treatment both in individuals with AN and more widely. Cognitive behavioural interventions specifically targeting perfectionism appear to be effective in significantly reducing perfectionism across a range of disorders including eating disorders and those with clinical perfectionism. The behavioural perfectionism tasks used within this thesis may be adapted for use within such interventions as a means of illustrating or targeting perfectionism. The findings of this thesis do not however support the use of neuropsychological assessment or the targeting of maternal perfectionism in addressing perfectionism in AN.
Supervisor: Tchanturia, Ketevan ; Schmidt, Ulrike Hermine Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available