The unique contribution of perfectionistic cognitions to anxiety disorder symptoms in a treatment-seeking sample

ABSTRACT

Perfectionistic cognitions are thinking patterns that reflect excessive striving and are associated with emotional disorders in nonclinical samples. Despite literature connecting trait perfectionism with psychological disorders, much remains unknown about how perfectionistic cognitions relate to anxiety disorder symptoms in clinical populations. This is the first study to our knowledge that investigates how symptoms of anxiety and related symptoms are influenced by the frequency of perfectionistic cognitions when controlling for well documented correlates of anxiety. Perfectionistic cognitions, depressive symptoms, emotion regulation, anxiety sensitivity, and anxiety symptom severity were assessed prior to starting treatment in 356 treatment-seeking patients diagnosed with an anxiety or anxiety-related disorder at a specialty anxiety clinic. Perfectionistic cognitions were significantly correlated with all anxiety symptom measures as well as measures of depression, emotion regulation and anxiety sensitivity (range of rs =.22-.68). Hierarchical regression analyses revealed that when controlling for depressive symptoms, anxiety sensitivity, and emotion regulation, perfectionistic cognitions significantly and uniquely contribute to the variance of GAD (p <.01) and PTSD (p <.05) symptoms but not other anxiety-related symptoms (all ps >.05). Regardless of specific diagnoses, treatment-seeking individuals reporting frequent perfectionistic thoughts are more likely to report more severe symptoms of PTSD and GAD.

KEYWORDS:

• Perfectionism
• anxiety disorders
• cognitions
• transdiagnostic
• treatment-seeking

Acknowledgments

The authors would like to acknowledge the creators of REDCap (Harris et al., 2009), which was used to collect and store data used in this study. Furthermore, we would like to thank Jody Zhong and Kathy Benhamou, who served as research assistants on the original development of this research database and assisted our team with navigating the software efficiently. Furthermore, we would like to thank Dr. Edna Foa, Founding Director of the Center for the Treatment and Study of Anxiety and Dr. Lily Brown, the current Director for supporting this research program. Most importantly, we would like to thank the patients who agreed to participate in this naturistic study so that we may learn more about the clinical disorders that led them to seek treatment.

Disclosure statement

No potential conflict of interest was reported by the authors.