***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Patients in the National Institute of Mental Health Treatment of Depression Collaborative Research Program ( TDCRP ) were administered at intake with the  Dysfunctional Attitude Scale ( DAS ; A. N. Weissman & A. T. Beck , 1978 ) . Factor analyses of the DAS in the TDCRP data as well as in several independent sample s reveal two primary factors : an interpersonal factor , Need for Approval , and a self-critical factor , Perfectionism . This study explored the hypotheses that these factors , assessed prior to treatment , would have differential interactions with the two forms of psychotherapy evaluated in the TDCRP as well as differential relationships to various outcome measures ( depression , clinical functioning , and social adjustment ) . DAS Perfectionism had consistently significant negative relationships with all the outcome measures in all four treatment conditions . Contrary to expectations , however , there were no significant interactions between the two DAS factors and the four types of brief treatment ( cognitive-behavioral therapy , interpersonal therapy , imipramine , and placebo ) A r and omized , controlled clinical trial was conducted to determine the efficacy of receiving feedback in a sample of maladaptive perfectionists . A total of 60 young adults were r and omly assigned to a feedback intervention or control group . Hierarchical Linear Modeling was utilized to analyze the effects of perfectionism over time , as well as the effects of treatment condition on the relationship between perfectionism and outcomes . Measures of interest included emotional reactivity , self-esteem , and psychological distress . Findings revealed that providing feedback to maladaptive perfectionists reduced self-reported global symptomatic distress as well as emotional reactivity . The results are discussed in light of treatment implication s , especially with regard to the manner in which perfectionists respond to therapeutic interventions . Overall , study findings suggest that a brief , low-cost feedback intervention is effective at decreasing psychological distress in maladaptive perfectionists and may serve as a beneficial precursor to individual therapy or counseling AIM The purpose of the present study was to evaluate reducing perfectionism as a potential treatment target for individuals with Bulimia Nervosa ( BN ) . METHOD Forty-eight individuals meeting DSM-IV criteria for BN or eating disorder - not otherwise specified with binge eating [ objective or subjective ] or purging at least once per week were recruited . Participants were r and omly assigned to receive 8 sessions of manual-based guided self-help ( GSH ) over a 6-week period that was focused on either cognitive behaviour therapy ( CBT ) for perfectionism , CBT for BN , or a placebo . Individuals were assessed at baseline , pre-treatment , post-treatment and at six-month follow-up on 12 outcome variables , including diagnostic criteria and psychological variables . RESULTS There was no significant change in any of the outcome variables over a 6-week no-treatment period but at post-treatment and 6-month follow-up there were significant main effects of time for 10 and 8 outcome variables respectively , suggesting that all groups reported significant reductions in bulimic symptomatology and related psychopathology at post-treatment and follow-up . CONCLUSIONS These findings show potential for the use of novel interventions in GSH for BN Despite the growing evidence that perfectionism is associated with  adolescent psychological distress  , few studies have investigated this relationship prospect ively with measures design ed for use in adolescent population s. In the present study , within a diathesis-stress framework , we investigated the extent to which perfectionism and acute life stress predict depression , anxiety and self-harm among adolescent school children ( n = 515 ) over a 6 month period ( Time 1-Time 2 ) .  Socially prescribed perfectionism ( SPP ) , self-oriented perfectionism-critical ( SOP-critical ) and the associated interactions with acute life stress differentially predicted anxiety , depression and self-harm . Acute life stress was an independent predictor of depression , anxiety and self-harm . SPP predicted depression and interacted with acute life stress to predict self-harm . SOP-critical and the SOP-critical by acute life stress interaction predicted anxiety . Self-oriented perfectionism-striving ( SOP-striving ) did not predict any of the Time 2 measures of distress . The dimensions of perfectionism are differentially associated with psychological distress . Tailored clinical interventions focused on adolescent perfectionism should offer promise in tackling psychological morbidity in adolescence BACKGROUND Several lines of evidence suggest that cognitive behavioral therapy ( CBT ) is an effective treatment for  depression and anxiety disorders . Evidence suggests that the therapeutic effects of CBT are related to neurophysiologic changes in the cortex , particularly γ-aminobutyric acid ( GABA ) potentiation . Transcranial magnetic stimulation ( TMS ) represents a noninvasive method of measuring cortical inhibition , which is a neurophysiologic mechanism associated with the pathophysiology of several psychiatric disorders . OBJECTIVE /HYPOTHESIS To demonstrate the effectiveness of a 12-week CBT intervention compared with a wait list control group measuring cortical inhibition in participants with pathologic perfectionism . Participants within the CBT group would demonstrate increases in cortical inhibition and improvements on clinical outcomes relative to the wait list control group . METHODS Twenty-four right-h and ed perfectionists were r and omly assigned to a 12-week CBT intervention or a wait list control group .  Cortical inhibition was measured at pre- and postintervention with TMS paradigms specifically short-interval cortical inhibition and the cortical silent period , which index GABAA and GABAB receptor-mediated inhibitory neurotransmission , respectively . RESULTS The CBT group demonstrated a significant potentiation of the cortical silent period when compared with the wait list control group . The CBT group demonstrated a decrease in anxiety sensitivity and automatic thoughts relative to the control group . CONCLUSIONS These findings demonstrate that CBT tailored for perfectionism is accompanied by an increase in cortical inhibition of the motor cortex and positive changes on clinical outcomes . These findings provide compelling evidence for an association between positive CBT effects and a potentiation of GABAergic inhibitory neurotransmission BACKGROUND Research indicates that psycho-education and cognitive behavioural interventions can reduce perfectionism but to date no group treatments have been examined . AIMS The current study utilized a case series design to compare psycho-education material s and subsequent eight-week group cognitive behaviour therapy ( CBT ) to a baseline waitlist in an outpatient community psychiatry sample ( n = 21 ) . METHOD Participants were assessed on five occasions : baseline , 4 weeks later ( waitlist ) , 4 weeks after receiving psycho-education material , post-treatment ( 8 weeks after receiving the group intervention ) , and 3-month follow-up . RESULTS There was a main effect of time for perfectionism and negative affect from baseline to post-group ( effect sizes ranging from 1.46 to 1.91 ) that were maintained at 3-month follow-up . CONCLUSIONS These results suggested that group CBT for clinical perfectionism may be beneficial , but that psycho-education alone is not effective for reducing perfectionism or negative affect Perfectionism can be a problem in its own right and it can impede the progress of treatment of Axis I disorders . This study reports on a preliminary r and omised controlled trial of cognitive-behaviour therapy ( CBT ) for “ clinical perfectionism ” . Twenty participants were r and omly assigned to either immediate treatment ( IT ) ( n=10 ) or a waitlist ( NL ) ( n=10 ) . Treatment consisted of ten sessions of CBT over eight weeks . Two participants did not complete the follow-up assessment s ( 10 % ) . Fifteen of the original 20 participants ( 75 % ) were clinical ly significantly improved after treatment and the effect size was large ( 1.8 ) . Treatment gains were maintained at 8-week and 16-week follow-up The effect of perfectionism on acute treatment outcomes was explored in a r and omized controlled trial of 439 clinical ly depressed adolescents ( 12–17 years of age ) enrolled in the Treatment for Adolescents with Depression Study ( TADS ) who received cognitive behavior therapy ( CBT ) , fluoxetine , a combination of CBT and FLX , or pill placebo . Measures included the Children 's Depression Rating Scale – Revised , the Suicidal Ideation Question naire– Grade s 7–9 , and the perfectionism subscale from the Dysfunctional Attitudes Scale ( DAS ) . Predictor results indicate that adolescents with higher versus lower DAS perfectionism scores at baseline , regardless of treatment , continued to demonstrate elevated depression scores across the acute treatment period . In the case of suicidality , DAS perfectionism impeded improvement . Treatment outcomes were partially mediated by the change in DAS perfectionism across the 12-week period OBJECTIVE To develop and pilot Life Smart , an eight-lesson program aim ed at reducing risk factors for both eating disorders and obesity . METHODS Grade 7 girls and boys ( N = 115 ) from one independent school were r and omly allocated to the Life Smart ( two classes ; N = 51 ) or control ( three usual classes ; N = 64 ) conditions . Risk factors were measured at baseline and post-program ( 5 weeks later ) . RESULTS Life Smart was rated as moderately enjoyable and valuable by participants . ANCOVAs with baseline as a covariate revealed a significant main effect for group favoring Life Smart for shape and weight concern ( Effect Size [ ES ] = .54 ) , with post-hoc testing finding girls particularly benefited on this variable ( ES = .78 ) . CONCLUSIONS Feedback was generally favorable , with some suggestions for even more interactive content . The program showed more promise with girls . Informed by these findings , the program underwent revisions and is now being evaluated in a r and omized controlled trial Abstract This study assessed the effectiveness of a web-based cognitive behavioral intervention ( CBT ) in reducing  perfectionism and psychological distress in post- secondary students . Participants assessed as high in perfectionism ( n=77 ) were r and omized to one of three 10-week , web-based , intervention conditions ( no treatment [ NT ] , general stress management [ GSM ] , or CBT ) . Results indicated the CBT condition was effective in reducing perfectionism , and supported a pattern of significantly greater improvement than observed in participants in the GSM or NT conditions . While both CBT and GSM demonstrated capacities to significantly reduce distress , for CBT participants changes in perfectionism were significantly correlated with changes in depression and anxiety . Results offer support for the effectiveness of web-based CBT in positively affecting perfectionist-related problems . Given the considerable proportion of individuals who suffer from perfectionism-related distress , the intervention 's apparent effectiveness , cost-effectiveness and ease of dissemination warrant future replication studies 
    Output:
    
RESULTS Large pooled effect sizes were found for the Personal St and ards and Concern over Mistakes subscales of the FMPS and the Self Orientated Perfectionism subscale of the HMPS , whilst a medium sized effect was found for change in Socially Prescribed Perfectionism .
Medium pooled effect sizes were also found for symptoms of anxiety and depression .
CONCLUSIONS There is some support that it is possible to significantly reduce perfectionism in individuals with clinical disorders associated with perfectionism and /or clinical levels of perfectionism .
There is also some evidence that such interventions are associated with decreases in anxiety , depression , eating disorder and obsessive compulsive symptoms .