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A meta-synthesis of qualitative studies of the link between anxiety, depression and perfectionism: implications for treatment

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posted on 2023-05-21, 13:45 authored by Egan, SJ, Wade, TD, Grace FitzallenGrace Fitzallen, O'Brian, A, Shafran, R

Background:: Meta-analyses show an association between perfectionism and depression and anxiety (negative affect), and that therapy for perfectionism impacts positively on negative affect. No systematic reviews have focused on qualitative studies of perfectionism.

Aims:: Our aim was to perform a systematic, meta-synthesis of qualitative literature to (i) help inform our understanding of how perfectionism is associated with negative affect, so that we can (ii) inform future development of treatment for perfectionism in young people and to make it more effective.

Method:: Included in the meta-synthesis were 37 qualitative studies.

Results:: Six themes related to perfectionism were found: (1) the association with negative affect, (2) self-worth dependent on achievement, (3) cognitive and behavioural maintaining factors, (4) the expectations of others, (5) effective elements of interventions, and (6) barriers to treatment.

Conclusion:: The qualitative literature supports the notion of perfectionism as an important construct to consider in reducing negative affect. While cognitive behavioural therapy for perfectionism holds promise as a treatment to target negative affect, there was a paucity of qualitative research, particularly related to young people. A greater understanding of the views of young people are required to help tailor more effective interventions for perfectionism that can impact negative affect in this group.


Publication title

Behavioural and Cognitive Psychotherapy








School of Psychological Sciences



Place of publication


Rights statement

© The Author(s), 2021. Published by Cambridge University Press on behalf of the British Association for Behavioural and Cognitive Psychotherapies. This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) licence (, which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Open

Socio-economic Objectives

Determinants of health; Mental health; Adolescent health

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