Sand, L;
Shafran, R;
(2025)
Using CBT-E in the Treatment of Anorexia Nervosa With Comorbid Obsessive-Compulsive Personality Disorder and Clinical Perfectionism.
Journal of Clinical Psychology
10.1002/jclp.23806.
(In press).
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Abstract
Objective: Several studies and clinical vignettes emphasize the association between eating disorders and maladaptive personality traits that should be targeted in treatment to strengthen the therapeutic prognosis and outcome. The aim of this paper is to present a single case study with a patient showing comorbid Anorexia Nervosa (AN) and Obsessive-Compulsive Personality Disorder (OCPD) with perfectionistic traits, using Cognitive Behavioral Therapy for Eating disorders (CBT-E) and Perfectionism (CBT-P). Methods: The patient, a young girl aged 17 years, was underweight when entering therapy and received an enhanced version of CBT-E with 40 sessions as recommended in the manual. The treatment was adjusted for adolescents with a heightened focus on motivation, therapeutic alliance, and parental involvement. The clinical interventions were structured in accordance with CBT-E for adolescents with six added sessions targeting clinical perfectionism based on CBT-P focusing on over-evaluation of achievements in addition to weight and shape. Results: The patient showed a gradual decrease in eating disorder symptoms and perfectionism through the 1-year treatment. She was normal weight by the end of therapy, enjoyed varied food, was more socially engaged and balanced clinical perfectionism with more healthy strivings and standards. She was also able to express her need for boundaries and rest to family, friends and her sports team. At the final assessment, she did not fulfill diagnostic criteria for AN or OCPD with perfectionistic traits, but she showed some symptoms in achievement situations that was targeted by information and preventive interventions. Conclusion: In accordance with the manual for CBT-E, perfectionism should be targeted as part of the treatment for eating disorders when in the clinical range. This was done in the present case with AN and perfectionistic traits within a comorbid OCPD, using elements of CBT-P that showed positive results and meaningful changes for the patient.
| Type: | Article |
|---|---|
| Title: | Using CBT-E in the Treatment of Anorexia Nervosa With Comorbid Obsessive-Compulsive Personality Disorder and Clinical Perfectionism |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1002/jclp.23806 |
| Publisher version: | https://doi.org/10.1002/jclp.23806 |
| Language: | English |
| Additional information: | © 2025 The Author(s). Journal of Clinical Psychology published by Wiley Periodicals LLC. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
| Keywords: | CBT‐E, anorexia nervosa, eating disorders, perfectionism, personality disorders |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Population, Policy and Practice Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10208432 |
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