A randomised controlled trial of cognitive-behaviour therapy for clinical perfectionism: a preliminary study

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 randomised controlled trial of cognitive-behaviour therapy (CBT) for "clinical perfectionism". Twenty participants were randomly assigned to either immediate treatment (IT) (n=10) or a wait list (NL) (n=10). Treatment consisted of ten sessions of CBT over eight weeks. Two participants did not complete the follow-up assessments (10%). Fifteen of the original 20 participants (75%) were clinically significantly improved after treatment and the effect size was large (1.8). Treatment gains were maintained at 8-week and 16-week follow-up.     

Letter position dyslexia in Arabic: from form to position

This study reports the reading of 11 Arabic-speaking individuals with letter position dyslexia (LPD), and the effect of letter form on their reading errors. LPD is a peripheral dyslexia caused by a selective deficit to letter position encoding in the orthographic-visual analyzer, which results in migration of letters within words, primarily of middle letters. The Arabic orthography is especially interesting for the study of LPD because Arabic letters have different forms in different positions in the word. As a result, some letter position errors require letter form change. We compared the rate of letter migrations that change letter form with migrations that do not change letter form in 10 Arabic-speaking individuals with developmental LPD, and one bilingual Arabic and Hebrew-speaking individual with acquired LPD. The results indicated that the participants made 40% letter position errors in migratable words when the resulting word included the letters in the same form, whereas migrations that changed letter form almost never occurred. The error rate of the Arabic-Hebrew bilingual reader was smaller in Arabic than in Hebrew. However, when only words in which migrations do not change letter form were counted, the rate was similar in Arabic and Hebrew. Hence, whereas orthographies with multiple letter forms for each letter might seem more difficult in some respects, these orthographies are in fact easier to read in some forms of dyslexia. Thus, the diagnosis of LPD in Arabic should consider the effect of letter forms on migration errors, and use only migratable words that do not require letter-form change. The theoretical implications for the reading model are that letter form (of the position-dependent type found in Arabic) is part of the information encoded in the abstract letter identity, and thus affects further word recognition processes, and that there might be a pre-lexical graphemic buffer in which the checking of orthographic well-formedness takes place.     

Clinical perfectionism: a cognitive-behavioural analysis

This paper reviews the characteristics of clinical perfectionism and proposes a new definition of the phenomenon. It is suggested that the defining feature of clinically significant perfectionism is the overdependence of self-evaluation on the determined pursuit (and achievement) of self-imposed personally demanding standards of performance in at least one salient domain, despite the occurrence of adverse consequences. It is suggested that such clinical perfectionism is maintained by the biased evaluation of the pursuit and achievement of personally demanding standards. Specifically, it is suggested that people with perfectionism react to failure to meet their standards with self-criticism. If they do meet their standards, the standards are re-evaluated as being insufficiently demanding. Anorexia nervosa and bulimia nervosa are considered to have a particular relationship to perfectionism, with both disorders often being direct expressions of perfectionism. Under these circumstances self-evaluation is dependent on the pursuit and attainment of personally demanding standards in the domain of control over eating, shape and weight. The implications of this analysis for research and practice are considered.     

Question production in agrammatism: the tree pruning hypothesis

This study investigated question production in agrammatic aphasia, focusing on the comparison between Wh questions and yes/no questions and on the interaction between the question production deficit and language-specific properties. A total of 16 agrammatic aphasics (13 Hebrew speakers, 2 Palestinian Arabic speakers, and 1 English speaker) participated in the study, which included sentence elicitation and repetition tasks. In addition, the patients' spontaneous speech, containing 2272 utterances, was analyzed. The main findings were that Hebrew- and Arabic-speaking agrammatics encounter severe difficulties in Wh question production but retain the ability to produce yes/no questions. English-speaking agrammatics do not show this dissociation and can form neither Wh nor yes/no questions. These dissociations as well as the error pattern, are explained by reference to the Tree Pruning Hypothesis, according to which the highest nodes of the syntactic tree, which are required for Wh questions in Hebrew, Arabic, and English and for yes/no questions in English, are impaired or inaccessible in agrammatism.     

Correction to: Exploring Latent Profiles of Psychopathology in a Sample of Lonely People Seeking Treatment

Journal of Psychopathology and Behavioral Assessment -