Self-Critical Perfectionism and Stress Reactivity Following Cognitive Behavioral Therapy for Depression

Abstract

Although cognitive behavioral therapy (CBT) is an effective treatment for depression, a substantial number of individuals experience relapse following treatment. It is possible that these individuals remain vulnerable due to personality characteristics such as self-critical perfectionism. This study examined the longitudinal association of depressive symptoms, stressful events, and self-critical perfectionism using post-treatment data from the Component Analysis of Cognitive-Behavioral Treatment for Depression study. The temporal relationship between depressive symptoms and stressful events (assessed at treatment termination and at 6-, 12-, 18-, and 24-month follow-ups) was evaluated using the Latent Difference Score (LDS) structural modelling framework. Four theoretical models (no association, stress generation, stress reactivity, transactional) were compared. Results supported the stress reactivity model, in which stressful events led to subsequent depression symptom change. Multigroup LDS analysis demonstrated that longitudinal stress reactivity occurred only for individuals experiencing high levels of self-critical perfectionism. The results suggest that maintenance of treatment gains following CBT is related to an individual’s personality style and stress reactivity.