{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T23:39:19Z","timestamp":1789429159784,"version":"build-2803163510"},"reference-count":49,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,1,2]],"date-time":"2020-01-02T00:00:00Z","timestamp":1577923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000155","name":"Social Sciences and Humanities Research Council of Canada","doi-asserted-by":"publisher","award":["410\u20102009\u20101050"],"award-info":[{"award-number":["410\u20102009\u20101050"]}],"id":[{"id":"10.13039\/501100000155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bpspsychub.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psychol Psychother"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The negative impact of pre\u2010treatment patient perfectionism on therapeutic alliance and outcomes has been well documented. However, there is much to learn about how patient perfectionism impacts the development of the therapeutic alliance. Our study addressed this by examining the extent to which trait and self\u2010presentational components of perfectionism influence clinician\u2019s perceptions of patients during an initial interview.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>\n                      In a re\u2010analysis of data from Hewitt\n                      <jats:italic>et al.<\/jats:italic>\n                      , 2008, Psychiatry, 71, 93\u2013122, participants were\u00a090 treatment\u2010seeking adults (aged 19\u201364,\n                      <jats:italic>M<\/jats:italic>\n                      <jats:sub>age<\/jats:sub>\n                      \u00a0=\u00a036.2; 40 men) recruited\u00a0from outpatient mental health clinics. Each patient had a one\u2010on\u2010one, semi\u2010structured interview with a clinician that lasted approximately\u00a050\u00a0min.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>Patients completed self\u2010report measures assessing trait perfectionism, perfectionistic self\u2010presentation, and symptom distress before the interview. Patients were then invited to discuss reasons for seeking treatment and to reflect on the two most challenging situations in their lives in which they had not coped well. Following the interview, clinicians indicated their overall impressions of patients by responding to three self\u2010report questions and rated patients\u2019 distress and hostility via nine adjectives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After controlling for patients\u2019 symptom distress, other\u2010oriented perfectionism and non\u2010display of imperfection had small positive relationships with clinician\u2010rated hostility; self\u2010oriented perfectionism, socially prescribed perfectionism, and non\u2010disclosure of imperfection had small\u2010to\u2010moderate negative relationships with clinician impressions. Additionally, path analysis revealed other\u2010oriented perfectionism and non\u2010display of imperfection indirectly predicted less favourable clinician impressions through clinician\u2010rated hostility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Findings highlight the importance of evaluating and addressing trait and self\u2010presentation components of perfectionism early in the therapeutic process.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Practitioner points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Higher levels of other\u2010oriented perfectionism and non\u2010display of imperfection were associated with greater clinician\u2010rated hostility during an initial interview.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Patient hostility mediated the relationship between patients\u2019 other\u2010oriented perfectionism, non\u2010display of imperfection, and less favourable clinician impressions.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Our study highlights the importance of assessing and attending to patient perfectionism and displays of hostility during the earliest stages of therapeutic contact.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  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