Perfectionism and psychopathology: a review of research and treatment

"I'm so dumb and worthless right now": factors associated with heightened momentary self-criticism in daily life

Self-criticism is a trait associated with increased psychopathology, but self-criticism is also a personality state reflecting an action that people do in moments of time. In the current study, we explored factors associated with heightened self-criticism in daily life. Participants (N = 197) received five random prompts per day for one week on their mobile phones, where they reported their current affect (negative and positive affect), willpower self-efficacy, distress intolerance, degree of support and criticism from others, current context (location, activity, hunger, tiredness) and momentary self-criticism. We first demonstrated that self-criticism varies over time and across contexts, and is associated with heightened trait self-criticism. Then, using multilevel modelling, we explored the contextual factors associated with greater self-criticism. We found that self-criticism was higher when people were at home, and more tired. We also found higher self-criticism to be associated with greater negative and lower positive affect, greater distress intolerance, lower willpower and greater perceived criticism from others. In addition, self-criticism predicted subsequent distress intolerance, willpower and positive affect in lagged analyses. This study provides evidence that both environmental and psychological factors are associated with the dynamics of self-critical thoughts.

Risk and resilience in eating disorders: differentiating pathways among psychosocial predictors

OBJECTIVE

Eating disorders (EDs) represent a rising global health concern. The current study takes a multivariate approach to examine psychological (i.e., perfectionism, anxiety sensitivity [AS], emotion dysregulation) and sociocultural factors (i.e., body dissatisfaction) that may relate to risk and resilience in EDs.

METHODS

Participants were 698 undergraduate students (Mage = 21, SDage = 4.02), mainly female (71%) and Hispanic (61.6%), who participated in an online survey assessing perfectionism, emotion dysregulation, AS, body dissatisfaction, and eating behaviors.

RESULTS

The results from structural equation model analyses revealed differential associations with disordered eating (DE) outcomes. Self-oriented perfectionism and dysmorphic appearance concerns were associated with increased dieting/carb restriction, desire for thinness, and binging tendencies. Specifically, emotional nonacceptance and lack of emotional awareness showed associations with elevated risk for dieting/carb restriction and purging tendencies, respectively. Conversely, lack of emotional clarity showed a protective pathway to these risk behaviors. Anxiety sensitivity cognitive concerns related to higher purging tendencies, while AS social concerns related to lower purging and binging tendencies.

DISCUSSION

Findings highlight the differential pathways of psychosocial risk and resilience for EDs. Subscales of emotional dysregulation and AS showed risk as well as resilience associations with DE outcomes. This information is key for advancing transdiagnostic prevention and intervention to reduce the rising rates of EDs.

A moderated mediation analysis on the influence of social support and cognitive flexibility in predicting mental wellbeing in elite sport

The purpose of this study was to examine the mechanism by which social support influences mental wellbeing. Using the thriving through relationships model to provide a theoretical underpinning, cognitive flexibility was hypothesised as a mediator. Additionally, the research examined the consistency of this pathway between elite athletes, retired athletes, and non-athletes. Survey responses from a sample of 247 participants (n = 49 elite athletes, n = 61 retired athletes, n = 137 convenience sample; of which 127 (51.4%) were males were included in the analysis. Initial mediation analysis revealed a significant indirect pathway from social support to mental wellbeing through cognitive flexibility. Moderated mediation analysis revealed this pathway was significant for retired athletes and the convenience sample, but not for elite athletes. Results provide additional insight into the mechanisms by which social support influences wellbeing. Cognitive flexibility interventions may not be as effective for elite athletes.

Investigating the Theory of Clinical Perfectionism in a Transdiagnostic Eating Disorder Sample Using Network Analysis

Eating disorders are deadly psychiatric illnesses, with treatments working for less than half of individuals who seek treatment. The transdiagnostic theory of eating disorders proposes that eating disorders share similar maintaining symptoms, such as what this theory calls clinical perfectionism (i.e., high levels of concern over mistakes and personal standards). However, it has been difficult to examine the interrelationship of specific aspects of perfectionism, beyond assessing moderation effects, which have generally not found support for the theory of clinical perfectionism in eating disorders. Thus, we used network analysis to test the theory of perfectionism by testing the interrelationships between maladaptive perfectionism facets (concern over mistakes, personal standards, parental criticism, parental expectations, and personal standards) and eating disorder symptoms in 397 individuals diagnosed with an eating disorder. Concern over mistakes was a central symptom and demonstrated the strongest interrelationships with eating disorder symptoms compared to the other aspects of perfectionism, connecting to eating concerns and cognitive restraint. Objective binge eating had a strong negative connection to personal standards. We identified specific central symptoms and illness pathways of perfectionism, which partially supports the theory of clinical perfectionism. Results, if replicated, may suggest that concern over mistakes might be best reconceptualized as part of eating disorder pathology and be targeted to improve treatment outcomes for eating disorders.

The role of mindfulness on the psychological aspects of anorexia nervosa

OBJECTIVE

Emotion regulation, perfectionism, and rumination are perpetuating factors in anorexia nervosa (AN). Mindfulness can be protective and therapeutic. We aimed to understand the relationship between these factors and mindfulness in AN.

METHODS

20 adolescent girls in the acute phase of the AN, 16 in remission, and 40 in the control group were evaluated.

RESULTS

Mindfulness was lowest in the acute AN group. The difference in the acute AN group regarding body dissatisfaction, emotion dysregulation, perfectionism, and mindfulness disappeared after controlling for the effects of depression and anxiety. The predictors of disordered eating in the entire study population were body dissatisfaction and depressive symptoms. Emotion regulation and perfectionism were the predictors of mindfulness in the acute AN group and the entire study population. When mindfulness decreased, concerns about body shape increased in both acute AN and remission groups, while dietary restriction and disordered eating behaviors increased only in the remission group.

DISCUSSION

Emotion regulation difficulties in acute AN could be related to depression and anxiety. Mindfulness interventions for emotion regulation could be used for depression during the acute phase while for perfectionism in remission. Early intervention for depression and body dissatisfaction seems protective, and mindfulness could be an appropriate intervention.

Does Parenting Perfectionism Ironically Increase Violent Behaviors from Parent towards Children?

BACKGROUND

Past research has shown that perfectionistic strivings (PS) and perfectionistic concerns (PC) in the parenting domain are associated with an increase in parental burnout (PB), and that PB causally increases violence towards one's offspring. One may therefore wonder whether parenting perfectionism may ironically increase violence towards one's offspring.

OBJECTIVE

To the best of our knowledge, no study has ever investigated whether perfectionism (PS and PC) predicts violence towards one's offspring, or whether PB could explain this link. In the current pre-registered cross-lagged study, we hypothesized that an increase in PS and PC would lead to an increase in violence via an increase in PB.

METHOD

228 participants responded to a longitudinal online survey, with three measurement occasions spaced 2 months apart.

RESULTS

Contrary to expectations, cross-lagged path models revealed that violence towards the offspring prospectively predicted an increase in PS and PC. Mediation models showed that PB was not a significant mediator. Results of all models did not change when controlling for social desirability.

CONCLUSION

The present study shows that violence towards the offspring increases the risk of PS and PC in parents. Results are discussed in light of the feeling of guilt experienced by parents.

IMPLICATIONS

Current worries that parenting perfectionism may paradoxically increase violence appear to be unwarranted at this stage. Moreover, correlation is not causation; thus, emphasizing caution before coming to clinically and societally relevant conclusions in cross-sectional studies. Thus, the PB and child maltreatment literature should slowly shift to using more longitudinal and causal designs.

The Associations between Obsessive Compulsive Personality Traits, Self-Efficacy, and Exercise Addiction

Exercise addiction refers to maladaptive exercise patterns involving compulsivity and addiction-like behaviors. Exercise addiction has been found to relate to negative physical and mental health outcomes such as heart abnormalities, physical injuries, and interpersonal conflicts. Based on the social cognitive theory, this study investigated the extent to which the interplay of obsessive compulsive personality disorder (OCPD) traits and self-efficacy beliefs would influence the development and maintenance of exercise addiction. A total of 1228 college students in the United States responded to an online survey. Based on cut-off scores of the Revised Exercise Addiction Inventory, the prevalence estimates of exercise addiction were 4.0% for males and 1.8% for females. Results showed that males are more prone to exercise addiction than females. Also, OCPD traits and self-efficacy significantly predicted exercise addiction after controlling for age and sex. Self-efficacy acted as a moderator in influencing the relationship between OCPD traits and exercise addiction, especially for females. At high levels of self-efficacy, more OCPD traits were significantly associated with a higher risk of exercise addiction. However, at low levels of self-efficacy, there was no association between OCPD traits and exercise addiction. The findings suggest that public education and intervention for exercise addiction should attend to the interplay between personality factors and sex.

Cognitive and behavioral predictors of procrastination behavior in adolescents at a mental health clinic in Turkey

OBJECTIVE

Procrastination behavior (PB) negatively impacts individuals' daily lives. Based on existing evidence that states executive function (EF) problems and internalizing symptoms (IS) are related to PB, this study examined IS, EF problems, and sluggish cognitive tempo (SCT) symptoms in adolescents, and their relationships with PB and gender.

METHODS

The sample consisted of 78 adolescents (56.4% female) aged 12-18 years. Participants and their families completed the Children's Depression Inventory (CDI), Screen for Child Anxiety Related Disorders (SCARED), Barkley Sluggish Cognitive Tempo Scale-Children and Adolescent (BSCTS-CA), General and Academic Procrastination Scales, Behavior Rating Inventory of Executive Function (BRIEF), and Strengths and Difficulties Questionnaire (SDQ).

RESULTS

The scores for academic PB were significantly positively associated with the CDI, SCARED, subscales comprising the metacognitive index of the BRIEF, and all four subscales of the SDQ but not with SCT. General and academic PB yielded similar results except for the conduct problems. Academic PB and EF problems were more prevalent in males. Lack of organizational skills, a part of EF; IS; and attention problems were associated with academic and general PB in girls and boys.

CONCLUSION

Adolescents who have difficulty organizing their work and attention problems may have higher PB.

The Dynamic between Self-Efficacy and Emotional Exhaustion through Studyholism: Which Resources Could Be Helpful for University Students?

While university students have experienced increased stress, anxiety, and study obsession (studyholism) during the COVID-19 emergency, supportive university environments and academic self-efficacy (ASE) were found to be protective factors. However, the perception of overstudying could have impaired ASE's protection against studyholism, akin to workaholism. Following the job-demands resource model, this contribution examines the moderating roles of study load and teaching staff support in the relationship between ASE and exhaustion, mediated by studyholism. 6736 students from 11 universities (69.8% females; Mean age 24.67 years) completed a self-report survey concerning various academic and life aspects. Results showed that ASE was partially mediated by studyholism in its negative relationship with exhaustion. Both study load and support moderate this relationship, although the interaction effect between studyholism and ASE is positive. Nonetheless, ASE plays a protective role for all levels of study load and support, while studyholism is confirmed to have a significant impact on exhaustion, both directly and through its mediating role. Considering the high scores of both studyholism and exhaustion in this sample, the enhancement of ASE should be complemented by teacher support centered around opportunities to review study strategies with the students and strong attention to preventive measures, such as in itinerant evaluation, which could enhance both the perception of positive support and strengthen ASE.

Transdiagnostic Approach and Obsessive Compulsive Disorder

The categorical approach of traditional psychiatric nosology has been a forceful approach for a very long time for explaining psychological disorders which are defined by symptom based diagnostic categories. However, in recent years, the importance of the "transdiagnostic" approach which is a new classification system is increasing. The transdiagnostic approach aims to examine dimensionally the common cognitive, behavioral, interpersonal and biological processes underlying many psychopathologies away from the categorical approach that classifies psychopathologies according to observable symptoms. This approach intends to treat the disorders through the common underlying processes and risk factors, thus heterogeneous and comorbid symptoms are better addressed and diagnostic categories that may change during treatment are avoided. In this review study, the current problems in diagnosing based on classification and gaps in the field were examined, and the approach itself was proposed as a solution. RDoC (Research Domain Criteria) which is a new classification system for psychiatric disorders within the scope of the approach, has created a new structure using modern research approaches in genetics, neuroscience and behavioral sciences. In the present study, the definition and emergence of the transdiagnostic approach, obsessive compulsive disorder and RDoC in the context of transdiagnostic approach and transdiagnostic treatment are explained. This review is intended to be a resource for both basic psychopathology research and the development of treatment methods within the framework of a transdiagnostic approach.

Perfectionism as Possible Predictor for Treatment Success in Mindfulness-Based Cognitive Therapy and Metacognitive Training as Third-Wave Treatments for Obsessive-Compulsive Disorder

Background

Identifying predictors of treatment outcome can guide treatment selection and optimize use of resources. In patients affected by obsessive-compulsive disorder (OCD), perfectionism has emerged as one possible predictor, with some data suggesting that cognitive-behavioral therapy outcomes are poorer for more perfectionistic patients. Findings so far are inconsistent, however, and research has yet to be extended to newer treatment approaches.

Methods

We administered measures of concern over mistakes, clinical perfectionism, as well as OCD and depression symptom severity to a sample of OCD patients in out-patient group treatments (N = 61), namely, metacognitive training (MCT-OCD) or mindfulness-based cognitive therapy (MBCT) for OCD. Hierarchical data over time was submitted to multi-level analysis.

Results

Neither concern over mistakes nor clinical perfectionism at baseline predicted OCD symptoms across time points. However, concern over mistakes at baseline did significantly predict comorbid depressive symptoms. Furthermore, exploratory analysis revealed change in clinical perfectionism during treatment as a predictor of OCD symptoms at follow-up.

Conclusion

These results suggest that initial concern over mistakes may not prevent patients with OCD from benefitting from third-wave treatments. Change in clinical perfectionism may present a putative process of therapeutic change. Limitations and avenues for future research are discussed.

Perfectionistic Children and Their Parents: Is There Room for an Intergenerational Transmission? A Study of a Clinical Sample of Italian Children and Their Parents

Introduction: The relationship between maladaptive perfectionism and Internalizing (ID) and Externalizing Disorders (ED) in children needs to be better understood, along with the intergenerational transmission of these traits from parents to children. The present work aimed to share light on both these issues. Method: 39 children with ID, 19 with ED, and their parents were recruited*. The Multidimensional Perfectionism Scale, the Big Five Inventory, the Child and Adolescent Perfectionism Scale, and the Hierarchical Personality Inventory for Children were used. The association between parent personality and perfectionism traits and children’s perfectionism dimensions was evaluated through hierarchical regression analysis. Results: ID and ED groups did not differ significantly concerning perfectionism. Fathers presented higher scores than mothers in Self-Oriented Perfectionism, Other-Oriented Perfectionism, and Socially-Prescribed Perfectionism. Parents of children with ID report higher levels of Obedience in their children, while parents of children with ED reported higher levels of Creativity and Perseverance. Significant associations were found between perfectionism in parents and their children, as well as between perfectionism and the personality of children. Conclusion: Results suggest a transdiagnostic nature of Perfectionism and support the transgenerational transmission of the personality traits investigated.

Parenting styles, maladaptive coping styles, and disturbed eating attitudes and behaviors: a multiple mediation analysis in patients with feeding and eating disorders

Background

Although preliminary studies support the roles of unhealthy parenting styles and maladaptive coping styles in increasing rates of disturbed eating attitudes and behaviors (EAB) and clinically significant feeding and eating disorders (FED), underlying mechanisms have not been well-recognized. This study aims to investigate the factors associated with disturbed EAB and the mediating roles of overcompensation and avoidance coping styles in the relationship between different types of parenting styles and disturbed EAB among patients with FED.

Methods

A total of 102 patients with FED in Zahedan, Iran, participating in this cross-sectional study (from April to March 2022) completed a sociodemographic information form and self-report measures of parenting styles, maladaptive coping styles, and EAB. Model 4 of Hayes' PROCESS macro in SPSS was employed to identify and explain the mechanism or process that underlies an observed relationship between study variables.

Results

The results showed that authoritarian parenting style, overcompensation and avoidance coping styles, and female gender might be related to disturbed EAB. The overall hypothesis that overcompensation and avoidance coping styles mediated the effect of fathers' and mothers' authoritarian parenting styles on disturbed EAB was also supported.

Conclusions

Our findings highlighted the necessity of evaluating particular unhealthy parenting styles and maladaptive coping styles as the important possible risk factors in the development and maintenance of higher level of disturbance in EAB among patients with FED. However, more research is needed to explore individual, family, and peer risk factors for disturbed EAB among these patients.

The clinical perfectionism questionnaire: psychometric properties of the Italian version in patients with eating disorders

BACKGROUND

Problematic perfectionism has been traditionally conceptualized as a multidimensional construct, and specific instruments have been developed to capture its various dimensions. However, the Clinical Perfectionism Questionnaire (CPQ) was recently designed to measure a unidimensional construct called "clinical perfectionism", but the questionnaire has not yet been validated in Italian.

AIM

This study aimed to propose the Italian version of the CPQ and examine its psychometric properties.

METHODS

The CPQ was translated into Italian using translation and back-translation procedures. Then, it was administered to 188 Italian-speaking patients with eating disorders and 126 non-eating disorder group (excluded if the Italian version of the Eating Attitudes Test-26 was ≥ 20). The clinical group also completed the Italian versions of the Frost Multidimensional Perfectionism Scale (FMPS), the Eating Disorder Examination Questionnaire (EDE-Q), and the Brief Symptom Inventory (BSI).

RESULTS

Confirmatory factor analysis revealed a good fit for the bifactor structure of the 10-item version. Internal consistency was high for the general clinical perfectionism factor, and test-retest reliability was good. Convergent validity was acceptable for the general clinical perfectionism and 'overvaluation of striving' group factors. The CPQ showed significantly higher scores in patients with eating disorders than in the non-eating disorder group.

CONCLUSIONS

Overall, the study demonstrated the good psychometric properties of the Italian version of the CPQ, and validated its use in Italian-speaking patients with eating disorders. Although further research is required, the CPQ has promising evidence as a reliable and valid measure of clinical perfectionism in its Italian version.

LEVEL OF EVIDENCE

Level V, Descriptive study.

The association between maternal perinatal mental health and perfectionism: A systematic review and meta-analysis

BACKGROUND

Perfectionism is an important feature of adult psychopathology. In the absence of a prior review of the role of perfectionism in perinatal psychopathology, we aimed to ascertain whether perfectionism was associated with symptoms of maternal perinatal depression and anxiety.

METHOD

We followed PRISMA guidance (PROSPERO: 42019143369), estimated weighted effect sizes and tested possible moderators: timing (pre or post- natal), scales used to measure constructs, infant gender, temperament and age; and rated study quality.

RESULTS

Fourteen studies met eligibility criteria. Perfectionism as a whole, and the perfectionistic concerns dimension, were moderately correlated with common maternal perinatal mental health difficulties r = .32 (95% Confidence Interval = 0.23 to 0.42). In sub-group analyses, perfectionistic concerns were associated with depression (r = .35, 95% CI = 0.26-0.43). We found no evidence of significant moderation of associations.

LIMITATIONS

Included studies had methodological and conceptual limitations. All studies examined depression and two examined anxieties; all examined perfectionistic concerns and four examined perfectionist strivings.

CONCLUSIONS

Perfectionism, namely perfectionistic concerns, is potentially associated with common maternal perinatal mental health problems. While further research is warranted, identification of perfectionism in the perinatal period may help focus resources for intervention, reducing the prevalence of perinatal mental health difficulties.

Reducing the influence of perfectionism and statistics anxiety on college student performance in statistics courses

The influence of perfectionism and statistics anxiety on academic performance (AP) in statistics courses was investigated using a multidimensional perfectionism scale and a statistics anxiety rating scale. For perfectionism, the factor of personal standards (PS) had a significant direct positive effect on AP, while the factor of parental expectations (PE) was significantly negatively correlated with AP. Other factors (concern over mistakes, organization, and doubts about actions) did not significantly influence AP. For statistics anxiety, the two factors (test and class anxiety and computation self-concept) significantly impaired AP. These results indicated a need for innovation in classroom instruction and the reform of statistics course content and presentation to reduce statistics anxiety and improve PS. There is also a need to ensure that students better internalize PE and to revise instructional design techniques to enhance students' independent learning ability.

A pilot randomised controlled trial of guided self-help cognitive behaviour therapy for perfectionism: Impact on diagnostic status and comorbidity

BACKGROUND AND OBJECTIVES

Perfectionism is associated with the development and maintenance of anxiety, mood, and eating disorders. Cognitive behaviour therapy (CBT) results in significant reductions in perfectionism and psychological symptoms however, the majority of studies have not examined clinical samples or impact on diagnostic status and comorbidity.

METHODS

Forty participants with elevated perfectionism, of whom 80% had a range of psychological disorders, were randomised to CBT for perfectionism or waitlist control.

RESULTS

The treatment group reported significant large effect size reductions in perfectionism measures of personal standards and concern over mistakes (d = 1.1-1.6), dichotomous thinking (d = 1.2), and medium effect size reductions in depression (d = 0.55) and increases in quality of life (d = 0.73), which were maintained at 4 month follow-up. The participants in the treatment group were significantly less likely to present with comorbid psychological disorders at post-treatment than the control group.

LIMITATIONS

The sample size was small, and there was no control condition at follow-up.

CONCLUSIONS

Findings lend further support for CBT for perfectionism as an efficacious transdiagnostic treatment for perfectionism and related psychopathology.

Online process-based training for perfectionism: A randomized trial

Process-based therapy (PBT) is model of psychotherapy designed to improve people's ability to use a variety of skills from evidence-based treatments to match environmental needs and personal goals in the moment. This randomized trial tested the effect of an online self-help intervention modeled after PBT principles for participants with perfectionism (N = 77). The intervention comprised two four-session trainings teaching skills from different evidence-based treatments (e.g., cognitive-behavioral therapy, acceptance and commitment therapy) and targeting cognitive and motivational processes: (1) cognitive training and (2) motivational training respectively. Participants completed 17 assessments throughout the intervention and at 3- and 6-month follow-up. Results indicated that the full intervention led to improvement in perfectionism, self-compassion, psychological distress, and cognitive skills targeted by the cognitive intervention (e.g., cognitive defusion; absolute βs = 0.02 to 0.66). In addition, the second four-session training (i.e., training after first four-session training) was associated with improvements in perfectionism, self-compassion, quality of life, and psychological distress (absolute βs = 0.09 to 2.90), suggesting it had incremental benefit. Whereas the cognitive training appeared to specifically impact cognitive processes, the motivational training increased both cognitive and motivational processes. These findings provide initial support for the feasibility and efficacy of a process-based approach, because they show that participants can benefit from learning skills from different orientations and applying them with reference to their goals. However, specific aspects of the PBT model, including whether interventions can precisely improve targeted skills, still need to be empirically tested in larger and more diverse clinical samples.

Examination of the relationship between dimensions of perfectionism, harm avoidance and incompleteness in college students

The present study aimed to examine the relationship between perfectionism, OCD symptom dimensions, harm avoidance, and incompleteness at varying levels (i.e., higher-order/subscale) in college students. College students (n = 548) completed measures of perfectionism, obsessive-compulsive symptoms, harm avoidance and incompleteness. The results revealed that all five higher-order dimensions of perfectionism were related to incompleteness but only three were related to harm avoidance. Parallel mediation revealed an indirect relationship between concern for mistakes and doubts about actions and checking and cleaning behaviors, respectively, through incompleteness. An indirect relationship between concern for mistakes and doubts about actions with ordering, respectively, through both incompleteness and harm avoidance was found. However, incompleteness played a stronger role than harm avoidance in this relationship. These results suggest that incompleteness might be a stronger motivator than harm avoidance for perfectionistic individuals. Therefore, interventions targeting incompleteness should be implemented to potentially circumvent the development or worsening of obsessive-compulsive symptoms.

Does Perfectionism Lead to Well-Being? The Role of Flow and Personality Traits

Perfectionism is a personality trait that plays an important role in understanding human behavior and functioning. There has been a focus on the negative aspects and outcomes of perfectionism, and less is known about whether and how perfectionism relates to adaptive characteristics of personality and normal functioning. We investigated associations between different aspects of perfectionism and psychological well-being in two studies by determining the role of dispositional flow and personality traits in this relationship. In Study 1, participants completed questionnaires for perfectionism, psychological well-being and flow. In Study 2, personality traits from the HEXACO model of personality were additionally measured. We found that psychological well-being had a positive correlation with conscientious perfectionism and a negative correlation with self-evaluative perfectionism. Flow mediates the relationship between conscientious perfectionism and psychological well-being. There was no correlation between self-evaluative perfectionism and dispositional flow. After controlling for relevant personality traits, dispositional flow remains the mediator between conscientious perfectionism and psychological well-being, but the relation becomes negative. Implications for the understanding of how different components of perfectionism are related to psychological well-being and how flow experience contributes to this relationship are discussed.

Predicting adolescent perfectionism: The role of socio-demographic traits, personal relationships, and media

BACKGROUND

The present study investigated perfectionism from the bioecological model perspective as a multidimensional construct manifested in forms of excessively high personal standards, exaggerated worries about personal mistakes, doubt in one’s performance, oversized order and organization emphasis, and the importance of parental valuations and expectations.

AIM

To investigate the relation between perfectionism; the quality of family, peer, and college relationships; and media usage and content interests.

METHODS

The research was implemented in 2020 with 203 students (134 female, 66%) aged 18-25 years, enrolled at the University of Osijek in Croatia. The questionnaire had five parts: A) sociodemographic data; B) the Multidimensional Perfectionism Scale; C) the “general life satisfaction” and “current situational life satisfaction” scale; D) family, peer, and college relationships quality scale; and E) media usage and content interests scale. All of the implemented instruments showed satisfactory reliability. A hierarchical regression analysis was implemented with the aim of establishing significant perfectionism predictors.

RESULTS

Age and gender were significant predictors of perfectionism. Participants with lower family relationship quality reported higher parental expectations and complaining as well as significantly higher doubts in personal performance and concern about mistakes. Similarly, a lower peer relationship quality predicted doubts in personal performance and stronger concerns about mistakes. The quality of college relationships positively predicted higher perfectionist personal standards and organization. General life satisfaction predicted higher concerns about mistakes, while current situational life satisfaction predicted higher levels of perfectionist organization. Media usage intensity had no significant effect. Adolescent interest in information-educational media predicted higher personal standards as well as concern about mistakes and organization. Higher interests in entertainment media content predicted more concern about mistakes, while interest in negative media content negatively predicted organization in adolescents.

CONCLUSION

Sociodemographic traits, relationships with family, peers and colleagues, as well as life satisfaction and media content interests represent significant adolescent perfectionism predictors, explaining 14%-28% of individual perfectionism dimensions.

Perfectionism, Mood States, and Choking in Asian University Baseball Players under Pressure during a Game

The purpose of this study was to investigate relationships among mood states, perfectionism, and choking, and to identify a mediating effect of perfectionism on the relationship between mood states and choking experienced by Asian university baseball players in extremely stressful situations during a game. Data collected from a total of 209 male university baseball players were analyzed using SPSS 21 and AMOS 21 statistical software. The mean age of study subjects was 20.25 years. Results are as follows. First, mood states had a positive influence on perfectionism. Second, mood states had no significant influence on choking. Third, perfectionism had a positive influence on choking. Lastly, perfectionism had a complete mediating effect on the relationship between mood states and choking. The study findings will provide basic data to relieve athletes’ psychological burdens, and prevent manifestations of extreme perfectionism and choking, which can ultimately help athletes maintain high self-control of their mood states and perfectionism for better performance.

The Associations of Common Psychological Problems With Mental Disorders Among College Students

Psychological problems like procrastination, perfectionism, low self-esteem, test anxiety and stress are common among college students. There are evidence-based interventions available for these problems that not only have direct effects on these problems, but also indirect effects on mental disorders such as depression and anxiety disorders. Targeting these psychological problems may offer new opportunities to prevent and treat mental disorders in a way that is less stigmatizing to students. In this study we examined the association of five psychological problems with five common mental disorders (panic, generalized anxiety, bipolar, major depressive, and substance use disorder) in a sample of 2,449 students from two Dutch universities. Psychological problems were measured with one item for each problem and mental disorders were measured with the Composite International Diagnostic Interview Screening Scales. Associations were examined with Poisson regression models as relative risks (RR) of the disorders as a function of the psychological problems. The population attributable fraction (PAF) indicates by what percentage the prevalence of the mental disorder would be reduced if the psychological problem was addressed successfully by an intervention. Especially generalized anxiety disorder was strongly associated with psychological problems (strong associations with stress and low self-esteem and moderately with test anxiety). The group with three or more psychological problems had a strongly increased risk for generalized anxiety (RR = 11.25; 95% CI: 7.51-16.85), and a moderately increase risk for major depression (RR = 3.22; 95% CI: 2.63-3.95), panic disorder (RR = 3.19; 95% CI: 1.96-5.20) and bipolar disorder (RR = 3.66; 95% CI: 2.40-5.58). The PAFs for having any of the psychological problems (one or more) were considerable, especially for generalized anxiety (60.8%), but also for panic disorder (35.1%), bipolar disorder (30.6%) and major depression (34.0%). We conclude that common psychological problems are associated with mental disorders and with each other. After adjustment, psychological problems are associated with different patterns of mental disorders. If the impact of the psychological problems could be taken away, the prevalence of several mental disorders would be reduced considerably. The psychological problems may provide a promising target to indirectly prevent and intervene in psychopathology in hard to reach college students with mental disorders.

Practice Does Not Make Perfect: The Tireless Pursuit of Achieving Perfect Sleep

Objective: Perfectionism is consistently identified as a predisposing and perpetuating factor for a wide range of mental health conditions and disorders. Given the unique cognitive, emotional, and physiological characteristics associated with perfectionism, perfection could have serious implications for a critical health behavior—our sleep. The current study examines the links between perfectionism and sleep health with the goal of identifying potential sleep-related beliefs as underlying mechanisms. Methods: Participants were 417 undergraduate students at a large, public university in the mid-Atlantic United States. Participants completed a one-time online survey with the Almost Perfect Scale-Revised, the Dysfunctional Beliefs about Sleep Scale, Perceived Competence Scale about their sleep, and the RU SATED sleep health scale. Results: A two-step structural equation modeling strategy was used. Greater perfectionism discrepancies predicted greater dysfunctional beliefs about sleep (β = 0.45) and worse perceived sleep competence (β = −0.33). Moreover, greater dysfunctional beliefs and worse perceived sleep competence predicted worse sleep health (β = −0.23 and 0.59, respectively). Dysfunctional beliefs and perceived sleep competence significantly mediated the effect of maladaptive perfectionism on sleep health (β = −0.302). Discussion: Dysfunctional beliefs and sleep competence emerged as mechanisms through which maladaptive perfectionism may function as a barrier to healthy sleep. Although prior research positions perfectionism as a primary correlate of poor sleep, the current study identifies the role of beliefs about sleep as the pathway from perfectionism to poorer sleep health. The results highlight the importance of addressing both maladaptive beliefs about sleep as well as beliefs about one’s own sleep competency with undergraduate students with higher maladaptive perfectionism.

Perceived Parenting Styles and Mental Health: The Multiple Mediation Effect of Perfectionism and Altruistic Behavior

Background

According to the ecological systems theory, the microsystems are important during the development process because they have direct effects on immediate and proximal factors that shape human development. The theory identifies the family as a microsystem that has profound influence on development since it is the immediate environment in which individuals live. This study explored the multiple mediation effect of perfectionism and altruistic behavior on the association between perceived parenting styles and mental health.

Methods

In this cross-sectional study, convenience cluster sampling was used, and the purpose was empirically examined by means of an online questionnaire survey. This study adopted the Demographic Questionnaire, short-form Egna Minnen Beträffande Uppfostran, Chinese Frost Multidimensional Perfectionism Scale, Self-Reported Altruism Scale, and General Health Questionnaire to conduct measurements in 525 university students.

Results

The results of the correlation analysis revealed that perceived parenting styles were significantly correlated to perfectionism, altruistic behavior, and mental health. In addition, perfectionism and altruistic behavior were significantly correlated to mental health, while negative perfectionism was not correlated to altruistic behavior. The results of the structural equation model analysis indicated that parental rejection and emotional warmth had direct and significant effects on children's mental health. Positive perfectionism and altruistic behavior not only played partial mediating roles between parental emotional warmth and children's mental health but also exerted a chain multiple mediation effect. Altruistic behavior played a partial mediating role between positive perfectionism and mental health.

Conclusion

Therefore, parents should practice positive parenting styles such as parental emotional warmth toward their children to ensure that positive perfectionism and altruistic behavioral tendency improve mental health.

Review of Perfectionism Research From 1990 to 2019 Utilizing a Text-Mining Approach

Perfectionism is a personality characteristic that has been explored for its implications in mental health; reviews and meta-analyses were conducted to synthesize research findings. This study systemically synthesizes the perfectionism literature using a text-mining approach. Co-word analysis and Dirichlet Multinomial Regression topic modeling were performed on a total of 1,529 perfectionism abstracts published from 1990 to 2019. Analysis revealed that perfectionism research is closely connected with “disorder,” with “symptom” being the most frequently addressed issue. Topic-modeling results found a total of 15 topics represented perfectionism research of the past three decades. Most articles were published in psychology journals, with social and clinical psychology subdisciplines publishing perfectionism articles most frequently. There were overlaps in research topics by journal subdisciplines, while differences were also observed. This study provides a panoramic view of perfectionism literature and highlights frequently and infrequently explored areas that could be considered in future research endeavors.

Depressive symptoms and academic achievement in UK adolescents: a cross-lagged analysis with genetic covariates

BACKGROUND

The relationship between adolescent depressive symptoms and academic achievement remains poorly understood. The aim of this study was to help clarify the nature and directionality of this association.

METHODS

We used a sample of 13,599 British adolescents (main sample of N=3,809 participants). We fitted cross-lagged panel models using four repeated measures of self-reported depressive symptoms and four measures of academic achievement based on British national records between 11-18 years, separately for male and female adolescents and considering polygenic risk scores (PRS) for educational attainment and depression, alongside other child and parental covariates.

RESULTS

We found evidence of an overall negative association that was stronger in boys (R=-0.21, 95% CI -0.31 to -0.11) than in girls (-0.13, -0.31 to 0.05). Higher depressive symptoms were associated with lower academic achievement at a later stage up to the end of compulsory education (16 years), when the direction of the association reversed, although girls with lower achievement also appeared vulnerable to depressive symptoms at previous stages. The genetic variables derived for this study showed stronger associations for academic achievement, but the PRS for depression also showed a negative association with academic achievement in girls. Child intelligence quotient and peer victimization also showed relevant associations.

LIMITATIONS

Observational design, variation around measurement times, missing data.

CONCLUSIONS

Depressive symptoms and academic achievement should be considered jointly when designing school-based programmes for children and adolescents, alongside gender, child ability and school experience. Including genetic information in research can help to disentangle average from time-varying effects.

An exploratory study of perfectionism, professional factors and psychological well-being of dentistry academics

BACKGROUND

Well-being might be lower among dentistry professionals than other health professionals, and differ by personal, professional and sociodemographic factors. Few studies have considered dentistry academics who have different work roles and functions than clinicians. This exploratory study focused on well-being among dentistry academics and aimed to explore associations with perfectionism, professional factors and sociodemographics.

METHOD

An online survey was carried out with academic staff in Dentistry and Oral Health departments of nine Universities in Australia and New Zealand. Well-being was assessed using the 22-item Psychological General Well-Being Index, with a maximum score of 110 indicating good well-being. Perfectionism was assessed using the 8-item Short Almost Perfect Scale, with a maximum score of 56 and a higher score indicating perfectionism. Twenty items were used to assess professional and 7 items assessed sociodemographic factors. Associations were explored using correlation and multiple linear regression.

RESULTS

There was no significant bivariate association between perfectionism and well-being. Multiple linear regression indicated a significant association between hours of undergraduate teaching and psychological well-being, after adjustment for age, gender, income and overall health.

CONCLUSION

This exploratory study showed poor well-being among dentistry academics, particularly in those teaching undergraduate students for more than 6 h/week.

Does physical appearance perfectionism predict disordered dieting?

Despite that disordered eating has been repeatedly associated with perfectionism, the results are inconsistent as to which exact dimensions of perfectionism it is related to. Moreover, the increasing evidence that perfectionism is best conceptualized as a domain-specific, as opposed to a global, trait contribute to the lack of clarity. Therefore, the aim of this study was to examine which dimensions of global and physical appearance perfectionism statistically predict disordered dieting in a non-clinical adult female sample. In total 437 participants completed the Short Almost Perfect Scale, which distinguishes between adaptive and maladaptive perfectionism, the Physical Appearance Perfectionism Scale, which distinguishes between hope for perfection and worry about imperfection, and the Dieting subscale of the Eating Attitudes Test-26. A hierarchical regression analysis revealed that only maladaptive, as opposed to adaptive, global perfectionism statistically predicted disordered dieting. Furthermore, both dimensions of physical appearance perfectionism statistically predicted disordered dieting, although worry about imperfection, its maladaptive dimension, was the strongest statistical predictor. The present results demonstrate that worry about imperfection is an effective statistical predictor of disordered dieting among women, possibly serving as a starting point for further research investigating the utility of its incorporation in prevention and treatment protocols for disordered eating.

Perfectionism, depression and anxiety in chronic fatigue syndrome: A systematic review

OBJECTIVE

High levels of depression and anxiety are experienced alongside Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). Psychological causal and maintenance factors are not well-understood. Perfectionism is a multifactorial, transdiagnostic risk factor for various physical and mental health conditions. This systematic review assesses the association between perfectionism and depression and/or anxiety in people with CFS/ME.

METHOD

Systematic literature searches used a combination of terms for 'perfectionism', 'depression', 'anxiety' and 'CFS/ME'. Peer-reviewed English-language papers reporting quantitative data regarding the relationship between perfectionism and depression and/or anxiety in adults (aged 18-65 years) with a clinical diagnosis of CFS/ME were included. Screening, selection and assessment of risk of bias was completed independently by two authors. Bivariate and multivariate associations between perfectionism and anxiety and depression were extracted. Data were synthesised narratively.

RESULTS

Seven studies, reported in eight papers, were included. Seven examined the relationship between perfectionism and depression. Moderate-strong significant positive associations were found between depression and maladaptive perfectionism (r = 0.42 to .48, p < .01), and its component factors of concern over mistakes (r = 0.40 to .60, p < .01) and doubts about actions (r = 0.51 to .60, p < .01). Methodological limitations included sample size justification and selection, psychometric measures, and control of potential confounders.

CONCLUSION

Maladaptive perfectionism is consistently associated with depression in patients with CFS/ME. The relationship between perfectionism and anxiety is under-researched. Corroboration is required from longitudinal, cross-cultural studies. Clinical understanding may be increased through examining the interplay between maladaptive perfectionism, depression and anxiety and the physical and cognitive symptoms of CFS/ME.

Managing Procrastination on Social Networking Sites: The D-Crastinate Method

Procrastination refers to the voluntary avoidance or postponement of action that needs to be taken, that results in negative consequences such as low academic performance, anxiety, and low self-esteem. Previous work has demonstrated the role of social networking site (SNS) design in users’ procrastination and revealed several types of procrastination on SNS. In this work, we propose a method to combat procrastination on SNS (D-Crastinate). We present the theories and approaches that informed the design of D-Crastinate method and its stages. The method is meant to help users to identify the type of procrastination they experience and the SNS features that contribute to that procrastination. Then, based on the results of this phase, a set of customised countermeasures are suggested for each user with guidelines on how to apply them. To evaluate our D-Crastinate method, we utilised a mixed-method approach that included a focus group, diary study and survey. We evaluate the method in terms of its clarity, coverage, efficiency, acceptance and whether it helps to increase users’ consciousness and management of their own procrastination. The evaluation study involved participants who self-declared that they frequently procrastinate on SNS. The results showed a positive impact of D-Crastinate in increasing participants’ awareness and control over their procrastination and, hence, enhancing their digital wellbeing.

Toward a More Perfect Conceptualization of Perfectionism: An Exploratory Factor Analysis in Undergraduate College Students

Previous investigations on the factor structure of perfectionism have largely focused on the Frost Multidimensional Perfectionism Scale and the Multidimensional Perfectionism Scale. The current study aimed to identify the underlying factor structure of perfectionism, based on several widely used measures, and to examine how these factors related to psychopathology and personality broadly. College students (N = 598) completed several measures of perfectionism and broadband measures of psychopathology and personality. Exploratory structural equation modeling (ESEM) was conducted to examine the hierarchical structure of perfectionism followed by exploratory factor analysis. The hierarchical structure examined provides a framework for understanding the relationship between models of perfectionism at different levels of the hierarchy. The exploratory factor analysis revealed five dimensions of perfectionism: Achievement Striving, Evaluative Concerns, Expectations From Others, Narcissistic Perfectionism, and Organization. These dimensions were associated with psychopathology to differing degrees and were differentially related to personality. These results support using a multidimensional perspective to understand perfectionism.

Covert and overt expressions of self‐criticism and perfectionism and their relation to depression

Multiple measures of both the covert and overt expressions of self‐criticism and perfectionism have been developed. The present study examined the relation between a measure of overt self‐criticism and several measures of covert self‐criticism and perfectionism, using 59 male and 152 female university students. The study also examined the relation between these constructs and depression. The results replicated previous reports that two factors, self‐critical perfectionism and high personal standards, underlie existing measures of covert expressions. Self‐critical perfectionism and overt self‐criticism were shown to be independent predictors of depression, suggesting the importance of assessing the overt interpersonal, as well as the covert, manifestations of self‐criticism. Copyright © 2003 John Wiley & Sons, Ltd.

Perfectionism Dimensions and the Five–factor Model of Personality

This study of university students ( n = 357) and community adults ( n = 223) examined personal standards (PS) and evaluative concerns (EC) higher–order dimensions of perfectionism that underlie several measures from three different theoretical frameworks. In both students and community adults, confirmatory factor analyses supported PS perfectionism and EC perfectionism higher–order latent factors. In relation to the revised NEO Personality Inventory, PS perfectionism was primarily related to conscientiousness and achievement striving. In contrast, EC perfectionism was primarily related to neuroticism, and lower positive emotions, trust and competence. EC perfectionism accounted for unique variance in current depressive and anxious symptoms over and above the five–factor domain scores. Copyright © 2011 John Wiley & Sons, Ltd.

Perfectionism and psychological distress: evidence of the mediating effects of rumination

Three studies investigated the role of ruminative tendencies in mediating the effects of multidimensional perfectionism (Hewitt & Flett, 1991) on psychological distress. Study 1 (Sample 1, N = 279; Sample 2, N = 224) and Study 2 (N = 205) found evidence, cross‐sectionally and prospectively, that brooding ruminative response style either fully or partially mediated the effects of socially prescribed and self‐oriented perfectionism on psychological distress, depression and hopelessness levels. In addition, Study 3 (N = 163) confirmed these mediation effects for socially prescribed perfectionism in relation to depression and hopelessness, 2 months later, after initial levels of distress were controlled. Overall, these findings provide evidence that brooding ruminative response style is an important mechanism that can explain, in part, the relationship between perfectionism and distress. Copyright © 2006 John Wiley & Sons, Ltd.

Does Workload Moderate the Association Between Perfectionism and Workaholism?

Abstract. The aim of this study is to examine, with a longitudinal design, the moderating role of workload in the relationship between perfectionism and workaholism. It was hypothesized that self-oriented perfectionism (SOP) and socially prescribed perfectionism (SPP) predict an increase in workaholism and that workload may exacerbate this association. Four hundred and thirty workers completed a self-report questionnaire at two different time points, and the hypothesized relationships were tested using structural equation modeling. Overall, SOP and SPP were not associated with workaholism over time. The interaction between SOP, but not SPP, and workload was significant. SOP predicted an increase in workaholism over time in workers facing high workload. Accordingly, SOP may be a risk factor for workaholism when workload is high.

Struggling with perfectionism: When good enough is not good enough

Perfectionism includes a tendency for high standards for self and others with a clear goal of successful performance in a variety of areas. A perfectionist often reacts with critical evaluations whenever performance falls below these standards. Moreover, perfectionists emphasize personal goals to gauge their worth, neglecting intimate bonds or openness to new experience. At the core of perfectionism lies a view of self as weak, flawed, and easily rejected. Perfectionism can result in chronic tendencies for emotional distress and interpersonal conflict. Treatment aims to explore personal views of self and others, viewing perfectionism as a form of maladaptive coping. When clients understand the role of perfectionism, they can discontinue striving to meet their extreme goals and unrealistic standards. The authors of the papers in the issue present their views on how to treat these maladaptive tendencies according to their preferred therapeutic orientation.

How to Cope with Perfectionism? Perfectionism as a Risk Factor for Suicidality and the Role of Cognitive Coping in Adolescents

Suicide among adolescents is a significant health concern. Gaining more knowledge about markers that contribute to or protect against suicide is crucial. Perfectionism is found to be a personality trait that is strongly predictive for suicidality; it can be divided into personal standards perfectionism (PS) and concerns about mistakes and doubts perfectionism (CMD). This study investigated the association between PS, CMD, and suicidality in a sample of 273 Dutch secondary school students aged between 12 and 15 years old (M = 13.54, SD = 0.58, 55.8% males). We also examined whether adaptive, or maladaptive cognitive coping strategies influenced these associations. We hypothesized that students high in PS or CMD would experience an increased suicidality. Moreover, we expected that adaptive coping strategies would act as buffer between the association of perfectionism and suicidality, and that maladaptive coping strategies would strengthen this association. For analyses, we used a regression model with latent variables. The results showed that higher scores in perfectionism (PS and CMD) were related to an increase in suicidality. High levels of maladaptive coping in combination with high levels of perfectionism were associated with an increase in suicidality. Although adaptive coping was related to a decrease in suicidality, adaptive coping in interaction with PS and with CMD was not a predictor of suicidality. The results are relevant for prevention, and intervention programs. This paper makes recommendations for clinical practice and further research in order to prevent suicidality in adolescents.

Perfectionism in a Transdiagnostic Context

Abstract. Despite recent claims that perfectionism is a transdiagnostic process, few studies have directly tested this hypothesis. We investigated the relationship between perfectionism measured by the Almost Perfect Scale-Revised (APS-R) and the Axis I psychopathology (affective and anxiety disorders) using a transdiagnostic approach. Adult participants ( N = 450, 78% females, Mage = 33 years) completed a series of online self-report measures of perfectionism, anxiety, and depression for this cross-sectional study. The results support a linear relationship between the Discrepancy subscale of APS-R and anxiety/affective psychopathology, while a non-linear relationship appeared between the High Standards subscale of APS-R and anxiety/affective psychopathology. Overall, we provided additional evidence for the transdiagnostic nature of perfectionism, as higher levels of perfectionistic concerns appear to be associated with higher number of clinical symptoms in multiple domains. The possible implications of the study are discussed.