Moral affect and cognitive processes: Differentiating shame from guilt among men and women

Men (n = 103) and women (n = 183) completed measures of shame, guilt, self-critical cognitions, and perfectionism in order to explore gender differences in cognitive processes associated with moral affect. Women reported significantly higher rates of shame and guilt than men. Separate factor analyses for gender indicated that for men, shame loaded with self-critical cognitions while guilt loaded with dimensions of perfectionism. For women, both shame and guilt loaded with self-critical cognitions, but only socially-prescribed perfectionism. Results suggest that a person's gender may need to be considered in evaluations of shame and guilt.     

Personal standards and evaluative concerns dimensions of "clinical" perfectionism: a reply to Shafran et al. (2002, 2003) and Hewitt et al. (2003)

Shafran, Cooper, and Fairburn (2002, 2003) provided a cognitive-behavioral analysis of "clinical" perfectionism, a construct they considered to involve both the determined pursuit of self-imposed standards and extremely vulnerable self-evaluation. They argued against a multidimensional perspective to studying perfectionism. We respond to Shafran et al. (2002, 2003) and Hewitt, Flett, Besser, Sherry, and McGee's (2003) reply to Shafran et al. (2002) by considering the theoretical, empirical, and clinical implications of findings identifying two higher-order dimensions of perfectionism reflecting personal standards (PS) and self-critical evaluative concerns. Analyses of data from two diverse study groups, a college student sample (N = 527) and a clinical sample of patients with binge eating disorder (N = 236), revealed that self-criticism accounts for the relation between perfectionism measures and depressive, anxious, and eating disorder symptoms. We conclude that possessing high PS is not by itself maladaptive. Rather, self-critical evaluative tendencies are more relevant than PS to the critical processes Shafran et al. (2002) suggested contribute to the maintenance of clinical perfectionism.     

Assessing self-critical perfectionism in clinical depression

Several facets of perfectionism have been strongly associated with depression and anxiety. Dunkley and Blankstein (2000) combined these maladaptive traits with self-criticism to create a general construct labeled self-critical perfectionism. In this study, we employed confirmatory factor analysis to evaluate a model for assessing self-critical perfectionism in a clinically depressed sample using scales from 3 instruments. Participants were 356 depressed adult outpatients who completed 2 multidimensional measures of perfectionism and a measure of self-criticism. A confirmatory factor model that separated a self-critical perfectionism construct from a more adaptive, achievement-striving component of perfectionism was supported. A composite scale assessing self-critical perfectionism demonstrated much larger correlations with distress measures compared to a composite scale assessing achievement striving and also showed evidence of discriminant validity. In this study, we provided further support for the valid assessment of self-critical perfectionism and extended evidence for its assessment to a clinically depressed sample.     

Informant reports add incrementally to the understanding of the perfectionism–depression connection: Evidence from a prospective longitudinal study

Perfectionism is a putative risk factor for depressive symptoms. However, most research in this area uses cross-sectional designs (which fail to address temporal precedence) and mono-source designs (which are influenced by various biases). The present study overcomes these limitations by using a novel design involving both self- and informant reports of self-critical perfectionism (i.e., negative reactions to perceived failures, concern over others’ criticism and expectations, doubts about performance abilities, and intense self-rebuke). It was hypothesized that self- and informant reports of self-critical perfectionism would correlate moderately and that self- and informant reports of self-critical perfectionism would predict increases in depressive symptoms over time. A sample of 155 target participants and 588 informants was recruited and studied using a prospective longitudinal design. All study hypotheses were supported, including evidence that self- and informant reports of self-critical perfectionism each add incrementally to the understanding of the self-critical perfectionism–depressive symptoms connection. Informant reports may provide a more complete picture of the self-critical perfectionist and her or his vulnerability to depressive symptoms.     

Self-oriented and socially prescribed perfectionism dimensions and their associations with disordered eating

This study examined the relationship between self-oriented and socially prescribed dimensions of perfectionism (using two measures of perfectionism) and disordered eating assessed across multiple time points in a sample of young women. Study participants (n=406) reported on their levels of perfectionism and on their subsequent patterns of dieting and bulimic symptoms. Self-oriented perfectionism was strongly linked to dietary restraint, whether using the theoretically derived perfectionism dimensions from the Multidimensional Perfectionism Scale (MPS) [Hewitt, P.L., & Flett, G.L. (1991a). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456-470] or the dimensions derived from the Perfectionism subscale of the Eating Disorder Inventory (EDI) [Garner, D. M., Olmsted, M. P., & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2, 15-34]. A less clear-cut pattern emerged when bulimic symptoms were investigated, with both self-oriented (MPS and EDI) and socially prescribed perfectionism (MPS) being associated with bulimic symptoms. After controlling for negative affect, only a self-oriented dimension of perfectionism predicted unique variance in bulimic symptoms. What constitutes maladaptive perfectionism, concerns about using EDI-Perfectionism dimensions interchangeably with MPS dimensions, and future directions are discussed.     

Loss of control over eating reflects eating disturbances and general psychopathology

This study examined the clinical significance of the loss of control over eating as a key component of eating disorders. It investigated the association of eating-related psychopathology and general psychopathology with objective bulimic episodes (OBEs; experiencing a loss of control while consuming large amounts of food) and subjective bulimic episodes (SBEs; experiencing a loss of control while consuming small/moderate amounts). A community sample of 81 women with a range of disordered eating was recruited: binge-eating disorder, bulimia nervosa, subclinical eating disturbances, or no eating disorders. They were interviewed using the Eating Disorder Examination and completed measures of eating-related and general psychopathology. Both OBE and SBE frequencies correlated significantly with measures of eating-related and general psychopathology, and no significant differences were found between the magnitudes of the correlations with either binge episode type. SBE frequency significantly and independently predicted global eating disorder psychopathology. The loss of control over eating, without consuming large amounts of food, was as closely associated with specific eating disorder psychopathology and general mental health as were traditionally defined OBEs. SBEs may be an important target of treatment and should be considered for future diagnostic classifications of eating disorders.     

Perfectionism in depression, obsessive-compulsive disorder and eating disorders

High levels of perfectionism have been observed in major depression, anxiety disorders and eating disorders. Though few studies have compared levels of perfectionism across these disorders, there is reason to believe that different dimensions of perfectionism may be involved in eating disorders than in depression or anxiety [Bardone-Cone, A. M. et al. (2007). Perfectionism and eating disorders: Current status and future directions. Clinical Psychology Review, 27, 84-405]. The present study compared patients with major depression, obsessive-compulsive disorder, and eating disorders on dimensions of perfectionism. Concern over Mistakes was elevated in each of the patient groups while Pure Personal Standards was only elevated in the eating disorder sample. Doubts about Actions was elevated in both patients with obsessive-compulsive disorder and eating disorders, but not in depressed patients. Analyses of covariance indicated that Concern over Mistakes accounted for most of the variance in the relationship of perfectionism to these forms of psychopathology.     

The influence of social networks within sports teams on athletes’ eating and exercise psychopathology: A longitudinal study

Teammates have been found to have an impact on athletes’ eating and exercise psychopathology via multiple influence mechanisms (e.g., modelling, making critical comments). However, far less is known about the role of the team social network (i.e. the pattern and strength of relationships between teammates). This novel longitudinal study aimed to explore how athletes’ eating and exercise psychopathology becomes more (convergence) or less (divergence) similar to their teammates’ over time and to explore how this varies for male and female athletes. A second aim was to identify the role of team social network variables (e.g., popularity) in determining individuals’ levels of eating and exercise psychopathology. Athletes (N = 199, mean age 18 years, n = 123 female) from 20 teams/training groups completed a survey regarding their teammate relationships and eating/exercise psychopathology (Eating Disorder Inventory-2; Athlete Compulsive Exercise Test) at three time points over a 7-month period. Significant interaction effects between time and gender were noted for athlete team variability in eating and exercise psychopathology, where both convergence and divergence of eating and exercise psychopathology was evident. In addition, being well connected to teammates, acting as the bridge between groups of teammates or being part of a cohesive team were longitudinally associated with reduced exercise psychopathology. Disordered eating and exercise prevention strategies should look to harness the behavioural convergence effect demonstrated here, by encouraging healthy eating/exercise practices among teammates. Furthermore, coaches should foster cohesive teammate relationships and be aware of how an athlete’s social positioning within their team may affect their susceptibility to exercise psychopathology.     

Perfectionism and the pursuit of personal goals: A self-determination theory analysis

Previous studies have shown that self-critical and personal standards forms of perfectionism are associated with progress on personal goals in opposite ways. The present study used a 5-wave prospective longitudinal design to examine what motivational factors account for the finding that self-critical perfectionism has been reliably associated with poor goal progress whereas personal standard perfectionism has been associated with good progress. Specifically, we adopted a self-determination theory perspective to examine the role of autonomy in mediating the effects of perfectionism. Our results replicated previous findings linking the two forms of perfectionism with opposite patterns of goal progress. Importantly, the results suggested that the negative goal effects of self-critical perfectionism are mediated by lower levels of autonomous goal motivation. The results also demonstrated links from personal standards perfectionism to greater autonomous goal motivation. Interestingly, the effects of self-critical perfectionism on goal progress appeared to be dynamic over time and implicated affective mechanisms. The results of the investigation point to the value of adopting a self-determination theory perspective to understand perfectionism.     

Discrimination and Eating Disorder Psychopathology: A Meta-Analysis

Eating disorders occur in diverse populations, and discrimination may be a specific factor that is related to higher eating disorder psychopathology among marginalized individuals. To evaluate the current evidence on this topic, a meta-analysis was used to quantitatively synthesize the literature on discrimination and eating disorder psychopathology across a heterogeneous range of studies. Searches were conducted in peer-reviewed journals and accessible unpublished dissertations of all years through January 2020. Studies were coded by two authors using a tailored coding form, and zero-order bivariate correlations were used as effect size measures. There were 55 cross-sectional studies extracted for inclusion in the meta-analysis. Results showed a small-to-medium association between discrimination and eating disorder psychopathology that was consistent across domains. Effect sizes were typically higher for weight discrimination. For binge eating and general eating disorder pathology, effects were smaller in studies that had larger proportions of women, and for binge eating only, effects were higher in college samples. These findings could suggest that discrimination represents a contributory factor related to eating disorder psychopathology across types of discrimination and eating disorder psychopathology. Implications are discussed for future research on discrimination and psychopathology including possible mechanisms.     

Intuitive Heuristics Linking Perfectionism, Control, and Beliefs Regarding Body Shape in Eating Disorders

A number of correlational studies have established a clear association between perfectionism, control and beliefs regarding body shape in eating disorders (EDs). The aim of this study is to test the effectiveness of the above- mentioned associations in exploring the presence of intuitive heuristics. Intuitive heuristics can be conceived as as mental shortcuts, cognitive processes that are highly susceptible to irrational biases. Forty one non clinical female controls and 27 in-patient females with an ED diagnosis participated in an experimental task that tested whether participants would show an intuitive rather than a logically based link between perfectionism in different domains (study, work, hygiene) and a thin body shape. In the healthy female participants the occurrence of proposed link was noted in the hygiene domain only, while ED participants showed this intuitive association in all the domains explored: study, work, and hygiene. The study confirms in clinical ED sample a wider employment of heuristics associating perfectionism and thinness that is based on purely intuitive irrational reasoning.     

Perfectionism and eating disturbances in Korean immigrants: Moderating effects of acculturation and ethnic identity

Korean society highly values personal appearance. Given the established links between perfectionism and eating disorders in Western countries, the present project investigated such links and the extent to which these were moderated by the acculturation patterns of the participants. Korean immigrants to New Zealand (N = 123) completed measures of perfectionism, ethnic identity, eating disorders, and social desirability. Positive and negative perfectionism were associated with eating‐disorder symptoms. For males, but not females, negative perfectionism was more strongly associated with increased body satisfaction only among those who identified strongly as Korean.     

The role of perfectionism in daily self-esteem, attachment, and negative affect

This study of university students (64 men, 99 women) examined the role of self-critical (SC) and personal standards (PS) higher order dimensions of perfectionism in daily self-esteem, attachment, and negative affect. Participants completed questionnaires at the end of the day for 7 consecutive days. Trait and situational influences were found in the daily reports of self-esteem, attachment, and affect. In contrast to PS perfectionism, SC perfectionism was strongly related to aggregated daily reports of low self-esteem, attachment fears (fear of closeness, fear of dependency, fear of loss), and negative affect as well as instability indexes of daily self-esteem, attachment, and negative affect. Multilevel modeling indicated that both SC and PS perfectionists were emotionally reactive to decreases in self-esteem, whereas only SC perfectionists were emotionally reactive to increases in fear of closeness with others. These results demonstrate the dispositional and moderating influences of perfectionism dimensions on daily self-esteem, attachment, and negative affect.     

Self-Defining Memories of Body Image Shame and Binge Eating in Men and Women: Body Image Shame and Self-Criticism in Adulthood as Mediating Mechanisms

Despite the growing evidence of the association between shame experiences and eating psychopathology, the specific effect of body image-focused shame memories on binge eating remains largely unexplored. The current study examined this association and considered current body image shame and self-criticism as mediators. A multi-group path analysis was conducted to examine gender differences in these relationships. The sample included 222 women and 109 men from the Portuguese general and college student populations who recalled an early body image-focused shame experience and completed measures of the centrality of the shame memory, current body image shame, binge eating symptoms, depressive symptoms, and self-criticism. For both men and women, the effect of the centrality of shame memories related to body image on binge eating symptoms was fully mediated by body image shame and self-criticism. In women, these effects were further mediated by self-criticism focused on a sense of inadequacy and also on self-hatred. In men, only the form of self-criticism focused on a sense of inadequacy mediated these associations. The present study has important implications for the conceptualization and treatment of binge eating symptoms. Findings suggest that, in both genders, body image-focused shame experiences are associated with binge eating symptoms via their effect on current body image shame and self-criticism.     

Examining a psychosocial interactive model of binge eating and vomiting in women with bulimia nervosa and subthreshold bulimia nervosa

The current study tested a psychosocial interactive model of perfectionism, self-efficacy, and weight/shape concern within a sample of women with clinically significant bulimic symptoms, examining how different dimensions of perfectionism operated in the model. Individuals with bulimia nervosa (full diagnostic criteria or subthreshold) completed measures of bulimic symptoms, multidimensional perfectionism, self-efficacy, and weight/shape concern. Among those who were actively binge eating (n=180), weight/shape concern was associated with binge eating frequency in the context of high perfectionism (either maladaptive or adaptive) and low self-efficacy. Among those who were actively vomiting (n=169), weight/shape concern was associated with vomiting frequency only in the context of high adaptive perfectionism and low self-efficacy. These findings provide support for the value of this psychosocial interactive model among actively binge eating and purging samples and for the importance of considering different dimensions of perfectionism in research and treatment related to bulimia nervosa.     

Bulimic symptomatology: the role of adaptive perfectionism, shape and weight concern, and self-esteem

An interactive model implicating high perfectionism, high weight and shape concern, and low self-esteem in the onset and maintenance of bulimic symptoms ( [Bardone et?al., 2000] and [Vohs et?al., 1999] ) has received mixed support. This study aimed to replicate the cross-sectional model in a clinical sample of women with eating disorders, and to investigate whether the model could predict changes in binge eating and purging at the end of treatment. Eating disorder outpatients (n = 353) completed measures of perfectionism, weight/shape concern, self-esteem, and bulimic symptoms at pre-treatment and discharge. Contrary to the hypotheses, the three-way interaction did not predict binge eating or purging cross-sectionally or prospectively as a moderator of psychotherapy outcome. It was concluded that the robustness of the interactive model seems questionable and may be impacted by an inadequate conceptualization of the perfectionism construct.     

Perfectionism, acne and appearance concerns

This study investigated the relationship between perfectionism and two aspects of appearance worry: acne-related concerns and dysmorphic concerns. One-hundred and sixty five female university students completed measures of three facets of perfectionism: self-oriented, other-oriented and socially prescribed [Hewitt, P. L., & Flett, G. L. (1991a). Perfectionism in the self and social contexts: conceptualization, assessment and association with psychopathology. Journal of Personality and Social Psychology, 60, 456–470], general psychopathology (GHQ-28), acne health related quality of life [Girman, C. J., Hartmaier, S., Thiboutot, D., Johnson, J., Barter, B., DeMunro-Mercon, & Waldstreicher, J. (1996). Evaluating health-related quality of life in patients with facial acne: development of a self-administered questionnaire for clinical trials. Quality of Life Research, 5, 481–490] and dysmorphic concerns [Oostuizen, P., Lambert, T., & Castle, D.J. (1998). Dysmorphic concern: prevalence and associations with clinical variables. Australian and New Zealand Journal of Psychiatry, 32, 129–132]. Multiple regression analyses showed that, after controlling for general psychopathology, a high level of socially prescribed perfectionism was associated with a greater tendency to be concerned about acne in particular and appearance in general.     

Perfectionistic Automatic Thoughts,Trait Perfectionism,and Bulimic Automatic Thoughts in Young Women

The current research examined the associations among perfectionistic automatic thoughts, trait perfectionism, negative automatic thoughts, and bulimic automatic thoughts. A non-clinical sample of 94 undergraduate women completed the Perfectionism Cognitions Inventory, the Multidimensional Perfectionism Scale, the Automatic Thoughts Questionnaire, and the Bulimic Automatic Thoughts Test. Correlational tests revealed that two automatic thoughts measures (perfectionistic automatic thoughts and negative automatic thoughts) and two trait perfectionism measures (self-oriented and socially prescribed perfectionism) were associated significantly with bulimic automatic thoughts with the strongest association being between perfectionistic automatic thoughts and bulimic automatic thoughts. Regression analyses showed that perfectionistic thoughts predicted unique variance in bulimic thoughts beyond variance attributable to trait perfectionism and negative automatic thoughts. The findings are discussed in terms of the need to incorporate an explicit focus on perfectionistic automatic thoughts into treatment interventions and conceptual models of perfectionism and eating disorders.     

Self-Critical Perfectionism,Daily Interpersonal Sensitivity,and Stress Generation: a Four-Year Longitudinal Study

This study of 145 community adults examined heightened interpersonal-sadness sensitivity as a mediator of the relationship between self-critical (SC) perfectionism and stress generation four years later. Participants completed questionnaires assessing perfectionism dimensions at Time 1, baseline depressive symptoms at Time 1 and Year 3, daily negative social interactions and affect for 14 consecutive days at Month 6 and Year 3, and a contextual-threat stress interview at Year 4. Path analyses indicated that SC perfectionism predicted daily interpersonal-sadness sensitivity (i.e., greater increases in sadness in response to increases in negative social interactions) between Month 6 and Year 3. This, in turn, explained why individuals with higher SC perfectionism had greater interpersonal stress generation four years later, controlling for the effects of depressive symptoms. Findings also demonstrated that responding to negative social interactions with broader negative affect or accumulated negative social interactions did not mediate the prospective relation between SC perfectionism and interpersonal stress generation. SC perfectionism was not related to Year 4 noninterpersonal stress generation or independent stress. Findings highlight the importance of targeting interpersonal-sadness sensitivity in order to reduce the propensity of SC perfectionistic individuals to generate negative interpersonal life events several years into the future.