Perfectionism and depression symptom severity in major depressive disorder.

In recent years it has been recognized that perfectionism is a multidimensional construct and two Multidimensional Perfectionism Scales have been developed and investigated in relative isolation [Frost, R.O., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449-468; Hewitt, P.L., & Flett, G.L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment and association with psychopathology. Journal of Personality and Social Psychology, 60, 456-470]. The present study sought to evaluate the association between various dimensions of perfectionism, higher-order personality dimensions, and self and observer rated depressive symptoms in a group of 145 patients with major depressive disorder. Only three of ten perfectionism dimensions (socially prescribed perfectionism, concern over mistakes and self-criticism) displayed medium to large correlations with depressive symptoms, especially self-report symptoms reflecting depressive cognitive distortions. The results are discussed in relation to the specificity of perfectionism dimensions to depression, adaptive versus maladaptive aspects of perfectionism, and in the context of previous research, much of which has relied on college student samples.     

Dimensions of perfectionism across the anxiety disorders

To explore the role of perfectionism across anxiety disorders, 175 patients with either panic disorder (PD), obsessive compulsive disorder (OCD), social phobia, or specific phobia, as well as 49 nonclinical volunteers, completed two measures [Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R., (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449-468; Hewitt, P. L., & Flett, G. L., (1991). Perfectionism in the self and social contexts: Conceptualization, assessment and association with psychopathology. Journal of Personality and Social Psychology, 60, 456-470.] that assess a total of nine different dimensions of perfectionism. Relative to the other groups, social phobia was associated with greater concern about mistakes (CM), doubts about actions (DA), and parental criticism (PC) on one measure and more socially prescribed perfectionism (SP) on the other measure. OCD was associated with elevated DA scores relative to the other groups. PD was associated with moderate elevations on the CM and DA subscales. The remaining dimensions of perfectionism failed to differentiate among groups. The clinical implications of these findings are discussed.     

Dimensions of depression and perfectionism in pregnant and nonpregnant women: their levels and interrelationships and their relationship to marital satisfaction

The authors studied S. J. Blatt's (1974) 2 dimensions of depression (anaclitic and introjective), P. L. Hewitt and G. L. Flett's (1991b) 3 dimensions of perfectionism (socially prescribed, self-oriented, and other-oriented), and the relationship between these and marital satisfaction in 100 married women in the last trimester of their first pregnancy and in 50 married women who had not yet experienced pregnancy. The measures used were the Depressive Experiences Questionnaire (S. J. Blatt, J. P. D'Afflitti, & D. M. Quinlan. 1976a, 1976b), the Multidimensional Perfectionism Scale (P. L. Hewitt & G. L. Flett, 1989), and G. B. Spanier's (1976) Dyadic Adjustment Scale. Pregnant and nonpregnant women did not differ in anaclitic depression, but the level of introjective depression of pregnant women was lower than that of nonpregnant women. The two groups did not differ in level of marital satisfaction or in any of the dimensions of perfectionism. For both groups, introjective depression was positively correlated with socially prescribed perfectionism and negatively correlated with marital satisfaction. Self-oriented perfectionism was positively related to introjective depression and negatively related to marital satisfaction for nonpregnant women. For the pregnant women, there was a negative relationship between socially prescribed perfectionism and marital satisfaction. Anaclitic depression and other-oriented perfectionism were unrelated to any of the other variables studied.     

A new measure of perfectionism: the Perfectionism Inventory

In this investigation, we produced a new 8-scale measure of perfectionism called the Perfectionism Inventory (PI) that is designed to capture the important constructs provided by 2 existing Multidimensional Perfectionism Scale (MPS; Frost, Marten, Lahart, & Rosenblate, 1990; Hewitt & Flett, 1991b) measures, along with new perfectionism scales. In the results from 3 studies, we describe scale development, scale psychometric properties, and criterion-related validity evidence for the 8 PI scales: Concern Over Mistakes, High Standards for Others, Need for Approval, Organization, Parental Pressure, Planfulness, Rumination, and Striving for Excellence. We present relationships between the 8 PI scales, relevant MPS scales, and other criterion measures. Second-order exploratory and confirmatory analyses provide support for the 8-scale PI model as well as support for 2 composite PI factors labeled Conscientious Perfectionism and Self-Evaluative Perfectionism.     

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.     

Perfectionism as an Explanatory Construct in Comorbidity of Axis I Disorders

Understanding comorbidity is an important challenge for psychopathology researchers and diagnostic systems given the repeated finding of very high comorbidity rates among Axis I disorders in psychiatric samples. This paper proposes that perfectionism may be a critical factor for understanding levels of comorbidity, and a conceptual argument for the importance of perfectionism as an explanatory construct for comorbidity is advanced. The link between perfectionism and comorbidity in a large sample of patients (N = 345) who attended an anxiety disorders clinic is examined using a variety of methods. Diagnoses were established using the Structured Clinical Interview for DSM-IV (SCID-IV), and perfectionism was assessed using both the Hewitt and Flett and Frost Multidimensional Perfectionism Scales. Overall, scores on both the Hewitt and Flett and Frost perfectionism scales were correlated with the number of diagnoses, and a logistic regression analysis, controlling for current symptoms, showed that maladaptive evaluative concerns perfectionism in particular predicted higher levels of comorbidity.     

The Effect of Perfectionism and Unconditional Self-acceptance on Depression

The study examined the relationships between perfectionism, unconditional self-acceptance and depression. The non-clinical sample comprised 134 participants, each of whom completed a battery of questionnaires, including the Unconditional Self-Acceptance Questionnaire (USAQ), the Center for Epidemiological Studies Depression Inventory (CES-D) and several measures of perfectionism. Significant levels of association were found between all measures, and support was provided for the concept of perfectionism as having a neutral core, distinguishable from its consequences, and for the theory that it is the negative consequences of perfectionism, rather than perfectionism per se, that lead to depression. Path Analysis provided support for the mediator model proposed by Flett et al. [Flett, G. L., Besser, A., Davis, R. A., Hewitt, P. L. (2003). Journal of Rational-Emotive & Cognitive-Behavior Therapy, 21, 119–138], in which unconditional self-acceptance mediates the effect of socially prescribed perfectionism on depression, and for a more generic model, in which the core construct of perfectionism can have negative consequences, which lead to low levels of unconditional self-acceptance, and thence to depression. Finally, a distinction was drawn between developmental and operational models of perfectionism.     

A preliminary look at loneliness as a moderator of the link between perfectionism and depressive and anxious symptoms in college students: does being lonely make perfectionistic strivings more distressing?

An integrative model involving perfectionism [Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456-470] and loneliness as predictors of depressive and anxious symptoms was proposed and tested in 383 college students. Beyond the expected additive influences of the two predictors in the prediction of symptoms, loneliness was also hypothesized to moderate the link between perfectionism and symptoms. Results indicated that other-oriented perfectionism predicted anxious symptoms, whereas socially prescribed perfectionism predicted both depressive and anxious symptoms. Loneliness was found to add incremental validity to these predictions. Moreover, the Perfectionism x Loneliness interaction was found to further augment the prediction of depressive and anxious symptoms. These findings are taken to offer support for a more contextual model of perfectionism. Some implications of the present findings are discussed.     

完美主义结构研究述评

早期研究者如Adler、Homey和Ellis认为完美主义是一种单维的人格结构。后来的研究者如Hewitt、Frost等多持多维观点,认为完美主义是由不同因素组成的复杂结构。目前越来越多学者认同完美主义的二维观,认为完美主义有积极和消极之分。今后研究应考虑完美主义的文化因素,同时应从心理咨询、心理治疗和心理健康教育效果的角度来佐证某种结构观的合理性。     

Psychometric Properties of the Multidimensional Perfectionism Scale of Hewitt in a Dutch-Speaking Sample: Associations With the Big Five Personality Traits

We administered the Dutch Multidimensional Perfectionism Scale of Hewitt and Flett (1991, 2004) in a large student sample (N = 959) and performed a confirmatory factor analysis to test the factorial structure proposed by the original authors. The existence of a method factor referring to the negatively keyed items in the questionnaire was investigated by including it in the tested models. Next, we investigated how the 3 perfectionism dimensions are associated with the Five-factor model (FFM) of personality. The 3-factor structure originally observed by the authors was confirmed, at least when a method factor that refers to the negatively keyed items was included in the model. Self-oriented and socially prescribed perfectionism were both distinguished by low extraversion and low emotional stability. Self-oriented perfectionism's positive relationship with both conscientiousness and openness to experience differentiated the 2 perfectionism dimensions from each other. Other-oriented perfectionism was not well-characterized by the Big Five personality traits.     

Resilience Mediates the Relations Between Perfectionism and College Student Distress

This study examined the relations among perfectionism dimensions, resilience, and distress. Participants were 413 undergraduate students. All 3 of Hewitt and Flett's (2004) dimensions of perfectionism were associated with greater reports of depression and anxiety; however, only socially prescribed perfectionism was significantly associated with resilience. Results indicated that resilience partially mediated the relations between socially prescribed perfectionism and distress. Implications for counselors in the prevention, assessment, and treatment of depression and anxiety are discussed.     

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.     

Overcoming Negative Aspects of Perfectionism through Group Treatment

The tendency to hold and pursue excessively high standards for oneself and for others can interfere with academic achievement. Counsellors who work in university settings are often presented with students whose capabilities do not reflect their levels of achievement. This study reports on the evaluation of an eight-week group intervention designed to help university students shift from negative and often debilitating perfectionism to positive and enhancing perfectionism. The group treatment focused on changing attitudes, beliefs, feelings, and interpersonal interactions affected by perfectionism using combined cognitive-behavioral and interpersonal approaches. Standardized measures, including the Beck Depression Inventory (Beck et al., BDI-II manual. San Antonio: The Psychological Corporation, 1996), the Beck Anxiety Inventory (Beck and Steer, Beck Anxiety Inventory: Manual. San Antonio: The Psychological Corporation, 1993), and the Multidimensional Perfectionism Scale (Hewitt and Flett, Journal of Personality & Social Psychology, 60, 456–470, 1991a), provided data for pre- and post analysis of a treatment group (n = 30), and comparison groups of students attending group programs on career planning (n = 30) and attending psychology classes (n = 30). Results show that students participating in the treatment group significantly reduced their levels of depression, anxiety, and perfectionism in comparison to students who did not attend the treatment program. Implications of the findings suggest the importance of considering perfectionism on a continuum of negative and positive influences while helping students to address the intrapersonal and interpersonal dimensions of perfectionism.     

Trait perfectionism, self-determination, and self-presentation processes in relation to exercise behavior

Objectives

Motivational and self-presentational processes pervade all aspects of our lives including exercise behaviors. Furthermore, trait perfectionism has been shown to heighten self-presentational tendencies and energize achievement striving ( [Flett and Hewitt, 2002] and [Hewitt et?al., 2003]). How maladaptive and adaptive perfectionism traits relate to these cognitive and behavioral processes specific to the exercise context remains to be determined. This study employed structural equation modeling to examine the associations between maladaptive and adaptive perfectionism, self-determination of exercise behavior, self-presentation in exercise, and exercise behavior.

Method

Two hundred and fifty-four undergraduate students completed items assessing frequency, intensity, and duration of aerobic exercise behavior, along with measures of Multidimensional Perfectionism (Cox, Enns, & Clara, 2002), Self-Presentation in Exercise ( [Conroy et?al., 2000] and [Gammage et?al., 2004]), and self-determination of exercise behavior utilizing the Behavioral Regulation in Exercise Questionnaire (BREQ-2; Markland & Tobin, 2004).

Results

Results supported a structural model in which the associations between perfectionism dimensions and aerobic exercise behavior were mediated by opposing relationships with relative autonomy (RAI; Markland & Tobin, 2004) and self-presentation processes. Distinctively, maladaptive perfectionism demonstrated an inverse direct effect on the RAI and positive direct effects on self-presentation processes. In contrast, adaptive perfectionism exerted a positive direct effect on the RAI and inverse direct effects on self-presentation processes.

Conclusions

These findings highlight the importance of both maladaptive and adaptive dimensions of perfectionism in the study of exercise outcomes and within the broader social context linking perfectionism and motivation.     

Examining the relationship of perfectionism,depression, and optimism: Testing for mediation and moderation

The present study investigated the relationship between perfectionism and depression, and the mediation/moderation effects of optimism. Participants were126 adults (78% women, mean age = 27 years) who completed an online survey that included the Multidimensional Perfectionism Scale (Frost, Marten, Lahart, & Rosenblate, 1990), the Revised Life Orientation Test (Scheier, Carver, & Bridges, 1994), and the Hamilton Depression Inventory (Reynolds & Kobak, 1995). Maladaptive, adaptive and total perfectionism were examined in separate analyses. In most analyses, the data fit a mediation model. Optimism limited the effect (relationship) of total and maladaptive perfectionism on depression. Adaptive perfectionism was related to depression only through optimism. There was a small gender difference, with indirect effects greater for men. These results are consistent with past research and support the notion that correlations between perfectionism, as a trait, and affective variables must be examined using multivariate models that allow for the determination of complex relationships.     

A mediated model of perfectionism,affect, and physical health

This study tested a structural model in which positive and negative affect mediate the relationship between perfectionism and physical health. A community sample of young adults completed questionnaires including the Multidimensional Perfectionism Scale (MPS-H; Hewitt & Flett, 1991b), the Positive and Negative Affect States Survey (PANAS; Watson, Clark, & Tellegen, 1988) and items assessing three aspects of physical health. Results supported a structural model in which self-oriented perfectionism was associated with better physical health and this relationship was fully mediated by high positive affect and low negative affect. In contrast, socially prescribed perfectionism was associated with poorer physical health and this relationship was partially mediated by low positive affect and high negative affect. These findings are discussed in terms of the adaptive and maladaptive aspects of perfectionism within a general context of linkages between personality and health.     

Perfectionism and burnout in junior elite soccer players: The mediating influence of unconditional self-acceptance

ObjectivesIt has been argued that elite junior athletes may be especially vulnerable to the development of burnout [Coakley, D. (1992). Burnout among adolescent athletes: A personal failure or social problem. Sociology, 9, 271–285; Feigley, D. A. (1984). Psychological burnout in high-level athletes. The Physician and Sports Medicine, 12, 108–119; Raedeke, T. D. (1997). Is athlete burnout more than just stress? A sport commitment perspective. Journal of Sport and Exercise Psychology, 19, 396–418]. Few studies to date have examined the psychological mechanisms that may underpin this vulnerability. One exception was a study by Gould, Tuffrey, Udry, and Loehr [(1996). Burnout in competitive junior tennis players: I. A quantitative psychological assessment. The Sport Psychologist, 10, 332–340], which found that a form of perfectionism reflecting a preoccupation with avoiding mistakes differentiated between burnout and non-burnout tennis players. The first purpose of the present investigation was to extend this research and examine the influence of self-oriented and socially prescribed perfectionism on burnout in elite junior soccer players. A second purpose was to examine whether the association between perfectionism and burnout was mediated by unconditional self-acceptance.DesignA correlational design was employed.MethodOne hundred and fifty-one soccer players (M age=14.4 years, SD=2.4 years) completed an inventory that included Flett and Hewitt's (1991) Multidimensional Perfectionism Scale, Chamberlain and Haaga's (2003) Unconditional Self-acceptance Scale, and Raedeke and Smith's [(2001). Development and preliminary validation of an athlete burnout measure. Journal of Sport and Exercise Psychology, 23, 281–306] Athlete Burnout Questionnaire (ABQ).ResultsStructural equation modeling indicated that unconditional self-acceptance partially mediated the relationship between the two dimensions of perfectionism and athlete burnout. Contrary to the hypotheses, self-oriented perfectionism demonstrated both a positive indirect association with symptoms of burnout, as well as a direct inverse relationship.ConclusionThe findings provide support for the contention that a contingent sense of self-worth is central to both socially prescribed and self-oriented perfectionism [Flett, Besser, Davis, &; Hewitt (2003). Dimensions of perfectionism, unconditional self-acceptance, and depression. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 21, 119–138; Flett, Hewitt, Oliver, &; MacDonald (2002). Perfectionism in children and their parents: A developmental analysis. In G. L. Flett &; P. Hewitt (Eds.), Perfectionism: Theory, research and treatment (pp. 89–132). Washington, DC: American Psychological Association], and that this association may underpin maladaptive achievement striving and increase vulnerability to athlete burnout.     

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.     

Narcissism, Perfectionism, and Self-Termination from Treatment in Outpatient Cocaine Users

This study examines perfectionism in individuals with a Diagnostic and Statistical Manual-IV, Text Revised [American Psychiatric Association, 2000. Diagnostic and statistical manual of mental disorders (4th ed.). Text revision (DSM-TV-TR). Washington, DC: American Psychiatric Association] diagnosis of Narcissistic Personality Disorder and a coexisting diagnosis of cocaine abuse or dependence. Participating clients were treated in outpatient settings that provided cognitive-behavioral therapy. Clients were administered Hewitt and Flett's (1991b) [Journal of Personality and Social Psychology, 60, 456-470] Multidimensional Perfectionism Scale prior to treatment. Scores for dimensions of perfectionism were compared with those obtained from cocaine abusers in treatment with diagnoses of Antisocial Personality or Affective Disorder. Clients with Narcissistic Personality Disorder were characterized by relatively higher levels of other-oriented and socially prescribed perfectionism. Survival analysis suggests that self-termination from treatment by cocaine-abusing clients with a diagnosis of Narcissistic Disorder is related to high levels of other-oriented perfectionism. The clinical implications and limits of this study are discussed.