Abstract
Existing research into perfectionism in Anorexia Nervosa (AN) is limited by a reliance upon self-report measures. This study used novel performance based measures to investigate whether there is behavioural evidence for elevated perfectionism in AN. 153 participants took part in the study – 81 with a diagnosis of AN and 72 healthy controls (HCs). Participants completed two performance based tasks assessing perfectionism – a text replication task and a bead sorting task – along with self-report measures of perfectionism. Significant group differences were observed on both tasks. In the text replication task the AN group took significantly longer compared with healthy controls (p = 0.03, d = 0.36) and produced significantly higher quality copies (p = <0.01, d = 0.45). In the bead sorting task, there was a trend towards more participants in the AN group choosing to check their work compared with the HC group (p = 0.07, d = 0.30) and the AN group took significantly longer checking than those in the HC group (p = <0.01, d = 0.45). Only copy quality uniquely predicted scores on self report measures of perfectionism. This study provides empirically tested evidence of elevated performance based perfectionism in AN compared with a healthy control group.
Highlights
Anorexia nervosa (AN) is an eating disorder characterized by restriction of energy intake leading to a significantly low body weight; intense fear of gaining weight, or persistent behaviour that interferes with weight gain; and disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight [1]
Demographic and clinical variables AN and healthy controls (HCs) groups were matched in age
This study builds upon previous research which has relied upon self-report measures of perfectionism and is the first evidence of elevated perfectionism in AN patients compared with HCs using novel experimental paradigms
Summary
Anorexia nervosa (AN) is an eating disorder characterized by restriction of energy intake leading to a significantly low body weight; intense fear of gaining weight, or persistent behaviour that interferes with weight gain; and disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or persistent lack of recognition of the seriousness of the current low body weight [1]. Perfectionism has been implicated as both a risk and maintaining factor for AN [2,3,4,5] It is a multi-dimensional personality feature or temperament characterised by the setting of extremely high and demanding performance standards, which an individual with perfectionism strives for and bases their self-evaluation on. Consistent evidence has been found for elevated self-reported perfectionism in individuals with eating disorders [6,8,9] and there is evidence that levels of perfectionism are elevated in eating disorders relative to other disorders [8]. Perfectionism has been identified as a potential target for interventions in AN [6]
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