Clinical Perfectionism Research Articles

The relationship between perfectionism and self-esteem in adults: a systematic review and meta-analysis.

Perfectionism dimensions, including perfectionistic strivings and perfectionistic concerns, have a significant positive association with psychopathology. Clinical perfectionism is defined as when an individual's self-esteem is excessively reliant on meeting high standards despite negative consequences. Numerous studies have found that higher perfectionistic concerns correlate with lower self-esteem; however, evidence for the association with perfectionistic strivings has been mixed. The focus of this systematic review and meta-analysis was to inform theoretical understanding of the relationships between perfectionism dimensions and self-esteem in adults. A systematic literature search was conducted in Medline, PsycINFO, PsychARTICLES, ProQuest Central, and Scopus on 31 May 2023. There were 83 articles included, with 32,304 participants (Mage=∼24.66 years). There was a significant negative moderate pooled association between self-esteem and perfectionistic concerns, r=-.42, 95% CI [-0.47 to -0.38]. A significant negligible positive pooled association was found between self-esteem and perfectionistic strivings, r=.06, 95% CI [0.01 to 0.11]. Results indicate higher perfectionistic concerns is associated with lower self-esteem, providing indirect support for the cognitive-behavioural model of clinical perfectionism. Future research should compare cognitive behaviour therapy for perfectionism to treatments for low self-esteem on outcomes of perfectionistic concerns and psychopathology.

The role of clinical perfectionism and psychological flexibility in distress and wellbeing

ABSTRACT Objectives Clinical perfectionism, characterised by stringent standards and persistent striving, correlates with self-criticism and poor wellbeing. In this study we explored the mediating roles of psychological flexibility and inflexibility, and self-compassion, in the relationships of clinical perfectionism with distress, and clinical perfectionism and wellbeing. Methods We used a cross-sectional correlational study design. A non-clinical sample of 210 Australian residents aged between 18 to 65 years old completed an online survey. Data were analysed using correlational, multiple regression, and parallel mediation analysis. Results Heightened clinical perfectionism was associated with lower wellbeing and increased distress. Regression models revealed significant mediation by psychological inflexibility processes (self-as-content, experiential avoidance, cognitive fusion) and self-compassion. Cognitive fusion and inaction mediated clinical perfectionism-distress, while self-compassion and inaction mediated clinical perfectionism-psychological wellbeing. Conclusions These findings support clinical perfectionism as a transdiagnostic predictor of distress and reduced wellbeing. Those with high clinical perfectionism tend to rigidly respond to perfectionistic thoughts, avoid uncomfortable emotions, and engage in value-disconnected inaction. Associations between psychological flexibility and inflexibility processes emphasise their multidimensional nature, distinct yet interrelated. Inaction emerges as a common process in clinical perfectionism-distress and clinical perfectionism-wellbeing, while cognitive fusion specifically influences distress, and limited self-compassion affects wellbeing.

Body checking and avoidance among dancers

Dancers are at heightened risk for eating disorders (EDs) and have job and training demands that obscure ED assessment and likely impede treatment. Two behavioral manifestations of ED psychopathology that may present uniquely in a dance environment are body checking and body avoidance. The current study sought to provide a foundational understanding of the phenomenology of body checking and avoidance among dancers by assessing the reliability (i.e., internal consistency) of existing body checking and avoidance measures and the relationships, or convergent validity, between measures of body checking and avoidance and measures of related constructs. Eighty professional and pre-professional (i.e., conservatory level) dancers (78.8 % female) from seven dance genres completed self-report measures of body checking and avoidance, ED pathology, clinical perfectionism, depression, and anxiety. Across the dancer sample, body checking and avoidance measures demonstrated adequate internal consistency. More frequent body checking and body avoidance was strongly related to higher levels of ED pathology. There were moderate to strong correlations between body checking and body avoidance and clinical perfectionism, depression, and anxiety such that higher body checking and body avoidance was related to higher clinical perfectionism, depression, and anxiety. Exploratory analyses found no significant differences between ballet dancers and dancers of other dance genres; professional dancers scored in the normative range on measures of body checking and body avoidance. Dancers' qualitative descriptions of body checking and avoidance revealed behaviors not included in existing questionnaires, such as unique mirror use behaviors, technology-assisted body checking, and the checking and avoidance of body parts relevant to the dance-specific body ideal. Results support the inclusion of body checking and avoidance interventions in ED treatments for dancers (particularly pre-professional dancers) and emphasize the need for dancer-specific ED assessment methods.

Understanding eating disorder symptoms in adolescents: testing a cognitive-behavioural model of eating disorders in a community sample

ABSTRACT Clinical perfectionism, self-esteem, mood intolerance, and interpersonal difficulties are associated with eating disorder symptoms in clinical samples. The aim of the current study was to test a model including clinical perfectionism, self-esteem, mood intolerance, and interpersonal difficulties to understand eating disorder symptoms in an adolescent community sample. Adolescents (N = 446, M age = 16.25 years, SD = 1.64; 74.2% female) completed measures of clinical perfectionism, self-esteem, mood intolerance, interpersonal difficulties, and eating disorder symptoms. Path analysis indicated clinical perfectionism, self-esteem, mood intolerance, and interpersonal difficulties were all directly associated with symptoms of eating disorders, and that clinical perfectionism was indirectly associated with eating disorders through self-esteem, mood intolerance, and interpersonal difficulties. The results indicate the cognitive-behavioural model of eating disorders can be applied to adolescents in the community with symptoms of eating disorders. Directional causality between constructs should be established to understand whether increased clinical perfectionism, and reduced self-esteem, mood intolerance, and interpersonal difficulties are vulnerabilities to the development and maintenance of eating disorders.

Treating perfectionism via the Internet: a randomized controlled trial comparing cognitive behavior therapy to unified protocol

ABSTRACT Perfectionism can be problematic when your self-worth is dependent on achievements and leads to inflexible standards, cognitive biases, and rigid behaviors. Cognitive behavior therapy for perfectionism is shown to be effective, including for targeting psychiatric symptoms and when delivered via the Internet (iCBT-P). However, few studies have compared it to an active comparator. The current study randomly assigned 138 participants seeking help for perfectionism to iCBT-P or Internet-based Unified Protocol (iUP). Both treatments provided guidance on demand from a therapist and were eight weeks in duration. The results indicated large within-group effects of Cohen’s d 2.03 (iCBT) and 2.51 (iUP) on the Clinical Perfectionism Questionnaire at post-treatment, and maintained effects at 6- and 12-month follow-up, but no between-group difference (β = 0.02, SE = 1.04, p = .98). Secondary outcomes of depression, anxiety, quality of life, self-compassion, procrastination, and stress ranged from small to large, with no differences between the conditions. Both treatments were deemed credible, relevant, of high quality, and well-adhered by the participants. Further research needs to be conducted, but the findings could indicate a lack of specificity, perhaps suggesting there is no need to differentiate between different treatments that are transdiagnostic in nature.

Russian adaptation of the Clinical Perfectionism Questionnaire

Adaptation of the Russian version of the Clinical Perfectionist Questionnaire (CPQ, Fairburn, Cooper, Shafran 2002) and evaluation of its psychometric features. One hundred and thirty-five people (98 (72.6%) women, 37 (27.4%) men) at the age from 18 to 36 (M=25.10; SD=4.92) took part in this study. Fifty-seven participants are diagnosed with eating disorder. Respondents completed the adapted version of CPQ, The Eating Attitudes Test (EAT-26) (Skugarevsky and Sivuha adaptation) and the Three-factor perfectionism questionnaire (Garanyan, Holmogorova). Three-factor structure was found from 12 questions of CPQ: self-esteem based on achievements; correspondence with high standards; negative evaluation of results. Inner coherence of the factors is high and acceptable (Cronbachs alpha 0.784, 0.691 and 0.609, respectively). There are statistically significant positive correlations between scales of CPQ and scales of the Three-factor perfectionism questionnaire. There is a significant positive correlation between CPQ scale «self-esteem based on achievements» and summed result of EAT-26 (p<0.05). No significant differences in results of each CPQ scale between people with- and without diagnosed eating disorder is found. The adapted Russian version of CPQ showed relevant psychometric characteristics, therefore it may be used as an additional instrument for diagnosing of eating desorders.

Impostor phenomenon is a common feature among individuals with primary hyperhidrosis.

Primary hyperhidrosis consists of excessive focal sweating. Affected individuals camouflage the sweating on their body, avoiding stigmatisation. Hence, misrepresentation in social interactions is a common feature in patients with hyperhidrosis. The aim of this study was to investigate impostor phenomenon, perfectionism, self-compassion, stress and anxiety among individuals with primary hyperhidrosis. A cross-sectional study was conducted at our clinic among 100 participants with axillary and palmar primary hyperhidrosis. The questionnaire contained a hyperhidrosis part and Perceived Stress Scale-4, Generalised Anxiety Disorder Scale-2, Clinical Perfectionism Questionnaire-6, Self-Compassion Scale Short form and Clance Impostor Phenomenon Scale. Descriptive statistics was used for analyses of categorical variables. As data were normally distributed independent t-test and one-way analysis of variance with post hoc Tukey test were used to compare the mean values for the questionnaires with other variables. Pearson's correlation was used, and a forward multiple linear regression model was performed to predict presence of impostor phenomenon with gender, age and other scales in this study. Impostor phenomenon occurred in almost half of our patients (48%) with hyperhidrosis. While feelings of impostor phenomenon were more common in women, there was no difference between gender regarding its intensity levels (p = 0.07). In addition, we found a significant (p < 0.001) negative correlation between impostor phenomenon and self-compassion, while feelings of impostoer phenomenon increased with stress, anxiety and perfectionism (p < 0.001). Feelings of impostor phenomenon was found in 48% of individuals with hyperhidrosis which indicates that it is a common feature in this patient group. Future research is warranted regarding the prevalence of impostor phenomenon in hyperhidrosis and other medical conditions, among men and women, seeking medical healthcare. Psychological interventions in hyperhidrosis may be beneficial both for the individual and in public health, by facilitating management of patients' daily lives and saving considerable resources in healthcare regarding pharmacological interventions and medical consultations.

Investigating differences in cognitive flexibility, clinical perfectionism, and eating disorder-specific rumination across anorexia nervosa illness states

ABSTRACT Introduction: Cognitive inflexibility, clinical perfectionism, and eating disorder (ED)-specific rumination are common characteristics reported in anorexia nervosa (AN) and may contribute to the maintenance of the illness. It is suggested that clinical perfectionism and rumination may mediate the relationship between cognitive flexibility and AN pathology; however, research to date has not investigated all these factors together. The aim of the current study was to explore the relationships between these factors and how they may relate to ED symptoms in AN. Methods: Participants included 15 women with a current diagnosis of AN, 12 women who had a past diagnosis of AN and were currently weight-restored, and 15 healthy controls (HCs). Results: The results revealed that participants with both acute and weight-restored AN self-reported poorer cognitive flexibility than HCs, but the groups did not differ in performance on objective assessments of cognitive flexibility. Participants with AN also reported significantly greater clinical perfectionism and ED-specific rumination than HC. A parallel mediation analysis found that ED-specific rumination mediated the relationship between subjective cognitive flexibility and ED symptoms. Further, subjective cognitive flexibility directly influenced ED symptoms. However, the mediation model was not significant for objective cognitive flexibility. Conclusion: The findings of this study have implications for potential treatment barriers and factors which might contribute to the risk of relapse.

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.

Exploring clinical perfectionism in higher education students: Key recommendations and reflections on a partnership

Exploring clinical perfectionism in higher education students: Key recommendations and reflections on a partnership

The contribution of transdiagnostic vulnerability factors in patients with chronic insomnia.

Various transdiagnostic factors have been associated with insomnia severity. The current study aimed to predict insomnia severity based on a group of transdiagnostic factors including neuroticism, emotion regulation, perfectionism, psychological inflexibility, anxiety sensitivity, and repetitive negative thinking after controlling for depression/anxiety symptoms and demographic characteristics. Two hundred patients with chronic insomnia disorder were recruited from a sleep disorder clinic. Participants completed the Insomnia Severity Index (ISI), Clinical Perfectionism Questionnaire (CPQ), Acceptance and Action Questionnaire-II (AAQ-II), Anxiety Sensitivity Index-3 (ASI-3), Repetitive Thinking Questionnaire (RTQ-10), Big Five Inventory (BFI-10), Emotion Regulation Questionnaire (ERQ), and Depression Anxiety Stress Scale (DASS-21). After controlling for the confounding variables (depression/anxiety symptoms and demographic characteristics), hierarchical multiple linear regression suggested the significant association of neuroticism (BFI), cognitive reappraisal (ERQ), personal standards (CPQ), evaluative concerns (CPQ), physical concerns (ASI), cognitive concerns (ASI), and repetitive negative thinking (RTQ) with insomnia severity. The findings support the role of transdiagnostic factors, especially physical concerns, repetitive negative thinking, and neuroticism in chronic insomnia. Future research using longitudinal designs is required to verify the causal status of transdiagnostic variables.

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

BackgroundIdentifying 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.MethodsWe 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.ResultsNeither 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.ConclusionThese 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.

The relationship between clinical perfectionism and nonsuicidal self-injury: The roles of experiential avoidance, self-esteem, and locus of control.

Perfectionism is linked to nonsuicidal self-injury (NSSI). Individuals with elevated perfectionism tend to avoid undesirable emotions and experience lower self-esteem, which are associated with NSSI. However, it is unclear if these mechanisms explain the link between clinical perfectionism and NSSI, and if locus of control is involved. We aimed to explore whether experiential avoidance and self-esteem would mediate the relationship between clinical perfectionism and NSSI, and if locus of control would moderate links between clinical perfectionism and both experiential avoidance and self-esteem. As part of a larger study, 514 Australian university students (Mage = 21.15 years, SD = 2.40; 73.5% female) completed an online survey of NSSI, clinical perfectionism, experiential avoidance, self-esteem, and locus of control. Clinical perfectionism was associated with NSSI history, but not with recent NSSI or past year NSSI frequency. Lower self-esteem, but not experiential avoidance, mediated links between clinical perfectionism and NSSI history, recent NSSI, and NSSI frequency. More external locus of control was associated with NSSI, experiential avoidance, and lower self-esteem, but locus of control did not moderate pathways between clinical perfectionism and experiential avoidance or self-esteem. University students reporting elevated clinical perfectionism may have a tendency to experience lower self-esteem which is associated with NSSI history, recency, and severity.

Perfectionism: Its Structure, Transdiagnostic Nature, and Cognitive Behavioral Therapy

The term perfectionism is often characterized by insisting that everything should be perfect and flawless, believing in only one truth, and having difficulty transforming perspectives and thoughts. Although perfectionism is not a newly introduced concept in the literature, it has recently become one frequently aired both in research and daily life. The popularity of the concept in empirical studies stems from both its dual nature and its alleged roles in the origin, emergence, retention, and treatment of various psychological disorders. Indeed, despite the abundance of evidence that perfectionism is multifaceted within two major dimensions (perfectionist strivings and perfectionist concerns), it is still debated that the dimensions in different numbers better represent the construct. In addition, the relevant literature hosts diverse views and criticisms about which sub-dimensions the two higher-order dimensions will consist of, whether the conceptual content of a combination of these sub-dimensions is positive or negative, and how to calculate the total impact of the sub-dimensions. On the other hand, previous research consistently addressed the relationship of perfectionism with different psychopathologies and comorbidities. In this respect, it is also deemed important to discuss perfectionism in psychotherapy because even settling perfectionist traits may bring about improvements in more than one disorder associated with perfectionism. Thus, the Cognitive Behavioral Approach (CBT) conceptualized perfectionism (clinical perfectionism) and presented techniques for therapy. Moreover, the evidence is also proliferating for the efficiency of CBT for perfectionism. Therefore, in this article, the current literature on the structure, transdiagnostic nature and cognitive behavioral therapy of perfectionism has been reviewed.

Examining and enhancing the reliability of the Arabic version of the Clinical Perfectionism Questionnaire

BackgroundClinical perfectionism has been implicated among risks for developing depression, anxiety, and eating disorders. This study aimed to translate the widely used Clinical Perfectionism Questionnaire (CPQ) into Arabic and examine its psychometric properties. A general population sample of 1598 Saudi adults completed an online survey. Respondents were randomly selected to create two separate samples of n = 400 each, thus meeting the sample size recommendations for Rasch analysis. We applied the partial credit Rasch model to one independent sample to investigate and improve the psychometric characteristics of the scale and replicated our findings with another independent sample of the equal size.ResultsMinor modifications were required to address local dependency issues and resulted in a good fit of the Arabic CPQ to the unidimensional Rasch model in both samples. The scale demonstrated unidimensionality, invariance across personal factors, and good reliability (PSI = 0.78). As expected, the scale scores were positively associated with depression, anxiety, and disordered eating behaviors.ConclusionsOverall, the Arabic CPQ demonstrated robust psychometric properties after minor modifications that did not change the original scale format. The utility and accuracy of the Arabic CPQ can be enhanced by converting ordinal scores into interval scale scores using conversion tables presented in this paper.

Day hospital program for anorexia nervosa in children and adolescents: Assessment, management and specific focus on early onset anorexia nervosa

IntroductionThe French day hospital program specialized in eating disorders (ED) opened in January 2018. Our study presents preliminary data on clinical profiles of patients with anorexia nervosa (AN). We describe more specifically clinical characteristics of patients with early onset AN and according to their therapeutics orientations. Then, we compare the weight gain of patients managed only in day-patient (DP) treatment with those managed initially inpatient (IP) treatment and relays in DP. MethodsNinety-two patients with AN, aged between 8 and 18 years, were evaluated with several questionnaires (EDI-2, EDE-Q, BSQ, EDS-R, CDI, STAI-Y, VSP-A, EPN-13). ResultsPatients with early onset AN, n = 23 (25.3%), presented more restrictive behaviors, less marked dietary symptomatology, a lower degree of clinical perfectionism and a less marked feeling of ineffectiveness than adolescent patients with AN. Regarding the choice of hospitalization modality (DP alone or IP-DP), the only difference highlighted was the severity of patient undernutrition. Among the patients who were treated (IP-DP n = 27 vs DP alone n = 25), the weight evolution after one month and at discharge was favorable for both groups. ConclusionThese preliminary data suggest the effectiveness of DP in the care of AN in children and adolescents.

Self-compassion as a moderator between clinical perfectionism and psychological distress

ABSTRACT Objective Clinical perfectionism is associated with psychological distress, however, few studies have examined factors that moderate the relationship. Self-compassion is a useful construct to examine as it is a component of cognitive-behavioural treatment (CBT) for clinical perfectionism, and lower self-compassion is related to higher perfectionism and distress. Method The aim was to determine if self-compassion is a moderator between clinical perfectionism and distress. Adults who had mild symptoms of anxiety and depression (N = 344, 82% female, M age= 28.14 years, SD = 12.79) completed online measures. Results In considering the total self-compassion score, when self-compassion was higher the association between clinical perfectionism and psychological distress was lower, relative to when self-compassion was lower, hence self-compassion was a moderator between clinical perfectionism and distress. When the Self-Compassion Scale was considered on the basis of the positive and negative subscales, these were not significant moderators between clinical perfectionism and distress. Conclusion Self-compassion may be one explanation of how clinical perfectionism is associated with distress, when considered as a total score. The results support the need for future research examining the moderating role of self-compassion between perfectionism and distress, given the contrast in findings when considered at a subscale level. KEY POINTS What is already known about this topic: Perfectionism is associated with psychological distress. Few studies have examined factors that explain the relationship. Self-compassion is one factor that could explain this link. What this topic adds: Self-compassion may explain how perfectionism is associated with distress. Future research is needed on the moderating role of self-compassion. Treatments for perfectionism should target self-compassion.

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

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

Assessing cognitive flexibility in anorexia nervosa using eye tracking: A registered report.

Cognitive flexibility research in anorexia nervosa (AN) has primarily focused on group differences between clinical and control participants, but research in the general population utilizing the mixed pro- anti-saccade flexibility task has demonstrated individual differences in trait anxiety are a determinant of switching performance, and switching impairments are more pronounced for keypress than saccadic (eye-movement) responses. The aim of the current research is to explore trait anxiety and differences in saccadic and keypress responding as potential determinants of performance on flexibility tasks in AN. We will compare performance on the mixed pro- anti-saccade paradigm between female adult participants with a current diagnosis of AN and matched control participants, observing both saccadic and keypress responses while controlling for trait anxiety (State - Trait Anxiety Inventory) and spatial working memory (Corsi Block Tapping Test). Associations with eating disorder-related symptoms (Eating Disorder Examination Questionnaire), flexibility in everyday life (Eating Disorder Flexibility Index), and the Clinical Perfectionism Questionnaire will also be assessed. Data which controls for individual differences in trait anxiety and assesses flexibility at both the task- and response-set level may be used to more accurately understand differences in performance on cognitive flexibility tasks by participants with AN. Clarifying the effects of trait anxiety on flexibility, and differences between task- and response-set switching may advance our understanding of how cognitive flexibility relates to flexibility in everyday life and improve translation to therapeutic approaches. This research will compare performance on a flexibility task between participants with anorexia nervosa (AN) and controls while observing their eye-movements to examine whether trait anxiety and type of response (eye-movement and keypress) are associated with performance. This data may improve our understanding of why participants with AN perform more poorly on cognitive flexibility tasks, and how poor cognitive flexibility relates to eating disorder-related issues with flexibility in everyday life.

Psychometric properties of the Brazilian version of Clinical Perfectionism Questionnaire after rewording negatively keyed items

The present study aims to verify the psychometric properties of the Brazilian version of Clinical Perfectionism Questionnaire after rewording negatively keyed items into positive (CPQ+). It was used a convenience sample of 168 Brazilian university students (M=25.37, SD=7.40), being 76.8% women. After rewording the negatively keyed items into positive, the CPQ+ was applied. The Depression, Anxiety and Stress Scales – Short Form (DASS-21) were also applied. The Corrected Item-Total Correlation values of CPQ+ items were close to or higher than the cutoff point. After exclusion of item 8, due to crossloading, and correlation between errors of items 3 and 10, the correlated two-factor model presented the best fit of latent structure to CPQ+, through Confirmatory Factor Analysis. The Perfectionistic Concerns dimension of CPQ+ was greater related to global score of DASS-21 in comparison to the Perfectionistic Striving dimension, indicating good validity regarding other variables. In summary, results recommend the use of CPQ+ presented in this study, it is, a version with 11 positive items.