Trait Perfectionism Research Articles

Surgical Performance Anxiety and Wellbeing Among Surgeons

Objective: This national cross-sectional study aims to establish the prevalence and potential impact of performance anxiety among surgeons and investigate its association with psychological traits and wellbeing. Summary and Background Data: Despite a growing awareness that human factors, non-technical skills and wellbeing in healthcare affect patient outcomes, an area that has remained unexplored is surgical performance anxiety (SPA). Methods: A prospectively registered, cross-sectional study using mixed methods was conducted across the United Kingdom. Data captured included demographics, surgical specialty, trait anxiety, trait perfectionism, SPA, and surgical perfectionism scores. Wellbeing was assessed using The Short Warwick-Edinburgh Mental Wellbeing Scale, whereas qualitative data were collected regarding surgeons’ experiences of SPA. Results: A total of 631 responses were collected. Mean age was 41·2 years and mean surgical experience 15·3 years. A total of 62% were male and 52% of consultant/attending grade. A total of 100% felt that SPA affected surgeons, with 87% having experienced it themselves. A total of 65% reported SPA negatively impacted surgical performance and 96% felt SPA negatively impacted surgeons’ wellbeing. Male surgeons reported significantly better wellbeing than female surgeons. Surgeons with SPA reported significantly worse wellbeing compared with surgeons who did not experience SPA. Surgeons in general experienced significantly lower mental wellbeing compared with population norms. Thematic analysis highlighted a reticence to share SPA openly and need for cultural change. Conclusions: Surgical performance anxiety is a very common and significant challenge among surgeons across all specialties at all levels of experience in the United Kingdom. It is perceived by surgeons to affect surgical performance adversely and is associated with worse psychological wellbeing. A more open culture of sharing and acknowledgment has been identified to be beneficial.

Examining the Link Between Multidimensional Perfectionism and Depression: A Longitudinal Study of the Intervening Effects of Social Disconnection

Introduction: The Perfectionism Social Disconnection Model (PSDM) posits that perfectionism confers risk for depression by promoting social disconnection. However, the specific indirect effect of social disconnection on the prospective relation of perfectionism dimensions with depression severity is not well understood. The aim of the current study was to provide the first comprehensive examination of the PSDM. Methods: A diverse community sample of 447 completed measures of trait perfectionism, perfectionistic self-presentation styles, and depressive symptoms at baseline. Six months later, participants completed measures of perfectionistic self-presentation styles, social disconnection, and depressive symptoms. Indirect effects models were analyzed to examine the impact of each facet of perfectionism on social disconnection and subsequent depression severity. Results: Consistent with the PSDM, all perfectionism traits and self-presentation styles resulted in greater depression severity via one or more facets of social disconnection, with social hopelessness and loneliness demonstrating the most widespread effects. Furthermore, perfectionistic self-presentation styles and social disconnection demonstrated sequential indirect effects on the relation of self-oriented and socially prescribed perfectionism with depressive symptoms at follow-up. Discussion: This study is the first to demonstrate the depressogenic effects of all perfectionism dimensions. Findings delineate the interpersonal mechanisms underlying the perfectionism-depression link.

Orthorexia Nervosa: differences between clinical and non-clinical samples

BackgroundOrthorexia Nervosa (ON) is a construct characterized by behaviors, emotions, and beliefs on eating healthy food and excessive attention to diet; moreover, dieting has been considered a risk factor in ON symptoms development. The principal aim of this study was to investigate the differences in clinical and non-clinical groups most at risk of ON. Aspects that could be associated with ON (Eating Disorders [EDs], obsessive-compulsive symptomatology, perfectionistic traits, anxiety, depression, Body Mass Index [BMI]) were investigated in all groups.MethodsThe sample consisted of 329 adults belonging to four different groups. Three were on a diet: Anorexia/Bulimia Nervosa group (N = 90), Obesity/Binge Eating Disorder group (N = 54), Diet group (N = 91). The Control group consisted of people who were not following a diet (N = 94). Participants completed several self-administered questionnaires (EHQ-21, EDI-3, OCI-R, MPS, BAI, BDI-II) to assess ON-related features in different groups.ResultsAnalyses highlighted higher orthorexic tendencies in Anorexia/Bulimia Nervosa, Obesity/BED, and Diet groups than in the Control group. Moreover, results have shown that in the AN/BN group, eating disorders symptomatology and a lower BMI were related to ON and that in Obesity/Binge Eating Disorder and Diet groups, perfectionism traits are associated with ON.ConclusionIndividuals who pursue a diet share some similarities with those who have an eating disorder regarding emotions, behaviors, and problems associated with orthorexic tendencies. Moreover, perfectionistic traits seem to predispose to higher ON tendencies. In general, these results confirm the ON as an aspect of the main eating disorders category.

Trait Perfectionism and Dance Goals Among Young Female Dancers: An Application of the 2 × 2 Model of Perfectionism.

This study provided the first test of the 2 × 2 model of perfectionism with respect to dancers' goals for dancing in competitive dance. Four hundred twenty-five young female North American competitive dancers (M = 11.33years; SD = 2.14) completed questionnaires assessing multidimensional perfectionism and goals for participation in dance. The latent moderated structural equations approach along with procedures outlined by Gaudreau indicated partial support for the 2 × 2 model of perfectionism. Pure Evaluative Concerns Perfectionism was associated with fewer intrinsic goals for dance and greater extrinsic goals for dance relative to nonperfectionism. Pure Personal Standards Perfectionism was related to less endorsement of extrinsic goals relative to nonperfectionism. Findings were complex with respect to mixed perfectionism, with this form of perfectionism being related to greater endorsement of both intrinsic and extrinsic goals for dance. Results provide partial support for the 2 × 2 model in youth dance.

Nutrition knowledge moderates the association between perfectionism and shape/weight concerns.

Perfectionistic traits have been associated with stronger weight and diet concerns. Maladaptive perfectionism is tied to critical evaluation tendencies such as excessive concern about making mistakes, increasing one's risk for eating disorder pathology. Knowledge about healthy diet and nutrition may be one factor influencing associations between perfectionistic tendencies, as individuals with eating disorders may be more attuned to sources of nutrients. The current study examined whether nutrition knowledge moderates the association between one facet of perfectionism, concern over mistakes, and shape/weight concerns and the association between concern over mistakes and global eating pathology. College women (N = 122) completed questionnaires on disordered eating attitudes, nutrition knowledge, and perfectionism. Concern over mistakes was positively related to shape/weight concerns and global eating pathology. Nutrition knowledge significantly moderated the association between concerns over mistakes and shape/weight concerns, such that the association was stronger among those with higher levels of nutrition knowledge. Furthermore, nutrition knowledge displayed trend-level significance for the moderation of the association between concern over mistakes and global eating pathology. College women displaying high levels of concern over mistakes who are more informed about nutrition knowledge may be more vulnerable to developing concerns about body shape/weight and eating disorder pathology.

Perfectionistic concerns cognitions predict burnout in college athletes: a three-month longitudinal study

ABSTRACT The majority of research examining the relationship between perfectionism and athlete burnout has focused on trait perfectionism, while overlooking the importance of the cognitive elements of perfectionism. Perfectionistic cognitions represent an influential cognitive bias driving perfectionistic behaviour. Although perfectionistic cognitions have been shown to correlate with burnout symptoms in athletes, this body of work is very limited and does not include college athletes. In addition, it is currently unclear whether perfectionistic cognitions also predict changes in athlete burnout over time. To address these issues, we conducted a two-wave, three-month longitudinal study and measured perfectionistic cognitions and burnout in a sample of 170 college athletes both at the start and end of a competitive season. In doing so, we also sought to empirically test the different models of perfectionistic cognitions that have been proposed (original, short, and multidimensional). Using cross-lagged panel models, we found that perfectionistic concerns cognitions predicted increases in burnout. The findings provide initial evidence that perfectionistic cognitions predict changes in athlete burnout over time in college athletes. Consequently, the findings have important implications for our understanding of both athlete burnout and perfectionistic cognitions.

The unique contribution of perfectionistic cognitions to anxiety disorder symptoms in a treatment-seeking sample

ABSTRACT Perfectionistic cognitions are thinking patterns that reflect excessive striving and are associated with emotional disorders in nonclinical samples. Despite literature connecting trait perfectionism with psychological disorders, much remains unknown about how perfectionistic cognitions relate to anxiety disorder symptoms in clinical populations. This is the first study to our knowledge that investigates how symptoms of anxiety and related symptoms are influenced by the frequency of perfectionistic cognitions when controlling for well documented correlates of anxiety. Perfectionistic cognitions, depressive symptoms, emotion regulation, anxiety sensitivity, and anxiety symptom severity were assessed prior to starting treatment in 356 treatment-seeking patients diagnosed with an anxiety or anxiety-related disorder at a specialty anxiety clinic. Perfectionistic cognitions were significantly correlated with all anxiety symptom measures as well as measures of depression, emotion regulation and anxiety sensitivity (range of rs =.22-.68). Hierarchical regression analyses revealed that when controlling for depressive symptoms, anxiety sensitivity, and emotion regulation, perfectionistic cognitions significantly and uniquely contribute to the variance of GAD (p <.01) and PTSD (p <.05) symptoms but not other anxiety-related symptoms (all ps >.05). Regardless of specific diagnoses, treatment-seeking individuals reporting frequent perfectionistic thoughts are more likely to report more severe symptoms of PTSD and GAD.

Psychiatric Comorbidities and the Risk of Suicide in Obsessive-Compulsive and Body Dysmorphic Disorder

Obsessive-compulsive disorder (OCD) is a chronic psychiatric disorder that is characterized by obsessions and compulsions. Obsessions are uncontrollable distressful thoughts. Compulsions are recurrent behaviors or thoughts performed in an attempt to decrease the anxiety of the obsessions. Body dysmorphic disorder (BDD) is a mental disorder characterized by a distressful preoccupation with a perceived defect in appearance. The perceived flaw in appearance is minimal or unnoticed by others. BDD was considered an anxiety disorder in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). In the DSM-V, it was added to the obsessive-compulsive and related disorders category. The objective of this literature review was to explore the psychiatric comorbidities and the risk of suicide associated with OCD and BDD. Our study results showed OCD and BDD share common genetic and environmental risk factors, clinical features, and sociodemographic profiles. Both OCD and BDD are related disorders that commonly coexist. The suicide risk in OCD is increased as the intensity of the obsessions, trait perfectionism, and alexithymia increases. The suicide risk in BDD is increased by the presence of other disorders such as substance use disorder, major depressive disorder, eating and personality disorders. People with comorbid OCD-BDD have high morbidity, a decrease in insight and poor psychosocial functions. They have higher rates of anxiety, schizotypal features, and suicidal ideation compared to those with BDD or OCD alone.

Sleeping perfectly? Trait perfectionism, perceived stress, and sleep quality

The aims of our study were to test the role of stress in explaining the links between multidimensional perfectionism and sleep quality and to replicate our findings with two distinct samples and two different measures of perfectionism. Sample 1 included 335 Canadian undergraduate students (n = 276 women, Mage = 21.7 years, SD = 4.9) who completed surveys assessing perfectionism via the Almost Perfect Scale-Revised, perceived stress, and sleep quality. Sample 2 included 296 American adults recruited from MTurk (n = 141 women, Mage = 34.8 years, SD = 9.8) who completed surveys measuring multidimensional perfectionism with the Multidimensional Perfectionism Scale, perceived stress, and sleep quality. Path analyses in both samples indicated that PS was related to better sleep via lower levels of stress whereas PC was associated with poorer sleep via higher levels of stress. There was no support for treating stress as a moderating factor of the association between perfectionism and sleep. Our findings substantiate that from a multidimensional perspective, trait perfectionism is both positively and negatively associated with sleep and further underscores the value of examining the role of perceived stress in understanding how multidimensional trait perfectionism contributes to sleep.

Standards for Socially-and Achievement-Oriented Roles in Major Depressive Disorder and Generalized Anxiety Disorder.

People with major depressive disorder (MDD) and generalized anxiety disorder (GAD) have elevated trait perfectionism. We tested whether they hold perfectionistic standards for specific life roles and examined the extent to which they met their own expectations for, gained satisfaction from, and expended effort in these roles. Seventy-four women with MDD, GAD, both disorders, or no mental disorders (CTL) described their standards for a socially- and achievement-oriented roles, coded for perfectionism. Using ecological momentary assessment, participants reported the extent to which they met, how much satisfaction they gained from, and how much effort they expended in each role. Although the clinical groups endorsed elevated trait perfectionism, they did not differ from CTLs in their role-specific standards. Compared to CTLs, the clinical groups reported meeting their standards to a lesser extent and receiving less satisfaction from both roles. The two MDD groups reported expending less effort in achievement-oriented, but not socially-oriented, roles than the other two groups. Despite similar standards for socially- and achievement-oriented roles, people with MDD and/or GAD are less likely to meet their standards and gain satisfaction from these roles. Having MDD, independent of GAD, is associated with putting less effort into achievement-oriented roles.

A Systematic Review of the Psychometric Properties of Multidimensional Trait Perfectionism Self-Report Measures

AbstractDifferent and evolving conceptualisations of perfectionism have led to the development of numerous perfectionism measures in an attempt to capture the true representations of the construct. It is, therefore, important to ensure that these instruments are valid and reliable. The present systematic review examined the literature for the psychometric properties of the most commonly used general multidimensional trait perfectionism self-report measures. Relevant studies were identified by a systematic electronic search of academic databases. A total of 349 studies were identified, with 38 of these meeting inclusion criteria. The psychometric properties presented in each of these studies were subjected to assessment using a standardised protocol. All studies were evaluated by two reviewers independently. Results indicated that while none of the included measures demonstrated adequacy across all of the nine psychometric properties assessed, most were found to possess adequate internal consistency and construct validity. The absence of evidence to support adequate measurement properties over a number of domains for the measures included in this review may be attributed to the criteria of adequacy used, with some appearing overly strict and less relevant to perfectionism measures. Clinical and research relevance of the present findings and directions for future research are discussed.

Perfectionism and Perceived Control in Posttraumatic Stress Disorder Symptoms.

In this study, we sought to examine associations between dimensions of trait perfectionism and posttraumatic stress disorder (PTSD) symptoms among a community sample of adults who experienced at least one traumatic event and determine whether the associations between trait perfectionism dimensions and PTSD symptomatology varied as a function of perceived control. A sample of 161 (57% women; M = 33.24 years, SD = 10.84 years) community adults who experienced at least one traumatic event in their lives completed self-report measures of trait perfectionism, perceived control, personality, and PTSD symptomatology. Results from multiple regression analyses indicated that socially prescribed perfectionism was associated with higher levels of PTSD symptomatology. However, this finding was qualified by a significant interaction with perceived control such that higher levels of socially prescribed perfectionism were associated with greater PTSD symptomatology only under conditions of low perceived control. Findings underscore the importance of individual differences in socially prescribed perfectionism and perceived control for PTSD symptomatology.

Trait perfectionism and performance satisfaction in challenging laboratory problem-solving tasks

This study investigated the relationship between self-oriented and socially prescribed perfectionism and performance satisfaction in response to challenging laboratory problem-solving tasks. In the laboratory session, 130 undergraduate students completed measures of perfectionism and stress and then attempted time-limited arithmetic and anagram tasks individually in groups of three or four. Upon task completion, the experimenter announced each participant's scores and the mistakes they made (no participant achieved a perfect score on either task). Participants then rated their performance satisfaction and perceived importance of their performances. Neither self-oriented nor socially prescribed perfectionism were significantly associated with participants' scores. Furthermore, both self-oriented and socially prescribed perfectionism uniquely predicted lower ratings of satisfaction after controlling gender, task scores, stress, and perceived task importance. Our findings provide further evidence for the notion that people with elevated self-oriented and socially prescribed perfectionism are susceptible to lowered satisfaction in response to performances.

Perfectionistic traits and self-presentation are associated with negative attitudes and concerns about seeking professional psychological help.

Numerous factors influence whether an individual is able and willing to seek professional help for psychological difficulties. One of these may be perfectionism, a multidimensional personality construct that has been linked to poor psychological adjustment. The current study investigated whether perfectionism traits and self-presentational facets were associated with negative help-seeking attitudes and concerns about psychotherapy. Samples of university (N = 299) and community (N = 77) men and women completed the Multidimensional Perfectionism Scale, Perfectionistic Self-Presentation Scale, Attitudes Towards Seeking Professional Help Scale, and Thoughts About Psychotherapy Survey. Various components of perfectionism were associated with both negative help-seeking attitudes and concerns about psychotherapy. The findings suggest that perfectionistic behaviour may be an important dispositional factor that interferes with seeking and obtaining help for psychological difficulties. Theoretical and clinical implications are discussed.

Examining the Contribution of Perfectionistic Traits to the Construct Validity of the DSM-5 Alternative Model of Personality Disorder.

Scholars of perfectionism have proposed significant modifications to DSM-5's alternative model of personality disorders (AMPD), such that (1) perfectionism be expanded beyond the inclusion of a singular trait-rigid perfectionism-and (2) perfectionistic traits be specified as trait descriptors of personality disorders (PDs) other than obsessive-compulsive PD. In this study, we evaluate these proposals by examining the degree to which (a) perfectionistic traits are already instantiated in Section II and Section III models of personality pathology; and (b) perfectionistic traits meaningfully augment the construct validity of AMPD PDs. We conducted these approaches in a large sample (N =3D 435) from an Iranian undergraduate population that is atypically found in the literature. Results showed that perfectionistic traits are already fairly well instantiated in Section III Criterion B. Perfectionistic traits minimally improved the construct validity of OCPD, but did not meaningfully do so for other PDs. Future investigation into the clinical utility of perfectionistic traits is needed.

Perfectionism, Shame, and Aggression in Depressive Patients With Narcissistic Personality Disorder.

Depressive symptoms are known to co-occur in patients with narcissistic personality disorder (NPD). From a psychodynamic perspective, perfectionism, shame, and aggression are regarded as prominent in depressed patients. The authors investigated the occurrence of perfectionism, shame, and aggression in patients with NPD, and whether shame is a mediating or a moderating factor for aggression. Two groups of patients with depression, 61 diagnosed with NPD and no other personality disorders (PD) were compared with 56 without any PD, using the SCID screening questionnaire and a semistructured interview. All participants were administered the Multidimensional Perfectionism Scale, the Internalized Shame Scale, and the Buss-Perry Aggression Questionnaire. The NPD group showed significantly higher scores for self-oriented and socially prescribed perfectionism, shame, and aggression (i.e., physical, verbal, anger, and hostility). Shame was found to act as a mediating factor, reducing levels of aggression in patients with perfectionistic traits.

Patient perfectionism and clinician impression formation during an initial interview.

The negative impact of pre-treatment patient perfectionism on therapeutic alliance and outcomes has been well documented. However, there is much to learn about how patient perfectionism impacts the development of the therapeutic alliance. Our study addressed this by examining the extent to which trait and self-presentational components of perfectionism influence clinician's perceptions of patients during an initial interview. In a re-analysis of data from Hewitt et al., 2008, Psychiatry, 71, 93-122, participants were90 treatment-seeking adults (aged 19-64, Mage =36.2; 40 men) recruitedfrom outpatient mental health clinics. Each patient had a one-on-one, semi-structured interview with a clinician that lasted approximately50min. Patients completed self-report measures assessing trait perfectionism, perfectionistic self-presentation, and symptom distress before the interview. Patients were then invited to discuss reasons for seeking treatment and to reflect on the two most challenging situations in their lives in which they had not coped well. Following the interview, clinicians indicated their overall impressions of patients by responding to three self-report questions and rated patients' distress and hostility via nine adjectives. After controlling for patients' symptom distress, other-oriented perfectionism and non-display of imperfection had small positive relationships with clinician-rated hostility; self-oriented perfectionism, socially prescribed perfectionism, and non-disclosure of imperfection had small-to-moderate negative relationships with clinician impressions. Additionally, path analysis revealed other-oriented perfectionism and non-display of imperfection indirectly predicted less favourable clinician impressions through clinician-rated hostility. Findings highlight the importance of evaluating and addressing trait and self-presentation components of perfectionism early in the therapeutic process. Higher levels of other-oriented perfectionism and non-display of imperfection were associated with greater clinician-rated hostility during an initial interview. Patient hostility mediated the relationship between patients' other-oriented perfectionism, non-display of imperfection, and less favourable clinician impressions. Our study highlights the importance of assessing and attending to patient perfectionism and displays of hostility during the earliest stages of therapeutic contact.

Trait perfectionism and competitiveness: Conceptual similarities and differences in a lab-based competitive task

Trait perfectionism has often been studied in competitive situations. Although past research has examined trait perfectionism and competitiveness, the two constructs have not been directly compared in a lab-based competitive task. The primary objectives of the study were to examine the associations between the three facets of the Multidimensional Perfectionism scale and the four facets of the Competitiveness Orientation Measure in a competitive performance and with self-reported participant motivations and strategies over several competitive rounds. Pairs of participants (N = 70) completed the self-report trait measures and then competed in a series of timed letter search tasks. Three separate hierarchical regressions were conducted with perfectionism and competitiveness facets as the predictors and competitive performance, motivations and strategies as the respective criterion variables. The results demonstrate the unique contribution that both trait perfectionism and competitiveness have in association with their overall performance in a competitive task, motivation for competing, and for the particular self-reported strategies used during competitive rounds. Similarities and differences between the two scales are discussed.

The Mistake Rumination Scale: Development, Validation, and Utility of a Measure of Cognitive Perfectionism

In the current article, we describe the development and validation of the Mistake Rumination Scale as a supplement to existing trait and cognitive measures of perfectionism. The Mistake Rumination Scale is a seven-item inventory that taps the tendency to ruminate about a past personal mistake. Psychometric analyses confirmed that the Mistake Rumination Scale consists of one factor assessed with high internal consistency. Analyses established that elevated levels of mistake rumination are associated with trait perfectionism, ruminative brooding, depression, and social anxiety. Moreover, scores on the Mistake Rumination Scale significantly predicted unique variance in depression beyond the variance accounted for by trait perfectionism dimensions, rumination, and automatic thoughts. Overall, our findings attest to the further use of the Mistake Rumination Scale and highlight the tendency of certain perfectionists to suffer from cognitive forms of perfectionism involving overthinking about past mistakes and related imperfections involving the self.

The Self-Generated Stress Scale: Development, Psychometric Features, and Associations With Perfectionism, Self-Criticism, and Distress

In the current article, we describe the development and validation of a self-report measure of self-generated stress and its associations with measures of perfectionism, self-criticism, and distress. The Self-Generated Stress Scale is a seven-item inventory that taps the tendency to see oneself as someone who generates and adds to existing personal stress (i.e., making a challenging situation worse or turning a life problem into a bigger problem). Psychometric analyses with data from three samples of university students showed that the Self-Generated Stress Scale has one factor and acceptable internal consistency. Analyses established that self-generated stress is associated with trait perfectionism, self-criticism, dependency, and self-silencing, as well as indices tapping cognitive perfectionism and perfectionistic self-presentation. Self-generated stress was also associated with distress and psychosomatic health symptoms. Regression analyses established that scores on the Self-Generated Stress Scale predict unique variance in distress and negative affect beyond the variance attributable to self-criticism and other measures of stress. Overall, our findings attest to the further use of the Self-Generated Stress Scale in various contexts and highlight that certain perfectionists suffer from a perceived tendency to make their lives more stressful. The implications of these findings are discussed along with directions for future research.