An extensive body of research exists on perfectionism and its potential links to eating disorder onset (Boone, Soenens, Vansteenkiste, & Braet, 2012; Brown, Parman, Rudat & Craighead, 2012; Wade & Tiggemann, 2013;). In light of this, having an understanding of what perfectionism is and how it presents is pertinent to the prevention and management of eating disorders.
What is perfectionism?
A common misconception is that perfectionism is simply ‘doing something perfectly’ (Fursland, Raykos & Steel, 2009). However, perfectionism is much more complex than this. According to widespread research, perfectionism is a personality trait centring on extreme self-pressure to meet increasingly high standards, which powerfully influences the way one perceives themselves (Fursland, Raykos & Steel, 2009; Brown et al., 2012; Wade & Tiggemann, 2013). Bieling, Israeli & Antony (2004) suggest that perfectionism consists of two major components; personal standards (setting and striving for high personal standards and goals) and evaluative concerns (negative reaction to failure, performance doubts and concern over criticism and expectations).
Although perfectionism is defined in different ways among literature, there is general consensus that perfectionism is best understood as a multi-dimensional construct (Brown et al., 2012; Wade & Tiggemann, 2013; Lloyd, Schmidt, Khondoker & Tchanturia, 2015). When measuring perfectionism, researchers often refer to Hewitt and Flett’s (1991) Multi-dimensional Perfectionism Scale. This 45-item measure divides characteristics of perfectionism into three distinct subscales: self-orientated, other-orientated and socially-prescribed. The self-orientated subscale includes items relating to high standards and self-criticism, other-orientated includes items that relate to high expectations of others and socially-prescribed includes items relating to others holding high standards for the individual (Hewitt & Flett, 1991).
Research has shown that perfectionism can be detrimental to an individual’s productivity and self-worth (Lloyd et al., 2015). Dr. Brene Brown (2010), a well-known researcher and public speaker on vulnerability, suggests that perfectionists are often attached to their achievements and argues that there is a clear distinction between helpful pursuit of excellence and unhelpful striving for perfection.
Characteristics of Perfectionism
Perfectionism can present differently in individuals. Current research acknowledges common behaviours and characteristics associated with perfectionism (Fursland et al., 2009; Brown et al., 2012; Wade & Tiggemann, 2013), inclusive of:
- Increasingly high standards
- Fear of failure/ Concern over mistakes
- Difficulty in decision making
- Reassurance seeking
- Excessive organising or list making
- All or nothing thinking
It is important to note that individuals do not have to exhibit all of the aforementioned behaviours, they may only portray one, some or many. In addition to the above, Fursland et al. (2009) argue that rules and assumptions are often evident in individuals with perfectionism, such as; constant checking, should/ must language and the need for structure, order or routine.
The link between eating disorders and perfectionism
Perfectionism has been identified as a potential risk factor for the development of an eating disorder (Boone et al., 2012; Wade & Tiggemann, 2013; Brown et al., 2012). A recent study exploring the role of perfectionism in body dissatisfaction, found that individuals with a lower desired BMI and a smaller ideal silhouette portrayed higher levels of perfectionistic traits, particularly concern over mistakes, organisation and doubt about actions (Wade & Tiggemann, 2013). These findings indicate a negative correlation between perfectionistic characteristics and body image. Additional studies have explored the impact of perfectionism on eating behaviours. Boone et al. (2012) undertook an experimental study, which involved university students being randomly placed in perfectionistic conditions and non-perfectionistic conditions. Results indicated that students placed in perfectionistic conditions reported higher levels of restraint and binge eating over time (Boone et al., 2012). Furthermore, Sassarolli et al. (2008) found that individuals with anorexia nervosa (AN) and bulimia nervosa (BN) showed significantly higher perfectionism traits than controls.
Although evidence acknowledges a relationship between eating disorders and perfectionism, a large body of research also suggests that perfectionism is malleable and therefore a potential target for interventions with eating disorders (Kenneth & Karen, 2002; Wilksch, Burbridge & Wade, 2008).
Bieling, P. J., Israeli, A. L., & Antony, M. M. (2004). Is perfectionism good, bad, or both? Examining models of the perfectionism construct. Personality and Individual Differences, 36, 1373–1385.
Boone, L., Soenens, B., Vansteenkiste, M., & Braet, C. (2012). Is there a perfectionist in each of us? An experimental study on perfectionism and eating disorder symptoms. Appetite, 59(2), 531–540.
Brown, A. J., Parman, K. M., Rudat, D. A., & Craighead, L. W. (2012). Disordered eating, perfectionism, and food rules. Eating Behaviors, 13(4), 347–353.
Brown, B. (2010). The Gifts of Imperfection. Hazelden Information & Educational Services; US.
Egan, S. J., Wade, T. D., & Shafran, R. (2011). Perfectionism as a transdiagnostic process : A clinical review. Clinical Psychology Review, 31(2), 203–212.
Fursland, A., Raykos, B. and Steele, A. (2009). Perfectionism in Perspective. Perth, Western Australia: Centre for Clinical Interventions.
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(3), 456-70.
Kenneth, G., & Karen, J. (2002). The adaptive/ maladaptive perfectionism scale. Measurement and Evaluation in Counselling Development, 34(4), 210–222.
Lloyd, S., Schmidt, U. Khondoker, M., & Tchanturia, K. (2015). Can psychological interventions reduce perfectionism? A systematic review and meta-analysis. Behavioural and Cognitive Psychotherapy, 43(May 2014), 705 – 731.
Sassaroli, S., Lauro, L. J. R., Ruggiero, G. M., Mauri, M. C., Vinai, P., & Frost, R. (2008). Perfectionism in depression, obsessive–compulsive disorder and eating disorders. Behaviour Research and Therapy, 46, 757−765.
Wade, T.D., O’Shea, A., & Shafran, R. (2016). Perfectionism and eating disorders. In F. Sirois & D.S. Molnar (Eds.), Perfectionism, Health, and Well-being (pp. 205-222). Switzerland: Springer.
Waller, G., Shaw, T., Meyer, C., Haslam, M., Lawson, R., & Serpell, L. (2012). Persistence, perseveration and perfectionism in the eating disorders. Behavioural and Cognitive Psychotherapy, 40(4), 462–73.
Wilksch, S. M., Durbridge, M. R., & Wade, T. D. (2008). A Preliminary Controlled Comparison of Programs Designed to Reduce Risk of Eating Disorders Targeting Perfectionism and Media Literacy. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 939–947.
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