Perfectionistic Self-Presentation and Psychopathology: A Systematic Review and Meta-Analysis.

Decades of research implicate perfectionism as a risk factor for psychopathology. Most research has focused on trait perfectionism (i.e., needing to be perfect), but there is a growing focus on perfectionistic self-presentation (PSP) (i.e., the need to seem perfect). The current article reports the results of a meta-analysis of previous research on the facets of PSP and psychopathology outcomes (either clinical diagnoses of psychiatric disorders or symptoms of these disorders). A systematic literature search retrieved 30 relevant studies (37 samples; N = 15,072), resulting in 192 individual effect-size indexes that were analysed with random-effect meta-analysis. Findings support the notion of PSP as a transdiagnostic factor by showing that PSP facets are associated with various forms of psychopathology, especially social anxiety, depression, vulnerable narcissism and-to lesser extent-grandiose narcissism and anorexia nervosa. The results indicated that there both commonalities across the three PSP and some unique findings highlighting the need to distinguish among appearing perfect, avoiding seeming imperfect and avoiding disclosures of imperfections. Additional analyses yielded little evidence in the results across studies including undergraduates, community samples and clinical samples. Our discussion includes a focus on factors and processes that contribute to the association between PSP and psychopathology.

A pilot feasibility and acceptability trial of an internet indicated prevention program for perfectionism to reduce eating disorder symptoms in adolescents.

PURPOSE: Perfectionism is a transdiagnostic risk factor for eating disorders. Treating perfectionism can reduce symptoms of eating disorders. No research has examined an indicated prevention trial using internet-based Cognitive-Behavioural Therapy for Perfectionism (ICBT-P) in adolescent girls at elevated risk for eating disorders. Our aim was to conduct a preliminary feasibility trial using a co-designed ICBT-P intervention. It was hypothesised that a higher proportion of participants in the ICBT-P condition would achieve reliable and clinically significant change on perfectionism, eating disorders, anxiety and depression, compared to waitlist control. METHODS: Twenty-one adolescent girls with elevated symptoms of eating disorders (M age = 16.14 years) were randomised to a 4-week online feasibility trial of a co-designed ICBT-P prevention program or waitlist control. Qualitative surveys were used to gain participant perspectives. RESULTS: The ICBT-P condition had a higher proportion of participants achieve reliable change and classified as recovered on perfectionism and symptoms of eating disorders and anxiety, compared to waitlist control. Qualitative findings indicated that 100% of participants found the program helpful. CONCLUSION: The results indicate ICBT-P is a feasible and acceptable program for adolescent girls with elevated eating disorder symptoms. Future research is required to examine outcomes in a randomised controlled trial. LEVEL OF EVIDENCE: Level III: Evidence obtained from well-designed cohort or case-control analytic studies. TRIAL REGISTRATION NUMBER: This trial was prospectively registered with Australian and New Zealand Clinical Trials Registry (ACTRN12620000951954P) on 23/09/2020.

Direct, indirect, and reciprocal associations between perfectionism, compulsive exercise and eating disorder pathology in adolescents with eating disorders.

BACKGROUND: There is a strong association between perfectionism and eating disorders. In a cognitive-behavioural model of compulsive exercise it has been suggested there are reciprocal associations between perfectionism, eating disorder pathology, and compulsive exercise. No study has examined if there is an indirect association between perfectionism and compulsive exercise through eating disorder pathology, which would inform a preliminary understanding of the cognitive-behavioural model of compulsive exercise. METHODS: The sample included 301 adolescent females diagnosed with eating disorders (age M = 14.89, SD = 0.85, range 13-17). We tested models of direct and indirect associations of compulsive exercise in the relationship between perfectionism and eating disorder pathology, and direct and indirect associations of eating disorder pathology in the relationship between compulsive exercise and perfectionism. RESULTS: Perfectionism was directly associated with eating disorder pathology and compulsive exercise. Perfectionism was indirectly associated with eating disorder pathology through compulsive exercise. Perfectionism also had an indirect association with compulsive exercise through eating disorder pathology. DISCUSSION: The findings suggest it would be useful for future prospective research to examine the cognitive-behavioural model of compulsive exercise in adolescents with eating disorders. Compulsive exercise and perfectionism may be useful targets for future research to improve eating disorder treatment. Level of evidence Level V: Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

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

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 (ß = 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.

Relationship between perfectionism, overactivity, pain severity, and pain interference in individuals with chronic pain: A cross-lagged panel model analysis.

OBJECTIVES: Overactivity is a characteristic of individuals with chronic pain. Previous cross-sectional studies demonstrated a relationship between perfectionism and overactivity. Therefore, the present study used a longitudinal design to determine whether pain severity and pain interference were exacerbated by overactivity and whether overactivity was exacerbated by perfectionism. METHODS: Participants with chronic pain were recruited using crowdsourcing. The participants completed the questionnaires at three time points: T1, T2, and T3 (September, October, and November 2021, respectively). The questionnaire assessed overactivity, perfectionistic strivings, perfectionistic concerns, pain severity, and pain interference. We created cross-lagged panel models to examine the hypothesized relationships among pain, overactivity, and perfectionism. RESULTS: After excluding ineligible participants and invalid response sets, we analyzed the questionnaires completed by 666 participants at T1, 560 at T2, and 554 at T3. The average duration of chronic pain at T1 was 36.35 ± 53.53 months. Perfectionistic strivings were partially linked to overactivity, and pain interference was partially related to overactivity. Contrary to our expectations, overactivity did not predict pain severity or pain interference. CONCLUSIONS: The hypotheses that perfectionism exacerbates overactivity and that overactivity exacerbates pain severity and pain interference were not supported. These results may have been affected by the quality of the assessment of overactivity. Therefore, further research with a refined evaluation of overactivity is required.

A multi-design investigation of perfectionism risk profiles for traumatic injury in sport.

Every year, many university athletes find themselves experiencing sports injuries while practicing their sport. Not all athletes are equal to each other, and some get injured more often. Individual differences in personality could explain these differences. This study focuses on how within-person combinations of perfectionistic strivings and perfectionistic concerns are associated with the risk of traumatic injury in university athletes. Two most prominent person-oriented approaches of perfectionism (the tripartite and 2x2 models) were tested in a retrospective (N=143) and a prospective (N=98) sample. Cluster analyses identified perfectionism profiles consistent with the two theoretical models in both samples. Furthermore, the profile with high levels of perfectionistic strivings and concerns was found to be the most at risk of experiencing a traumatic injury using both designs. This study supports the tripartite model of perfectionism in recognizing the exacerbating role of perfectionistic strivings on the maladaptive effect of perfectionistic concerns. Coaches and sports specialists will need to consider monitoring athletes' levels of PC, especially in conjunction with high PS levels, to reduce the risk of injury in athletes.

A randomised controlled evaluation of an online perfectionism intervention for people with disordered eating - how perfect does it need to be?

Less help-seeking for an eating disorder is predicted by higher levels of denial of, and failure to perceive, illness severity. This research evaluates a "backdoor" approach to early intervention by investigating whether internet cognitive behaviour therapy for perfectionism can significantly improve disordered eating. Additionally, we investigated whether a more interactive intervention impacted outcomes. Participants were recruited worldwide online; 368 were screened, 172 (46.7%) met inclusion criteria (endorsed high shape, weight, or eating concerns) and randomised to an interactive (Focused Minds Program; FMP) or static PDF intervention (Centre for Clinical Intervention; CCI-P) or waitlisted (control condition). Participants completed assessments on disordered eating, perfectionism, and a range of secondary variables at the end of treatment, and 1- and 3-month follow-up. Intent-to-treat analyses indicated that, compared to control, FMP resulted in significantly lower levels of disordered eating at each assessment and CCI-P at the 1- and 3-month follow-up (respective 3-month follow-up between group effect sizes of 0.78 and 0.54). There were no significant differences between the two active interventions on any measure except depression and hated self. Results suggest an alternative approach to directly tackling disordered eating that is low-cost is effective, with a more interactive intervention producing a more rapid effect.Trials Registration: Australian New Zealand Clinical Trials Registry (ANZCTR) Trial Number: ACTRN12621001448831.

The triangle of anxiety, perfectionism, and academic procrastination: exploring the correlates in medical and dental students.

INTRODUCTION: Academic procrastination is a common phenomenon among medical science students. This issue can negatively affect the students' academic performance. The aim of this study was to investigate perfectionism and anxiety as potential predictors of academic procrastination in medical and dental students. METHODS: This cross-sectional study was conducted among medical and dental students of a public medical sciences university in the south of Iran. Students were assessed using the procrastination assessment scale for students (PASS), Tehran multidimensional perfectionism scale (TMPS), and anxiety subscale of the general health questionnaire (GHQ). Predictors of academic procrastination were evaluated using multiple regression analysis with adjustments made for gender and academic semester. RESULTS: A total of 176 medical and 79 dental students participated in the study. None of the perfectionism components were predictors of academic procrastination. However, anxiety was a significant predictor of academic procrastination in the total sample of students (standardized ß = 0.404, p < 0.001), as well as dental (standardized ß = 0.356, p < 0.001) and medical (standardized ß = 0.478, p < 0.001) students. Anxiety and academic procrastination were both negatively correlated with students' grade point averages. CONCLUSIONS: The findings of this study suggest that anxiety, as opposed to perfectionism, has a more significant influence on academic procrastination among medical and dental students. Interventions aimed at lowering anxiety may be beneficial for reducing academic procrastination, thereby enhancing the academic performance of the students.

Cultural threads in writing mastery: a structural analysis of perfectionism, learning self-efficacy, and motivation as mediated by self-reflection in Chinese EFL learners.

BACKGROUND: The study explores language acquisition in Chinese English as a Foreign Language (EFL) education, where English proficiency is crucial for global opportunities. As China gains prominence, the demand for English skills rises beyond communication to include academic and business success. The Chinese education system emphasizes proficient English writing for further education and professional achievement. This research investigates the complex linguistic context for EFL learners in China, analyzing the intersection of psychological factors, cultural nuances, varied pedagogy, and individual experiences. METHODS: Structural Equation Modeling (SEM) is utilized for analysis, enabling the creation of a metric set to explore intangibles such as perfectionism, learning self-efficacy, motivation, study habits, cultural influences, and introspection. The research utilizes a diverse sample from multiple universities across different regions of China, incorporating demographic factors to encompass the varied characteristics within the EFL learner community. RESULTS: Results reveal that perfectionism (ß = 0.30, p < 0.001), learning self-efficacy (ß = 0.25, p = 0.005), motivation (ß = 0.35, p < 0.001), study habits (ß = 0.20, p = 0.01), and self-reflection (ß = 0.28, p < 0.001) significantly predict writing proficiency. Cultural effects (Beta = 0.15, p = 0.05) show a statistically significant, albeit minimal, impact. Mediation-moderation analysis underscores perfectionism as a mediator (Beta = 0.25, p = 0.005), emphasizing its influence on other predictors. Cultural factors act as moderators (Beta = 0.15, p = 0.01), shaping the link between predictors and writing skills. The combined mediation and moderation effects on writing proficiency are positively significant (Beta = 0.20, p = 0.02). CONCLUSIONS: This study makes a significant theoretical contribution, enhancing existing models and providing practical insights for EFL educators and policymakers. Emphasizing the intricate relationship between psychological factors and cultural dynamics underscores the necessity for a sophisticated, culturally sensitive approach to language acquisition in Chinese EFL instruction. Beyond language skills, the research recognizes the importance of fostering a conducive environment that encourages personal development, socio-cultural awareness, and a holistic learning approach.

Comparisons between atypical anorexia nervosa and anorexia nervosa: Psychological and comorbidity patterns.

OBJECTIVE: Literature comparing "atypical" anorexia nervosa (atypical AN) and anorexia nervosa (AN) suggests these diagnoses share significant similarities in eating disorder (ED) pathology and psychiatric comorbidities. This study evaluated potential differences in ED pathology, psychiatric comorbidity, associated mechanisms (i.e., ED fears and perfectionism), and demographic factors (i.e., ethnicity and age) between individuals with atypical AN and AN. METHOD: Data from seven protocols were combined for a total 464 individuals diagnosed with atypical AN (n = 215) or AN (n = 249). Between-group differences in ED severity and behaviors, psychiatric comorbidities, ED fears, perfectionism, and demographic factors were assessed using t-tests, Wilcoxon rank-sum tests, and Fisher's exact test. RESULTS: Participants with atypical AN reported higher levels of overvaluation of weight and shape than those with AN. Participants with AN scored higher on food-related fears (anxiety about eating, food avoidance behaviors, and feared concerns) and fears of social eating, as well as obsessive-compulsive symptoms. Participants with AN were more likely to identify as Asian or Pacific Islander. No other statistically significant differences were found between groups for overall ED severity, ED behaviors, psychiatric comorbidities, general ED fears, perfectionism, or demographic factors. DISCUSSION: Overall, results support previous literature indicating limited differences between individuals with atypical AN and AN, though individuals with atypical AN reported more overvaluation of weight and shape and those with AN reported higher food and social eating fears and obsessive-compulsive symptoms. Relatively few overall differences between atypical AN and AN highlight the importance of exploring dimensional conceptualizations of AN as an alternative to the current categorical conceptualization. PUBLIC SIGNIFICANCE: This study assessed differences among individuals with atypical anorexia nervosa and anorexia nervosa in eating disorder severity and behaviors, comorbid psychiatric diagnoses, associated mechanisms, and demographic factors. Few differences emerged, though participants with atypical anorexia nervosa reported more overvaluation of weight and shape, while those with anorexia nervosa reported more food and social eating fears and higher obsessive-compulsive symptoms. Results support exploration of these diagnoses as a spectrum disorder.

Insatisfacción corporal, ortorexia y dependencia al ejercicio en corredores amateur de resistencia / Insatisfação corporal, ortorexia e dependência do treino em corredores amadores de resistência / Body image dissatisfaction, orthorexia and training addiction in amateur endurance runners

El objetivo del estudio fue conocer si existe relación entre la insatisfacción corporal, la ortorexia y la dependencia al ejercicio en una muestra de corredores de resistencia aficionados, así como examinar las variables psicológicas como la identidad, el perfeccionismo y el enfoque a través de la comparación entre grupos y la obtención de perfiles. Para ello, 129 corredores participantes en la edición XIII del Trail 7 Colinas de Tartessos en 2023 (96 hombres y 33 mujeres; media de edad M=45.5; DT=8.4), completaron el cuestionario de imagen corporal (Body Shape Qustionnaire, BSQ 14), la ortorexia 11 (ORTO-11), el Inventario de perfeccionismo multidimensional en el Deporte en competición (MIPS), la Escala de medición de identidad deportiva (AIMS), el cuestionario ad hoc de Satisfacción Manifiesta (CS), el cuestionario de Percepción de Éxito (POSQ). También se registraron los datos y parámetros como corredor. Los resultados mostraron que el 15% de los corredores presentaron insatisfacción corporal y el 16 % ortorexia. Además, el 13 % de los corredores presentaron ambas manifestaciones. Se encontró una correlación significativa positiva entre la insatisfacción corporal y la ortorexia. Ambas variables también presentaron correlaciones negativas con la satisfacción manifiesta sobre la imagen corporal. Sin embargo, no se encontró relación con la dependencia del ejercicio, aunque los componentes de esta última se relacionaron con variables psicológicas; el componente positivo mostró una correlación negativa con el perfeccionismo, y el componente negativo se relacionó positivamente con la identidad deportiva. Ambas variables resultaron relevantes en la comparación de los grupos en relación a la ortorexia, y de manera separadas en la discriminación; el perfeccionismo sobre la insatisfacción manifiesta y la escala de identidad sobre la ortorexia.(AU)

The aim of the present study was to find out whether there is a relationship between body dissatisfaction, orthorexia, and exercise dependence in a sample of amateur endurance runners, as well as to examine psychological variables such as identity, perfectionism, and focus by comparing groups and obtaining profiles. To this end, 129 runners participating in the XIII edition of the Trail 7 Colinas de Tartessos in 2023 (96 men and 33 women; mean age M=45.5; SD=8.4), completed the Body Shape Questionnaire (BSQ14),the Orthorexia 11 (ORTO-11), the Multidimensional Perfectionism Inventory in Competitive Sport (MIPS), the Athletic Identity Measurement Scale (AIMS), the ad hoc Satisfaction Questionnaire (CS), the Perception of Success Questionnaire (POSQ). Data and parameters as a runner were also recorded. The results showed that 15% of the runners presented body dissatisfaction and 16% orthorexia. In addition, 13 % of the runners had both manifestations. A significant positive correlation was found between body dissatisfaction and orthorexia. Both variables were also negatively correlated with expressed satisfaction with body image. However, no relationshipwas found with exercise dependence, although components of exercise dependence were related to psychological variables; the positive component showed a negative correlation with perfectionism, and the negative component was positively related to sports identity. Both variables were relevant in the comparison of the groups in relation to orthorexia, and separately in discrimination,perfectionism on manifest dissatisfaction and the identity scale on orthorexia.(AU)

O objectivo do estudo foi analisar se existe uma relação entre insatisfação corporal, ortorexia e dependência do exercício numa amostra de corredores amadores de endurance, bem como analisar variáveis psicológicas como a identidade, o perfeccionismo e o foco, através da comparação entre grupos e da obtenção de perfis. Para o efeito, 129 corredores participantes na XIII edição do Trail 7 Colinas de Tartessos em 2023 (96 homens e 33mulheres; idade média M=45.5; DP=8.4), preencheram o Body ShapeQuestionnaire(BSQ 14), o Orthorexia 11 (ORTO-11), o Multidimensional Perfectionism Inventory in Competitive Sport (MIPS), a Athletic Identity Measurement Scale (AIMS), o ad hoc Satisfaction Questionnaire (CS), e o Perception of Success Questionnaire (POSQ). Foram igualmente registados os dados e os parâmetros enquanto corredores. Os resultados mostraram que 15% dos corredores apresentavam insatisfação corporal e 16% ortorexia. Para alémdisso, 13% dos corredores apresentavam ambas as manifestações. Foi encontrada uma correlação positiva significativa entre a insatisfação corporal e a ortorexia. Ambas as variáveis estavam também negativamente correlacionadas com a satisfação expressa com a imagem corporal. No entanto, não foi encontrada qualquer relação com a dependência do exercício, embora os componentes da dependência do exercício estivessem relacionados com variáveis psicológicas; a componente positiva evidenciou uma correlação negativa com o perfeccionismo, e a componente negativa estava positivamente relacionado coma identidade desportiva. Ambas as variáveis foram relevantes na comparação dos grupos em relação à ortorexia, e separadamente na discriminação; o perfeccionismo na insatisfação manifesta e a escala de identidade na ortorexia.(AU)

Perfectionism as a moderator of the relationship between orthorexia nervosa and obsessive-compulsive symptoms.

PURPOSE: Orthorexia nervosa (ON), a proposed disorder describing an obsessive focus on "healthy" eating, is characterised as having overlapping symptoms with obsessive-compulsive disorder. However, ON/obsessive-compulsive (OC) symptom relationships are inconsistently reported. The current study aimed to investigate if the contribution of OC symptoms and beliefs explain variability in ON symptoms and determine if perfectionism, a transdiagnostic factor, moderates the ON/OC symptom relationship. METHODS: The study comprised 190 participants (Mage = 28.63, SDage = 9.88; 80% female) recruited via an undergraduate research programme, social media, advocacy organisations, and a participant registry. Participants completed an online questionnaire assessing ON, OC, and perfectionism symptoms. RESULTS: A linear regression analysis found OC symptoms and beliefs explained 22.9% variability in ON symptoms (p < 0.001, f2 = 0.38) and perfectionism moderated the ON/OC symptom relationship, where higher levels of perfectionism with higher levels of OC symptoms was associated with higher levels of ON symptoms, explaining 2.2% variability (p = .01, f2 = 0.03). CONCLUSION: OC symptoms appear more common in ON than previous studies indicate. However, the interaction between perfectionism and OC symptoms may drive obsessions in ON. Findings help refine our current understanding of ON phenomenology with implications for ON treatment development. Future research should further explore perfectionism in ON phenomenology. LEVEL OF EVIDENCE: Level V (Opinions of respected authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees).

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.

A preliminary investigation of the mediating roles of self-compassion and emotion dysregulation in the relationship between maladaptive perfectionism and obsessive-compulsive behaviors.

INTRODUCTION: Recent research has highlighted an association between maladaptive perfectionism and obsessive-compulsive disorder (OCD). However, the mechanisms underlying this relationship are not well understood. The primary aim of this preliminary study was to investigate whether self-compassion and emotion dysregulation independently mediated this relationship. The secondary aim was to determine whether serial mediation existed between these factors. Whether these relations held for overall obsessive-compulsive (OC) symptoms, versus distinct dimensions of OCD, was also of interest. METHOD: Three hundred and ninety-two university students (Mage = 21.81, SD = 8.01), predominantly female (79.18%), participated in an online questionnaire that included a dimensional measure of OCD. Scales assessing maladaptive perfectionism, self-compassion, emotion dysregulation, and negative emotion states were also included. RESULTS: Greater maladaptive perfectionism was related to more severe OCD. Emotion dysregulation, but not self-compassion, independently mediated this relationship. A serial mediation relationship was found, in that greater maladaptive perfectionism was associated with lower self-compassion, which was linked to greater emotion dysregulation, and in turn related to more severe OC behaviors. In addition, distinct patterns emerged for separate OC dimensions. CONCLUSIONS: These findings highlight emotion regulation and self-compassion as potential targets for OCD prevention, especially in individuals with symptoms in the symmetry and unacceptable thoughts dimensions.

Is the road to burnout paved with perfectionism? The prevalence of obsessive-compulsive personality disorder in a clinical longitudinal sample of female patients with stress-related exhaustion.

OBJECTIVES: Few studies have investigated the relationship between stress-related mental health problems and obsessive-compulsive personality disorder (OCPD). Similarly, little research has focused on the moderating effect of OCPD on recovery in clinical patients with stress-related mental health problems. The general aim of this study was to investigate the prevalence of OCPD and the associations between OCPD and level of burnout, anxiety, and depression symptoms, during a 7-years follow-up in a clinical longitudinal sample of female patients with stress-related exhaustion. METHOD: The included patients (n = 84) were referred to a specialist outpatient clinic for patients with stress-related exhaustion between 2006 and 2011. Data was collected at the initial examination and during a 7-year treatment follow-up. RESULTS: OCPD was the most common personality disorder in the present clinical sample, with 40% of patients fulfilling the criteria. There was a significant association between OCPD and the degree of burnout symptoms as well as the degree of depression, both at baseline and during the 7-year follow-up. No significant association between OCPD and levels of anxiety was observed. CONCLUSION: The results support the hypothesis that there might be an association between OCPD and stress-related exhaustion, including preservation of symptoms over time. OCPD and its related traits, such as perfectionism, may be important factors to consider when constructing effective treatment and rehabilitation plans for these patients.

Perfectionism, perceived stress, and presleep arousal in insomnia: effects on sleep in a daily life study.

STUDY OBJECTIVES: Perfectionism is considered a predisposing and maintaining factor for insomnia disorder. However, previous studies were predominantly based on retrospective self-reports of sleep and have yielded mixed results. Here, we investigated associations between perfectionism, daily stress levels, pre-sleep arousal, and actigraphic and sleep diary-derived sleep in insomnia using an experience sampling design. METHODS: Individuals with insomnia (n = 63) reported their trait perfectionism levels and completed assessments on seven consecutive days. Momentary stress levels were reported on mobile phones at three semirandom time points each day. Presleep arousal levels were rated each morning for the previous night. Sleep onset latency, total sleep time, wake after sleep onset, and sleep efficiency were assessed prospectively using actigraphic watches and sleep diaries. RESULTS: Perfectionism dimensions and daily stress levels did not predict self-reported or actigraphic sleep parameters. Higher levels of somatic and cognitive presleep arousal were robustly associated with indicators of poorer same-night sleep. The concern over mistakes and doubts dimension of perfectionism interacted with cognitive presleep arousal in predicting self-reported sleep parameters. In the presence of higher presleep arousal, participants with high concern over mistakes and doubts experienced shorter self-reported total sleep time and lower sleep efficiency (both Ps < .01) than on days with lower cognitive arousal. CONCLUSIONS: Taken together, our results did not indicate an impact of heightened perfectionism levels on sleep in individuals with insomnia, based on prospective sleep assessments. However, our findings provide further evidence for the role of somatic and cognitive presleep arousal, potentially interacting with perfectionism, in the perpetuation of insomnia symptoms. CITATION: Küskens A, Stricker J, Hertrampf LS, Pietrowsky R, Gieselmann A. Perfectionism, perceived stress, and presleep arousal in insomnia: effects on sleep in a daily life study. J Clin Sleep Med. 2024;20(3):433-443.

The relationships between perfectionism and symptoms of depression, anxiety and obsessive-compulsive disorder in adults: a systematic review and meta-analysis.

Perfectionism is a transdiagnostic process associated with depression, anxiety, and obsessive-compulsive disorder (OCD). The focus of this systematic review and meta-analysis was to examine evidence for the association between perfectionistic strivings and perfectionistic concerns with symptoms of depression, general anxiety, social anxiety, task anxiety, and OCD in adults. A total of 416 studies were included, with 113,118 participants aged 17 to 90 years (M = 23.83). Perfectionistic concerns had significant medium correlations with anxiety, OCD and depressive symptoms (pooled r = .38 to .43). Perfectionistic strivings had significant, small correlations with OCD, depression and all anxiety outcomes (pooled r = .10 to .21), except social anxiety where there was no association. Results demonstrate perfectionistic concerns have a stronger relationship with psychological distress than perfectionistic strivings, but strivings are significantly related to distress. Future research should examine the causal relationships between perfectionism dimensions and psychopathology.

A randomized clinical trial of a gamified app for the treatment of perfectionism.

OBJECTIVES: Perfectionism is a common transdiagnostic problem that may lead to substantial distress and functional impairments. Cognitive behavioural therapy (CBT) is an effective treatment for perfectionism. However, the existing significant barriers to access and utilization of mental health services, including among college students, demand the development of low-intensity accessible interventions. The aim of the present study was to evaluate the effectiveness of a low-intensity CBT-based self-help gamified app developed specifically for perfectionism in a sample of college students. METHODS: Participants completed assessments of perfectionism, related symptoms, emotional burden and functional impairments at pretreatment, posttreatment and at one-month follow-up. RESULTS: Compared with the waitlist condition (n = 35), the app condition (n = 35) demonstrated a significant and greater reduction in perfectionism, obsessive-compulsive symptoms, functional impairments and subjective ratings of emotional burden. CONCLUSIONS: Results suggest that a brief, daily app-based game-like intervention targeting maladaptive perfectionistic beliefs may be a viable, low-cost alternative to traditional CBT treatments for vulnerable populations on college campuses.

Applying process-oriented hypnosis to treat perfectionism-related depression.

This paper brings together concepts, tools, and case examples that provide guidance for ways to use process-oriented clinical hypnosis to shift perfectionistic tendencies to help resolve depression and enhance well-being. Perfectionism is a transdiagnostic risk factor for clinical and subclinical suffering of many types including depression. Over time, perfectionism is becoming more widespread. Perfectionism-related depression can be effectively treated when clinician attention is directed toward core skills and themes. Case examples illustrate how to help clients moderate overly extreme thinking, create and use realistic standards, and develop and apply a balanced self-evaluation. A variety of clinician styles and approaches, especially when tailored to individual client characteristics, preferences, and needs, are compatible with process-oriented hypnotic interventions for perfectionism and depression.