Perfectionism and eating attitudes in portuguese students: A longitudinal study

A meta-analysis of disordered eating and its association with self-criticism and self-compassion

OBJECTIVE

Future treatments for eating disorders (ED) need to be enhanced by targeting maintaining mechanisms. Literature suggests self-criticism and self-critical perfectionism act as key mechanisms exacerbating ED, and self-compassion protects against self-criticism. This meta-analysis examines associations between self-criticism and self-critical perfectionism on disordered eating (DE), and reviews how self-compassion and self-criticism relate to each other with respect to DE.

METHOD

Searches across three databases yielded 135 studies across 42,952 participants. Heterogeneity, publication bias, and quality assessments were analyzed. Moderation analyses between self-criticism measures, self-compassion measures, between clinical and nonclinical samples, and between cross-sectional and experimental studies were also conducted.

RESULTS

Random-effects models showed a medium positive link between self-criticism and DE (r = .37), and 10 subgroups pertaining to various measures of self-criticism utilized in literature showed small to large positive links with DE (r = .20-.52). Preliminary evidence also suggests negative relationships between self-compassion and DE (r = -.40 to -.43) and negative relationships between self-compassion and self-criticism (r = -.04 to -.88).

DISCUSSION

Greater levels of self-criticism is linked with greater levels of DE and reduced levels of self-compassion, suggesting a need to tackle self-criticism and nurture self-compassion in standard treatments for ED. Understanding these interactions better in conjunction with dismantling intervention studies can help develop more effective and efficient interventions targeting self-criticism and self-compassion for people with DE.

PUBLIC SIGNIFICANCE STATEMENT

Higher levels of self-criticism are linked with higher levels of DE and lower self-compassion. Self-compassion interventions could be more effective and efficient in reducing ED symptoms if self-criticism is tackled early in such treatments.

The indirect role of orthorexia nervosa and eating attitudes in the association between perfectionism and muscle dysmorphic disorder in Lebanese male University students - results of a pilot study

BACKGROUND

The literature highly concentrates on disorders related to body image among women but only minimally when it comes to the male population; hence, in order to provide general practitioners, and primary care physicians in general, and psychiatrists in particular, with additional information concerning muscle dysmorphia among male university students in Lebanon, this study seemed essential, and was therefore conducted to (1) identify the prevalence of MDD, and (2) evaluate the indirect effect of eating attitudes in general and orthorexia nervosa in particular, in the association between perfectionism and muscle dysmorphic disorder (MDD) among a sample of male university students.

METHODS

In this cross-sectional study conducted between September 2021 and May 2022, 396 male university students from multiple universities in Lebanon filled the online Arabic questionnaire.

RESULTS

The results showed that 26 (6.6%) of the participants had MDD. Orthorexia nervosa and eating attitudes mediated the association between perfectionism and MDD; higher perfectionism was significantly associated with higher ON and more inappropriate eating; higher ON and more inappropriate eating were significantly associated with higher MDD, whereas perfectionism had a significant total direct effect on MDD. The high prevalence of MDD among male university students in Lebanon implies further investigation on the national level in the country.

CONCLUSION

Awareness campaigns among the university students could be adopted at the national level to increase the level of knowledge on the concepts of obsessive self-destructive perfectionism, orthorexia nervosa and muscle dysmorphia.

Examining the effectiveness of cognitive bias modification for perfectionism in exploration of the mediating and moderating effects of body dissatisfaction and self-efficacy

The relationship between perfectionism, body dissatisfaction, and self-efficacy is unclear. This study attempted to distinguish the relationship between different dimensions of perfectionism and to examine how they relate to body dissatisfaction and self-efficacy. Experiment 1 examined the effectiveness of two types of Cognitive Bias Modification for Interpretation (CBM-I) techniques in the induction of perfectionism. Experiment 2 explored the mediation and moderation effects of perfectionism facets, body dissatisfaction, and self-efficacy in the induction of perfectionism. Participants were randomly assigned to one of the four CBM-I conditions and completed self-report measures of trait and state perfectionism, body dissatisfaction, self-efficacy, as well as a behavioural task that assessed perfectionistic behaviours before and after the CBM-I induction. The results indicated no significant differences in perfectionism between the experimental groups and the control groups following the perfectionism induction. Using baseline participant characteristics, body dissatisfaction was found to mediate socially-prescribed perfectionism and self-efficacy. Self-oriented perfectionism moderated the association between body dissatisfaction and self-efficacy. State perfectionism may not be influenced by a single session (30 trials) of CBM-I training. Treatment targeting body dissatisfaction may enhance self-efficacy in socially-prescribed perfectionists. Further, interventions that decrease self-oriented perfectionism may reduce body dissatisfaction while increasing self-efficacy.

Eating disorder symptoms and the 2 × 2 model of perfectionism: mixed perfectionism is the most maladaptive combination

PURPOSE

The 2 × 2 model of perfectionism (Gaudreau and Thompson in Personal Individ Diff 48:532-537, 2010) represents an important addition to the perfectionism literature, but so far has not been studied in relation with disordered eating.

METHOD

Using the 2 × 2 model as analytic framework, this study examined responses from a convenience sample of 716 participants aged 19-68 years (71% female) investigating how self-oriented perfectionism (SOP) and socially prescribed perfectionism (SPP) predicted individual differences in eating disorder symptoms, additionally controlling for body mass index, gender, and age.

RESULTS

Results showed a significant SOP × SPP interaction indicating that the combination of high SOP and high SPP-called "mixed perfectionism"-was associated with the highest levels of eating disorder symptoms.

CONCLUSIONS

The findings demonstrate the utility of the 2 × 2 model of perfectionism as an analytic framework for examining perfectionism and disordered eating. Moreover, they suggest that mixed perfectionism is the most maladaptive form of perfectionism when it comes to disordered eating, such that having high levels of SPP combined with high levels of SOP represents the most maladaptive combination of perfectionism in terms of risk of eating disorder.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

The relationships between socially prescribed perfectionism, in-group affect, negative urgency, and disordered eating in women

Socially prescribed perfectionism (SPP) is often considered as a key risk factor for disordered eating (DE). However, current conceptualizations of SPP largely assume that this perfectionism pressure is non-specific (i.e., a global pressure), despite research indicating that for females experiencing DE, female-dominated groups impose this pressure (as a perceived norm). Furthermore, this relationship may be mediated by a negative reaction to this pressure, in the form of impulsivity (or negative urgency). To date, no research has investigated whether the relationship between SPP and DE is mediated by negative urgency, nor has there been research clarifying how in-group identification relates to DE, independent of SPP and negative urgency. To address these gaps, we assessed these variables in 147 female dieters (M_age  = 25.12 years, SD = 3.08) using a cross-sectional design. Consistent with our hypotheses, negative urgency fully mediated the link between female-based SPP and disordered eating, while female-based in-group affect (identification) was predictive of disordered eating (although the latter relationship was not sustained in a multiple regression model). These findings suggest that the SPP from other women may relate to DE through increasing negative urgency, and that the link between in-group (female) affect and DE may be better explained by SPP's link to DE.

Perfectionism and eating disorder symptoms in female university students: the central role of perfectionistic self-presentation

PURPOSE

Numerous studies have found perfectionism to show positive relations with eating disorder symptoms, but so far no study has examined whether perfectionistic self-presentation can explain these relations or whether the relations are the same for different eating disorder symptom groups.

METHODS

A sample of 393 female university students completed self-report measures of perfectionism (self-oriented perfectionism, socially prescribed perfectionism), perfectionistic self-presentation (perfectionistic self-promotion, nondisplay of imperfection, nondisclosure of imperfection), and three eating disorder symptom groups (dieting, bulimia, oral control). In addition, students reported their weight and height so that their body mass index (BMI) could be computed.

RESULTS

Results of multiple regression analyses controlling for BMI indicated that socially prescribed perfectionism positively predicted all three symptom groups, whereas self-oriented perfectionism positively predicted dieting only. Moreover, perfectionistic self-presentation explained the positive relations that perfectionism showed with dieting and oral control, but not with bulimia. Further analyses indicated that all three aspects of perfectionistic self-presentation positively predicted dieting, whereas only nondisclosure of imperfection positively predicted bulimia and oral control. Overall, perfectionistic self-presentation explained 10.4-23.5 % of variance in eating disorder symptoms, whereas perfectionism explained 7.9-12.1 %.

CONCLUSIONS

The findings suggest that perfectionistic self-presentation explains why perfectionistic women show higher levels of eating disorder symptoms, particularly dieting. Thus, perfectionistic self-presentation appears to play a central role in the relations of perfectionism and disordered eating and may warrant closer attention in theory, research, and treatment of eating and weight disorders.

Perfectionism and disordered eating in overweight woman

INTRODUCTION

Perfectionism constitutes a risk factor for the development of eating disorders. In overweight women, knowledge about the nature of this association is scarce.

OBJECTIVES

To investigate the relationship between perfectionism, eating behaviors and affect in overweight women.

METHODS

The Portuguese versions of the Eating Disorder Examination Questionnaire/EDEQ, the Multidimensional Perfectionism Questionnaire and the Profile of Mood States were administered to an outpatient sample of 276 women (mean age=43.85±11.89years; mean BMI=32.82±5.43kg/m(2)).

RESULTS

Correlations between Socially Prescribed Perfectionism/SPP, EDEQ total (T) and its dimensional scores (Weight and Shape Concern and Dissatisfaction/WSCD, Eating Concern/EC, Dietary Restraint/DR) were significant (r>.30; p>.001). Self-Oriented Perfectionism/SOP was significantly correlated with EDEQ-T, WSCD and DR (r=.20). Participants with high (>M+SD) vs. low (<M-SD) SOP and SPP had significantly higher means in EDEQ-T, WSCD, EC and DR (p<.001). Linear regression showed that SPP was predictor of EDEQ-T and EC (p<.001).

CONCLUSIONS

SPP and SOP are related to disordered eating in overweight women.

Perfectionistic cognitions and eating disturbance: distinct mediational models for males and females

OBJECTIVE

Perfectionism has long been known to correlate with eating disturbance (ED). One mechanism through which this personality tendency may lead to ED is through increasing one's daily perfectionistic thoughts. This study examined the mediating role of perfectionistic thinking in the personality perfectionism-ED relationship among both male and female college students, and included measures assessing both typically-male and typically-female ED symptoms.

METHOD

A majority-White sample of 140 males and 329 females completed online versions of the Multidimensional Perfectionism Scale (Hewitt & Flett, 1991), Perfectionism Cognitions Inventory (Flett, Hewitt, Blankstein, & Gray, 1998), Drive for Muscularity Scale (McCreary, Sasse, Saucier, & Dorsch, 2004), items from the Eating Disorder Examination Questionnaire (Fairburn, 2008), and other measures. Regression tests examined the hypothesized role of perfectionistic cognitions as a mediator, including participant age, BMI, and positive and negative affect as covariates.

RESULTS

Among women, relationships between both self-oriented (Sobel's statistic=-4.63, p<.001) and socially prescribed perfectionism (Sobel's statistic=-5.77, p<.001) and dieting behavior were fully mediated by increased perfectionistic thinking. Among men, however, the relationship between only self-oriented perfectionism and bulimic (but not dieting) behavior, was fully mediated by increased perfectionistic thinking (Sobel's statistic=-2.53, p=.01).

CONCLUSIONS

Perfectionistic cognitions play an important linking role between personality perfectionism and ED, and can illuminate important differences by gender in eating disturbance. Such findings can improve validity of ED assessment in both genders, and provide a clear pathway to interventions to decrease ED in both genders.

Disordered eating behaviors and sleep disturbances

The aim of the present study was to investigate if disordered eating behaviors predicted the development of sleep disturbances. A total of 870 students participated at baseline, 592 one year later (T1) and 305 two years later (T2). The Eating Attitudes Test-40 was used to assess global disordered eating behaviors, dietary concerns (DC), bulimic behaviors (BB) and social pressure to eat (SPE). Sleep disturbances were assessed by two items related to difficulties initiating sleep (DIS) and maintaining sleep (DMS). A sleep disturbance index (SDI) was calculated by summing DIS and DMS scores. Results revealed that global disordered eating behaviors at baseline predicted DIS, DMS and SDI at T1 and T2. Students with increased BB and SPE scores at baseline were more likely to experience sleep onset and sleep maintenance difficulties in the long term. These results suggest that assessment and correction of eating behaviors might prevent sleep disturbances.

Sleep disturbances, body mass index and eating behaviour in undergraduate students

This study investigates the association between sleep disturbances, body mass index (BMI) and eating behaviour in a sample of undergraduate students. The sample comprises 870 medicine and dentistry students from Coimbra University (62.5% females), aged between 17 and 25 years. The Eating Attitudes Test-40 was used to measure eating behaviour, and two questions were applied addressing difficulties of initiating sleep (DIS) and difficulties of maintaining sleep (DMS). A sleep disturbance index (SDI) was calculated from the sum of DIS and DMS scores. Body mass index (BMI) was determined from self-reported weight and height. The correlation analyses generally indicated that global eating disturbance, bulimic behaviour dimension and social pressure to eat were associated particularly with sleep difficulties. An association between diet concerns and sleep difficulties was less consistent. Regression analyses showed that bulimic behaviour (BB) and social pressure to eat (SPE) dimensions were associated significantly with sleep difficulties (DIS, DMS, SDI) in the total sample (BB: from P<0.01 to P<0.001; SPE: P<0.05) and in males (BB: from P<0.05 to P<0.001; SPE: P<0.05) and with insomnia symptoms (P<0.01). In females, bulimic behaviour was the only factor associated significantly with sleep difficulties (SDI, DIS; P<0.01) and with insomnia symptoms (P<0.05). Although BMI was correlated negatively with sleep difficulties (P<0.05), regression analyses indicated that it was not associated significantly with them. Our findings support an association between eating behaviour and sleep disturbances in both genders, which may have treatment implications.