One factor? Two factor? Bi-factor? A psychometric evaluation of the Frost Multidimensional Scale and the Clinical Perfectionism Questionnaire

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

OBJECTIVES

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.

METHOD

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.

RESULTS

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.

CONCLUSION

University students reporting elevated clinical perfectionism may have a tendency to experience lower self-esteem which is associated with NSSI history, recency, and severity.

Cognitive-emotional networks in students with and without a history of non-suicidal self-injury

BACKGROUND

Contemporary models of non-suicidal self-injury (NSSI) suggest that emotional vulnerabilities, negative self-schemas, and beliefs about NSSI work together to differentiate students who self-injure from those who do not. However, it is unclear how these mechanisms are differentially related among students with and without a history of NSSI. Considering this, we used a network analysis approach to explore how students with and without a history of NSSI vary in processing their emotional experiences in relation to their self-concepts and beliefs about NSSI.

METHOD

A sample of 480 university students (M_age = 21.18, SD = 2.43; 73.5 % female) completed self-report measures about their perceived emotional experiences (e.g., emotional reactivity, emotion regulation difficulties), self-concepts (e.g., self-esteem, self-efficacy), and NSSI.

RESULTS

A network comparison test revealed that students with a history of NSSI perceived themselves to have difficulties regulating particularly intense, unwanted negative emotions. In light of this, students with a history of NSSI expected some benefits of NSSI (e.g., emotion regulation) regardless of potential barriers (e.g., pain). Conversely, for students without a history of NSSI, expecting NSSI to have aversive outcomes was tied to expecting NSSI to have few benefits.

LIMITATIONS

The cross-sectional design limits inferences to be made about the network structures.

CONCLUSIONS

Students with and without a history of NSSI appear to differ in their cognitive processing of negative emotions and strategies used to deal with these emotions.

Concurrent and predictive relations of multidimensional perfectionism with test anxiety in secondary school students

Background and Objectives. Perfectionism is a multidimensional personality trait often viewed as a risk factor for developing test anxiety. A recent meta-analysis showed positive correlations of perfectionism facets with test anxiety dimensions. However, all previous research into the perfectionism-test anxiety relation has been cross-sectional. Thus, it is unclear whether perfectionism facets longitudinally predict test anxiety.Design. In this study, we investigated concurrent and predictive relations of two perfectionism facets with cognitive test anxiety (worry) and affective test anxiety (emotionality) in secondary school students (N = 478, mean age at T1 = 11.95 years). At T1, participants completed self-report measures of text anxiety and perfectionism. Almost five years later, participants again reported their test anxiety levels (T2).Results. Concern over mistakes and doubts correlated positively with current worry and emotionality. Personal standards correlated positively with current worry. Neither concern over mistakes and doubts nor personal standards significantly predicted later test anxiety beyond baseline.Conclusions. Perfectionism and test anxiety share common manifestations. Yet, this study raises the question whether perfectionism truly influences test anxiety development or whether other factors (e.g., construct overlap) may explain the identified cross-sectional correlations. Future research is needed to provide more nuanced insights into perfectionism-test anxiety associations.

Influence of Public Sports Services on Residents' Mental Health at Communities Level: New Insights from China

It is generally believed that sports play an important role in healing and boosting mental health. The provision of public sports services is important for enhancing residents' physical fitness and mental health, and for promoting their satisfaction with government public services. To build and strengthen a high-quality sports service-oriented society, it is important to explore whether community public sports services influence residents' mental health. To explore this phenomenon, the study gathered data from China and employed multi-level regression models to meet the study objective. The results show that the residents' age difference is 0.03, and the average daily exercise time is 0.02, which is significantly correlated with residents' mental health. The results show that the lower the availability and greening of sports facilities, and the fewer rest facilities there are, the higher the mental distress of residents may be. Conversely, the improvement of the greening and availability of sports facilities can facilitate the promotion of residents' mental health levels. Moreover, it was found that the mental health of residents is mainly and positively affected by the cleanliness of sports facilities. The street environment affects mental health and is attributed to the damage to sports facilities. Neighborhood communication also improves residents' mental health, and trust between neighbors has the greatest impact on reducing mental distress. Finally, the study proposes that the government should propose strategies to optimize the provision of community public sports services in the study area to boost both social and mental health benefits.

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.

A Randomized Test of Interpretation Bias Modification for Perfectionism Versus Guided Visualization Relaxation Among High Perfectionistic Undergraduate Students

Clinical perfectionism contributes to the onset and maintenance of multiple psychological concerns. We conducted a randomized, longitudinal test of the efficacy of a web-based intervention for perfectionism (specifically, cognitive bias modification, interpretation retraining; CBM-I), compared to an active treatment comparison condition (specifically, guided visualization relaxation training) for reducing perfectionism and related psychopathology. College students (N = 167) with elevated perfectionism were randomized to one of the two study conditions and were asked to complete their assigned intervention twice weekly for 4 weeks. Participants completed measures of perfectionism and psychological symptoms at baseline, 2 weeks (midway through the intervention period), 4 weeks (at the conclusion of the intervention period), and 8 weeks (1 month follow-up). CBM-I was rated as acceptable overall, though relaxation training was rated slightly more favorably. CBM-I outperformed relaxation training on improving perfectionism-relevant interpretation biases (i.e., increasing nonperfectionistic interpretations and decreasing perfectionistic interpretations), though with small effect sizes and inconsistency across study timepoints. Self-reported perfectionism showed small decreases across time in both intervention conditions. Support was found for a key hypothesized mechanism of CBM-I, such that randomization to CBM-I had a longitudinal, indirect effect on decreasing psychopathology symptom scores through improving perfectionism-relevant interpretation biases. However, in light of small effect sizes, the present study failed to provide compelling evidence that CBM-I for perfectionism contributes meaningfully to the treatment of perfectionism.

A protocol for unguided internet self-help cognitive behaviour therapy for perfectionism in adolescents at-risk of eating disorders

Perfectionism has a strong association with eating disorders, anxiety and depression. Unguided internet cognitive behaviour therapy for perfectionism has demonstrated efficacy in female adolescents without elevated eating disorder symptoms. No research to date has examined unguided internet cognitive behaviour therapy for perfectionism for adolescents with elevated eating disorder symptoms as an indicated prevention for eating disorders and co-occurring symptoms of anxiety and depression. The protocol outlines the plan for a randomised controlled trial of a co-designed, unguided internet cognitive behaviour therapy for perfectionism with female adolescents with elevated symptoms of eating disorders. The intervention will be a 4-week programme compared to a waitlist control. Outcomes on eating disorder symptoms, anxiety and depression will be measured pre and post intervention and follow-up.

TRIAL REGISTRATION

This trial was registered on 23 September 2020 with the Australian New Zealand Clinical Trials Registry (ACTRN12620000951954P).

Benchmarking in Academic Physical Therapy Using the PT-GQ Survey: Wave 2 Update With Application to Accreditation Reporting

OBJECTIVE

The Benchmarking in Academic Physical Therapy study uses the Physical Therapist-Graduation Questionnaire (PT-GQ) survey to develop comprehensive performance benchmarks for physical therapist education. These benchmarks facilitate interprofessional comparisons and have application to accreditation self-study reporting. The purpose of this study is to report updated benchmarks from enrollment Wave 2 of the study, with an emphasis on curricular areas that align with accreditation standards.

METHODS

Seventy doctor of physical therapy (DPT) programs (26.5% national sample) administered the survey to graduates during 2020-2021. Where possible, respondent data were contextualized by statistical comparison with published medical student data (Welch t test, Hedges g).

RESULTS

There were 1894 respondents who participated in the study (response rate: 63.9%). The average survey duration was 32.9 minutes. White-only, non-Hispanic/Latino/a/x individuals (78.8%) exceeded the 2020 US Census prevalence (60.1%), and only one-half of respondents perceived a benefit to their training from the diversity present in their programs. Over 94% of respondents indicated that their curricula were characterized by "problem solving/critical thinking" and "clinical reasoning," but nearly one-half indicated "busywork" was prevalent. High curricular satisfaction ratings clustered in content areas relating to profession-specific technical skills and low ratings clustered in foundational sciences. DPT respondents reported significantly lower tolerance for ambiguity, significantly more exhaustion, and significantly less disengagement than medical students. Respondents endorsed higher levels of "adaptive" perfectionism (striving for high performance) than "maladaptive" perfectionism (concern over negative evaluations). Respondents with loans (27.7%) had debt exceeding $150,000, the benchmark above which the DPT degree loses economic power.

CONCLUSION

PT-GQ benchmarks revealed strengths (eg, curricula emphasizing problem solving/critical thinking and clinical reasoning) and challenges (eg, low diversity, problematic student debt) in physical therapist education.

IMPACT

Programs can use benchmarking for quality-improvement efforts and as a data source for accreditation self-study reports. The ongoing study will refine national benchmarks and pilot items to address new research questions.

The association of perfectionism, health-focused self-concept, and erroneous beliefs with orthorexia nervosa symptoms: A moderated mediation model

OBJECTIVE

Orthorexia nervosa (ON) is a putative eating disorder linked to perfectionism among people who eat healthily (or who want to eat healthily). However, little is known about the process by which perfectionism fosters ON symptoms. Like the Transdiagnostic Cognitive-Behavioral Theory of Eating Disorders, we hypothesized that perfectionism among people who eat healthily (or who want to eat healthily) fosters ON symptoms indirectly by cultivating a health-focused self-concept (i.e., placing overriding importance on health for self-definition and self-worth). We also hypothesized that a health-focused self-concept would be associated with ON symptoms among people who have erroneous beliefs about the safety and efficacy of maladaptive healthy eating strategies.

METHOD

To test this moderated mediation model, a sample of people following a healthy eating diet plan and/or who believe they are leading a healthy eating lifestyle (N = 456) were recruited from Amazon's Mechanical Turk and completed measures that assessed perfectionism, health-focused self-concept, ON symptoms, and erroneous beliefs about the safety and efficacy of maladaptive healthy eating strategies. They also completed a measure of appearance-focused self-concept.

RESULTS

Health-focused and appearance-focused self-concepts were empirically distinct. As expected, perfectionism was indirectly and positively associated with ON symptoms via a health-focused self-concept. Importantly, the indirect association was only observed among participants high, but not low, in erroneous beliefs.

DISCUSSION

The findings support the role of perfectionism in ON. The findings also advance knowledge by identifying a health-focused self-concept and erroneous beliefs as potential factors in the etiology and maintenance of ON.

Perfectionism dimensions: A network analysis of their relationships with affect and obsessive-compulsive pathological personality traits

This study investigated the associations of multidimensional perfectionism with positive affect and negative outcomes (affect and Obsessive-Compulsive Personality Disorder [OCPD] pathological traits) through network analysis. The sample consisted of 604 Brazilian adults aged 18-74 years. The network analysis showed that perfectionistic concerns (PC) is strongly and positively associated with negative outcomes, while perfectionistic strivings (PS) maintain positive associations with positive affect, but not negative affect. Negative affect seems to operate as a bridge between perfectionism and OCPD pathological traits, raising crucial questions about the antecedent and consequential role of affect for understanding perfectionism's development and the traits observed in individuals with OCPD. We discuss the limitations and strengths of the study.

Modeling pathways to non‐suicidal self‐injury: The roles of perfectionism, negative affect, rumination, and attention control

Objective

Using the Emotional Cascade Model as a theoretical framework, this study tested whether the relationship between perfectionism and non‐suicidal self‐injury (NSSI) operates through rumination and negative affect. Additionally, we tested whether the associations between perfectionism and both rumination and negative affect are moderated by attention control.

Methods

Using a correlational cross‐sectional design, adults aged 18–25 with (N = 197) and without (N = 271) a history of NSSI completed measures of perfectionism, rumination, negative affect, attention control, and NSSI.

Results

Perfectionism was directly associated with increased odds of NSSI, and indirectly associated with odds of NSSI through rumination and negative affect. The relationship between perfectionism and rumination was moderated by attention focusing, such that the relationship was stronger for individuals who were higher in attention focusing.

Conclusion

Integrating perfectionism and attention with existing models of NSSI may improve understanding of the factors contributing to NSSI and offers insights into future clinical directions.

Cross-cultural adaptation of the Clinical Perfectionism Questionnaire (CPQ) for Brazilians

Abstract The goals of this paper are the cross-cultural adaptation and psychometric properties evaluation of the Brazilian version of the Clinical Perfectionism Questionnaire (CPQ), a scale that measures the tendency of a person to pursue self-demanding standards and the subjective consequences provided by achieving them or not. The original instrument was translated to Portuguese and back-translated to English. The preliminary version was judged by one of the authors of the instrument and by Brazilian specialists, producing content validity indicators. The final version was applied to a sample of 250 Brazilian undergraduate students, aged from 18 to 60 years old (M=24.9, SD=8.63), mostly female (76%). In the Exploratory Factor Analysis, data have revealed a bidimensional structure, and the other psychometric properties, such as internal consistency and validity regarding other variables, have shown adequate to the instrument. Additional analyses of unidimensional congruence reinforced the multidimensionality of the measure.

Measurement Invariance of Perfectionism Measures in Students with and without a History of Non-Suicidal Self-Injury

Perfectionism is a transdiagnostic process which may be implicated in the onset and maintenance of non-suicidal self-injury. No study has evaluated whether reported differences in perfectionism between individuals with and without a history of self-injury represent genuine group differences or measurement artefacts. The present study reports an investigation of the measurement invariance of two common scales of perfectionism, the Frost Multidimensional Perfectionism Scale-Brief (FMPS-Brief) and the Clinical Perfectionism Questionnaire (CPQ), among university students (M_age = 20.48, SD_age = 2.22, 75.3% female, 22.8% male) with and without a history of self-injury (total n = 711). Results revealed full residual error invariance for the two-factor model of FMPS-Brief, while the bifactor model of the FMPS-Brief and the two-factor model of the CPQ demonstrated partial metric invariance. Accounting for partial metric invariance, the bifactor model of the FMPS-Brief also demonstrated partial residual error invariance. The current findings suggest that observed differences using the FMPS-Brief reflect genuine differences in perfectionism between individuals with and without a history of self-injury. Further, while researchers using the bi-factor model can have confidence that the general factor can adequately assess group differences, differential item functioning should be considered if using the strivings and concerns factors. Finally, in the current data, the CPQ did not perform as expected in baseline model fit and future research should replicate assessments of measurement invariance in this measure.

Perfectionism predicts disordered eating and gambling via focused self-concept among those high in erroneous beliefs about their disordered behavior

BACKGROUND AND AIMS

Perfectionism, a focused self-concept, and erroneous beliefs have been implicated in the development and maintenance of various disordered behaviors. However, researchers have yet to examine how these factors combine to explain different disordered behaviors. Herein, we addressed this gap and hypothesized a moderated-mediation model whereby perfectionism fosters the development of disordered behaviors through a focused self-concept. Critically, the effect of a focused self-concept on disordered behaviors is specific to people with erroneous beliefs about their disordered behaviors. The model was tested in the contexts of disordered gambling and disordered eating, particularly dietary restraint.

METHOD

In Study 1, participants were community members who gamble (N = 259). In Study 2, participants were university women (N = 219). In both studies, participants completed self-report measures of all constructs that are both reliable and valid.

RESULTS

In Study 1, as expected, there was a positive association between perfectionism and disordered gambling, which was mediated by financially focused self-concept. This mediation was only observed among participants who scored high on illusion of control and belief in luck. Likewise, in Study 2, there was a positive association between perfectionism and dietary restraint, which was mediated by appearance focused self-concept. The mediation effect was only observed among participants who believed that maladaptive dietary restraint behaviors were safe and efficacious.

DISCUSSION AND CONCLUSIONS

The findings support the transdiagnostic utility of our model, which may help explain an array of disordered behaviors, including other addictive behaviors as well as behaviors that involve rigid adherence to rules and control.

Is perfectionism always unhealthy? Examining the moderating effects of psychological flexibility and self-compassion

OBJECTIVE

Perfectionism is generally associated with worse mental health outcomes, though evidence suggests elements of it may be helpful. In light of these findings, we examined whether psychological skills like psychological flexibility and self-compassion moderated the relationship between perfectionism and wellbeing (i.e., quality of life, symptom impairment, and psychological distress).

METHODS

Undergraduate students (N = 677) completed self-report measures.

RESULTS

A latent profile analysis identified three perfectionism groups (low, average, and high) based on four perfectionism subscales: concern over mistakes, need for approval, rumination, and striving for excellence. Generally, we found that psychological flexibility and/or self-compassion buffered the impact of average and high perfectionism on quality of life and symptom impairment.

CONCLUSION

Our results support the utility of practicing psychological flexibility and/or self-compassion for people with average and high levels of perfectionism. Limitations include using a cross-sectional design and nonclinical sample.