Academic journal article Journal of Eating Disorders

The Role of Perfectionism in Body Dissatisfaction

Academic journal article Journal of Eating Disorders

The Role of Perfectionism in Body Dissatisfaction

Article excerpt

Author(s): Tracey D Wade[sup.1] and Marika Tiggemann[sup.1]


Perfectionism has come to be viewed as an important maintaining factor of disordered eating. In the transdiagnostic theory of eating disorders, Fairburn, Cooper and Shafran [1] assert that clinical perfectionism is one of four core mechanisms that maintain eating disorder pathology and if it were to be ameliorated then "...a potent additional network of maintaining mechanisms would be removed thereby facilitating change" (p. 516). In the cognitive-interpersonal model of anorexia nervosa [2], perfectionism/cognitive rigidity is one of the four postulated maintaining factors. In addition, the three-factor theory by Bardone-Cone and colleagues [3] implicates the interaction between high perfectionism, high body dissatisfaction, and low self-esteem in the growth of bulimic behaviour. In support of these theoretical positions, research consistently shows perfectionism to be elevated in people with eating disorders and people recovering from eating disorders compared to controls [4, 5].

However the precise nature of the construct of perfectionism continues to be debated in the literature. Perfectionism has been proposed to be a multidimensional construct by two groups of theorists. The first construct, proposed by Hewitt and Flett [6], focuses on the interpersonal components of perfectionism, and the associated 45-item scale is divided into three subscales. The self oriented perfectionism subscale relates to setting high standards for achievement and self-criticism for not meeting standards. The other oriented perfectionism subscale includes items that relate to having high standards for other people that are unrealistic. The socially prescribed perfectionism subscale items are related to perceiving that other people hold unrealistically high standards for the individual.

The second theory proposes a 6 factor construct for perfectionism, measured using the Frost Multidimensional Perfectionism Scale (FMPS [7]): Personal Standards (setting high standards), Concern over Mistakes (negative reactions to mistakes and perceiving mistakes as failures), Doubts about Actions (doubting one's own performance), Parental Expectations (parents setting high standards), Parental Criticism (parents criticising for mistakes), and Organisation (organisation and neatness). Factor analyses have consistently shown a two factor solution, consisting of adaptive (achievement striving) perfectionism (Personal Standards and Organisation), and maladaptive evaluative concerns (Concern over Mistakes, Doubt about Action, Parental Expectations, and Parental Criticism) [8, 9]. Achievement striving is typically associated with healthy functioning while maladaptive evaluative concerns is more consistently associated with psychopathology [8]. There is one exception to this general finding, which is that elevated levels of both types of perfectionism are associated with eating disorders [10]. Thus it has been suggested that elevated levels of both types of perfectionism confers most risk for disordered eating [11].

Less studied is the way in which (if at all) perfectionism relates to the risk factors for eating disorders. This is particularly true for body dissatisfaction which is considered to be a robust risk factor for eating pathology [12] along with a related construct, weight concern. These constructs have been found to predict the development of disordered eating in adolescent samples across a number of studies, resulting in their status as "the best confirmed and most potent risk factor" (page 131) for eating disorders [13]. While one study has shown that body image concerns (as measured with the Body Attitudes Test [14]) was positively associated with both adaptive and maladaptive perfectionism [15], tests of the three-factor theory show that adaptive and maladaptive perfectionism interacted with body dissatisfaction to predict binge eating, while only adaptive perfectionism interacted with body dissatisfaction to predict self-induced vomiting [3]. …

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