Academic journal article American Journal of Psychotherapy

Perfectionism and Personality Disorders as Predictors of Symptoms and Interpersonal Problems

Academic journal article American Journal of Psychotherapy

Perfectionism and Personality Disorders as Predictors of Symptoms and Interpersonal Problems

Article excerpt


Perfectionism reflects an unflinching pursuit of unusually high levels of achievement, for example, in the areas of financial, athletics and/or academia. In general, perfectionism has been considered, a multidimensional, rather than singular, personality trait. Frost and colleagues (1990) suggested perfectionism is composed of six semi-independent elements including 1) setting high standards for performance, 2) having negative reactions to projected punishments for errors 3) having feelings of inferiority when anticipating an error, 4) negatively perceiving parents critiques of any flaws, 5) doubting one's performance, and 6) being overly concerned with organization and order. Hewitt and Flett (1991) suggested perfectionism is made up of three elements: self-oriented perfectionism, which involves both setting high standards for achievement and selfcriticizing when there is a perception these standards are unmet; otheroriented perfectionism, which involves setting unrealistically high standards for other people, and socially prescribed perfectionism, which involves a perception that others hold unrealistically high expectations about the self.

Perfectionism may play a causal role in the development of different forms of symptom disorders (Egan, Wade & Shafran, 2011; Harvey et al., 2004; Sassaroli et al., 2008). For instance, persons with eating disorders exhibit heightened levels of perfectionism (Bardone-Cone, Wonderlich, Frost et al., 2007) that may predate the onset of illness (Lilenfield et al., 2006). Perfectionism is correlated with levels of depression and suicidal ideation (Hewitt, Flett, Sherry & Caelian, 2006) and mood instability in bipolar disorders (Alloy, Abramson, Walshaw et al., 2009). Heightened perfectionism has also been found in individuals experiencing general anxiety (Frost & DiBartolo, 2002), social anxiety (Juster et al., 1996) and obsessive compulsive disorder (Obsessive Compulsive Cognitions Working Group, 1997).

Perfectionism may also contribute to social dysfunction among persons with a psychiatric condition. The link between perfectionism and symptoms of depression has been suggested to be mediated by negative social interactions, avoidant coping and the perception of a lack of social support (Dunkey, Zuroff & Blankstein, 2003). A relationship between concern about mistakes and doubts concerning actions with general symptomatology was found to be mediated by maladaptive coping (Park et al., 2010).

Perfectionism may also play a role in many personality disorders ([PDs1] Ayearst et al., 2012; Benjamin, 1996). Obsessive compulsive PD [OCPD] often involves setting high standards and battling procrastination, which is a result of doubt and an association between self-oriented perfectionism and compulsivity. This has been found in non-clinical (Hewitt & Flett, 1991; Sherry et al., 2007) and clinical (Grilo, 2004) samples. Perfectionism also appears in narcissism in the form of high standards for both oneself and others and harsh criticism of others (McCown & Carlson, 2004). Persons with depressive PD excessively blame themselves for any setbacks and are judgmental of others (Huprich, Porcerelli, Keaschuk, Binienda & Engle, 2008). Heightened socially prescribed perfectionism has also been found in borderline, avoidant, and dependent PD (Hewitt & Flett, 1991; Hewitt, Flett & Turnbull, 1992). Persons with avoidant PD are self-critical and expect to reach unreasonably high standards of performance in social situations, and they fear criticism, which may correspond to internalized criticism by their parents. Individuals with passive-aggressive PD tend to be overly critical of others and themselves. Their concern about making mistakes often hampers the ability to make decisions.

Personality disorders and perfectionism may interact and intensify one another (Sherry et al., 2007). The presence of both perfectionism and OCPD is a risk factor for the development of eating disorders (Goodwin, Haycraft, Willis & Meyer, 2011), and the combination of perfectionism and narcissism has been linked to unneeded cosmetic surgery (Fitzpatrick et al. …

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