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Self-oriented and socially prescribed perfectionism dimensions and their associations with disordered eating

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Abstract

This study examined the relationship between self-oriented and socially prescribed dimensions of perfectionism (using two measures of perfectionism) and disordered eating assessed across multiple time points in a sample of young women. Study participants (n=406) reported on their levels of perfectionism and on their subsequent patterns of dieting and bulimic symptoms. Self-oriented perfectionism was strongly linked to dietary restraint, whether using the theoretically derived perfectionism dimensions from the Multidimensional Perfectionism Scale (MPS) [Hewitt, P.L., & Flett, G.L. (1991a). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456–470] or the dimensions derived from the Perfectionism subscale of the Eating Disorder Inventory (EDI) [Garner, D. M., Olmsted, M. P., & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2, 15–34]. A less clear-cut pattern emerged when bulimic symptoms were investigated, with both self-oriented (MPS and EDI) and socially prescribed perfectionism (MPS) being associated with bulimic symptoms. After controlling for negative affect, only a self-oriented dimension of perfectionism predicted unique variance in bulimic symptoms. What constitutes maladaptive perfectionism, concerns about using EDI-Perfectionism dimensions interchangeably with MPS dimensions, and future directions are discussed.

Introduction

Perfectionism has been proposed as an important correlate of concurrent psychological distress as well as a risk factor for future distress (Bieling, Israeli, & Antony, 2004). In particular, perfectionism has been linked to eating disorders, anxiety, and depression (Flett & Hewitt, 2002). While early work, especially in the eating disorders, focused on perfectionism as a unidimensional construct, more recent work has posited perfectionism as multidimensional with different dimensions of perfectionism having potentially differential relationships with distress. The current study explores the associations of self-oriented and socially prescribed dimensions of perfectionism with dieting and bulimic symptoms in a sample of young women.

Perfectionism has a history of being conceptualized multidimensionally (e.g., normal and neurotic perfectionism; Hamachek, 1978), although measures designed to assess different dimensions have existed only since the 1990s. One approach to the multidimensionality of perfectionism involves considering both its personal and social components. Hewitt and Flett (1991a) took this approach in developing their Multidimensional Perfectionism Scale (MPS) which reflects intrapersonal perfectionism via self-oriented perfectionism (having excessively high personal standards and being motivated to attain them) and interpersonal perfectionism via socially prescribed perfectionism (believing that others hold excessively high standards for oneself). Interestingly, confirmatory factor analyses of the most commonly used perfectionism measure in the eating disorder field, the Perfectionism subscale of the Eating Disorder Inventory (EDI; Garner, Olmsted, & Polivy, 1983), suggest that, despite having been created as a unidimensional measure, this perfectionism measure contains a self-oriented dimension and a socially prescribed dimension (Joiner & Schmidt, 1995; Sherry, Hewitt, Besser, McGee, & Flett, 2004).

The link between perfectionism and disordered eating has been supported with meta-analysis (Stice, 2002). However, most research on perfectionism and eating pathology has assessed perfectionism unidimensionally, in particular, using the Perfectionism subscale of the EDI. Of note, the perfectionism subscale of the EDI was developed as part of an instrument assessing eating pathology and characteristics of individuals with eating disorders, rather than being created with the focus on the perfectionism construct.

Fewer studies of perfectionism and eating disorders have used a multidimensional measure of perfectionism (i.e., either the MPS or the Multidimensional Perfectionism Scale [Frost MPS; Frost, Marten, Lahart, & Rosenblate, 1990]). Researchers assessing individuals with anorexia nervosa consistently find elevated levels of multiple dimensions of perfectionism. For example, Cockell et al. (2002) and Bastiani, Rao, Weltzin, and Kaye (1995) found that self-oriented perfectionism (SOP-MPS) and socially prescribed perfectionism (SPP-MPS) were both elevated in their anorexic sample compared to healthy controls. Halmi et al. (2000) and Bastiani et al. (1995) used the Frost MPS to find that a range of perfectionism subscales including Concern Over Mistakes and Personal Standards (associated with SPP-MPS and SOP-MPS, respectively; Enns & Cox, 2002) were elevated in patients with anorexia nervosa. With regard to multidimensional perfectionism and bulimia nervosa, Lilenfeld et al. (2000) found higher scores on many of the Frost MPS subscales, including Concern Over Mistakes and Personal Standards in their bulimic sample compared to controls, but Pratt, Telch, Labouvie, Wilson, and Agras (2001) found that those with bulimia had higher scores for SOP-MPS, but not SPP-MPS. Thus, there is evidence in clinical samples for both self-oriented and socially prescribed dimensions of perfectionism being associated with anorexia nervosa, but the evidence regarding these dimensions and bulimia nervosa is mixed.

Limited research has looked at the associations between multidimensional perfectionism and disordered eating in non-clinical samples. This sort of research is arguably important especially in non-clinical samples (such as undergraduate females) where disordered eating is prevalent and distressing (Cohen & Petrie, 2005) and where prevention/intervention efforts are needed. McLaren, Gauvin, and White (2001) found that both SOP-MPS and SPP-MPS were correlated with dietary restraint in female college students. Sherry et al. (2004) used the self-oriented and socially prescribed dimensions of the EDI-Perfectionism to conclude that each dimension (after controlling for the other dimension) was associated with anorexic attitudes and behaviors. However, in a sample of young adolescents, McVey, Pepler, Davis, Flett, and Abdolell (2002) found that self-oriented perfectionism but not socially prescribed perfectionism (from the children's version of the MPS) was associated with higher levels of dietary restraint and weight/food preoccupation. Assessing a broader range of disordered eating, Hewitt, Flett, and Ediger (1995) found that SOP-MPS and SPP-MPS were correlated with a measure of anorexic attitudes and behaviors, but that only SPP-MPS was associated with bulimic symptoms. Pearson and Gleaves (2006) found that neurotic perfectionism (which included Concern Over Mistakes), but not normal perfectionism (which included Personal Standards), was associated with bulimic symptoms. Thus, based on the limited literature, there is evidence in non-clinical samples for both self-oriented and socially prescribed dimensions of perfectionism being associated with dietary restraint and anorexic attitudes/behaviors, and preliminary evidence for socially prescribed perfectionism being associated with bulimic symptoms.

The aim of the current study was to explore the relationship between self-oriented and socially prescribed perfectionism and disordered eating using a non-clinical sample of young women. These relationships were examined using both the theoretically derived self-oriented and socially prescribed dimensions of the MPS and the factor analytically derived dimensions of the EDI-Perfectionism. Particularly novel elements of this study include the use of two measures of perfectionism and a longitudinal perspective involving multiple assessments of dieting and bulimic symptoms.

Of interest was: (1) whether perfectionism dimensions accounted for unique variance in disordered eating, and (2) how those with significant eating pathology compared to those with low levels of disordered eating on perfectionism dimensions. It was hypothesized that, for both perfectionism measures, self-oriented and socially prescribed perfectionism would account for unique variance in dieting, but only socially prescribed perfectionism would account for unique variance in bulimic symptoms. Similarly, it was hypothesized that those with elevated dieting would be significantly higher on both dimensions of perfectionism (regardless of measure used) compared to those with low levels of dieting, and those with elevated bulimic symptoms would be significantly higher on only socially prescribed perfectionism compared to those with low bulimic pathology. Analyses involving bulimic symptoms were also performed controlling for negative affect (given the strong relationship between negative affect and bulimic symptoms; Stice, 2002) in order to see if perfectionism explained unique variance in bulimic symptoms beyond anxiety and depression. Based on limited prior work that has controlled for negative affect in this context (Pratt et al., 2001), it was predicted that the relationship between perfectionism and bulimic symptoms would be the same regardless of whether or not negative affect was controlled.

Section snippets

Participants

Four hundred and twenty-six women attending introductory psychology classes at a large Midwestern university were randomly selected to participate in a study on women's health and lifestyles in exchange for class credit. Of the participants who began the semester-long study, 20 did not complete it (due to reasons such as illness or not needing course credit) or were dropped from the analyses due to habitually late (and therefore unreliable) data. The descriptive statistics and analyses that

Data analytic strategy

In order to take advantage of the variability captured by the repeated measures design of this study, and to account for the non-independence of the weekly assessments of disordered eating, multivariate multiple regression analyses were performed (Johnson & Wichern, 2002). The dependent variables were the 11 weeks of continuous, non-overlapping disordered eating data (e.g., the 11 weekly EDI-Bulimia reports). Independent variables were the perfectionism dimensions. In order to determine whether

Discussion

This study used two measures of perfectionism and multiple time points for the assessment of disordered eating to examine the relationship between self-oriented and socially prescribed dimensions of perfectionism and the outcome measures of dieting and bulimic symptoms. Using either the MPS or EDI-Perfectionism and all 11 weeks of dieting data, only self-oriented perfectionism accounted for unique variance in dieting. Similarly, when comparing high and low-level dieters on perfectionism

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