Mediators between perfectionism and eating disorder psychopathology in a community sample
Highlights
► Mediators between perfectionism and eating disorders were investigated. ► Conditional goal setting and shape weight overvaluation were significant mediators. ► Prevention programs may consider targeting perfectionism.
Introduction
Perfectionism, defined as the setting of excessively high standards for performance accompanied by overly critical self-evaluation (Frost, Marten, Lahart, & Rosenblate, 1990), has a robust link to eating pathology (Bardone-Cone et al., 2007, Egan et al., 2011). Despite intermediary mechanisms potentially serving as conduits between perfectionism and eating pathology, few studies have examined mediation models in clinical or community populations (Bardone-Cone et al., 2007).
Watson, Raykos, Street, Fursland, and Nathan (2011) investigated the mediators of shape and weight overvaluation and conditional goal-setting among women with eating disorders (n = 201). Shape and weight overvaluation occurs when the individual evaluates self-worth largely or almost entirely on body shape and weight, to the exclusion of other domains (e.g., work, hobbies, study, friendships) and is related to but distinct from perfectionism (Wade and Bulik, 2007, Watson et al., 2011). Cognitive behavioral theories (Fairburn et al., 2003, Garner and Bemis, 1985, Slade, 1982) propose that perfectionism is a proximal risk or etiological factor for the development of shape and weight overvaluation. Conditional goal-setting is a cognitive style informed by broader social cognitive theories and described within conditional goal-setting theory (Street, 2002). Traditional goal theories propose that individuals arrange personal goals in hierarchies; from concrete, proximal goals at the lower level, to abstract, distal goals – most commonly personal happiness – at the pinnacle. Conditional goal-setting is the belief that a higher order goal is only attainable upon reaching connected lower order goals (“I will only be happy when I get the promotion I want”, “I will only be happy when I get pregnant”). Watson et al. (2011) found that women with eating disorders who exhibited higher conditional goal-setting related to shape and weight (e.g., “I will only be happy if I weigh _ _ pounds”) had more severe eating pathology. Further, shape and weight overvaluation and conditional goal-setting for shape and weight were found to mediate the relation between self-oriented perfectionism and eating pathology.
Based on Watson et al. (2011) findings, we hypothesize that shape and weight overvaluation and conditional goal-setting will mediate the relation between perfectionism and eating pathology in a community sample of adult women.
Section snippets
Participants
Participants were a community sample of 202 women recruited through snowball sampling. Snowball sampling is a process whereby an initial set of participants begin the recruitment process, serving as informants about the research to other potential participants. An attempt was made to recruit a diverse set of initial informants, i.e. young adult women, through university notices, email networks, and social networking sites. Inclusion criteria were female, 18 + years, and English-speaking.
Participant characteristics
Participants had a mean age of 30 (SD = 11) years, 52% were married or defacto, and 89% were employed. The highest education level completed was tertiary (74%), technical/trade certificate (7%), higher school certificate (Yr 12) (17%), or leaving certificate (Yr 10) (2%). English was the first language of 97% of respondents, and region of birth was Australia (79%), United Kingdom (7%), Asia (4%), Africa (3%), North America (2%), New Zealand (2%), Europe (2%), and South America (< 1%).
The mean
Discussion
As hypothesized, shape and weight overvaluation and conditional goal-setting mediated the relationship between self-oriented perfectionism and eating pathology among women in the general community, replicating the model previously established among treatment-seeking women with clinical eating disorders (Watson et al., 2011).
Perfectionism, broadly, is implicated in the development and maintenance of a variety of psychiatric symptoms, including anxiety, depression, and eating pathology (Egan et
Role of funding sources
This study had no funding.
Contributors
Authors Watson and Egan designed the study, author Joyce collected data and conducted statistical analyses. Authors Watson and Egan drafted the final manuscript. Author Kane provided statistical advice. All authors have approved the final manuscript.
Conflict of interest
All authors declare that they have no conflicts of interest.
References (34)
Self-oriented and socially prescribed perfectionism dimensions and their associations with disordered eating
Behaviour Research and Therapy
(2007)- et al.
Perfectionism and eating disorders: Current status and future directions
Clinical Psychology Review
(2007) - et al.
Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment
Behaviour Research and Therapy
(2003) - et al.
Changes during treatment for bulimia nervosa: A comparison of three psychological treatments
Behaviour Research and Therapy
(1993) - et al.
The role of perfectionism, dichotomous thinking, shape and weight overvaluation, and conditional goal setting in eating disorders
Eating Behaviors
(2011) - et al.
Eating Disorder Examination Questionnaire (EDE-Q): norms for young adult women
Behaviour Research and Therapy
(2006) - et al.
A randomised controlled trial of cognitive-behaviour therapy for clinical perfectionism: A preliminary study
Behaviour Research and Therapy
(2007) - et al.
Clinical perfectionism: A cognitive-behavioural analysis
Behaviour Research and Therapy
(2002) - et al.
Reliability and validity of the Conditional Goal Setting in Eating Disorders Scale (CGS-EDS) among adults with eating disorders
Eating Behaviors
(2010) - et al.
Eating Disorder Examination Questionnaire and Clinical Impairment Assessment Questionnaire: General population and clinical norms for young adult women in Sweden
Behaviour Research and Therapy
(2011)
Structural equation modeling in practice: A review and recommended two-step approach
Psychological Bulletin
The interplay of cultural syndromes and personality in predicting life satisfaction: Comparing Asian Americans and European Americans
Journal of Cross-Cultural Psychology
Structural equations with latent variables
Structural equation modeling with AMOS: Basic concepts, applications, and programming
Body image, media, and eating disorders
Academic Psychiatry
Perfectionism as a transdiagnostic process: A clinical review
Clinical Psychology Review
Assessment of eating disorders: Interview or self-report questionnaire?
International Journal of Eating Disorders
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