The existential model of perfectionism and depressive symptoms: Tests of incremental validity, gender differences, and moderated mediation

Highlights

• People high in socially prescribed perfectionism (SPP) struggle to accept the past.

• 141 men and 128 women were studied, and all results generalized across gender.

• SPP predicted unique variance in accepting the past beyond self-esteem.

• A moderated mediation model clarified when and why SPP is related to depression.

• The effect of SPP on depression through accepting the past was conditional on SPP.

Abstract

Socially prescribed perfectionism (i.e., perceiving others are demanding perfection of oneself) is a putative vulnerability factor for depressive symptoms. However, there is still much to learn about when and why socially prescribed perfectionists get depressed. Drawing on the existential model of perfectionism and depressive symptoms (EMPDS), we proposed difficulty in accepting the past (i.e., viewing life experiences as coherent, acceptable, satisfying, and meaningful) clarifies when and why socially prescribed perfectionism is linked to depressive symptoms. In the present study of 269 undergraduates (141 men and 128 women), we tested if accepting the past predicts depressive symptoms beyond competing explanations (e.g., self-esteem). And we extended existing research by testing a novel moderated mediation model wherein the strength of the mediated effect of socially prescribed perfectionism on depressive symptoms through accepting the past is stronger at higher levels of socially prescribed perfectionism than at lower levels of socially prescribed perfectionism. We also tested if our results generalized across women and men. Hypotheses were largely supported. Consistent with the EMPDS, our results suggested people high in socially prescribed perfectionism get depressed because they struggle to consolidate their life experiences into a personally meaningful story.

Introduction

Evidence suggests a robust link between perfectionism and depressive symptoms. Although several intervening variables (e.g., moderators and mediators) are proposed to explain the relationship between perfectionism and depressive symptoms, there is still much to learn about the link between perfectionism and depressive symptoms.

There are several well-established dimensions of perfectionism (e.g., Frost et al., 1990, Hewitt and Flett, 1991). According to one model, self-oriented perfectionism involves demanding perfection of oneself, other-oriented perfectionism involves demanding perfection of others, and socially prescribed perfectionism involves perceiving others are demanding perfection of oneself (Hewitt & Flett, 1991). Among these dimensions, socially prescribed perfectionism is consistently linked to depressive symptoms (Sherry, Hewitt, Flett, & Harvey, 2003). People high in socially prescribed perfectionism show many of the key characteristics of those prone to depressive symptoms, including harsh self-scrutiny, evaluative fears, unrealistic expectations, and perceived criticism.

Drawing on the existential model of perfectionism and depressive symptoms (EMPDS; Graham et al., 2010), we propose that difficulty in accepting the past (i.e., viewing life experiences as coherent, acceptable, satisfying, and meaningful) explains when and why socially prescribed perfectionism is linked to depressive symptoms (Graham et al., 2010). Existential theorists (Frankl, 1984) suggest an inability to see one’s life experiences as purposeful and satisfactory is conducive to depressive symptoms. Cognitive behavioral theorists also suggest the inability to accept thoughts, emotions, and experiences fosters depressive symptoms (Hayes, 2004). In sum, difficulty accepting the past is likely to contribute to depressive symptoms.

People high in socially prescribed perfectionism may have difficulty accepting the past for several reasons (Graham et al., 2010). Such people often try to meet the expectations of others, rather than following their own authentic desires, which is likely to undermine personal meaning and satisfaction (Hewitt & Flett, 1991). In attempting to achieve perfection, people high in socially prescribed perfectionism may avoid activities wherein perfection is unobtainable, thereby experiencing a narrow set of life events focused on achievement and excluding social relationships and personal growth. Perfection is also difficult to attain and the constant pursuit of perfection may result in frequent disappointment. People high in socially prescribed perfectionism are also prone to harsh self-criticism and evaluative fears wherein setbacks are seen as unacceptable and threatening to the self. Past events are viewed through this self-critical lens and perceived failures are seen as intolerable. Theory and research suggest difficulty accepting the past may explain why people high in socially prescribed perfectionism are vulnerable to depressive symptoms (Graham et al., 2010).

We propose socially prescribed perfectionism is robustly related to accepting the past. If this is the case, socially prescribed perfectionism should predict unique variance in accepting the past beyond competing variables (e.g., self-esteem). We also tested whether accepting the past predicted depressive symptoms over and above self-esteem. Self-esteem (i.e., one’s subjective evaluation of one’s worth) is correlated with socially prescribed perfectionism, acceptance, and depressive symptoms (Flett et al., 2003, Preusser et al., 1994). Self-esteem is therefore a stringent covariate in the present study.

Women are nearly twice as likely to experience depressive symptoms as men (Patten et al., 2006). What is less well known is whether proposed models for understanding depressive symptoms, including the EMPDS, generalize to women and to men. Knowledge of whether explanatory models of depressive symptoms generalize to women and to men is important in order to provide appropriate and gender-sensitive clinical services. In contrast to past studies that focus primarily on women or include only a small percentage of men (e.g., Graham et al., 2010), the present study has roughly equal number of women and men, allowing for more appropriate tests of gender differences.

Studies on perfectionism and depressive symptoms have examined several intervening variables to assist in explaining the relationship between perfectionism and depressive symptoms. Moderational models explain when (i.e., the conditions under which) perfectionism is related to depressive symptoms (e.g., when interpersonal stress is present; Enns and Cox, 2005, Sherry et al., 2003); mediational models explain why (i.e., the mechanisms through which) perfectionism is related to depressive symptoms (e.g., through difficulty accepting the past; Graham et al., 2010). Past research usually offers little compelling rationale as to why an intervening variable should be a mediator or a moderator. Very few studies of perfectionism examine both moderators and mediators in the same model.

In contrast, the present study tests a moderated meditation model (Preacher, Rucker, & Hayes, 2007). Moderated mediation occurs when the magnitude of an indirect effect (i.e., why one variable influences another) depends on the level of a moderator (i.e., when a variable influences another). In the present study we examined the indirect effect of socially prescribed perfectionism on depressive symptoms through difficulty accepting the past (i.e., mediation). We also examined whether the level of socially prescribed perfectionism (i.e., moderation) influenced the strength of the indirect effect (i.e., moderated mediation). Socially prescribed perfectionism was selected as the moderator given long standing evidence that depressive symptoms are higher at higher levels of socially prescribed perfectionism (Sherry et al., 2003).

Building upon past research (Graham et al., 2010), we hypothesized socially prescribed perfectionism would contribute incrementally to our understanding of accepting the past beyond self-esteem. As in past research (e.g., Flett et al., 2003), we also hypothesized accepting the past would contribute incrementally to the prediction of depressive symptoms beyond self-esteem. We also tested whether the relationships between socially prescribed perfectionism, accepting the past, and depressive symptoms differ across men and women. Given the scarcity of research on this area, this question was considered exploratory.

Drawing on research supporting the EMPDS (Graham et al., 2010), we hypothesized a moderated mediation model wherein the strength of the mediation effect (i.e., the relationship between socially prescribed perfectionism and depressive symptoms would be mediated through difficulty accepting the past) would depend on the level of socially prescribed perfectionism (Fig. 1). Specifically, we hypothesized the mediation effect would be stronger at higher levels of socially prescribed perfectionism than at lower levels of socially prescribed perfectionism, consistent with past research showing depressive symptoms are higher at higher levels of socially prescribed perfectionism (Sherry et al., 2003).