Perfectionism in chronic and state symptoms of depression.

Tested whether perfectionism dimensions uniquely predict chronic unipolar and chronic bipolar symptoms. A sample of 121 patients and former patients (mean age 46.1 yrs) completed the Multidimensional Perfectionism Scale, the General Behavior Inventory, and the Beck Depression Inventory. The results confirm that the perfectionism dimensions are related to chronicity of depression symptoms. Whereas self-oriented perfectionism was uniquely associated only with chronic unipolar symptoms, both socially prescribed and other-oriented perfectionism were uniquely associated with chronic bipolar symptoms. Importantly, these relationships remained significant after controlling for the effects of concurrent state depression. Finally, only socially prescribed perfectionism was uniquely associated with state depression. The results provide support for the position that perfectionism dimensions are important in both chronic. and state depression symptoms, but the perfectionism dimensions may differ in terms of their degree of association with various facets of depressive phenomena. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perfectionism as a predictor of subsequent adjustment: Evidence for a specific diathesis–stress mechanism among college students.

The relations among perfectionism, stress, subsequent psychological symptoms, and hopelessness were examined among 215 college students. Hierarchical regression analyses were conducted to determine whether dimensions of perfectionism (P. Hewitt & G. Flett, 1991) predicted psychological symptoms and hopelessness (1 month later), and the extent to which stress scores added incremental validity to these predictions. Results indicated that socially prescribed perfectionism was a significant predictor of both adjustment measures. In addition, stress accounted for a significant amount of additional variance in predicting adjustment beyond perfectionism. Consistent with a diathesis–stress model, a significant Perfectionism × Stress interaction was found in predicting scores on adjustment measures beyond perfectionism and stress. However, this interaction was only found for socially prescribed perfectionism. Results provide support for a specific diathesis–stress mechanism and important implications for developing specific interventions in working with perfectionistic college students. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perfectionism and relationship adjustment in pain patients and their spouses.

The authors assessed whether social facets of perfectionism were associated with indexes of dyadic and family adjustment. A sample of 83 pain patients and their spouses completed the Multidimensional Perfectionism Scale, Dyadic Adjustment Scale, Family Assessment Device, Beck Depression Inventory, and Multiaxial Pain Inventory. After controlling for depression, the authors found that pain patients' relationship adjustments were associated with their spouses' other-oriented perfectionism. Also, pain patients rated their other-oriented perfectionistic spouses as less supportive. Spouses' reports of poor dyadic and family adjustment were associated with their own socially prescribed perfectionism. The findings suggest that social aspects of perfectionism contribute to poor family adjustment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relative stability of dimensions of perfectionism in depression.

Investigated the degree of absolute change, affective state dependence, and relative trait stability of several dimensions of perfectionism assessed by two popular, multidimensional measures. The study sample was 105 adult outpatients from a university hospital mood disorders program who met diagnostic criteria for major depressive episode at Time 1 and did not meet criteria for major depressive episode one year later (Time 2). Mean total scores on the Beck Depression Inventory decreased by almost 50% (from 28 to 15). Absolute change on perfectionism indices was smaller but significant for some maladaptive dimensions. Correlational, regression, and path analyses all indicated the presence of affective state dependence for several maladaptive dimensions of perfectionism (e.g., concern over mistakes, socially prescribed perfectionism). However, in all cases strong evidence was also found for the enduring trait stability of these dimensions. The results support a state-trait conceptualization of maladaptive perfectionism dimensions, which denotes stable individual difference variables that are elevated in the depressive state. Adaptive aspects of perfectionism showed little or no evidence of affective state dependence, consistent with findings from other research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dimensions of perfectionism in unipolar depression.

We tested the hypothesis that self-oriented perfectionism, other-oriented perfectionism, and socially prescribed perfectionism are related differentially to unipolar depression. The Multidimensional Perfectionism Scale was administered along with measures of depression and anxiety to 22 depressed patients, 22 matched normal control Ss, and 13 anxiety patients. It was found that the depressed patients had higher levels of self-oriented perfectionism than did either the psychiatric or normal control Ss. In addition, depressed patients and anxious patients reported higher levels of socially prescribed perfectionism than did the normal control Ss. The results suggest that various dimensions of perfectionism may play an important role in clinical depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Perfectionism and depression: Longitudinal assessment of a specific vulnerability hypothesis.

The authors tested whether perfectionism dimensions interact with specific stress to predict depression over time. A sample of 103 current and former patients completed measures of perfectionism and depression at Time 1 and measures of stress and depression 4 months later. After controlling for Time 1 depression, self-oriented perfectionism interacted only with achievement stress to predict Time 2 depression. Socially prescribed perfectionism did not interact with achievement or social stress to predict Time 2 depression, but it did predict Time 2 depression as a main effect. The results provide support for the contention that perfectionism dimensions are involved in vulnerability to depression over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

High-performance liquid chromatographic determination of midazolam in rat brain

The authors tested whether perfectionism dimensions interact with specific stress to predict depression over time. A sample of 103 current and former patients completed measures of perfectionism and depression at Time 1 and measures of stress and depression 4 months later. After controlling Time 1 depression, self-oriented perfectionism interacted only with achievement stress to predict Time 2 depression. Socially prescribed perfectionism did not interact with achievement or social stress to predict Time 2 depression, but it did predict Time 2 depression as a main effect. The results provide support for the contention that perfectionism dimensions are involved in vulnerability to depression over time.     

Vulnerability to depression: Reexamining state dependence and relative stability.

Treatment-related decreases in Dysfunctional Attitudes Scale (DAS; Weissman & Beck, 1978) scores have been interpreted as evidence that dysfunctional attitudes are state-dependent concomitants of depression. Data from the National Institute of Mental Health Treatment of Depression Collaborative Research Program were used to reexamine the stability of dysfunctional attitudes. Mean scores for Perfectionism, Need for Approval, and total DAS decreased after 16 weeks of treatment. However, test–retest correlations showed that the DAS variables displayed considerable relative stability. Structural equation models demonstrated that dysfunctional attitudes after treatment were significantly predicted by initial level of dysfunctional attitudes as well as by posttreatment depression. The relative stability of dysfunctional attitudes was even higher during the 18-month follow-up period. The results were consistent with Beck's (1967) and Blatt's (1974) theories of vulnerability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological distress and the frequency of perfectionistic thinking

Five studies tested the hypotheses that there are individual differences in the frequency of automatic thoughts involving perfectionism and that these thoughts are associated with psychological distress. Research with the Perfectionism Cognitions Inventory (PCI) established that this new measure has adequate psychometric properties, and high PCI scorers tend to spontaneously report perfectionistic thoughts in naturalistic situations. Additional research confirmed that frequent perfectionism thoughts account for unique variance in distress, over and above variance predicted by standard measures of negative automatic thoughts and trait perfectionism measures. Overall, the findings support the view that personality traits involved in depression and anxiety have a cognitive component involving ruminative thoughts and that activation of this cognitive personality component contributes to distress.     

Granulocyte colony-stimulating factor, granulocyte-macrophage colony-stimulating factor and macrophage colony-stimulating factor in the treatment of acute myeloid leukemia and acute lymphoblastic leukemia

To explore the role of perfectionism across anxiety disorders, 175 patients with either panic disorder (PD), obsessive compulsive disorder (OCD), social phobia, or specific phobia, as well as 49 nonclinical volunteers, completed two measures [Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R., (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449-468; Hewitt, P. L., & Flett, G. L., (1991). Perfectionism in the self and social contexts: Conceptualization, assessment and association with psychopathology. Journal of Personality and Social Psychology, 60, 456-470.] that assess a total of nine different dimensions of perfectionism. Relative to the other groups, social phobia was associated with greater concern about mistakes (CM), doubts about actions (DA), and parental criticism (PC) on one measure and more socially prescribed perfectionism (SP) on the other measure. OCD was associated with elevated DA scores relative to the other groups. PD was associated with moderate elevations on the CM and DA subscales. The remaining dimensions of perfectionism failed to differentiate among groups. The clinical implications of these findings are discussed.     

The structure and temporal stability of the Child and Adolescent Perfectionism Scale.

In this study, the authors examined the factor structure and temporal stability of the Child and Adolescent Perfectionism Scale (CAPS; G. L. Flett, P. L. Hewitt, D. J. Boucher, L. A. Davidson, & Y. Munro, 1997) in 2 samples of adolescents (15–16 years old). In Sample 1 (n = 624), confirmatory factor analysis did not support a 2-factor structure (self-oriented and socially prescribed perfectionism). As in B. T. McCreary, T. E. Joiner, N. B. Schmidt, & N. S. Ialongo (2004), reanalysis suggested a 3-factor solution (i.e., socially prescribed perfectionism, self-oriented–Striving perfectionism, self-oriented–Critical perfectionism). The authors validated their 3-factor model in an independent replication sample (Sample 2; n = 514) and confirmed that the 3-factor structure was invariant across gender and time (test–retest over 6 months). Taking these analyses together, the authors concluded that their discriminant 3-factor structure is robust. Theoretical and clinical implications are discussed. More research on the predictive validity of the CAPS is suggested. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evaluating stability and change in personality and depression

Critics have argued that personality factors believed to represent a vulnerability to depression are not stable and are therefore state dependent. However, conclusions regarding the stability of personality and the relation between personality and depression have been drawn (a) without differentiating relative stability among individual differences from absolute stability of change scores and (b) without explicitly modeling change in personality as a function of change in depression. The relation between neuroticism and depression was examined in a sample of depressed outpatients (N = 71) receiving a 5-week trial of pharmacotherapy. Measures of neuroticism and extraversion demonstrated both relative stability and absolute change, and changes in neuroticism and extraversion scores were modestly or not at all accounted for by changes in depression scores. Claims that personality scores are not stable and are state dependent must be reconsidered.     

La mesure de perfectionnisme: Validation canadienne-fran?aise du Positive and Negative Perfectionism Scale.

The purpose of this study was to verify the validity of a French version of the Positive and Negative Perfectionism Scale developed by L. A. Terry-Short (1995). This instrument measures the type as well as the level of perfectionism in adolescents. The instrument was first administered to 734 7th, 9th, and 11th grade students. Four weeks later, 596 Ss were invited to answer the questionnaire once more. The factorial structure, temporal stability and internal consistency of each subscales of the translated version of the instrument correspond to those of the original version. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impact of perfectionism and need for approval on the brief treatment of depression: The National Institute of Mental Health Treatment of Depression Collaborative Research Program revisited.

[Correction Notice: An erratum for this article was reported in Vol 63(3) of Journal of Consulting and Clinical Psychology (see record 1995-33936-001). Research Program Revisited," by Sidney J. Blatt, Donald M. Quinlan, Paul A. Pilkonis, and M. Tracie Shea reported significant negative relationships of pretreatment scores on the Dysfunctional Attitude Scale (DAS) Perfectionism factor to residualized measures of therapeutic change. Further analyses revealed several errors in the original report concerning two of the five measures of therapeutic change: the Global Assessment Scale (GAS) and the Social Adjustment Scale (SAS). Pretreatment DAS Perfectionism scores predicting residualized GAS and SAS change scores yield a standard regression weight of-.328 (instead of-.270), t(145) = -3.28, p = .001, and .250 (instead of .297), t(145) = 2.50, p = .014, respectively. The linear contrast of level of posttreatment SAS among the four quartiles of pretreatment perfectionism increases slightly, F(l, 50) = 7.93, p     

The relationship of perfectionism, depression, and therapeutic alliance during treatment for depression: Latent difference score analysis.

The authors examined the longitudinal relationship of patient-rated perfectionism, clinician-rated depression, and observer-rated therapeutic alliance using the latent difference score (LDS) analytic framework. Outpatients involved in the Treatment for Depression Collaborative Research Program completed measures of perfectionism and depression at 5 occasions throughout treatment, with therapeutic alliance measured early in therapy. First, LDS analyses of perfectionism and depression established longitudinal change models. Further LDS analyses revealed significant longitudinal interrelationships, in which perfectionism predicted the subsequent rate of depression change, consistent with a personality vulnerability model of depression. In the final LDS model, the strength of the therapeutic alliance significantly predicted longitudinal perfectionism change, and perfectionism significantly predicted the rate of depression change throughout therapy. These results clarify the patterns of growth and change for these indicators throughout depression treatment, demonstrating an alternative method for evaluating longitudinal dynamics in therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dyadic perfectionism as a predictor of relationship continuity and distress among college students.

This study examined the nature and impact of dyadic perfectionism over a 3-month interval within a sample of 116 college students who were currently involved in an intimate heterosexual relationship. Dyadic perfectionism scores were stable and correlated as expected with scores on concurrent measures of adult attachment orientations and relationship satisfaction. Logistic regression analyses revealed that, controlling for initial commitment status and adult attachment orientations, Time 1 dyadic perfectionism scores significantly and uniquely predicted relationship continuity 3 months later. Lastly, controlling for social desirability, relationship commitment status, and Time 1 adult attachment orientation scores, Time 1 dyadic perfectionism scores also uniquely predicted Time 2 relationship distress. Findings provide additional evidence that dyadic perfectionism is a risk factor for relationship dysfunction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Negative attributional style as a moderator of the link between perfectionism and depressive symptoms: Preliminary evidence for an integrative model.

An integrative model involving perfectionism and negative attributional style as predictors of depressive symptoms was proposed and tested in 222 college students. Beyond the expected additive influences of the 2 predictors in the prediction of dysphoria, negative attributional style was also hypothesized to moderate the link between perfectionism and depressive symptoms. As theorized, results indicated that dimensions of perfectionism (P. Hewitt & G. Flett, 1991b) predicted depressive symptoms (2 months later) and that a negative attributional style added incremental validity to these predictions. Moreover, consistent with the proposed model, the Perfectionism?×?Negative Attributional Style interaction was found to further augment the prediction of depressive symptoms. These findings are taken to offer preliminary support for the proposed model. Some implications for future studies are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Role of perfectionism and personality disorder features in response to brief treatment for depression.

Using data from the Treatment of Depression Collaborative Research Program (TDCRP), the authors compared the role of patients' perfectionism and features of personality disorder (PD) in the outcome of brief treatment for depression. Data were extracted as to patients' intake levels of symptoms; perfectionism; and PD features, measured as continuous variables, as well as their symptoms at termination; their contribution to the therapeutic alliance; and their satisfaction with social relations. Poorer therapeutic outcome was demonstrated for patients with elevated levels of perfectionism and odd-eccentric and depressive PD features. Patients' contribution to therapeutic alliance and satisfaction with social relations were predicted by perfectionism but not by PD features. Results highlight the central role played by patients' personality in the course of brief treatment for depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dimensions of perfectionism, daily stress, and depression: A test of the specific vulnerability hypothesis.

Tested whether perfectionism dimensions interact with specific stressors to predict depression. A depressed patient sample (N?=?51) and a general psychiatric sample (N?=?94) completed measures of perfectionism, hassles, and depression. Ss in Sample 2 also completed other personality measures to assess the amount of unique variance in depression. Partial support was obtained: In both samples, self-oriented perfectionism interacted only with achievement stressors to predict depression. Socially prescribed perfectionism interacted with interpersonal stress in Sample 1 and with achievement stress in Sample 2 to predict depression. Several personality variables, including socially prescribed perfectionism, accounted for unique variance in depression. The results suggest that perfectionism dimensions are associated with depression and may constitute specific vulnerability factors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

When and how perfectionism impedes the brief treatment of depression: Further analyses of the National Institute of Mental Health Treatment of Depression Collaborative Research Program.

Perfectionism has previously been identified as having a significant negative impact on therapeutic outcome at termination in the brief (16-week) treatment of depression (S. J. Blatt, D. M. Quinlan, P. A. Pilkonis, & T. Shea, 1995) as measured by the 5 primary outcome measures used in the National Institute of Mental Health Treatment of Depression Collaborative Research Program (TDCRP). The present analyses of other data from the TDCRP indicated that this impact of perfectionism on therapeutic outcome was also found in ratings by therapists, independent clinical evaluators, and the patients and that this effect persisted 18 months after termination. In addition, analyses of comprehensive, independent assessments made during the treatment process indicated that perfectionism began to impede therapeutic gain in approximately 2/3 of the sample, in the latter half of treatment, between the 9th and 12th sessions. Implications of these findings are discussed, including the possibility that more perfectionistic patients may be negatively impacted by anticipation of an arbitrary, externally imposed termination date. (PsycINFO Database Record (c) 2010 APA, all rights reserved)