Een kritische analyse van het begrip perfectionisme in relatie tot eetstoornissen

Clinical experience and research established a strong relationship between perfectionism and eating disorders. The view on perfectionism has changed substantially during the last decades, such that it was first considered a unidimensional and pathological intrapersonal feature and was later considered from a multidimensional perspective. The latter approach distinguished between maladaptive and relatively more adaptive features of, perfectionism. In this review article, we provide an empirical overview of research on the role of perfectionism in eating disorders from a conceptual perspective. This overview suggests that, although both adaptive and maladaptive perfectionism are involved in eating disorders, the effects of maladaptive perfectionism are more consistent and pronounced than the effects of adaptive perfectionism. We provide some critical notes and identify some problems in extant perfectionism research and review existing treatments of perfectionism within the context of eating disorders

Perfectionism, body dissatisfaction, and bulimic symptoms: the intervening role of perceived pressure to be thin and thin ideal internalization

Mounting evidence suggests that perfectionism contributes to the development and maintenance of eating disorder (ED) symptoms. Research adopting a multidimensional conceptualization of perfectionism has shown evaluative concerns (EC) perfectionism to be more strongly associated with ED pathology compared to personal standards (PS) perfectionism. However, less research has addressed the underlying mechanisms accounting for these relations. Based on the sociocultural theory, the aim of this study was to examine perceived pressure to be thin and thin ideal internalization as intervening variables through which PS and EC perfectionism could relate to body dissatisfaction and bulimic symptoms. A total of 559 adolescents (59% female; mean age = 13.9 years) participated in a three-wave longitudinal study. Structural equation modeling (SEM) analyses showed that EC perfectionism and PS perfectionism were related differentially to the intervening variables, with EC perfectionism being primarily related to perceived pressure to be thin and with PS perfectionism being primarily related to thin ideal internalization. Further, whereas EC perfectionism was related to increases in bulimic symptoms both directly and indirectly, PS perfectionism was only indirectly related to body dissatisfaction and bulimic symptoms through the sociocultural variables

Understanding limitations in at-work productivity in patients with active ankylosing spondylitis : the role of work-related contextual factors

Objective: To explore the effect of health-related and contextual factors on presenteeism, absenteeism, and overall work productivity loss in patients with active ankylosing spondylitis (AS). Methods: Consecutive patients with AS starting their first tumor necrosis factor inhibitor and in paid employment were eligible. Patients completed the Work Productivity and Activity Impairment (WPAI) questionnaire for AS to assess presenteeism, absenteeism, and overall work productivity loss in the previous 7 days. In addition, they answered questions about work characteristics (type, characteristics of workplace, satisfaction of contacts with colleagues, and importance of work in life) and health status [Bath AS Functional Index (BASFI), AS Disease Activity Score-C-reactive protein (ASDAS-CRP)]. Physicians assessed the Bath Ankylosing Spondylitis Metrology Index, presence of articular and extraarticular manifestations, comorbidities, and laboratory indicators of inflammation. Stepwise regression models were computed to determine which work-related and health-related factors contributed to WPAI outcomes. Results: The study included 80 patients. The WPAI presenteeism, absenteeism, and overall work productivity loss scores were 49.1%, 30.2%, and 53.1%, respectively. Presenteeism was associated with higher BASFI, female sex, and poor quality of contact with colleagues. Absenteeism was associated with increasing age, current smoking status, higher ASDAS-CRP, and low importance of work for life. Overall work productivity loss was associated with female sex, higher BASFI, past adaptation of job because of illness, number of working hours, and manual profession. Conclusion: Both health-related and contextual factors contribute to work limitations in patients with AS and suggest additional opportunities for improvement by addressing the working environment