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

Too strict or too loose? Perfectionism and impulsivity: the relation with eating disorder symptoms using a person-centered approach

Although both perfectionism (i.e. personal standards perfectionism and evaluative concerns perfectionism) and impulsivity have been shown to be implicated in eating disorders, no previous studies have examined the interplay between both personality dimensions in their association with eating disorder symptoms. This is the first study to investigate the relationship between empirically derived personality subtypes based on perfectionism and impulsivity and eating disorder symptoms (i.e., dietary restraint, and concerns over eating, weight and shape). Cluster analysis was used to establish naturally occurring combinations of perfectionism and impulsivity in adolescent boys and girls (N=460; M age=14.2 years, SD=.90). Evidence was obtained for four personality profiles: (1) a resilient subtype (low on perfectionism and impulsivity), (2) pure impulsivity subtype (high on impulsivity only), (3) pure perfectionism subtype (high on perfectionism only), and (4) combined perfectionism/impulsivity subtype (high on both perfectionism and impulsivity). Participants in these four clusters showed differences in terms of eating disorder symptoms in that participants with a combination of high perfectionism and high impulsivity (rather than the presence of one of these two characteristics alone) had the highest levels of ED symptoms. These findings shed new light on extant theories concerning ED.publisher: Elsevier articletitle: Too strict or too loose? Perfectionism and impulsivity: The relation with eating disorder symptoms using a person-centered approach journaltitle: Eating Behaviors articlelink: http://dx.doi.org/10.1016/j.eatbeh.2013.10.013 content_type: article copyright: Copyright © 2013 Elsevier Ltd. All rights reserved.status: publishe

Fostering self-endorsed motivation to change in patients with an eating disorder: the role of perceived autonomy support and psychological need satisfaction

Objective: Although several studies have established the beneficial effects of self-endorsed forms of motivation for lasting therapeutic change, the way patients with an eating disorder can be encouraged to volitionally pursue change has received less attention. On the basis of Self-Determination Theory, this longitudinal study addressed the role of an autonomy-supportive environment and psychological need satisfaction in fostering self-endorsed motivation for change and subsequent weight gain. Method: Female inpatients (n = 84) with mainly anorexia nervosa and bulimia nervosa filled out questionnaires at the onset of, during, and at the end of treatment regarding their perceived autonomy support from parents, staff members, and fellow patients, their psychological need satisfaction, and their reasons for undertaking change. Furthermore, the Body Mass Index (BMI) of the patients at the onset and end of treatment was assessed by the staff. Path analyses were used to investigate the relations between these constructs. Results: At the start of treatment, perceived parental autonomy support related positively to self-endorsed motivation through psychological need satisfaction. Perceived staff and fellow patients autonomy support related to changes in self-endorsed motivation over the course of treatment through fostering change in psychological need satisfaction. Finally, relative increases in self-endorsed motivation related to relative increases in BMI throughout treatment in a subgroup of patients with anorexia nervosa. Discussion: These results point to the importance of an autonomy-supportive context for facilitating self-endorsed motivation

The body perfect ideal and eating regulation goals: investigating the role of adolescents' identity styles

Adolescents are exposed to images depicting the thin or muscular ideal almost on a daily basis. When the body perfect ideal is adopted, adolescents are at increased risk for developing unhealthy and disordered eating behaviors. The aim of the current 3-wave longitudinal study among adolescents (N = 418; 54 % girls) was to investigate whether different styles of identity exploration (i.e., information-oriented, normative, and diffuse-avoidant) are associated differentially with changes in adoption of the body perfect ideal, which, in turn, would relate to changes in appearance-focused and health-focused eating regulation. Results indicated that the information-oriented style predicted decreases and the normative style predicted increases in adoption of the body perfect ideal. In turn, adoption of the body perfect ideal predicted significant increases in appearance-focused eating regulation but not in health-focused eating regulation. A diffuse-avoidant style was unrelated to changes in adoption of the body perfect, yet directly predicted decreases in health-focused eating regulation. Theoretical and clinical implications of these findings are discussed

Self-critical perfectionism and binge eating symptoms: a longitudinal test of the intervening role of psychological need frustration

Although abundant research has shown that self-critical perfectionism relates to binge eating symptoms, fewer studies have addressed the role of intervening processes that might explain why this is the case. Grounded in Self-Determination Theory, we hypothesized that self-critical perfectionism would relate to an increased risk for binge eating symptoms because it engenders frustration of the psychological needs for autonomy, competence, and relatedness. This hypothesis was tested in a sample of 566 adolescents (72% female; mean age 13.3 = years) using a three-wave longitudinal study with a 6-months interval. Structural equation modeling analyses showed that self-critical perfectionism related to increases in psychological need frustration which, in turn, predicted increases in binge eating symptoms. Structural relations were found to be equivalent for males and females. Theoretical and clinical implications of these findings are discussed