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Mükemmeliyetçilik: Yapısı, Tanılar üstü Doğası ve Bilişsel Davranışçı Terapisi

Year 2022, , 518 - 525, 27.12.2022
https://doi.org/10.18863/pgy.1082001

Abstract

Her şeyin, kusursuz ve hatasız olması konusunda katı talepkarlık, tek bir doğrunun olduğuna inanma, bakış açısını ve düşünceleri değiştirmede güçlük gibi özelliklerle tanımlanan mükemmeliyetçilik kavramı, alanyazına yeni kazandırılan bir kavram olmamasına karşın son yıllarda hem bilimsel çalışmalarda hem de gündelik hayatta sıklıkla sözü geçen kavramlardan biridir. Kavramın özellikle bilimsel çalışmalarda revaçta oluşu, hem ikili doğasından (olumlu ve olumsuz içerikli oluşu) hem de çeşitli psikolojik sorunların kökeni, ortaya çıkışı, sürdürülmesi ve tedavisindeki olası rollerinden kaynaklanmaktadır. Nitekim, çok alt boyutlu olduğu ve iki üst boyuttan (mükemmeliyetçi çaba ve mükemmeliyetçi kaygı) oluştuğu yönündeki kanıt çokluğuna rağmen, halen bazı araştırmalarda farklı sayılardaki boyut sayısının kavramın yapısını daha iyi temsil ettiği belirtilmektedir. Yanı sıra, iki üst düzey boyutun, hangi alt düzey faktörlerden oluşacağı, bu boyutların bir araya gelmesinin kavramsal içeriğinin olumlu mu yoksa olumsuz mu olduğu ve bu boyutların toplam etkisinin nasıl hesaplanacağına yönelik farklı görüşler ve eleştiriler de mevcuttur. Mükemmeliyetçiliğin farklı psikopatolojiler ve eş tanı ile ilişkisi de pek çok çalışmada ele alınmıştır. Bu nedenle mükemmeliyetçiliği psikoterapi sürecinde ele almak önemlidir çünkü yalnız mükemmeliyetçi özelliklerin sağaltılması bile kavramın ilişkili olduğu birden fazla bozuklukta iyileşmeyi beraberinde getirebilir. Bu doğrultuda, Bilişsel Davranışçı Yaklaşım, mükemmeliyetçiliği (klinik mükemmeliyetçilik) kavramsallaştırmış ve terapi için teknikler sunmuştur. Mükemmeliyetçilik için Bilişsel Davranışçı Terapi’nin etkililiğine dair kanıtlar da gün geçtikçe artış göstermektedir. Bu nedenle bu yazıda, mükemmeliyetçiliğin yapısı, tanılar üstü doğası ve bilişsel davranışçı terapisi üzerine güncel yazın gözden geçirilmiştir.

References

  • Amerikan Psikiyatri Birliği (2013) Diagnostic and statistical manual of mental disorders (DSM-5®), Washington, DC, American Psychiatric Publishing.
  • Antony MM, Purdon CL, Huta V, Swinson RP (1998) Dimensions of perfectionism across the anxiety disorders. Behav Res Ther, 36(12):1143–54.
  • Arpin-Cribbie C, Irvine J, Ritvo P (2012) Web-based cognitive-behavioral therapy for perfectionism: a randomized controlled trial. Psychother Res, 22(2):194–207.
  • Bieling PJ, Summerfeldt LJ, Israeli AL, Antony MM (2004) Perfectionism as an explanatory construct in comorbidity of axis I disorders. J Psychopathol Behav Assess, 26(3):193–201.
  • Black J, Reynolds WM (2013) Examining the relationship of perfectionism, depression, and optimism: Testing for mediation and moderation. Pers Individ Dif, 54(3):426–31.
  • Bulik CM, Tozzi F, Anderson C, Mazzeo SE, Aggen S, Sullivan PF (2013) The relation between eating disorders and components of perfectionism. Am J Psychiatry, 160(2):366–8.
  • Burns DD (1980) The perfectionist’s script for self-defeat. Psychol Today, 14(6):34–52.
  • Egan SJ, Shafran R (2018) Cognitive-behavioral treatment for perfectionism In The psychology of perfectionism: Theory, research, applications, (Eds J Stoeber): 19-46. New York, Routledge.
  • Egan SJ, van Noort E, Chee A, Kane RT, Hoiles KJ, Shafran R et al. (2014b) A randomised controlled trial of face to face versus pure online self-help cognitive behavioural treatment for perfectionism. Behav Res Ther, 63:107–13.
  • Egan SJ, Wade TD, Shafran R (2011) Perfectionism as a transdiagnostic process: a clinical review. Clin Psychol Rev, 31(2):203–12.
  • Egan SJ, Wade TD, Shafran R (2014a) Cognitive-behavioral treatment of perfectionism. New York, Guilford Publications.
  • Enns MW, Cox BJ, Borger SC (2001) Correlates of analogue and clinical depression: a further test of the phenomenological continuity hypothesis. J Affect Disord, 66(2–3):175–83.
  • Fairburn CG, Cooper Z, Shafran R (2003). Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behav Res Ther, 41(5):509–28.
  • Flett GL, Blankstein KR, Hewitt PL, Koledin S (1992) Components of perfectionism and procrastination in college students. Soc Behav Pers, 20(2): 85–94.
  • Frost RO, Heimberg RG, Holt CS, Mattia JI, Neubauer AL (1993) A comparison of two measures of perfectionism. Pers Individ Dif, 14(1):119–26.
  • Frost RO, Marten P, Lahart C, Rosenblate R (1990) The dimensions of perfectionism. Cognit Ther Res, 14(5):449–68.
  • Galloway R, Watson H, Greene D, Shafran R, Egan SJ (2021) The efficacy of randomised controlled trials of cognitive behaviour therapy for perfectionism: a systematic review and meta-analysis. Cogn Behav Ther, 1–15.
  • Garner DM, Olmstead MP, Polivy J (1983) Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. Int J Eat Disord, 2(2):15–34.
  • Gaudreau P, Thompson A (2010) Testing a 2×2 model of dispositional perfectionism. Pers Individ Dif, 48(5):532–7.
  • Hamachek DE (1978) Psychodynamics of normal and neurotic perfectionism. Psychol, 15:27–33.
  • Handley AK, Egan SJ, Kane RT, Rees CS (2015) A randomised controlled trial of group cognitive behavioural therapy for perfectionism. Behav Res Ther, 68:37–47.
  • Hewitt PL, Flett GL (1991) Dimensions of perfectionism in unipolar depression. J Abnorm Psychol, 100(1):98–101.
  • Hewitt PL, Flett GL (1991) Perfectionism in the self and social contexts: conceptualization, assessment, and association with psychopathology. J Pers Soc Psychol, 60(3):456–70.
  • Hewitt PL, Flett GL, Ediger E (1996) Perfectionism and depression: longitudinal assessment of a specific vulnerability hypothesis. J Abnorm Psychol, 105(2):276–80.
  • Hewitt PL, Norton GR, Flett GL, Callander L, Cowan T (1998) Dimensions of perfectionism, hopelessness, and attempted suicide in a sample of alcoholics. Suicide Life Threat Behav, 28(4):395–406.
  • Hill AP (2014). Perfectionistic strivings and the perils of partialling. Int J Sport Exerc Psychol, 12(4):302–15.
  • Hill AP (2016) The psychology of perfectionism in sport, dance and exercise, London, Routledge.
  • Hill RW, Huelsman TJ, Araujo G (2010) Perfectionistic concerns suppress associations between perfectionistic strivings and positive life outcomes. Pers Individ Dif, 48(5):584–9.
  • Hollender MH (1965) Perfectionism. Compr Psychiatry, 6(2):94-103.
  • Howell J, Anderson R, Egan S, McEvoy P (2020) One factor? Two factor? Bi-factor? A psychometric evaluation of the Frost Multidimensional Scale and the Clinical Perfectionism Questionnaire. Cogn Behav Ther, 49(6):518–30.
  • Juster HR, Heimberg RG, Frost RO, Holt CS, Mattia JI, Faccenda K (1996) Social phobia and perfectionism. Pers Individ Dif, 21(3):403–10.
  • Kaçar-Başaran S, Arkar H (2022) Common vulnerability factors in obsessive-compulsive and major depressive disorders: a transdiagnostic hierarchical model. Curr Psychol. http://dx.doi.org/10.1007/s12144-021-02599-2
  • Kim LE, Chen L, MacCann C, Karlov L, Kleitman S (2015) Evidence for three factors of perfectionism: Perfectionistic Strivings, Order, and Perfectionistic Concerns. Pers Individ Dif, 84:16–22.
  • Moretz MW, McKay D (2009) The role of perfectionism in obsessive-compulsive symptoms: “not just right” experiences and checking compulsions. J Anxiety Disord, 23(5):640–4.
  • Obsesif-Kompulsif Bilişleri Çalışma Grubu (1997) Cognitive assessment of obsessive-compulsive disorder. Behav Res Ther, 35(7):667–81.
  • Rhéaume J, Freeston MH, Dugas MJ, Letarte H, Ladouceur R (1995) Perfectionism, responsibility and obsessive-compulsive symptoms. Behav Res Ther, 33(7):785–94.
  • Rice KG, Ashby JS, Slaney RB (1998) Self-esteem as a mediator between perfectionism and depression: A structural equations analysis. J Couns Psychol, 45(3):304–14.
  • Rice KG, Pence SL (2006) Perfectionism and obsessive-compulsive symptoms. J Psychopathol Behav Assess, 28(2):103–11.
  • Riley C, Lee M, Cooper Z, Fairburn CG, Shafran R (2007) A randomised controlled trial of cognitive-behaviour therapy for clinical perfectionism: A preliminary study. Behav Res Ther, 45(9):2221–31.
  • Robinson K, Wade TD (2021). Perfectionism interventions targeting disordered eating: A systematic review and meta-analysis. Int J Eat Disord, 54(4):473–87.
  • Shafran R, Cooper Z, Fairburn CG (2002). Clinical perfectionism: a cognitive–behavioural analysis. Behav Res Ther, 40(7):773–91.
  • Slaney RB, Rice KG, Mobley M, Trippi J, Ashby JS (2001) The revised almost perfect scale. Meas Eval Couns Dev, 34(3):130–45.
  • Smith MM, Saklofske DH (2017) The structure of multidimensional perfectionism: Support for a bifactor model with a dominant general factor. J Pers Assess, 99(3):297–303.
  • Smith MM, Vidovic V, Sherry SB, Stewart SH, Saklofske DH (2018) Are perfectionism dimensions risk factors for anxiety symptoms? A meta-analysis of 11 longitudinal studies. Anxiety Stress Coping, 31(1):4–20.
  • Stoeber J, Gaudreau P (2017). The advantages of partialling perfectionistic strivings and perfectionistic concerns: Critical issues and recommendations. Pers Individ Dif, 104:379–86.
  • Stoeber J, Hutchfield J, Wood KV (2008) Perfectionism, self-efficacy, and aspiration level: Differential effects of perfectionistic striving and self-criticism after success and failure. Pers Individ Dif, 45(4):323–7.
  • Stoeber J, Madigan DJ, Gonidis L (2020) Perfectionism is adaptive and maladaptive, but what’s the combined effect? Pers Individ Dif 2020; 109846. http://dx.doi.org/10.1016/j.paid.2020.109846
  • Stoeber J, Otto K (2006) Positive conceptions of perfectionism: approaches, evidence, challenges. Pers Soc Psychol Rev, 10(4):295–319.
  • Suh H, Sohn H, Kim T, Lee D-G (2019) A review and meta-analysis of perfectionism interventions: Comparing face-to-face with online modalities. J Couns Psychol, 66(4):473–86.
  • Terry-Short LA, Owens RG, Slade PD, Dewey ME (1995) Positive and negative perfectionism. Pers Individ Dif, 18(5):663–8.

Perfectionism: Its Structure, Transdiagnostic Nature, and Cognitive Behavioral Therapy

Year 2022, , 518 - 525, 27.12.2022
https://doi.org/10.18863/pgy.1082001

Abstract

The term perfectionism is often characterized by insisting that everything should be perfect and flawless, believing in only one truth, and having difficulty transforming perspectives and thoughts. Although perfectionism is not a newly introduced concept in the literature, it has recently become one frequently aired both in research and daily life. The popularity of the concept in empirical studies stems from both its dual nature and its alleged roles in the origin, emergence, retention, and treatment of various psychological disorders. Indeed, despite the abundance of evidence that perfectionism is multifaceted within two major dimensions (perfectionist strivings and perfectionist concerns), it is still debated that the dimensions in different numbers better represent the construct. In addition, the relevant literature hosts diverse views and criticisms about which sub-dimensions the two higher-order dimensions will consist of, whether the conceptual content of a combination of these sub-dimensions is positive or negative, and how to calculate the total impact of the sub-dimensions. On the other hand, previous research consistently addressed the relationship of perfectionism with different psychopathologies and comorbidities. In this respect, it is also deemed important to discuss perfectionism in psychotherapy because even settling perfectionist traits may bring about improvements in more than one disorder associated with perfectionism. Thus, the Cognitive Behavioral Approach (CBT) conceptualized perfectionism (clinical perfectionism) and presented techniques for therapy. Moreover, the evidence is also proliferating for the efficiency of CBT for perfectionism. Therefore, in this article, the current literature on the structure, transdiagnostic nature and cognitive behavioral therapy of perfectionism has been reviewed.

References

  • Amerikan Psikiyatri Birliği (2013) Diagnostic and statistical manual of mental disorders (DSM-5®), Washington, DC, American Psychiatric Publishing.
  • Antony MM, Purdon CL, Huta V, Swinson RP (1998) Dimensions of perfectionism across the anxiety disorders. Behav Res Ther, 36(12):1143–54.
  • Arpin-Cribbie C, Irvine J, Ritvo P (2012) Web-based cognitive-behavioral therapy for perfectionism: a randomized controlled trial. Psychother Res, 22(2):194–207.
  • Bieling PJ, Summerfeldt LJ, Israeli AL, Antony MM (2004) Perfectionism as an explanatory construct in comorbidity of axis I disorders. J Psychopathol Behav Assess, 26(3):193–201.
  • Black J, Reynolds WM (2013) Examining the relationship of perfectionism, depression, and optimism: Testing for mediation and moderation. Pers Individ Dif, 54(3):426–31.
  • Bulik CM, Tozzi F, Anderson C, Mazzeo SE, Aggen S, Sullivan PF (2013) The relation between eating disorders and components of perfectionism. Am J Psychiatry, 160(2):366–8.
  • Burns DD (1980) The perfectionist’s script for self-defeat. Psychol Today, 14(6):34–52.
  • Egan SJ, Shafran R (2018) Cognitive-behavioral treatment for perfectionism In The psychology of perfectionism: Theory, research, applications, (Eds J Stoeber): 19-46. New York, Routledge.
  • Egan SJ, van Noort E, Chee A, Kane RT, Hoiles KJ, Shafran R et al. (2014b) A randomised controlled trial of face to face versus pure online self-help cognitive behavioural treatment for perfectionism. Behav Res Ther, 63:107–13.
  • Egan SJ, Wade TD, Shafran R (2011) Perfectionism as a transdiagnostic process: a clinical review. Clin Psychol Rev, 31(2):203–12.
  • Egan SJ, Wade TD, Shafran R (2014a) Cognitive-behavioral treatment of perfectionism. New York, Guilford Publications.
  • Enns MW, Cox BJ, Borger SC (2001) Correlates of analogue and clinical depression: a further test of the phenomenological continuity hypothesis. J Affect Disord, 66(2–3):175–83.
  • Fairburn CG, Cooper Z, Shafran R (2003). Cognitive behaviour therapy for eating disorders: a “transdiagnostic” theory and treatment. Behav Res Ther, 41(5):509–28.
  • Flett GL, Blankstein KR, Hewitt PL, Koledin S (1992) Components of perfectionism and procrastination in college students. Soc Behav Pers, 20(2): 85–94.
  • Frost RO, Heimberg RG, Holt CS, Mattia JI, Neubauer AL (1993) A comparison of two measures of perfectionism. Pers Individ Dif, 14(1):119–26.
  • Frost RO, Marten P, Lahart C, Rosenblate R (1990) The dimensions of perfectionism. Cognit Ther Res, 14(5):449–68.
  • Galloway R, Watson H, Greene D, Shafran R, Egan SJ (2021) The efficacy of randomised controlled trials of cognitive behaviour therapy for perfectionism: a systematic review and meta-analysis. Cogn Behav Ther, 1–15.
  • Garner DM, Olmstead MP, Polivy J (1983) Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. Int J Eat Disord, 2(2):15–34.
  • Gaudreau P, Thompson A (2010) Testing a 2×2 model of dispositional perfectionism. Pers Individ Dif, 48(5):532–7.
  • Hamachek DE (1978) Psychodynamics of normal and neurotic perfectionism. Psychol, 15:27–33.
  • Handley AK, Egan SJ, Kane RT, Rees CS (2015) A randomised controlled trial of group cognitive behavioural therapy for perfectionism. Behav Res Ther, 68:37–47.
  • Hewitt PL, Flett GL (1991) Dimensions of perfectionism in unipolar depression. J Abnorm Psychol, 100(1):98–101.
  • Hewitt PL, Flett GL (1991) Perfectionism in the self and social contexts: conceptualization, assessment, and association with psychopathology. J Pers Soc Psychol, 60(3):456–70.
  • Hewitt PL, Flett GL, Ediger E (1996) Perfectionism and depression: longitudinal assessment of a specific vulnerability hypothesis. J Abnorm Psychol, 105(2):276–80.
  • Hewitt PL, Norton GR, Flett GL, Callander L, Cowan T (1998) Dimensions of perfectionism, hopelessness, and attempted suicide in a sample of alcoholics. Suicide Life Threat Behav, 28(4):395–406.
  • Hill AP (2014). Perfectionistic strivings and the perils of partialling. Int J Sport Exerc Psychol, 12(4):302–15.
  • Hill AP (2016) The psychology of perfectionism in sport, dance and exercise, London, Routledge.
  • Hill RW, Huelsman TJ, Araujo G (2010) Perfectionistic concerns suppress associations between perfectionistic strivings and positive life outcomes. Pers Individ Dif, 48(5):584–9.
  • Hollender MH (1965) Perfectionism. Compr Psychiatry, 6(2):94-103.
  • Howell J, Anderson R, Egan S, McEvoy P (2020) One factor? Two factor? Bi-factor? A psychometric evaluation of the Frost Multidimensional Scale and the Clinical Perfectionism Questionnaire. Cogn Behav Ther, 49(6):518–30.
  • Juster HR, Heimberg RG, Frost RO, Holt CS, Mattia JI, Faccenda K (1996) Social phobia and perfectionism. Pers Individ Dif, 21(3):403–10.
  • Kaçar-Başaran S, Arkar H (2022) Common vulnerability factors in obsessive-compulsive and major depressive disorders: a transdiagnostic hierarchical model. Curr Psychol. http://dx.doi.org/10.1007/s12144-021-02599-2
  • Kim LE, Chen L, MacCann C, Karlov L, Kleitman S (2015) Evidence for three factors of perfectionism: Perfectionistic Strivings, Order, and Perfectionistic Concerns. Pers Individ Dif, 84:16–22.
  • Moretz MW, McKay D (2009) The role of perfectionism in obsessive-compulsive symptoms: “not just right” experiences and checking compulsions. J Anxiety Disord, 23(5):640–4.
  • Obsesif-Kompulsif Bilişleri Çalışma Grubu (1997) Cognitive assessment of obsessive-compulsive disorder. Behav Res Ther, 35(7):667–81.
  • Rhéaume J, Freeston MH, Dugas MJ, Letarte H, Ladouceur R (1995) Perfectionism, responsibility and obsessive-compulsive symptoms. Behav Res Ther, 33(7):785–94.
  • Rice KG, Ashby JS, Slaney RB (1998) Self-esteem as a mediator between perfectionism and depression: A structural equations analysis. J Couns Psychol, 45(3):304–14.
  • Rice KG, Pence SL (2006) Perfectionism and obsessive-compulsive symptoms. J Psychopathol Behav Assess, 28(2):103–11.
  • Riley C, Lee M, Cooper Z, Fairburn CG, Shafran R (2007) A randomised controlled trial of cognitive-behaviour therapy for clinical perfectionism: A preliminary study. Behav Res Ther, 45(9):2221–31.
  • Robinson K, Wade TD (2021). Perfectionism interventions targeting disordered eating: A systematic review and meta-analysis. Int J Eat Disord, 54(4):473–87.
  • Shafran R, Cooper Z, Fairburn CG (2002). Clinical perfectionism: a cognitive–behavioural analysis. Behav Res Ther, 40(7):773–91.
  • Slaney RB, Rice KG, Mobley M, Trippi J, Ashby JS (2001) The revised almost perfect scale. Meas Eval Couns Dev, 34(3):130–45.
  • Smith MM, Saklofske DH (2017) The structure of multidimensional perfectionism: Support for a bifactor model with a dominant general factor. J Pers Assess, 99(3):297–303.
  • Smith MM, Vidovic V, Sherry SB, Stewart SH, Saklofske DH (2018) Are perfectionism dimensions risk factors for anxiety symptoms? A meta-analysis of 11 longitudinal studies. Anxiety Stress Coping, 31(1):4–20.
  • Stoeber J, Gaudreau P (2017). The advantages of partialling perfectionistic strivings and perfectionistic concerns: Critical issues and recommendations. Pers Individ Dif, 104:379–86.
  • Stoeber J, Hutchfield J, Wood KV (2008) Perfectionism, self-efficacy, and aspiration level: Differential effects of perfectionistic striving and self-criticism after success and failure. Pers Individ Dif, 45(4):323–7.
  • Stoeber J, Madigan DJ, Gonidis L (2020) Perfectionism is adaptive and maladaptive, but what’s the combined effect? Pers Individ Dif 2020; 109846. http://dx.doi.org/10.1016/j.paid.2020.109846
  • Stoeber J, Otto K (2006) Positive conceptions of perfectionism: approaches, evidence, challenges. Pers Soc Psychol Rev, 10(4):295–319.
  • Suh H, Sohn H, Kim T, Lee D-G (2019) A review and meta-analysis of perfectionism interventions: Comparing face-to-face with online modalities. J Couns Psychol, 66(4):473–86.
  • Terry-Short LA, Owens RG, Slade PD, Dewey ME (1995) Positive and negative perfectionism. Pers Individ Dif, 18(5):663–8.
There are 50 citations in total.

Details

Primary Language English
Subjects Psychology
Journal Section Review
Authors

Servet Kaçar Başaran 0000-0001-6614-1103

Publication Date December 27, 2022
Acceptance Date May 3, 2022
Published in Issue Year 2022

Cite

AMA Kaçar Başaran S. Perfectionism: Its Structure, Transdiagnostic Nature, and Cognitive Behavioral Therapy. Psikiyatride Güncel Yaklaşımlar. December 2022;14(4):518-525. doi:10.18863/pgy.1082001

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