Subtypes of Adaptive and Maladaptive Perfectionism in Anorexia Nervosa: Associations with Eating Disorder and Affective Symptoms

  • Ann F. Haynos
  • Linsey M. Utzinger
  • Jason M. Lavender
  • Ross D. Crosby
  • Li Cao
  • Carol B. Peterson
  • Scott J. Crow
  • Stephen A. Wonderlich
  • Scott G. Engel
  • James E. Mitchell
  • Daniel Le Grange
  • Andrea B. Goldschmidt
Article

Abstract

Perfectionism is hypothesized to contribute to the etiology of anorexia nervosa (AN). However, there is little research regarding whether individuals with AN can be classified according to maladaptive (e.g., evaluative concerns) and adaptive (e.g., high personal standards) facets of perfectionism that predict distinct outcomes and might warrant different intervention approaches. In this study, a latent profile analysis was conducted using data from adults with AN (n = 118). Frost Multidimensional Perfectionism Scale (Frost et al. Cognitive Therapy and Research, 14(5), 449–46, 1990) subscales were used to identify subgroups differing according to endorsed perfectionism features (e.g., adaptive and maladaptive perfectionism). Generalized linear models were used to compare subgroups on eating disorder and affective symptoms measured through questionnaire and ecological momentary assessment. Four subgroups were identified: (a) Low Perfectionism; (b) High Adaptive and Maladaptive Perfectionism; (c) Moderate Maladaptive Perfectionism; and (d) High Maladaptive Perfectionism. Subgroups differed on overall eating disorder symptoms (p < .001), purging (p = .005), restrictive eating (p < .001), and body checking (p < .001) frequency, depressive (p < .001) and anxiety (p < .001) symptoms, and negative (p = .001) and positive (p < .001) affect. The Low Perfectionism group displayed the most adaptive scores and the Moderate and High Maladaptive Perfectionism groups demonstrated the most elevated clinical symptoms. The High Adaptive and Maladaptive Perfectionism group demonstrated low affective disturbances, but elevated eating disorder symptoms. Results support the clinical significance of subtyping according to perfectionism dimensions in AN. Research is needed to determine if perfectionism subtyping can enhance individualized treatment targeting in AN.

Keywords

Adaptive perfectionism Maladaptive perfectionism Anorexia nervosa Eating disorder 

Notes

Compliance with Ethical Standards

Conflict of Interest

Ann F. Haynos, Linsey M. Utzinger, Jason M. Lavender, Ross D. Crosby, Li Cao, Carol B. Peterson, Scott J. Crow, Stephen A. Wonderlich, Scott G. Engel, James E. Mitchell, Daniel Le Grange and Andrea B. Goldschmidt declare that they have no conflict of interest.

Experiment Participants

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Ann F. Haynos
    • 1
  • Linsey M. Utzinger
    • 2
  • Jason M. Lavender
    • 3
  • Ross D. Crosby
    • 4
    • 5
  • Li Cao
    • 4
  • Carol B. Peterson
    • 1
    • 6
  • Scott J. Crow
    • 1
    • 6
  • Stephen A. Wonderlich
    • 4
    • 5
  • Scott G. Engel
    • 4
    • 5
  • James E. Mitchell
    • 4
    • 5
  • Daniel Le Grange
    • 7
  • Andrea B. Goldschmidt
    • 8
  1. 1.Department of PsychiatryUniversity of MinnesotaMinneapolisUSA
  2. 2.Department of Psychiatry and Behavioral SciencesStanford UniversityStanfordUSA
  3. 3.Department of PsychiatryUniversity of CaliforniaSan DiegoUSA
  4. 4.Neuropsychiatric Research InstituteFargoUSA
  5. 5.Department of Psychiatry and Behavioral ScienceUniversity of North DakotaFargoUSA
  6. 6.The Emily ProgramMinneapolisUSA
  7. 7.Department of PsychiatryUniversity of California, San FranciscoSan FranciscoUSA
  8. 8.Department of Psychiatry and Human Behavior, The Miriam Hospital/Weight Control and Diabetes Research CenterWarren Alpert Medical School of Brown UniversityProvidenceUSA

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