Martin M. Antony

Is perfectionism good, bad, or both? Examining models of the perfectionism construct

Perfectionism has been conceptualized as a personality variable that underlies a variety of psychological difficulties. Recently, however, theorists and researchers have begun to distinguish between two distinct types of perfectionism, one a maladaptive form that results in emotional distress, and a second form that is relatively benign, perhaps even adaptive. In this study, we compared varying models of the perfectionism construct using the best known measures of perfectionism. In a sample of 198 students, three competing models of perfectionism were examined using confirmatory factor analysis. A model that incorporated two factors, one corresponding to maladaptive perfectionism and the other adaptive perfectionism, was a better fit to the data than a unitary perfectionism model. We also examined the relations of the two types of perfectionism, Maladaptive Evaluative Concerns and Positive Striving, to a well known measure of psychological distress. Maladaptive Evaluative Concerns was more strongly associated with depression, anxiety, stress, and test taking anxiety. Overall, this study supports the validity of a distinction between two types of perfectionism, and points to the importance of this duality for measurement and research on perfectionism.

Making the grade: the behavioural consequences of perfectionism in the classroom

Abstract The objective of this study was to examine the behavioural correlates of perfectionism in a real world achievement task and to assess whether perfectionism is associated with self regulation strategies, attributions, and behaviour that is self-defeating. We also examined the predictive validity of the distinction between adaptive and maladaptive perfectionism on our dependent measures. A total of 198 students completed questionnaires about perfectionism, their standards, attributions, and behaviours at two time points; one week before their mid-term exam, and one week after receiving their grades. Data were analyzed with a combination of correlational and between group statistics. Overall, individuals high in perfectionism set a higher standard for the exam, were more likely to fall short of their goals, and experienced more negative affect about the exam, whether they had met their goal or not. There were some important differences between adaptive and maladaptive perfectionism; adaptive perfectionism was associated with fewer negative consequences for this achievement situation. Over time, the behaviours and cognitive-emotional responses related to perfectionism could lead to significant distress and this research suggests an important potential pathway from perfectionism to psychopathology.

Psychological Treatments for Social Phobia

Objective: To review the empirical status of psychological treatments for social phobia (SP), commenting both on cognitive-behavioural interventions and on more recent iterations of those approaches. We also review the effective components of cognitive-behavioural therapy (CBT). Method: We qualitatively reviewed the empirical literature on the psychological treatment of SP. We include empirical studies, metaanalyses, and recent conference presentations in this review. Results: Cognitive and behavioural interventions for SP appear to be more effective than wait-list controls and supportive therapy. Comparisons of CBT and pharmacologic treatment have produced inconsistent results. Several new treatments for SP demonstrate promising results. Conclusion: Evidence suggests that various psychosocial treatments for SP are better than wait-list controls and credible placebo interventions. Ongoing projects investigate the relative efficacy of combining medication and psychosocial treatments over monotherapies; this line of research is important to continue. Further research should also focus on which components of CBT are most effective.

Evidence-based assessment of anxiety disorders in adults.

This article discusses issues related to the development and dissemination of evidence-based assessment strategies for anxiety disorders and associated problems. It begins with a review of the criteria that should be considered when determining whether particular assessment procedures are evidence-based. These include such factors as reliability, validity, cost-effectiveness, consumer acceptability, utility across different populations, and ease of dissemination. The importance of considering the purpose of the assessment process when deciding whether a procedure is evidence-based is emphasized. Next, the major assessment domains that are particularly important in the area of anxiety disorders (e.g., triggers for anxiety symptoms, avoidance behaviors) are reviewed. Finally, some potential obstacles to the dissemination of evidence-based assessment procedures are discussed along with suggestions for managing these obstacles.

Screening for obsessive and compulsive symptoms: validation of the Clark-Beck Obsessive-Compulsive Inventory.

The 25-item Clark-Beck Obsessive-Compulsive Inventory (CBOCI) was developed to assess the frequency and severity of obsessive and compulsive symptoms. The measure uses a graded-response format to assess core symptom features of obsessive-compulsive disorder (OCD) based on Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994) criteria and current cognitive-behavioral formulations. Revisions were made to the CBOCI on the basis of psychometric and item analyses of an initial pilot study of clinical and nonclinical participants. The construct validity of the revised CBOCI was supported in a subsequent validation study involving OCD, nonobsessional clinical, and nonclinical samples. A principal-factor analysis of the 25 items found 2 highly correlated factors of Obsessions and Compulsions. OCD patients scored significantly higher on the measure than nonobsessional anxious, depressed, and nonclinical samples. The questionnaire had strong convergent validity with other OCD symptom measures but more modest discriminant validity.

Perfectionism as an Explanatory Construct in Comorbidity of Axis I Disorders

Understanding comorbidity is an important challenge for psychopathology researchers and diagnostic systems given the repeated finding of very high comorbidity rates among Axis I disorders in psychiatric samples. This paper proposes that perfectionism may be a critical factor for understanding levels of comorbidity, and a conceptual argument for the importance of perfectionism as an explanatory construct for comorbidity is advanced. The link between perfectionism and comorbidity in a large sample of patients (N = 345) who attended an anxiety disorders clinic is examined using a variety of methods. Diagnoses were established using the Structured Clinical Interview for DSM-IV (SCID-IV), and perfectionism was assessed using both the Hewitt and Flett and Frost Multidimensional Perfectionism Scales. Overall, scores on both the Hewitt and Flett and Frost perfectionism scales were correlated with the number of diagnoses, and a logistic regression analysis, controlling for current symptoms, showed that maladaptive evaluative concerns perfectionism in particular predicted higher levels of comorbidity.

In the absence of rose-colored glasses: Ratings of self-attributes and their differential certainty and importance across multiple dimensions in social phobia

Sixty-seven individuals with social phobia (social anxiety disorder) and 60 healthy controls rated their perceived standing relative to others on 13 self-attribute dimensions, their level of certainty concerning those standings, and the importance of each dimension. As expected, individuals with social phobia provided self-ratings that were significantly more negative than controls across all dimensions. In addition, positive self-views were equated with higher levels of certainty and importance for controls, but not for individuals with social phobia. Thus, whereas reports of control participants reflected a healthy, positive framing of self-views, the ratings of clinical participants demonstrated an orientation toward self-framing that was neither positive nor negative. Together, these novel findings shed light on the nature of self-appraisals in social anxiety. Implications of these results are discussed in terms of contemporary cognitive-behavioral models of social phobia.

Different neural responses to stranger and personally familiar faces in shy and bold adults.

The shy-bold continuum is a fundamental behavioral trait conserved across human and nonhuman animals. Individual differences along the shy-bold continuum are presumed to arise from, and are maintained by, differences in the excitability of forebrain limbic areas involved in the evaluation of stimulus saliency. To test this hypothesis, the authors conducted an event-related functional MRI (fMRI) study in which brain scans were acquired on shy and bold adults during the presentation of neutral stranger and personally familiar faces. Shy adults exhibited greater bilateral amygdala activation during the presentation of stranger faces and greater left amygdala activation during personally familiar faces than their bold counterparts. Bold adults exhibited greater bilateral nucleus accumbens activation in response to stranger and personally familiar faces than shy adults. Findings suggest that there are distinct neural substrates underlying and maintaining individual differences along a shy-bold continuum in humans.

Establishing a trait anxiety threshold that signals likelihood of anxiety disorders

Abstract Evidence suggests that the State Trait Inventory for Cognitive and Somatic Anxiety (STICSA) may be a more pure measure of anxiety than other commonly used scales. Further, the STICSA has excellent psychometric properties in both clinical and nonclinical samples. The present study aimed to extend the utility of the STICSA – Trait version by identifying a cut-off score that could differentiate a group of clinically diagnosed anxiety disorder patients (n=398) from a group of student controls (n =439). Two receiver operating characteristic curve analyses indicated cut-off scores of 43 (sensitivity=.73, specificity=.74, classification accuracy=.74) and 40 (sensitivity=.80, specificity=.67, classification accuracy=.73), respectively. In a large community sample (n =6685), a score of 43 identified 11.5% of individuals as probable cases of clinical anxiety, while a score of 40 identified 17.0% of individuals as probable cases of clinical anxiety. As a result of differences in sensitivity and specificity, the present findings suggest a cut-off score of 43 is optimal to identify probable cases of clinical anxiety, while a cut-off score of 40 is optimal to screen for the possible presence of anxiety disorders.

Assessment and Treatment of Social Phobia

Social phobia is an anxiety disorder characterized by heightened fear and avoidance of one or more social or performance situations, including public speaking, meeting new people, eating or writing in front of others, and attending social gatherings. People with social phobia are typically anxious about the possibility that others will evaluate them negatively and/or notice symptoms of their anxiety. Social phobia affects up to 13% of individuals at some time in their lives and is usually associated with at least moderate functional impairment. Research on the nature and treatment of social phobia has increased dramatically over the past decade. As with many of the anxiety disorders, sensitive assessment instruments and effective treatments now exist for people suffering from heightened social anxiety. Typical assessment strategies include clinical interviews, behavioural assessments, monitoring diaries, and self-report questionnaires. Treatments with demonstrated efficacy for social phobia include pharmacotherapy (for example, phenelzine, moclobemide, selective serotonin reuptake inhibitor [SSRI] medications) and cognitive behaviour therapy (CBT) (for example, cognitive restructuring, in vivo exposure, social skills training). Although preliminary comparative studies suggest that both approaches are about equally effective in the short term, each approach has advantages and disadvantages over the other. Trials examining combined psychological and pharmacological treatments are now under way, although no published data on the relative efficacy of combined treatments are currently available.