Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-23T18:46:29.313Z Has data issue: false hasContentIssue false
  • English
  • Français

The relationship between perfectionism and self-esteem in adults: a systematic review and meta-analysis

Published online by Cambridge University Press:  16 September 2024

Viyona Khossousi Open the ORCID record for Viyona Khossousi [Opens in a new window] ,
Danyelle Greene Open the ORCID record for Danyelle Greene [Opens in a new window] ,
Roz Shafran Open the ORCID record for Roz Shafran [Opens in a new window] ,
Thomas Callaghan Open the ORCID record for Thomas Callaghan [Opens in a new window] ,
Sheree Dickinson Open the ORCID record for Sheree Dickinson [Opens in a new window]  and
Sarah J. Egan Open the ORCID record for Sarah J. Egan [Opens in a new window]
Viyona Khossousi
Affiliation:
Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
Danyelle Greene
Affiliation:
Discipline of Tourism, School of Business, The University of Queensland, Brisbane, Australia
Roz Shafran
Affiliation:
Great Ormond Street Institute of Child Health, University College London, London, UK
Thomas Callaghan
Affiliation:
Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
Sheree Dickinson
Affiliation:
Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia
Sarah J. Egan*
Affiliation:
Discipline of Psychology, School of Population Health, Curtin University, Perth, Australia enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
*
Corresponding author: Sarah J. Egan; Email: [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Background:

Perfectionism dimensions, including perfectionistic strivings and perfectionistic concerns, have a significant positive association with psychopathology. Clinical perfectionism is defined as when an individual’s self-esteem is excessively reliant on meeting high standards despite negative consequences. Numerous studies have found that higher perfectionistic concerns correlate with lower self-esteem; however, evidence for the association with perfectionistic strivings has been mixed.

Aims:

The focus of this systematic review and meta-analysis was to inform theoretical understanding of the relationships between perfectionism dimensions and self-esteem in adults.

Method:

A systematic literature search was conducted in Medline, PsycINFO, PsychARTICLES, ProQuest Central, and Scopus on 31 May 2023.

Results:

There were 83 articles included, with 32,304 participants (Mage=∼24.66 years). There was a significant negative moderate pooled association between self-esteem and perfectionistic concerns, r=–.42, 95% CI [–0.47 to –0.38]. A significant negligible positive pooled association was found between self-esteem and perfectionistic strivings, r=.06, 95% CI [0.01 to 0.11]. Results indicate higher perfectionistic concerns is associated with lower self-esteem, providing indirect support for the cognitive-behavioural model of clinical perfectionism.

Conclusions:

Future research should compare cognitive behaviour therapy for perfectionism to treatments for low self-esteem on outcomes of perfectionistic concerns and psychopathology.

Keywords

meta-analysisperfectionismself-esteemsystematic review
Type
Main
Information
Behavioural and Cognitive Psychotherapy , First View , pp. 1 - 20
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of British Association for Behavioural and Cognitive Psychotherapies

Introduction

Perfectionism has been proposed to be a transdiagnostic process across numerous psychological disorders (Egan et al., Reference Egan, Wade and Shafran2011). The Multidimensional Perfectionism Scales (FMPS, Frost et al., Reference Frost, Marten, Lahart and Rosenblate1990; HMPS, Hewitt and Flett, Reference Hewitt and Flett1991) have consistently been found to load on the two perfectionism dimensions of perfectionistic concerns (rumination over mistakes and the belief others expect the individual to be perfect), and perfectionistic strivings (striving towards high standards) (Smith and Saklofske, Reference Smith and Saklofske2017).

Another definition of perfectionism is clinical perfectionism, defined as self-esteem based on striving to meet high standards despite negative consequences (e.g. anxiety and depression) (Shafran et al., Reference Shafran, Cooper and Fairburn2002). The definition of clinical perfectionism emphasises both perfectionistic strivings and concerns as relevant to psychopathology if an individual bases their self-worth on their achievement of high standards (Shafran et al., Reference Shafran, Cooper and Fairburn2002). The cognitive-behavioural model of clinical perfectionism (Shafran et al., Reference Shafran, Cooper and Fairburn2002; Shafran et al., Reference Shafran, Egan and Wade2010) includes a range of processes that maintain clinical perfectionism, including for example, performance checking behaviours, re-setting standards higher following both success and failure, and a number of cognitive biases that the individual engages in (i.e. discounting success and focusing on flaws in performance). The Clinical Perfectionism Questionnaire (CPQ; Fairburn et al., Reference Fairburn, Cooper and Shafran2003) has been used to measure clinical perfectionism. Various studies have found different factor solutions, consisting of single, bi-factor and two factor solutions, consistent with an overall clinical perfectionism construct, in addition to factors congruent with both perfectionistic strivings and perfectionistic concerns (Egan et al., Reference Egan, Shafran, Lee, Fairburn, Cooper, Doll, Palmer and Watson2016; Howell et al., Reference Howell, Anderson, Egan and McEvoy2020; Prior et al., Reference Prior, Erceg-Hurn, Raykos, Egan, Byrne and McEvoy2018; Shu et al., Reference Shu, O’Brien, Watson, Anderson, Wade, Kane, Lampard and Egan2020).

A significant moderate positive association has been found between perfectionistic concerns and symptoms of anxiety, depression, obsessive-compulsive disorder (OCD), and eating disorders in adults (r=.33 to r=.43; e.g. Callaghan et al., Reference Callaghan, Greene, Shafran, Lunn and Egan2023; Stackpole et al., Reference Stackpole, Greene, Bills and Egan2023). Similarly, in adult samples, significant, although smaller correlations have been found between perfectionistic strivings and symptoms of anxiety, depression, OCD and eating disorders (r=.10 to r=.21; e.g. Callaghan et al., Reference Callaghan, Greene, Shafran, Lunn and Egan2023; Stackpole et al., Reference Stackpole, Greene, Bills and Egan2023). Indeed, higher perfectionistic concerns have been found to consistently relate to other correlates of poor mental health, including low self-esteem. Low self-esteem can be defined as a negative view toward oneself and poor self-worth, operationalised as low scores on common measures of self-esteem, such as Rosenberg’s (Reference Rosenberg1965) Self-Esteem Scale (RSES). Moderate to large negative associations have been found between self-esteem and perfectionistic concerns in numerous studies, indicating higher perfectionistic concerns is related to lower self-esteem (e.g. Jayakumar et al., Reference Jayakumar, Sudhir and Mariamma2016; Juwono et al., Reference Juwono, Kun, Demetrovics and Urbàn2022; Moroz and Dunkley, Reference Moroz and Dunkley2015; Murray et al., Reference Murray, Rieger, Karlov and Touyz2013; Piotrowski et al., Reference Piotrowski, Bojanowska, Nowicka and Janasek2023; Raedeke et al., Reference Raedeke, Blom and Kenttä2021). Similarly, meta-analytic evidence of longitudinal studies has demonstrated that low-self-esteem is associated with higher symptoms of anxiety, depression (Sowislo and Orth, Reference Sowislo and Orth2013), and eating disorders (Krauss et al., Reference Krauss, Dapp and Orth2023). The meta-analyses have demonstrated reciprocal effects between self-esteem and psychopathology, where self-esteem both leads to and is reduced by psychopathology (Krauss et al., Reference Krauss, Dapp and Orth2023; Sowislo and Orth, Reference Sowislo and Orth2013).

Unlike the association between perfectionism and psychopathology which has been summarised in numerous meta-analyses (e.g. Bills et al., Reference Bills, Greene, Stackpole and Egan2023; Callaghan et al., Reference Callaghan, Greene, Shafran, Lunn and Egan2023; Limburg et al., Reference Limburg, Watson, Hagger and Egan2017; Lunn et al., Reference Lunn, Greene, Callaghan and Egan2023; Smith et al., Reference Smith, Sherry, Ray, Hewitt and Flett2021; Stackpole et al., Reference Stackpole, Greene, Bills and Egan2023), to date there has been no meta-analysis of the relationship between perfectionism and self-esteem.

It is important to understand processes such as perfectionism which relate to low self-esteem, given the consistent relationship between self-esteem and psychopathology to further understand correlates of low self-esteem (Zeigler-Hill, Reference Zeigler-Hill2011). Furthermore, there are inconsistent associations between perfectionistic strivings and self-esteem, with some studies indicating a non-significant relationship (e.g. Moroz and Dunkley, Reference Moroz and Dunkley2015; Piotrowski et al., Reference Piotrowski, Bojanowska, Nowicka and Janasek2023), some a negative relationship (e.g. Murray et al., Reference Murray, Rieger, Karlov and Touyz2013; Jayakumar et al., Reference Jayakumar, Sudhir and Mariamma2016; Raedeke et al., Reference Raedeke, Blom and Kenttä2021), while others indicate a positive relationship (e.g. Barnes and Caltabianco, Reference Barnes and Caltabiano2017; Chen et al., Reference Chen, Zhong, Cao, Jin, Wang, Ling, Cen, Zhu, Yao, Zheng and Yi2017; Chou et al., Reference Chou, Huang, Lin, Lu, Chiu and Chen2019; Trumpeter et al., Reference Trumpeter, Watson and O’Leary2006).

Given the mixed directions of association and inconsistency in findings, it would be useful to summarise in a meta-analysis the associations between perfectionistic concerns and strivings, and self-esteem to gain clarity on the relationship between perfectionism and self-esteem. Understanding the relationships between perfectionism dimensions and self-esteem has important theoretical implications, particularly for understanding clinical perfectionism, where it is hypothesised that self-esteem is based on striving for high standards (Shafran et al., Reference Shafran, Cooper and Fairburn2002). The cognitive-behavioural approach to self-esteem also suggests that self-esteem and perfectionism are closely related, with the latter being a compensatory strategy to hide low self-esteem (Fennell, Reference Fennell2009). Gaining insight into the associations between the dimensions of perfectionism may provide a direction for future research on how to improve treatments aimed at decreasing perfectionism and improving self-esteem as transdiagnostic processes that maintain psychopathology (Egan et al., Reference Egan, Wade and Shafran2011; Fennell, Reference Fennell2009).

The aim of this systematic review and meta-analysis was to examine the association between perfectionistic strivings, perfectionistic concerns, and self-esteem in adults. We chose to restrict to adult samples rather than include studies across age ranges including children and adolescents given the rationale of developmental differences potentially impacting the results and that associations should be considered separately between youth and adults (Bills et al., Reference Bills, Greene, Stackpole and Egan2023; Lunn et al., Reference Lunn, Greene, Callaghan and Egan2023). Based on previous meta-analyses of the relationship between perfectionism dimensions and psychopathology (Bills et al., Reference Bills, Greene, Stackpole and Egan2023; Callaghan et al., Reference Callaghan, Greene, Shafran, Lunn and Egan2023; Lunn et al., Reference Lunn, Greene, Callaghan and Egan2023; Stackpole et al., Reference Stackpole, Greene, Bills and Egan2023) we predicted there would be a significant moderate negative pooled association between perfectionistic concerns and self-esteem. Given the mixed evidence to date regarding the association between perfectionistic strivings and self-esteem, with some studies finding a negative association, others finding no association, whilst others demonstrating positive correlations, we did not outline a hypothesis for this aim.

Method

The search terms and research protocol were registered on PROSPERO on 23 May 2023, prior to the search (Registration ID: CRD42023425443). The PRISMA guidelines (Page et al., Reference Page, McKenzie, Bossuyt, Boutron, Hoffmann, Mulrow, Shamseer, Tetzlaff, Akl, Brennan, Chou, Glanville, Grimshaw, Hrobjartsson, Lalu, Li, Loder, Mayo-Wilson, McDonald and Moher2021) were adhered to. The research conformed to the Declaration of Helsinki.

Inclusion and exclusion criteria

Studies were judged against the following inclusion criteria: (1) mean age of sample ≥18 years, or a minimum age of 18 in the age range when the mean was not available; (2) included a correlation or convertible effect size between self-esteem and perfectionism; (3) included a standardised measure of perfectionism and self-esteem; (4) reported unadjusted effect sizes; (5) correlational study designs or reported a group comparison; (6) published, quantitative research in peer-reviewed journals reported in English; and (7) from any country, published between 1 January 1990 and 31 May 2023. The rationale for using articles from 1990 onwards was this was the year of publication of the first multi-dimensional measure of perfectionism (FMPS; Frost et al., Reference Frost, Marten, Lahart and Rosenblate1990). Exclusion criteria were grey literature, qualitative studies, dissertations, study protocols, case conferences, and unpublished data.

Search strategy and selection process

A literature search was conducted on 31 May 2023 on PsycINFO, OVID Medline, PsychARTICLES, Scopus, and ProQuest Central. The search terms were decided by S.E. and R.S., and preliminary searches and search strategy were guided by a senior health librarian at Curtin University. The search terms were (perfectionis*) AND (self-esteem OR self-worth OR self-evaluation). Although we were interested in finding studies that were on self-esteem and included a specific measure of measure of self-esteem, the terms self-worth and self-evaluation were added to potentially detect relevant articles where self-esteem may not have been specifically mentioned in an abstract. The senior author (S.E.) trained V.K. (an Honours in psychology student) in how to perform article screening, who screened 100% of articles at title and abstract, and full text levels. A second independent assessor, another Honours student in psychology (S.D.), screened a random 30% of the studies at title and abstract (n=518) and full text (n=59) level. The two assessors (V.K., S.D.) worked independently and were blind to each other’s ratings. Cohen’s kappa coefficient was used to assess inter-rater reliability between the assessors and was calculated in SPSS (version 28; IBM Corporation, 2021). Kappa coefficients were interpreted as: no agreement (κ<0), slight agreement (κ=.01–.20), fair agreement (κ=.21–.40), moderate agreement κ =.41–.60), substantial agreement (κ=.61–.80), or near perfect agreement (κ=.81–.99) (Landis and Koch, Reference Landis and Koch1977). Inter-rater reliability between the first and second reviewers demonstrated substantial agreement at the title and abstract level (κ=.68) and near-perfect agreement at the full-text level (κ=.94). Discrepancies in study eligibility were discussed with S.E. until consensus was reached.

Data extraction and management

Data extraction was performed by V.K. and included Pearson’s correlation coefficients, sample size, study design, population (e.g. clinical or non-clinical), the instrument(s) used to measure self-esteem and perfectionism, the country where the study was conducted, gender, mean age of the sample including standard deviation and age range. In cases where studies did not report a correlation coefficient or the data required to calculate one (i.e. an effect size), V.K. contacted the corresponding author to obtain the data. Five authors were contacted, and two responded. Studies where authors did not respond with the required data were excluded. When extracting data from longitudinal and intervention studies, only the correlations at baseline were obtained to ensure independence of effect sizes. For intervention studies, effect sizes were calculated using the Campbell Collaboration Effect Size Calculator (Wilson, Reference Wilson2001) to transform means and standard deviations into correlation coefficients. The standard error (SE) for the r coefficient for each effect was calculated using the formula (SE=(1–r 2)/√N–3; Gnambs, Reference Gnambs2023).

Risk of bias

The risk of bias was assessed independently by V.K. following training from S.E. with the 14 items from the cross-sectional and observational section of the National Institutes of Health quality assessment tool (National Institutes of Health, 2014). The study design, selection bias, confounding variables, information bias and measurement bias, were rated ‘no’ (criterion not met), ‘yes’ (criterion met), ‘cannot determine’, ‘not applicable’, ‘not reported. An overall score was determined by dividing the number of ‘yes’ responses by the number of appropriate items and multiplying them by 100 to produce a percentage. Scores below 50% indicate ‘poor’ quality, 51–74.99% denote ‘fair’ quality, and 75% and above denote good quality (National Institutes of Health, 2014).

Assessment of heterogeneity

Cochran’s Q and I 2 statistics were calculated to assess the heterogeneity of effect sizes (Higgins et al., Reference Higgins, Thompson, Deeks and Altman2003). Heterogeneity was assessed using Cochran’s Q, with the Hunter-Schmidt method (Higgins et al., Reference Higgins, Thompson, Deeks and Altman2003). I² determined the percentage of variation across studies, where heterogeneity of 25–49% is ‘low’, 50–74% is ‘moderate’, and >75% is ‘high’ (Higgins et al., Reference Higgins, Thompson, Deeks and Altman2003). Generally, it is recommended to explore potential moderators when I² is high (≥75%; Higgins et al., Reference Higgins, Thompson, Deeks and Altman2003). Exploring potential variables can be useful in examining reasons for high heterogeneity (Cuijpers, Reference Cuijpers2016).

Meta-regressions were used where there was high heterogeneity (>75%; Cuijpers, Reference Cuijpers2016; Fu et al., Reference Fu, Gartlehner, Grant, Shamliyan, Sedrakyan, Wilt, Griffith, Oremus, Raina, Ismaila, Santaguida, Lau and Trikalinos2011). Following Deeks et al. (Reference Deeks, Higgins and Altman2023) recommendations, meta-regression can be used to investigate differences for categorical variables, as for subgroup analyses using dummy variables (e.g. 1=non-clinical, 2=clinical) in the meta-regression model, as it is for standard linear regression modelling. The regression coefficient indicated how the effect for each subgroup differed from the nominated reference subgroup and the p-value of each regression co-efficient was examined to indicate whether the differences were statistically significant. Potential sources of heterogeneity, classified as categorical variables, included the mean age of participants (i.e. young adult, 18–24.99 years or adult, 25 years and over), participants’ gender (male or female or mixed), sample type (university sample, community sample, non-clinical (psychological not physical) other or clinical (psychological), and study quality (poor, fair, or good quality). Following Lunn et al. (Reference Lunn, Greene, Callaghan and Egan2023), country of residence was another moderator and was classified as high, low or middle-income (LMIC) based on the Organisation for Economic Co-operation and Development (OECD) country classification system (Guedj, Reference Guedj2022). We did not run perfectionism measure as a moderator as some studies used several different measures which we averaged so that each sample only provided one data point per outcome. Please note that none of the clinical sample studies provided specific effect sizes for perfectionistic concerns or perfectionistic strivings. If a moderator was a significant, we ran subgroup analyses to determine the pooled effects for each category of that moderator.

Data synthesis, sensitivity analysis and assessment of publication bias

The meta-analysis was conducted using JASP (version 0.17.3; JASP Team, 2023). Pooled correlations between perfectionism and self-esteem represent the effect size in this meta-analysis and were estimated using a Hedges random effects model with 95% confidence intervals (Hedges and Olkin, Reference Hedges and Olkin1985). Cohen’s (Reference Cohen1992) conventions were used to interpret the pooled correlations as small (r=.10), medium (r=.30), or large (r≥.50).

Perfectionism outcomes were classified into perfectionistic concerns and perfectionistic strivings following the review of Limburg et al. (Reference Limburg, Watson, Hagger and Egan2017) (Table 1). In cases where correlation coefficients were presented for the subscales or reported for more than one perfectionism measure, the average effect sizes were calculated to determine an overall perfectionistic concerns or strivings correlation with self-esteem. For example, Pearson and Gleaves (Reference Pearson and Gleaves2006) reported two measures of perfectionism: the Almost Perfect Scale-Revised (APS-R; Slaney et al., Reference Slaney, Rice, Mobley, Trippi and Ashby2001) and the FMPS (Frost et al., Reference Frost, Marten, Lahart and Rosenblate1990). The subscales/measures that fit into perfectionistic strivings were averaged for each study (e.g. for the FMPS, the personal standards and organisation subscales were averaged to provide an overall correlation for perfectionistic strivings, the same was done for the high standards and order subscales of the APS-R). Studies were categorised as clinical or non-clinical depending on whether authors stated their sample met the criteria for a diagnosis of a psychological disorder based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013) or the International Classification of Diseases and Related Health Problems (ICD-11; World Health Organisation, 2019). Samples were classified as non-clinical if they did not meet the diagnostic criteria for a psychological disorder.

Table 1. Subscale classification of perfectionism measures into perfectionistic strivings and perfectionistic concerns

Adapted from ‘The Relationship Between Perfectionism and Psychopathology: A Meta-Analysis’ by K. Limburg, H. J. Watson, M. S. Hagger, and S. J. Egan (2017), Journal of Clinical Psychology, 73, 1303 (https://doi.org/10.1002/jclp.22435).

Publication bias was assessed through funnel plot visual inspection and Egger’s test for plot asymmetry (Egger et al., Reference Egger, Davey Smith, Schneider and Minder1997). If Egger’s test was significant (p<.05), plot asymmetry was assumed, indicating potential publication bias concerns. Forest plots were visually inspected for outliers, and case-wise diagnostics were conducted in JASP (JASP Team, 2023) to assess influential studies through Cook’s distance. Sensitivity analyses were conducted without the outliers to determine if removing these cases would meaningfully change the pooled effect sizes.

Results

Study characteristics

There were 83 studies found (Fig. 1) with 88 samples from which 58 effect sizes for perfectionistic strivings and 68 effect sizes for concerns were extracted or computed. Note that some studies/samples did not provide specific effect sizes for either perfectionistic strivings or concerns – instead they include only effect sizes for global perfectionism or another type of perfectionism. These studies are summarised in Table 2 but are not included in the meta-analysis.

Figure 1. Study selection flow chart in accordance with PRISMA 2020 guidelines. n, number of studies. *No valid/standardised measure refers to a questionnaire measure of perfectionism/self-esteem which did not have published evidence of a minimum reliability alpha co-efficient of .70 or above, validity, or other psychometric properties reported in the literature.

Table 2. Study characteristics

OCD, obsessive-compulsive disorder. Dash (—) reflects data not obtained or reported; F (%), percentage of sample that are female; RSES, Rosenberg Self-Esteem Scale; APS-R, Almost Perfect Scale-Revised; BTPS, Big Three Perfectionism Scale; HMPS=Hewitt and Flett Multidimensional Perfectionism Scale; FMPS=Frost Multidimensional Perfectionism Scale; EDI-P, Eating Disorder Inventory-Perfectionism subscale; PANPS, Positive and Negative Perfectionism Scale; CSEI, Coopersmith Self-Esteem Inventory; CPQ, Clinical Perfectionism Questionnaire; DEQ, Depressive Experiences Questionnaire; CSWS, Contingencies of Self-Worth Scale; S-HMPS, Short Multidimensional Perfectionism Scale based on HMPS; DAS-P, Dysfunctional Attitude Scale-Perfectionism subscale; SSES, State Self-Esteem Scale.

a Studies/samples not included in the meta-analysis as they did not include a specific effect size for perfectionistic strivings or concerns.

Studies were conducted between 1991 and 2023 across 20 countries. There were 32,304 participants (approximate mean pooled age=24.66 years). Sample sizes ranged from n=30 to n=4340, with an average sample size of n=367. Samples were predominantly from high-income countries including the USA (n=38), Europe (Belgium, Italy, Portugal, all n=3; Sweden, Germany, Hungary, all n=2, Croatia, Finland, Poland, all n=1), Australia (n=7), the United Kingdom (n=5) and Canada (n=3). There were a small number from high-income nations in Asia (South Korea, n=1; Taiwan, n=2). Low and middle-income countries represented a small number of studies (China, n=5; Lebanon, n=2; Iran, n=3; India, n=2; Turkiye, n=2). Samples were mainly non-clinical (n=82), with only six clinical samples, of which the diagnoses were eating disorders (n=4), OCD (n=1), and mixed psychological disorder diagnoses (n=1). Perfectionism was most commonly measured using the FMPS (n=40), followed by the HMPS (n=18; Hewitt and Flett, Reference Hewitt and Flett1991), APS-R (n=19; Slaney et al., Reference Slaney, Rice, Mobley, Trippi and Ashby2001), and EDI-P (n=10; Garner et al., Reference Garner, Olmstead and Polivy1983) with some studies using more than one measure of perfectionism (see Table 2 for all measures used). The Rosenberg Self-Esteem Scale (RSES; Rosenberg, Reference Rosenberg1965) was the most common measure of self-esteem (n=76).

Risk of bias

The quality rating scores were ‘poor’ (5% of studies), fair (70%) and good (25%) (Table 2). On average, studies were rated as fair (M=68.12%, SD=8.98%), which may be due to the cross-sectional design of most studies, with the majority not justifying their sample size or reporting details of sampling methods.

Publication bias

Egger’s test for plot asymmetry was significant, for perfectionistic concerns (z=2.35, p=.019). However, a trim-and-fill analysis did not impute any studies or alter the effect size, suggesting that there is unlikely to be publication bias. Therefore, asymmetry might be due to other factors. For perfectionistic strivings Egger’s test was not significant (z=–1.01, p=.311), indicating publication bias was not of concern. Visual inspection of funnel plots comprising pooled effect sizes confirmed symmetry for perfectionistic strivings, showing no evidence of publication bias (see Supplementary material for funnel plots).

Pooled correlations between perfectionism dimensions and self-esteem

Pooled correlations between perfectionistic concerns, perfectionistic strivings, and self-esteem are shown in Table 3. Consistent with our prediction, there was a significant, moderate negative pooled correlation (r=–.42) between perfectionistic concerns and self-esteem, indicating higher perfectionistic concerns are related to lower self-esteem. There was a negligible significant, positive pooled correlation between perfectionistic strivings and self-esteem (r=.06), indicating higher perfectionistic strivings are related to higher self-esteem.

Table 3. Summary statistics for pooled correlations between perfectionism dimensions and self-esteem

k, number of data points included (i.e. independent samples); r, pooled association; SE, standard error; CI, confidence interval; LL, lower limit; UL, upper limit; Q, Cochran’s Q; I 2, heterogeneity.

Sensitivity analysis

When assessing perfectionistic strivings, two studies were identified as influential outliers (Besharat, Reference Besharat2009; Moghadam et al., Reference Moghadam, Moghadam and Jahangir2021). Removing these outliers made little difference (r=.06 [.01, .10], p=.009) to the direction or significance of the results; therefore they were retained. Outliers on perfectionistic concerns were identified as Barnes and Caltabiano (Reference Barnes and Caltabiano2017), Chou et al. (Reference Chou, Huang, Lin, Lu, Chiu and Chen2019) and Koivula et al. (Reference Koivula, Hassmen and Fallby2002). Removing these outliers would not have a meaningful impact as the effect size was moved by −.03, and the relationship remained significant (r=−.45 [−.49, −.42], p<.001) hence these studies were also retained.

Heterogeneity

Heterogeneity was high, indicating wide variance in correlations across the studies (I 2≥75%), for perfectionistic concerns and self-esteem, I 2=95.35%; and perfectionistic strivings and self-esteem, I 2=93.22%. Meta-regressions were conducted (Table 4) on the mean age of participants (18–24.99 years and 25 years and older), participant gender (male or female, or mixed), country of residence (high or low- and middle income), the sample type (university or community or other non-clinical), and study quality (poor, fair, or good).

Table 4. Moderator analyses of heterogeneity

a Karatas et al. (Reference Karatas and Tagay2012) was excluded as we could not determine which age category it belonged to from the information provided.

b Reference group is under 25.

c Reference group is high income country.

d Reference group is university sample.

e Reference group is female samples.

f Reference group is poor quality studies. Other non-clinical: non-clinical refers to non-clinical in the sense of psychological disorders rather than physical disorders.

Regarding perfectionistic concerns, only one moderator was significant – gender (Table 4). Specifically, female-only samples had a stronger pooled effect (r=–.55 [–.64, –.45] p <.001, k=10) than mixed-gender samples (r=–.40 [–.45, –.35], p<.001, k=56). However, even after accounting for this moderator the level of heterogeneity was still high (Table 4). There were only two male-only samples that provided an effect size for this association; therefore, we do not provide the pooled effect for male-only samples.

Regarding perfectionistic strivings, again only one moderator was significant – gender. Specifically, inspecting subgroup analyses, mixed gender studies had a negligible positive pooled effect (pooled r=.09 [.04, .14], p<.001, k=48) but female-only had a non-significant pooled effect (pooled r=–.07 [–.23, .09], p=.388, k=8). However, even after accounting for this moderator the level of heterogeneity was still high (Table 4). There were only two male-only effect sizes included in this pooled association, therefore we do not provide a pooled effect for male-only samples.

Discussion

The aim of this meta-analysis was to examine the association between perfectionism dimensions and self-esteem in adults. Consistent with previous meta-analyses on the association between psychopathology and perfectionism in adults (Callaghan et al., Reference Callaghan, Greene, Shafran, Lunn and Egan2023; Limburg et al., Reference Limburg, Watson, Hagger and Egan2017; Stackpole et al., Reference Stackpole, Greene, Bills and Egan2023), perfectionistic concerns had a medium, negative pooled correlation with self-esteem, indicating higher perfectionistic concerns were related to lower self-esteem. Inconsistent with previous meta-analyses on psychopathology and perfectionism in adult samples (Callaghan et al., Reference Callaghan, Greene, Shafran, Lunn and Egan2023; Limburg et al., Reference Limburg, Watson, Hagger and Egan2017; Stackpole et al., Reference Stackpole, Greene, Bills and Egan2023), perfectionistic strivings had a negligible positive pooled correlation with self-esteem, indicating higher perfectionistic strivings are related to higher self-esteem. However, when considering these results, it should be noted that this positive correlation (r=.06) failed to reach Cohen’s (Reference Cohen1992) convention of a small correlation (r≥.10). Our moderators also explained little variance in the imputed effect sizes.

The finding that higher perfectionistic concerns is related to lower self-esteem fits with the wealth of meta-analyses demonstrating that perfectionistic concerns are associated with a range of negative psychological variables and psychopathology (Bills et al., Reference Bills, Greene, Stackpole and Egan2023; Callaghan et al., Reference Callaghan, Greene, Shafran, Lunn and Egan2023; Limburg et al., Reference Limburg, Watson, Hagger and Egan2017; Lunn et al., Reference Lunn, Greene, Callaghan and Egan2023; Smith et al., Reference Smith, Sherry, Ray, Hewitt and Flett2021). Clearly, higher perfectionistic concerns are related to many adverse psychological states, including lower self-esteem. The results also support the tenets of the cognitive-behavioural model of clinical perfectionism (Shafran et al., Reference Shafran, Cooper and Fairburn2002), which proposes that self-esteem is overly dependent on striving to meet demanding standards despite negative effects (e.g. psychopathology). Individuals with lower self-esteem may be more likely to base their self-evaluation on how well they perform when striving to achieve their goals, and a negative interpretation of failure to meet their high standards maintains low self-worth (Shafran et al., Reference Shafran, Cooper and Fairburn2002). Hence the findings of this meta-analysis provide some indirect support for the cognitive-behavioural model of clinical perfectionism (Shafran et al., Reference Shafran, Cooper and Fairburn2002).

We found that higher perfectionistic strivings was related to higher self-esteem, however this was a negligible association and in contrast to previous research on psychopathology and perfectionism in adults (Callaghan et al., Reference Callaghan, Greene, Shafran, Lunn and Egan2023; Limburg et al., Reference Limburg, Watson, Hagger and Egan2017; Stackpole et al., Reference Stackpole, Greene, Bills and Egan2023). It should be noted that this very small association (r=.06) was unlikely to be clinically meaningful. Furthermore, whether these results would be similar in clinical samples is unclear given the lack of clinical samples measuring this outcome in our meta-analysis. Unfortunately, there were insufficient clinical samples to conduct a robust analysis of the differences between clinical and non-clinical samples. It is possible that different relationships may be observed between perfectionistic strivings and self-esteem in clinical samples, in line with large reviews on the association between strivings and psychopathology in adults which had sufficient studies to analyse clinical samples (Callaghan et al., Reference Callaghan, Greene, Shafran, Lunn and Egan2023). Future meta-analyses should aim to classify samples into clinical and non-clinical for moderator analyses, to determine if clinical status makes a difference to the strength or direction of the relationship between perfectionistic strivings and self-esteem. It would also be helpful for more primary studies in clinical samples to be conducted measuring the association between perfectionism and self-esteem. Nonetheless, our findings support other meta-analyses documenting the association between perfectionistic strivings and some positive psychological states such as helpful academic outcomes (Osenk et al., Reference Osenk, Williamson and Wade2020).

Clinical implications

Given the meta-analysis involved cross-sectional data, no direct clinical implications can be drawn from this review. However, there are several directions for future research that may inform future clinical implications. Future research should continue to examine the cognitive-behavioural model of clinical perfectionism (Shafran et al., Reference Shafran, Cooper and Fairburn2002), where self-esteem is based on striving to meet high standards, which is the basis of cognitive behaviour therapy (CBT) for perfectionism, demonstrated to reduce symptoms of anxiety, depression, and eating disorders (Galloway et al., Reference Galloway, Watson, Greene, Shafran and Egan2022; Robinson and Wade, Reference Robinson and Wade2021). A core aim of CBT for perfectionism is to broaden an individual’s self-esteem, so it is less dependent on striving and achievement, whilst simultaneously reducing perfectionistic concerns (e.g. fear of making mistakes and performance-related self-doubt; Egan et al., Reference Egan, Wade, Shafran and Antony2014a; Shafran et al., Reference Shafran, Egan and Wade2018). CBT for perfectionism has been demonstrated to improve self-esteem. For example, Egan et al. (Reference Egan, van Noort, Chee, Kane, Hoiles, Shafran and Wade2014b) and Handley et al. (Reference Handley, Egan, Kane and Rees2015) found CBT for perfectionism resulted in significant increases in self-esteem, which were maintained at 6-month follow-up, concurrent with significant reductions psychopathology. These findings suggest preliminary evidence that interventions addressing perfectionism may have a transdiagnostic impact on reducing low self-esteem and psychopathology. However, further research is required to examine the efficacy of CBT for perfectionism in improving low self-esteem. It is also possible that interventions aimed at reducing low self-esteem such as Fennell’s (Reference Fennell2009) CBT for low self-esteem, may also improve perfectionism in addition to self-esteem. Future research could examine a head-to-head comparison of CBT for perfectionism and CBT for low self-esteem in terms of the relative efficacy on outcomes of perfectionism, self-esteem, and psychopathology to understand the most efficacious approach for clients presenting with low self-worth which is overly dependent on meeting their personally demanding standards.

Limitations

There were several limitations. A major limitation was that the data were cross-sectional. We cannot determine whether perfectionistic concerns and self-esteem are causally related. Future research should aim to conduct further experimental studies such as Hummel et al. (Reference Hummel, Cludius, Woud, Holdenrieder, Mende, Huber, Limburg and Takano2022), where an increase in perfectionistic concerns was found to result in an increase in psychological distress, with the assessment of self-esteem as the outcome from the manipulation of perfectionistic concerns. Another limitation was that grey literature was not included and we only included studies published in English, therefore it is possible that some literature was missed. In addition, while we included numerous databases for the search, inclusion of the Web of Science database may have been useful to locate further articles and would be helpful for future reviews to include as a search database. Furthermore, we did not conduct inter-rater reliability on risk of bias ratings.

Conclusion

The results of this meta-analysis indicate that in adults perfectionistic concerns were moderately related to lower self-esteem. Higher perfectionistic strivings were related to higher self-esteem, although this was a negligible, very small association. It should also be considered that perfectionistic strivings have been found to be associated with psychopathology such as eating disorders (e.g. Bills et al., Reference Bills, Greene, Stackpole and Egan2023; Stackpole et al., Reference Stackpole, Greene, Bills and Egan2023), even when the effect of perfectionistic concerns was controlled (e.g. Limburg et al., Reference Limburg, Watson, Hagger and Egan2017). Similar to recent meta-analyses (Callaghan et al., Reference Callaghan, Greene, Shafran, Lunn and Egan2023), we reiterate that further cross-sectional studies are unlikely to yield significantly new results. The field of perfectionism requires a focus now on experimental and longitudinal studies, and the examination of the causality between dimensions of perfectionism and negative psychological variables, including low self-esteem.

Supplementary material

The supplementary material for this article can be found at https://doi.org/10.1017/S1352465824000249

Data availability statement

The data are available upon request from the corresponding author.

Acknowledgements

None.

Author contributions

Viyona Khossousi: Conceptualization (supporting), Data curation (equal), Formal analysis (supporting), Investigation (lead), Methodology (equal), Project administration (equal), Writing – original draft (equal), Writing – review & editing (supporting); Danyelle Greene: Data curation (lead), Formal analysis (lead), Investigation (equal), Methodology (equal), Writing – original draft (equal), Writing – review & editing (equal); Roz Shafran: Conceptualization (equal), Writing – review & editing (equal); Thomas Callaghan: Conceptualization (supporting), Formal analysis (supporting), Investigation (supporting), Methodology (supporting), Supervision (supporting), Writing – review & editing (supporting); Sheree Dickinson: Investigation (supporting); Sarah Egan: Conceptualization (equal), Methodology (equal), Project administration (equal), Supervision (lead), Writing – original draft (equal), Writing – review & editing (lead).

Financial support

This research received no specific grant from any funding agency, commercial, or not-for-profit sectors.

Competing interests

Sarah Egan and Roz Shafran receive royalties for the books Cognitive-Behavioral Treatment of Perfectionism and Overcoming Perfectionism: A Self-Help Guide Using Cognitive Behavioural Techniques.

References

American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (5th edn). New York: American Psychiatric Association.Google Scholar
*Aldea, M. A., Rice, K. G., Gormley, B., & Rojas, A. (2010). Telling perfectionists about their perfectionism: effects of providing feedback on emotional reactivity and psychological symptoms. Behaviour Research and Therapy, 48, 1194–1203. https://doi.org/10.1016/j.brat.2010.09.003 Google ScholarPubMed
Bagby, R. M., Parker, J. D. A., Joffe, R. T., & Buis, T. (1994). Reconstruction and validation of the Depressive Experiences Questionnaire. Assessment, 1, 59–68. https://doi.org/10.1177/1073191194001001009 Google ScholarPubMed
*Barnes, M. A., & Caltabiano, M. L. (2017). The interrelationship between orthorexia nervosa, perfectionism, body image and attachment style. Eating and Weight Disorders, 22, 177–184. https://doi.org/10.1007/s40519-016-0280-x Google ScholarPubMed
*Bartsch, D. (2007). Prevalence of body dysmorphic disorder symptoms and associated clinical features among Australian university students. Clinical Psychologist, 11, 16–23. https://doi.org/10.1080/13284200601178532 Google Scholar
*Bean, P., Shiltz, T., Hallinan, P., & Holbrook, T. (2000). Self-functioning traits affecting meal compliance in eating disorder patients. Eating & Weight Disorders, 5, 198–205.Google ScholarPubMed
*Besharat, M. A. (2009). Reliability and factor validity of a Farsi version of the Positive and Negative Perfectionism Scale. Psychological Reports, 105, 99–110. https://doi.org/10.2466/pr0.105.1.99-110 Google Scholar
Bills, E., Greene, D., Stackpole, R., & Egan, S. J. (2023). Perfectionism and eating disorders in children and adolescents: a systematic review and meta-analysis. Appetite, 187, 1–10. https://doi.org/10.1016/j.appet.2023.106586 Google ScholarPubMed
*Blankstein, K. R., Dunkley, D. M., & Wilson, J. (2008). Evaluative concerns and personal standards perfectionism: self-esteem as a mediator and moderator of relations with personal and academic needs and estimated GPA. Current Psychology, 27, 29–61. https://doi.org/10.1007/s12144-008-9022-1 Google Scholar
*Boysan, M., & Kiral, E. (2017). Associations between procrastination, personality, perfectionism, self-esteem and locus of control. British Journal of Guidance and Counselling, 45, 284–296. https://doi.org/10.1080/03069885.2016.1213374 Google Scholar
*Brannan, M., Petrie, T. A., Greenleaf, C., Reel, J., & Carter, J. (2009). The relationship between body dissatisfaction and bulimic symptoms in female collegiate athletes. Journal of Clinical Sport Psychology, 3, 103–126. https://doi.org/10.1123/jcsp.3.2.103 Google Scholar
Callaghan, T., Greene, D., Shafran, R., Lunn, J., & Egan, S.J. (2023). The relationships between perfectionism and symptoms of depression, anxiety and obsessive-compulsive disorder in adults: a systematic review and meta-analysis. Cognitive Behaviour Therapy, 53, 121–132. https://doi.org/10.1080/16506073.2023.22771 Google ScholarPubMed
Chai, L., Yang, W., Zhang, J., Chen, S., Hennessy, D. A., & Liu, Y. (2020). Relationship between perfectionism and depression among Chinese college students with self-esteem as a mediator. OMEGA Journal of Death and Dying, 80, 490–503. https://doi.org/10.1177/0030222819849746 Google ScholarPubMed
*Chen, L., Zhong, M., Cao, X., Jin, X., Wang, Y., Ling, Y., Cen, W., Zhu, X., Yao, S., Zheng, X., & Yi, J. (2017). Stress and self-esteem mediate the relationships between different categories of perfectionism and life satisfaction. Applied Research in Quality of Life, 12, 593–605. https://doi.org/10.1007/s11482-016-9478-3 Google Scholar
*Chou, C. C., Huang, M. Y., Lin, T. W., Lu, F. J. H., Chiu, Y. H., & Chen, J. F. (2019). Moderating effect of self-esteem on the relationship between perfectionism and creative thinking among collegiate dancers. Creativity Research Journal, 31, 188–197. https://doi.org/10.1080/10400419.2019.1606620 Google Scholar
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159. https://oce.ovid.com/article/00006823-199207000-00008/HTML Google ScholarPubMed
*Cokley, K., Stone, S., Krueger, N., Bailey, M., Garba, R., & Hurst, A. (2018). Self-esteem as a mediator of the link between perfectionism and the impostor phenomenon. Personality and Individual Differences, 135, 292–297. https://doi.org/10.1016/j.paid.2018.07.032 Google Scholar
*Colle, L., Dimaggio, G., Carcione, A., Nicolo, G., Semerari, A., & Chiavarino, C. (2020). Do competitive contexts affect mindreading performance? Frontiers in Psychology, 11, 1–10. https://doi.org/10.3389/fpsyg.2020.01284 Google ScholarPubMed
Cuijpers, P. (2016). Meta-Analysis in Mental Health: A Practical Guide. Colofon.Google Scholar
*Cusack, C. E., Hughes, J. L., & Nuhu, N. (2013). Connecting gender and mental health to imposter phenomenon feelings. Psi Chi Journal of Psychological Research, 18, 74–81. https://doi.org/10.24839/2164-8204.JN18.2.74 Google Scholar
Deeks, J. J., Higgins, J. P. T., & Altman, G. G. (2023). Analysing data and undertaking meta-analyses. In J. Higgins & J. Thomas et al. (eds), Cochrane Handbook for Systematic Reviews of Interventions, version 6.4. Available at: https://training.cochrane/handbook/current15April2024.Google Scholar
*Deuling, J. K., & Burns, L. (2017). Perfectionism and work-family conflict: self-esteem and self-efficacy as mediator. Personality and Individual Differences, 116, 326–330. https://doi.org/10.1016/j.paid.2017.05.013 Google Scholar
*Doyle, I., & Catling, J. C. (2022). The influence of perfectionism, self-esteem and resilience on young people’s mental health. Journal of Psychology: Interdisciplinary and Applied, 156, 224–240. https://doi.org/10.1080/00223980.2022.2027854 Google ScholarPubMed
*Duncan-Plummer, T., Hasking, P., Tonta, K., & Boyes, M. (2023). The relationship between clinical perfectionism and nonsuicidal self-injury: the roles of experiential avoidance, self-esteem, and locus of control. Journal of Clinical Psychology, 79, 1799–1815. https://doi.org/10.1002/jclp.23506 Google ScholarPubMed
*Dunkley, D. M., Berg, J. L., & Zuroff, D. C. (2012). The role of perfectionism in daily self-esteem, attachment, and negative affect. Journal of Personality, 80, 633–663. https://doi.org/10.1111/j.1467-6494.2011.00741.x Google ScholarPubMed
Egan, S. J., Shafran, R., Lee, M., Fairburn, C. G., Cooper, Z., Doll, H. A., Palmer, R., & Watson, H. J. (2016). The reliability and validity of the Clinical Perfectionism Questionnaire in eating disorder and community samples. Behavioural and Cognitive Psychotherapy, 44, 79–91. https://doi.org/10.1017/S1352465814000629 Google ScholarPubMed
Egan, S. J., van Noort, E., Chee, A., Kane, R. T., Hoiles, K. J., Shafran, R., & Wade, T. D. (2014b). A randomised controlled trial of face to face versus pure online self-help cognitive behavioural treatment for perfectionism. Behaviour Research and Therapy, 63, 107–113. https://doi.org/10.1016/j.brat.2014.09.009 Google ScholarPubMed
Egan, S. J., Wade, T. D., & Shafran, R. (2011). Perfectionism as a transdiagnostic process: a clinical review. Clinical Psychology Review, 31, 203–212. https://doi.org/10.1016/j.cpr.2010.04.009 Google ScholarPubMed
Egan, S. J., Wade, T. D., Shafran, R., & Antony, M. M. (2014a). Cognitive-Behavioral Treatment of Perfectionism. New York: Guilford Press.Google ScholarPubMed
Egger, M., Davey Smith, G., Schneider, M., & Minder, C. (1997). Bias in meta-analysis detected by a simple, graphical test. British Medical Journal, 315, 629–634. https://doi.org/10.1136/bmj.315.7109.629 Google ScholarPubMed
*Elion, A. A., Wang, K. T., Slaney, R. B., & French, B. H. (2012). Perfectionism in African American students: relationship to racial identity, GPA, self-esteem, and depression. Cultural Diversity and Ethnic Minority Psychology, 18, 118–127. https://doi.org/10.1037/a0026491 Google ScholarPubMed
*Evangelista, M., Mota, S., Almeida, I. F., & Pereira, M. G. (2022a). Usage patterns and self-esteem of female consumers of antiaging cosmetic products. Cosmetics, 9, 1–14, article 49. https://doi.org/10.3390/cosmetics9030049 Google Scholar
*Evangelista, M., Vilaca, M., Almeida, I. F., & Pereira, M. G. (2022b). Quality of life in female users of antiageing cosmetic products/aesthetic treatments. International Journal of Cosmetic Science, 44, 650–662. https://doi.org/10.1111/ics.12804 Google ScholarPubMed
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Clinical Perfectionism Questionnaire. Unpublished scale: University of Oxford, UK.Google Scholar
*Fekih-Romdhane, F., Sawma, T., Obeid, S., & Hallit, S. (2023). Self-critical perfectionism mediates the relationship between self-esteem and satisfaction with life in Lebanese university students. BioMed Central Psychology, 11, 1–9. https://doi.org/10.1186/s40359-023-01040-6 Google ScholarPubMed
Fennell, M. J. V. (2009). Overcoming Low Self-Esteem: A Self-Help Guide Using Cognitive Behavioral Techniques. London, UK: Little Brown Book Company.Google Scholar
*Flett, G. L., Hewitt, P. L., Blankstein, K. R., & O’Brien, S. (1991). Perfectionism and learned resourcefulness in depression and self-esteem. Personality and Individual Differences, 12, 61–68. https://doi.org/10.1016/0191-8869%2891%2990132-U Google Scholar
Flett, G. L., Hewitt, P. L., Boucher, D. J., Davidson, L. A., & Munro, Y. (1997). Child and Adolescent Perfectionism Scale (CAPS) [Database record]. APA PsycTests. https://doi.org/10.1037/t00787-000 Google Scholar
Frost, R. O., Marten, P. A., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449–468. https://doi.org/10.1007/BF01172967 Google Scholar
Fu, R., Gartlehner, G., Grant, M., Shamliyan, T., Sedrakyan, A., Wilt, T. J., Griffith, L., Oremus, M., Raina, P., Ismaila, A., Santaguida, P., Lau, J., & Trikalinos, T. A. (2011). Conducting quantitative synthesis when comparing medical interventions: AHRQ and the effective health care Program. Journal of Clinical Epidemiology, 64, 1187–1197. https://doi.org/10.1016/j.jclinepi.2010.08.010 Google ScholarPubMed
Galloway, R., Watson, H. J., Greene, D., Shafran, R., & Egan, S. J. (2022). The efficacy of randomised controlled trials of cognitive behaviour therapy for perfectionism: a systematic review and meta-analysis. Cognitive Behaviour Therapy, 51, 170–184. https://doi.org/10.1080/16506073.2021.1952302 Google ScholarPubMed
Garner, D. M., Olmstead, M. P., & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2, 15–34. https://doi.org/10.1002/1098-108X(198321)2:2<15::AID-EAT2260020203>3.0.CO;2-6 Google Scholar
Gnambs, T. (2023). A brief note on the standard error of the Pearson correlation. Collabra: Psychology, 9, 1–5. https://doi.org/10.1525/collabra.87615 Google Scholar
*Gotwals, J. K., Dunn, J. G. H., & Wayment, H. A. (2003). An examination of perfectionism and self-esteem in intercollegiate athletes. Journal of Sport Behavior, 26, 1–22.Google Scholar
Guedj, E. (2022). Country Classification: Organisation for Economic Co-operation and Development (OECD). https://www.oecd.org/trade/topics/export-credits/documents/2022-cty-class-en-(valid-from-03-08-2022).pdf Google Scholar
Handley, A. K., Egan, S. J., Kane, R. T., & Rees, C. S. (2015). A randomised controlled trial of group cognitive behavioural therapy for perfectionism. Behaviour Research and Therapy, 68, 37–47. https://doi.org/10.1016/j.brat.2015.02.006 Google ScholarPubMed
Hedges, L. V., & Olkin, I. (1985). Statistical Methods for Meta-Analysis. Academic Press.Google Scholar
Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456–470. https://doi.org/10.1037/0022-3514.60.3.456 Google ScholarPubMed
*Hewitt, P. L., Flett, G. L., & Ediger, E. (1995). Perfectionism traits and perfectionistic self-presentation in eating disorder attitudes, characteristics, and symptoms. International Journal of Eating Disorders, 18, 317–326. https://doi.org/10.1002/1098-108X Google ScholarPubMed
Higgins, J. P., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003). Measuring inconsistency in meta-analyses. British Medical Journal, 327, 557–560. https://doi.org/10.1136/bmj.327.7414.557 Google ScholarPubMed
*Hill, A. P., Hall, H. K., & Appleton, P. R. (2011). The relationship between multidimensional perfectionism and contingencies of self-worth. Personality and Individual Differences, 50, 238–242. https://doi.org/10.1016/j.paid.2010.09.036 Google Scholar
*Hinterman, C., Burns, L., Hopwood, D., & Rogers, W. (2012). Mindfulness: Seeking a more perfect approach to coping with life’s challenges. Mindfulness, 3, 275–281. https://doi.org/10.1007/s12671-012-0091-8 Google Scholar
Howell, J., Anderson, R. A., Egan, S. J. & McEvoy, P. M. (2020). One Factor? Two Factor? Bi-factor? A psychometric evaluation of the Frost Multidimensional Scale and the Clinical Perfectionism Questionnaire. Cognitive Behaviour Therapy, 49, 518–530. https://doi.org/10.1080/1650673.2020.1790645 Google ScholarPubMed
Hummel, J., Cludius, B., Woud, M. L., Holdenrieder, J., Mende, N., Huber, V., Limburg, K., & Takano, K. (2022). The causal relationship between perfectionism and negative effect: two experimental studies. Personality and Individual Differences, 200, 111895. https://doi.org/10.1016/j.paid.2022.111895 Google Scholar
IBM Corporation (2021). IBM SPSS Statistics (version 28.0). [Computer software].Google Scholar
JASP Team (2023). JASP (version 0.17.3). [Computer software].Google Scholar
*Jayakumar, A., Sudhir, P., & Mariamma, P. (2016). Procrastination, perfectionism, coping and their relation to distress and self-esteem in college students. Journal of the Indian Academy of Applied Psychology, 42, 82–91.Google Scholar
*Jones, M. D., & Crowther, J. H. (2013). Predicting the onset of inappropriate compensatory behaviors in undergraduate college women. Eating Behaviors, 14, 17–20. https://doi.org/10.1016/j.eatbeh.2012.10.009 Google ScholarPubMed
Juwono, I. D., Kun, B., Demetrovics, Z., & Urbàn, R. (2022). Healthy and unhealthy dimensions of perfectionism: perfectionism and mental health in Hungarian adults. International Journal of Mental Health and Addiction, 21, 3017–3032. https://doi.org/10.1007/s11469-022-00771-8 Google Scholar
*Karatas, Z., & Tagay, O. (2012). Self-esteem, locus of control and multidimensional perfectionism as the predictors of subjective well-being. International Education Studies, 5, 131–137. https://doi.org/10.5539/ies.v5n6p131 Google Scholar
*Kempke, S., Luyten, P., Van Houdenhove, B., Goossens, L., Bekaert, P., & Van Wambeke, P. (2011). Self-esteem mediates the relationship between maladaptive perfectionism and depression in chronic fatigue syndrome. Clinical Rheumatology, 30, 1543–1548. https://doi.org/10.1007/s10067-011-1772-8 Google ScholarPubMed
*Klibert, J. J., Langhinrichsen-Rohling, J., & Saito, M. (2005). Adaptive and maladaptive aspects of self-oriented versus socially prescribed perfectionism. Journal of College Student Development, 46, 141–156. https://doi.org/10.1353/csd.2005.0017 Google Scholar
*Koivula, N., Hassmen, P., & Fallby, J. (2002). Self-esteem and perfectionism in elite athletes: effects on competitive anxiety and self-confidence. Personality and Individual Differences, 32, 865–875. https://doi.org/10.1016/S0191-8869 Google Scholar
*Kothari, R., Barker, C., Pistrang, N., Rozental, A., Egan, S., Wade, T., Allcott-Watson, H., Andersson, G., & Shafran, R. (2019). A randomised controlled trial of guided internet-based cognitive behavioural therapy for perfectionism: effects on psychopathology and transdiagnostic processes. Journal of Behavior Therapy and Experimental Psychiatry, 64, 113–122. https://doi.org/10.1016/j.jbtep.2019.03.007 Google ScholarPubMed
Krauss, S., Dapp, L. C., & Orth, U. (2023). The link between low self-esteem and eating disorders: a meta-analysis of longitudinal studies. Clinical Psychological Science, 11, 1141–1158. https://doi.10.1177/21677026221144255.Google Scholar
*Kresznerits, S., Rozsa, S., & Perczel-Forintos, D. (2022). A transdiagnostic model of low self-esteem: pathway analysis in a heterogeneous clinical sample. Behavioural and Cognitive Psychotherapy, 50, 171–186. https://doi.org/10.1017/S1352465821000485 Google Scholar
*Kuennen, M. R., & Waldron, J. J. (2007). Relationships between specific personality traits, fat free mass indices, and the Muscle Dysmorphia Inventory. Journal of Sport Behavior, 30, 453–470.Google Scholar
*Kun, B., Urban, R., Bothe, B., Griffiths, M. D., Demetrovics, Z., & Kokonyei, G. (2020). Maladaptive rumination mediates the relationship between self-esteem, perfectionism, and work addiction: a large scale survey study. International Journal of Environmental Research & Public Health, 17, 1–17. https://doi.org/10.3390/ijerph17197332 Google Scholar
*Lamanna, J., Grieve, F. G., Pitt Derryberry, W., Hakman, M., & McClure, A. (2010). Antecedents of eating disorders and muscle dysmorphia in a non-clinical sample. Eating and Weight Disorders, 15, 23–33. https://doi.org/10.1007/bf03325277 Google Scholar
*LaSota, M. T., & Kearney, C. A. (2017). Maladaptive perfectionism and depression and state-trait anxiety: a mediational analysis with self-esteem. Journal of Social and Clinical Psychology, 36, 346–357. https://doi.org/10.1521/jscp.2017.36.4.346 Google Scholar
*Le Marne, K. M., & Harris, L. M. (2016). Death anxiety, perfectionism and disordered eating. Behaviour Change, 33, 193–211. https://doi.org/10.1017/bec.2016.11 Google Scholar
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159. https://doi.org/10.2307/252931 Google ScholarPubMed
Limburg, K., Watson, H. J., Hagger, M. S., & Egan, S. J. (2017). The relationship between perfectionism and psychopathology: a meta-analysis. Journal of Clinical Psychology, 73, 1301–1326. https://doi.org/10.1002/jclp.22435 Google ScholarPubMed
Lunn, J., Greene, D., Callaghan, T., & Egan, S. J. (2023). Associations between perfectionism and symptoms of anxiety, obsessive-compulsive disorder and depression in young people: a meta-analysis. Cognitive Behaviour Therapy, 52, 460–487. https://doi.org/10.1080/16506073.2023.2211736 Google ScholarPubMed
*Methikalam, B., Wang, K. T., Slaney, R. B., & Yeung, J. G. (2015). Asian values, personal and family perfectionism, and mental health among Asian Indians in the United States. Asian American Journal of Psychology, 6, 223–232. https://doi.org/10.1037/aap0000023 Google Scholar
*Miegel, F., Moritz, S., Wagener, F., Cludius, B., & Jelinek, L. (2020). Self-esteem mediates the relationship between perfectionism and obsessive-compulsive symptoms. Personality and Individual Differences, 167, 1–6. https://doi.org/10.1016/j.paid.2020.110239 Google Scholar
*Minnich, A. M., Gordon, K. H., Holm-Denoma, J. M., & Troop-Gordon, W. (2014). A test of an interactive model of binge eating among undergraduate men. Eating Behaviors, 15, 625–631. https://doi.org/10.1016/j.eatbeh.2014.08.016 Google ScholarPubMed
*Mobley, M., Slaney, R. B., & Rice, K. G. (2005). Cultural validity of the Almost Perfect Scale-Revised for African American college students. Journal of Counseling Psychology, 52, 629–639. https://doi.org/10.1037/0022-0167.52.4.629 Google Scholar
*Moghadam, F., Moghadam, H. E., & Jahangir, P. (2021). The relationship between perfectionism, early maladaptive schemas, attachment styles, and body image concern by the mediating role of self-esteem in cosmetic surgery applicants. Journal of Client-Centered Nursing Care, 7, 27–42. https://doi.org/10.32598/jccnc.7.1.351.1 Google Scholar
*Moroz, M., & Dunkley, D. M. (2015). Self-critical perfectionism and depressive symptoms: low self-esteem and experiential avoidance as mediators. Personality and Individual Differences, 87, 174–179. https://doi.org/10.1016/j.paid.2015.07.044 Google Scholar
*Mousavi Asl, E., Mahaki, B., Ashouri, A., & Mohammadian, Y. (2022). Self-oriented and socially prescribed perfectionism: the psychometric properties of the Persian version of the Eating Disorder Inventory-Perfectionism Scale. International Journal of Preventive Medicine, 13, 1–6. https://doi.org/10.4103 Google Scholar
*Murray, S. B., Rieger, E., Karlov, L., & Touyz, S. W. (2013). An investigation of the transdiagnostic model of eating disorders in the context of muscle dysmorphia. European Eating Disorders Review, 21, 160–164. https://doi.org/10.1002/erv.2194 Google ScholarPubMed
National Institutes of Health (2014). Quality Assessment Tool for Cross-Sectional and Observational Studies. https://www.nhlbi.nih.gov/health-topics/studyquality-assessment-tools.Google Scholar
*Ortega, N. E., Wang, K. T., Slaney, R. B., Hayes, J. A., & Morales, A. (2014). Personal and familial aspects of perfectionism in Latino/a students. The Counseling Psychologist, 42, 406–427. https://doi.org/10.1177/0011000012473166 Google Scholar
Osenk, I., Williamson, P., & Wade, T. D. (2020). Does perfectionism or pursuit of excellence contribute to successful learning? A meta-analytic review. Psychological Assessment, 32, 972–983. https://doi.org/10.1037/pas0000942 Google ScholarPubMed
Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hrobjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., … & Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. PLoS Medicine, 18, article e1003583. https://doi.org/10.1371/journal.pmed.1003583 Google Scholar
*Park, H. J., & Jeong, D. Y. (2015). Psychological well-being, life satisfaction, and self-esteem among adaptive perfectionists, maladaptive perfectionists, and nonperfectionists. Personality and Individual Differences, 72, 165–170. https://doi.org/10.1016/j.paid.2014.08.031 Google Scholar
*Pearson, C. A., & Gleaves, D. H. (2006). The multiple dimensions of perfectionism and their relation with eating disorder features. Personality and Individual Differences, 41, 225–235. https://doi.org/10.1016/j.paid.2006.01.013 Google Scholar
*Pereira, M. G., Machado, A. M., Evangelista, M., Vilaça, M., & Almeida, A. C. (2022). Sociodemographic and psychological contributors to quality of life in users of anti-aging cosmetic products and procedures. Journal of Men’s Health, 18, 1–13. https://doi.org/10.31083/j.jomh1804095 Google Scholar
*Piotrowski, K., Bojanowska, A., Nowicka, A., & Janasek, B. (2023). Perfectionism and community-identity integration: the mediating role of shame, guilt and self-esteem. Current Psychology, 42, 1308–1316. https://doi.org/10.1007/s12144-021-01499-9 Google Scholar
*Pokrajac-Bulian, A., Ambrosi-Randic, N., & Kukic, M. (2008). Thin-ideal internalization and comparison process as mediators of social influence and psychological functioning in the development of disturbed eating habits in Croatian college females. Psychological Topics, 17, 221–245. https://doaj.org/article/24ef13d035684d29bf9eefd5fd67c25d Google Scholar
*Procopio, C. A., Holm-Denoma, J. M., Gordon, K. H., & Joiner, T. E., Jr. (2006). Two-three-year stability and interrelations of bulimotypic indicators and depressive and anxious symptoms in middle-aged women. International Journal of Eating Disorders, 39, 312–319. https://doi.org/10.1002/eat.20242 Google ScholarPubMed
Prior, K.L., Erceg-Hurn, D.M., Raykos, B.C., Egan, S.J., Byrne, S & McEvoy, P.M. (2018). Validation of the clinical perfectionism questionnaire in an eating disorder sample: a bifactor approach. International Journal of Eating Disorders, 51, 1176–1184. https://doi.org/10.1002/eat.22892 Google Scholar
*Pulford, B. D., Johnson, A., & Awaida, M. (2005). A cross-cultural study of predictors of self-handicapping in university students. Personality and Individual Differences, 39, 727–737. https://doi.org/10.1016/j.paid.2005.02.008 Google Scholar
*Puttevils, L., Vanderhasselt, M. A., & Vervaet, M. (2019). Investigating transdiagnostic factors in eating disorders: does self-esteem moderate the relationship between perfectionism and eating disorder symptoms? European Eating Disorders Review, 27, 381–390. https://doi.org/10.1002/erv.2666 Google ScholarPubMed
*Raedeke, T. D., Blom, V., & Kenttä, G. (2021). Perfectionism and self-perception profile comparisons on burnout and life satisfaction in aesthetic performers. Journal of Clinical Sport Psychology, 15, 351–372. https://doi.org/10.1123/jcsp.2019-0007 Google Scholar
*Raudasoja, M., Sorkkila, M., & Aunola, K. (2023). Self-esteem, socially prescribed perfectionism, and parental burnout. Journal of Child and Family Studies, 32, 1113–1120. https://doi.org/10.1007/s10826-022-02324-y Google Scholar
*Rice, K. G., & Dellwo, J. P. (2001). Within-semester stability and adjustment correlates of the multidimensional perfectionism scale. Measurement and Evaluation in Counseling and Development, 34, 146–156. https://doi.org/10.1080/07481756.2002.12069031 Google Scholar
*Rice, K. G., & Dellwo, J. P. (2002). Perfectionism and self-development: implications for college adjustment. Journal of Counseling and Development, 80, 188–196. https://doi.org/10.1002/j.1556-6678.2002.tb00182.x Google Scholar
*Rice, K. G., & Lopez, F. G. (2004). Maladaptive perfectionism, adult attachment, and self-esteem in college students. Journal of College Counseling, 7, 118–128. https://doi.org/10.1002/j.2161-1882.2004.tb00243.x Google Scholar
*Rice, K. G., Ashby, J. S., & Slaney, R. B. (1998). Self-esteem as a mediator between perfectionism and depression: a structural equations analysis. Journal of Counseling Psychology, 45, 304–314. https://doi.org/10.1037/0022-0167.45.3.304 Google Scholar
*Rice, K. G., Ashby, J. S., & Slaney, R. B. (2007). Perfectionism and the five-factor model of personality. Assessment, 14, 385–398. https://doi.org/10.1177/1073191107303217 Google ScholarPubMed
Robinson, K., & Wade, T.D. (2021). Perfectionism interventions targeting disordered eating: a systematic review and meta-analysis. International Journal of Eating Disorders, 54, 473–487. https://doi.org/10.1002/eat.23483 Google ScholarPubMed
Rosenberg, M. (1965). Society and the Adolescent Self-Image. Princeton University Press.Google Scholar
*Rosenberger, P. H., Henderson, K. E., & Grilo, C. M. (2006). Correlates of body image dissatisfaction in extremely obese female bariatric surgery candidates. Obesity Surgery, 16, 1331–1336. https://doi.org/10.1381/096089206778663788 Google ScholarPubMed
*Ruggiero, G. M., Bertelli, S., Boccalari, L., Centorame, F., Ditucci, A., La Mela, C., Scarinci, A., Vinai, P., Scarone, S., & Sassaroli, S. (2008). The influence of stress on the relationship between cognitive variables and measures of eating disorders (in healthy female university students): a quasi-experimental study. Eating and Weight Disorders, 13, 142–148. https://doi.org/10.1007/BF03327615 Google ScholarPubMed
*Sassaroli, S., Gallucci, M., & Ruggiero, G. M. (2008). Low perception of control as a cognitive factor of eating disorders. Its independent effects on measures of eating disorders and its interactive effects with perfectionism and self-esteem. Journal of Behavior Therapy and Experimental Psychiatry, 39, 467–488. https://doi.org/10.1016/j.jbtep.2007.11.005 Google ScholarPubMed
Shafran, R., Cooper, Z., & Fairburn, C. G. (2002). Clinical perfectionism: a cognitive-behavioural analysis. Behaviour Research and Therapy, 40, 773–791. https://doi.org/10.1016/S0005-7967(01)00059-6 Google ScholarPubMed
Shafran, R., Egan, S. J, & Wade, T. D (2010). Overcoming Perfectionism: A Self-Help Guide Using Scientifically Supported Cognitive Behavioural Techniques. London, UK: Constable & Robinson.Google Scholar
Shafran, R., Egan, S. J, & Wade, T. D. (2018). Overcoming Perfectionism: A Self-Help Guide Using Cognitive Behavioural Techniques (2nd edn). London, UK: Robinson.Google Scholar
*Shanmugam, V., Jowett, S., & Meyer, C. (2011). Application of the transdiagnostic cognitive-behavioral model of eating disorders to the athletic population. Journal of Clinical Sport Psychology, 5, 166–191. https://doi.org/10.1123/jcsp.5.2.166 Google Scholar
Shu, C. Y., O’Brien, A., Watson, H. J., Anderson, R. A., Wade, T. D., Kane, R. T., Lampard, A., & Egan, S. J. (2020). Structure and validity of the Clinical Perfectionism Questionnaire in female adolescents. Behavioural and Cognitive Psychotherapy, 48, 268–279. https://doi.org/10.1017/S1352465819000729 Google ScholarPubMed
Slaney, R. B., Rice, K. G., Mobley, M., Trippi, J., & Ashby, J. S. (2001). The Revised Almost Perfect Scale. Measurement and Evaluation in Counseling and Development, 34, 130–145. https://doi.org/10.1080/07481756.2002.12069030 Google Scholar
Smith, M. M., & Saklofske, D. H. (2017). The structure of multidimensional perfectionism: support for a bifactor model with a dominant general factor. Journal of Personality Assessment, 99, 297–303. https://doi.10.1080/00223891.2016.1208209 Google ScholarPubMed
Smith, M. M., Saklofske, D. H., Stoeber, J., & Sherry, S. B. (2016). The Big Three Perfectionism Scale: a new measure of perfectionism. Journal of Psychoeducational Assessment, 34, 670–687. https://doi.org/10.1177/0734282916651539 Google Scholar
Smith, M. M., Sherry, S. B., Ray, C., Hewitt, P. L., & Flett, G. L. (2021). Is perfectionism a vulnerability factor for depressive symptoms, a complication of depressive symptoms, or both? A meta-analytic test of 67 longitudinal studies. Clinical Psychology Review, 84, article e0101982. https://doi.org/10.1016/j.cpr.2021.101982 Google Scholar
Sowislo, J. F., & Orth, U. (2013). Does low self-esteem predict depression and anxiety? A meta-analysis of longitudinal studies. Psychological Bulletin, 139, 213–240. https://doi.org/10.1037/a0028931 Google ScholarPubMed
Stackpole, R., Greene, D., Bills, E., & Egan, S. J. (2023). The association between eating disorders and perfectionism in adults: a systematic review and meta-analysis. Eating Behaviors, 50, 101769. https://doi.org/10.1016/j.eatbeh.2023.101769 Google ScholarPubMed
*Steele, A., Corsini, N., & Wade, T. D. (2007). The interaction of perfectionism, perceived weight status, and self-esteem to predict bulimic symptoms: the role of ‘benign’ perfectionism. Behaviour Research and Therapy, 45, 1647–1655. https://doi.org/10.1016/j.brat.2006.08.007 Google ScholarPubMed
*Taylor, J. J., Papay, K. A., Webb, J. B., & Reeve, C. L. (2016). The good, the bad, and the interactive: evaluative concerns perfectionism moderates the effect of personal strivings perfectionism on self-esteem. Personality and Individual Differences, 95, 1–5. https://doi.org/10.1016/j.paid.2016.02.006 Google Scholar
Terry-Short, L. A., Owens, R. G., Slade, P. D., & Dewey, M. E. (1995). Positive and negative perfectionism. Personality and Individual Differences, 18, 663–668. https://doi.org/10.1016/0191-8869(94)00192-U Google Scholar
*Tissot, A. M., & Crowther, J. H. (2008). Self-oriented and socially prescribed perfectionism: risk factors within an integrative model for bulimic symptomatology. Journal of Social and Clinical Psychology, 27, 734–755. https://doi.org/10.1521/jscp.2008.27.7.734 Google Scholar
*Trumpeter, N., Watson, P., & O’Leary, B. J. (2006). Factors within multidimensional perfectionism scales: complexity of relationships with self-esteem, narcissism, self-control, and self-criticism. Personality and Individual Differences, 41, 849–860. https://doi.org/10.1016/j.paid.2006.03.014 Google Scholar
*Vergauwe, J., Wille, B., Feys, M., De Fruyt, F., & Anseel, F. (2015). Fear of being exposed: the trait-relatedness of the impostor phenomenon and its relevance in the work context. Journal of Business and Psychology, 30, 565–581. https://doi.org/10.1007/s10869-014-9382-5 Google Scholar
*Vohs, K. D., Voelz, Z. R., Pettit, J. W., Bardone, A. M., Katz, J., Abramson, L. Y., Heatherton, T. F., & Joiner, T. E., Jr (2001). Perfectionism, body dissatisfaction, and self-esteem: an interactive model of bulimic symptom development. Journal of Social and Clinical Psychology, 20, 476–497. https://doi.org/10.1521/jscp.20.4.476.22397 Google Scholar
*Wang, K. T. (2010). The Family Almost Perfect Scale: development, psychometric properties, and comparing Asian and European Americans. Asian American Journal of Psychology, 1, 186–199. https://doi.org/10.1037/a0020732 Google Scholar
*Wang, K. T., Puri, R., Slaney, R. B., Methikalam, B., & Chadha, N. (2012). Cultural validity of perfectionism among Indian students: examining personal and family aspects through a collectivistic perspective. Measurement and Evaluation in Counseling and Development, 45, 32–48. https://doi.org/10.1177/0748175611423109 Google Scholar
*Wang, K. T., Slaney, R. B., & Rice, K. G. (2007). Perfectionism in Chinese university students from Taiwan: a study of psychological well-being and achievement motivation. Personality and Individual Differences, 42, 1279–1290. https://doi.org/10.1016/j.paid.2006.10.006 Google Scholar
*Wang, Q., & Wu, H. (2022). Associations between maladaptive perfectionism and life satisfaction among Chinese undergraduate medical students: the mediating role of academic burnout and the moderating role of self-esteem. Frontiers in Psychology, 12, e774622. https://doi.org/10.3389/fpsyg.2021.774622 Google ScholarPubMed
*Watson, H. J., Steele, A. L., Bergin, J. L., Fursland, A., & Wade, T. D. (2011). Bulimic symptomatology: the role of adaptive perfectionism, shape and weight concern, and self-esteem. Behaviour Research and Therapy, 49, 565–572. https://doi.org/10.1016/j.brat.2011.04.002 Google Scholar
*Watson, P., Varnell, S. P., & Morris, R. J. (1999). Self-reported narcissism and perfectionism: an ego-psychological perspective and the continuum hypothesis. Imagination, Cognition and Personality, 19, 59–69. https://doi.org/10.2190/MD51-7P8N-WEYE-9H3X Google Scholar
Weissman, A. N., & Beck, A. T. (1978, March 27). Development and Validation of the Dysfunctional Attitude Scale: A Preliminary Investigation [Paper presentation]. 62nd Annual Meeting of the American Educational Research Association, Canada. https://eric.ed.gov/?id=ED167619 Google Scholar
Wilson, D. B. (2001). Practical Meta-Analysis Effect Size Calculator. [Online calculator]. https://campbellcollaboration.org/research-resources/effect-size-calculator.html (accessed 8 August 2023).Google Scholar
World Health Organization (2019). International Statistical Classification of Diseases and Related Health Problems (11th edn). https://icd.who.int/ Google Scholar
Zeigler-Hill, V. (2011). The connections between self-esteem and psychopathology. Journal of Contemporary Psychotherapy, 41, 157–164. https://doi.org/10.1007/s10879-010-9167-8 Google Scholar
*Zeigler-Hill, V., & Terry, C. (2007). Perfectionism and explicit self-esteem: the moderating role of implicit self-esteem. Self and Identity, 6, 137–153. https://doi.org/10.1080/15298860601118850 Google Scholar
*Zhang, B., & Cai, T. (2012a). Coping styles and self-esteem as mediators of the perfectionism-depression relationship among Chinese undergraduates. Social Behavior and Personality, 40, 157–168. https://doi.org/10.2224/sbp.2012.40.1.157 Google Scholar
*Zhang, B., & Cai, T. (2012b). Using SEM to examine the dimensions of perfectionism and investigate the mediating role of self-esteem between perfectionism and depression in China. Australian Journal of Guidance and Counselling, 22, 44–57. https://doi.org/10.1017/jgc.2012.3 Google Scholar
Figure 0

Table 1. Subscale classification of perfectionism measures into perfectionistic strivings and perfectionistic concerns

Figure 1

Figure 1. Study selection flow chart in accordance with PRISMA 2020 guidelines. n, number of studies. *No valid/standardised measure refers to a questionnaire measure of perfectionism/self-esteem which did not have published evidence of a minimum reliability alpha co-efficient of .70 or above, validity, or other psychometric properties reported in the literature.

Figure 2

Table 2. Study characteristics

Figure 3

Table 3. Summary statistics for pooled correlations between perfectionism dimensions and self-esteem

Figure 4

Table 4. Moderator analyses of heterogeneity

Supplementary material: File

Khossousi et al. supplementary material

Khossousi et al. supplementary material
Download Khossousi et al. supplementary material(File)
File 204.7 KB
Submit a response

Comments

No Comments have been published for this article.