1. Reaching below the surface
Automatic perfectionism associations in students and
persons suffering from an eating disorder
Kathleen De Cuyper
Proefschrift aangeboden tot het verkrijgen van de graad van
Doctor in de Psychologie
Promotor: Prof. dr. D. Hermans
Co-promotoren: Prof. dr. G. Pieters en Prof. dr. L. Claes
FACULTEIT PSYCHOLOGIE EN
PEDAGOGISCHE WETENSCHAPPEN
Centrum voor Leerpsychologie en Experimentele Psychopathologie
Universitair Psychiatrisch Centrum KU Leuven
2014
2. OVERVIEW
What is perfectionism?
Do we have blind spots in our self-knowledge regarding our level
of perfectionism?
Automatic versus controlled mental processes
Results of the two clinical studies in eating disorder patients
Conclusion
3. WHAT IS PERFECTIONISM?
Self-reported perfectionism is characterized by two dimensions:
1. The achievement striving dimension
2. The evaluative concerns dimension
Evaluative concerns dimension
Achievement striving
dimension
Combined
perfectionism
Achievement
striving
perfectionism
Nonperfectionism
inter-related
4. BLIND SPOTS IN OUR
SELF-KNOWLEDGE?
Our self-knowledge kan be depicted as mental associations
between concepts in our memory. For example: the extent to
which people choose suffering over failure = aspect of
perfectionism.
Failing Suffering
˗ ˗ ˗ ˗ ˗ ˗ ++++++
Controlled
processing
Automatic
processing
Behaviour/
Outcome
Dual process theories
5. CONTROLLED VS.
AUTOMATIC MODE
Renovations: in 2 days the walls
have to be broken down, because
then the construction workers will
start. Otherwise it will only be in 2
months.
A half year later: the walls have
to be filled up. There is still a lot
of work to do.
You put yourself in the mindset of
suffering in order not to fail (missing
a night of sleep) to reach a specific
goal, and in a well considered way
(a day of holiday already planned).
Nevertheless, the work goes
very slowly: you search for every
little hole in the wall. You cursed
yourself already several times
for that, but time after time you
catch yourself not being able to
put away the filling-knife.
Controlled
processing
Automatic
processing
Indirect measurement
tasks
Self-report
(questionnaires)
6. MEASURES OF
PERFECTIONISM
Indirect
measurement tasks
Implicit Association Tests:
Failing/Suffering IAT
(Aiming at Perfection SC-IAT)
Failing Suffering
˗ ˗ ˗ ˗ ˗ ˗ +++++
The extent to which suffering
is chosen over failure
Automatic
processing
Self-report
Questionnaires:
MPS-Frost
MPS-Hewitt
Achievement
striving
dimension
Evaluative
concerns
dimension
Controlled
processing
7. PREDICTION OF OUTCOME IN
EATING DISORDER PATIENTS
The self-worth of patients with an eating disorder depends on the
extent to which they can control their eating pattern, their weight
and their body shape ⇒ feelings of self-worth, security, control over
their negative emotions, less anxiety and/or cry for help.
Controling their eating pattern is their life buoy, so to speak.
The fear to be fat is that big that they develop a severely distorted
body image : they feel constantly as if they are too fat, although they
can be very thin.
Diagnoses of the included patients (n = 90): anorexia nervosa of the
restrictive and combined type, bulimia nervosa, and variants of
these diagnoses (the former EDNOS category)
8. METHOD
T2
Study 1 + 2
n = 87
T3 Study 2
n = 36
2 months 5 monthsT1
Study 1 + 2
n = 90
9. OVERVIEW OF THE
RESULTS
T2
Study 1 + 2
n = 87
T3 Study 2
n = 36
2 months 5 months
Achiement striving
dimension ↑
Evaluative
concerns
dimension ↑
Eating disorder
symptoms ↓
Eating disorder
symptoms ↑
Psychological
well-being ↓
Depressive
symptoms ↑
Controlled
processing
T1
Stud 1 + 2
n = 90
Choosing suffering
over failure ↑
When short illness
duration: eating
disorder symptoms ↑
Automatic
processing
11. CONCLUSION
The two self-reported dimensions of perfectionism have a different
predictive value in the long run:
1. The evaluative concerns dimension has only a negative effect!
2. Setting high standards for the self can have a positive effect in
the long run, BUT only as far as the self-worth is not dependent on
the extent to which the high standards are met.
This is seldom the case in eating disorder patients who
need intensive treatment!
This is a major focus for therapy!
12. Choosing suffering over failure (on an automatic level) has a
negative effect on
the eating disorder symptoms after 2 months, in patients
with short illness duration.
the course of weight gain in the anorexia nervosa patients
during treatment.
The Failing/Suffering IAT has only a predictive value in the
context of the treatment.
The test-retest correlation of this IAT (both measurement during
the treatment) is very high, in contrast to our expectations (.88).
Hypothesis: The Failing/Suffering IAT measures the extent to
which suffering is chosen over failure in reaction to being in
treatment.
CONCLUSION
13. Building on this hypothesis, the results can be interpreted as
follows: when patients associate the treatment with suffering in
order not to fail, this will have a negative effect on the eating
disorder symptoms at the end of the treatment.
⇒ Helping patients to find positive motivations to succeed in the
treatment, is an important objective during therapy.
CONCLUSION
14. THANK YOU FOR YOUR ATTENTION
Courtesy of A. Kutscherauer
