23 (1), 2012

61

Special article


. , .
,

2012, 23:6171

, , ,
. Frost,

. ,
,
. , , . ,
, ,
, .
, .

, . , ,
,
.
.
,
,
, . , ,
, -

62

E. .

23 (1), 2012

, ,
.
,
.
.
: , , .

(perfectionism) , ,
.
,

.1
Frost et al2
,
.
, , . 3
Horney4 .

.
,
,
, , :
.1,57
, -

, 8 ,9
,10 ,11
-.12
,
: . ,
,
,

.13
,

.5,14
Slade Owens15

,
.

,16
.
,
,
.
,
. ,

,
. ,
,

PSYCHIATRIKI 23 (1), 2012

63

,

. ,

, ,
, .15

)
.

,
.
.
, , , .
, ,
.12

,

.
.
Rice Mirzadeh17


, .


. , .
,
,

. 2
,
, ,
, . .1820 , ,

. ,
,
(

.
.

.21

Frost2

.
35 , 1 5 ( 1: , 5:
).
: () , () , () , ()
, () () .

(Multidimensional Perfectionism
Scale/MPS-F).
, Hewitt Flett22
, : ()
(
), () (
) ()
(
). -

64

E. .

H
(Multidimensional Perfectionism Scale/MPS-H)
45 ,

( 1: , 7:
).23

.22,24
,
. 5,7,25,26

. 23

,

.

.7
,
, . 27,28
.23,29,30
,
.31
()

, , .
, ,
.7
, ( )
,
, .

23 (1), 2012

, .
:
(.. ) , (.. ) ()
.
. 3

Flett Hewitt32


, .

. 33,34 :

. 35
H Franco-Paredes36

.
Cockell et al37
( , )
. , ,
( ) ( ),
, .
Geller et al -

PSYCHIATRIKI 23 (1), 2012

, . 37

,
. ,
.
,
,
(.. ). 38
,
Steele et al, 39 ,
,
,

.

Beck.40

. 2
, .

100%, .
Arpin-Cribbie Cribbie 41 , .

,
.

, , .40

65

,18,42,43 , . 21 ,

(
)
,
.44 ,

,


, ,
. 26


()
DSM-IV,

,

,
.... 30
, ,
,
.


, . 26,34

. Hewitt Flett22
,
,

(patterns) .

66

E. .

, ,
, .
, , .
O Sorotzkin45
,

, ,
.


, , .46
,
, , .26
, , .
.
, ,
,
. 3




( )

. 5 , 1

23 (1), 2012

. , .

. , , , .47
,
.
O Ellis25
:
, .


:

,
, , ,

, .


,

. ,
.
,
. 21

: ()
, () , () ,
() , ()
, () , ()

PSYCHIATRIKI 23 (1), 2012

() .1
:
. .
, ..:
!.
. :
. , ,
.14,34
.
 .
, ..:
"" .
.
 . ,
, ..:
.
. :
i.  : ,
..:
,
ii.  : ,
, ,
. ,

, ..:

.
.  .
,
..: :
.
.  .
, ..:
,
.
,

, .. .
. .
, ..: ,
.

67

. . , ..:
.


, : ()
. ()
,
.
()

. () ,
. ,

:
.
. , .
,
,
,
. , ,
.





.
, 26,32,34 , ,
.
, ,
, :


68

E. .

;

100%, ;

;

;
,
(..
, , , ).
.

.

:
,
;

, ,
:23
N ,

, .
N

,

.

N

.
N .

,
, ..

.

N

,

()
( ), ( )
(/ ).

N

.7,28
 .

, .
 , ;
 ,
;
 ;

23 (1), 2012

N

,
.

N

.48
, ,


, .
, , .

PSYCHIATRIKI 23 (1), 2012

. 21

,
.
,
, ,
.

-

69

,
.

,
, .
:
()
, .
.
.

Clinical perfectionism
and cognitive behavioral therapy
E. Papadomarkaki, S. Portinou
Hellenic Centre for Mental Health and Research, Athens, Greece

Psychiatriki 2012, 23:6171

The present study constitutes a brief literature overview, in which the term of clinical perfectionism, its etiopathology, its assessment and its relation to psychopathology, as well as the
therapeutic interventions based on the Cognitive Behavioral Model are discussed. According
to Frost, perfectionism is associated with ones desire to achieve the greatest degree of performance and it is accompanied by an extremely strict evaluation of that particular performance.
The relationship with oneself as well as the relationship with others are both characterised by
high standards and demands which tend to exhaust one individual and dramatically toughen
the development of proximity with the others. Perfectionism, as a personality trait, presents
functional and dysfunctional elements for a person. Dysfunctional, clinical perfectionism a
term recently coined by researchers has been linked to a number of disorders, such as social
phobia, obsessive-compulsive disorder, eating disorders anorexia and bulimia nervosa depression and personality disorders. From a perfectionists point of view, perfection exists and
its attaintment is feasible. The existence of a particularly high and often unrealistic goal can
lead the person to severe disappointment when this specific goal is not finally reached. A person with functional perfectionism is possible to set another, more achievable, goal next time,
while a person with clinical perfectionism will interpret this failure as a sign of personal inadequacy and will either make another attempt to reach the same goal or will abandon the
effort altogether. A sense of weakness and subsequent negative automatic thoughts are the
aftermath of both the first and the second choice. Cognitive Behavioral Therapy focuses on
the realisation that clinical perfectionism is undesirable, on the dispute of negative automatic
thoughts and on the replacement of unfunctional cognitive schemas with other, more func-

70

E. .

23 (1), 2012

tional ones. In the therapeutic process, one individual can learn how to set specific and realistic
goals, to focus on the process of a task instead of its result, to organise activities in a hierarchy
depending on their significance and, finally, to feel fulfilled even if they have not brought a
task to completion. It is a fact that the core schemas of clinical perfectionism are characterised
by rigidity due to the excessive number of secondary benefits they provide for one person.
The exploration of those benefits and the discovery of alternative sources of fulfillment are
areas of therapeutic work.
Key words: Perfectionism, schemas, cognitive behavioral therapy.

1. F
 erguson KL, Rodway MR. Cognitive Behavioral Treatment
of Perfectionism: Initial Evaluation Studies. Res Soc Work
Pract 1994, 4:283308
2. F
 rost RO, Marten P, Lahart C, Rosenblate R. The dimensions
of perfectionism. Cognit Ther Res 1990, 14:449468
3.
 aplan HIS, Sadock BJ (eds) . .
, , 2000
4. H
 orney, K. Neurosis and human growth. Norton, New York,
1950
5. A
 ntony MM, McCabe RE. Perfectionism. In: Freeman et al
(eds) Encyclopedia of Cognitive Behavioral Therapy. Springer,
USA, 2005:273277
6. P
 acht, AR. Reflections on perfection. American Psychologist
1984, 39:386390
7.
 , . . .

, , 1994
8. H
 amachek DE. Psychodynamics of normal and neurotic perfectionism. Psychology 1978, 15:2733
9. T
 erry-Short LA, Owens RG, Slade PD, Dewey ME. Positive
and negative perfectionism. Personal Individ Differenc 1995,
18:663668
10. A
 dkins KK, Parker W. Perfectionism and suicidal preoccupation. J Personal 1996, 64:529543
11. R
 haume J, Freeston MH, Ladouceur R, Bouchard C, Gallant
L, Talbot F et al. Functional and dysfunctional perfectionists:
Are they different on compulsive-like disorders? Behav Res
Ther 2000, 38:119128
12. R
 ice K, Bair CJ, Castro JR, Cohen BN, Hood CA. Meanings
of Perfectionism: A Quantitative and Qualitative Analysis. J
Cognit Psychother 2003, 17:3958

17. R
 ice KG, Mirzadeh SA. Perfection, Attachment and Adjustment.
J Counsel Psychol 1999, 47:238250
18. E
 nns MW, Cox BJ, Clara I. Adaptive and maladaptive perfectionism: developmental origins and association with depression proness. Personal Individ Differenc 2002, 33:921935
19. F
 lett GL, Hewitt PL, Singer A. Perfectionism and parental
authority styles. Individual Psychology: J Adlerian Theor Res
Pract 1995, 51:5060
20. K
 awamura KY, Frost RO, Harmatz MG. The relationship of
perceived parenting styles to perfectionism. Personal Individ
Differenc 2002, 32:317327
21. H
 ollander MH. Perfectionism. Comprehens Psychiatry 1965,
6:94103
22. H
 ewitt PL, Flett GL, Turnbull-Donovan W, Mikail SF. The
Multidimensional Perfectionism Scale: Reliability, validity, and
psychometric properties in psychiatric samples. Psychologic
Assessm 1991, 3:464468
23. A
 ntony MM, Purdon CL, Huta V, Swinson RP. Dimensions of
perfectionism across the anxiety disorders. Behav Res Ther
1998, 36:11431154
24. S
 toeber J. The Frost Multidimensional Perfectionism Scale:
More perfect with four (instead of six) dimensions. Personal
Individ Differenc 1998, 24:481491
25. E
 llis A. The role of irrational beliefs in perfectionism. In:
Flett, Hewitt (eds) Perfectionism: Theory, research, and treatment. American Psychological Association, Washington DC,
2002:217229
26. S
 hafran R, Mansell W. Perfectionism and psychopathology:
A review of research and treatment. Clin Psychol Rev 2001,
21:879906

13. S
 toeber J, Otto K. Positive Conceptions of Perfectionism:
Approaches, Evidence, Challenges. Personal Soc Psychol
Rev 2006, 10:295319

27. C
 lark DM, Wells A. A cognitive model of social phobia. In:
Heimberg, Liebowitz, Hope, Scneier (eds) Social phobia:
Diagnosis, assessment and treatment. Guildford Press, New
York, 1995:6993

14. E
 gan SJ, Piek JP, Murray JD, Rees CS. The role of dichotomous thinking and rigidity in perfectionism. Behav Res Ther
2007, 45:18131822

28. H
 awton, K, Clarke D, Salkovskis P, Kirk J (eds) Cognitive
Behavioral Therapy for Psychiatric Problems. A Practical
Guide. Oxford University Press, USA, 1998

15. S
 lade PD, Owens RG. A dual process model of perfectionism based on reinforcement theory. Behav Modific 1998,
22:372390

29. A
 shbaugh A, Antony MM, Liss A, Summerfeldt LJ, McCabe,
RE, Swinson RP. Changes in perfectionism following cognitive behavioral treatment for social phobia. Depress Anxiet
2007, 24:169177

16. R
 iley C, Lee M, Cooper Z, Fairburn CG, Shafran R. A randomized controlled trial of cognitive-behaviour therapy for
clinical perfectionism: A preliminary study. Behav Res Ther
2007, 45:22212231

30. R
 osser S, Issakidis C, Peters L. Perfectionism and social phobia: Relationship between the constructs and impact on cognitive behavior therapy. Cognit Ther Res 2003, 27:143151

PSYCHIATRIKI 23 (1), 2012

31. J
 uster HR, Heimberg RG, Frost RO, Holt CS, Mattia JI,
Faccenda K. Social phobia and perfectionism. Personal
Individ Differenc 1996, 20:323
32. F
 lett GL, Hewitt PL. Possitive versus negative perfectionism
in psychopathology. Behav Motivat 2006, 30:472495
33. F
 riedlander ML, Siegel SM. Separation-individuation difficulties and cognitive behavior indicators of eating disorders
among college women. J Counsel Psychol 1990, 37:7478
34. S
 hafran R, Cooper Z, Fairburn CG. Clinical perfectionism:
A cognitive behavioural analysis. Behav Res Ther 2002,
40:773791
35. B
 ardone-Cone AM, Wonderlich SA, Frost RO, Bulik CM,
Mitchell JE, Uppala S et al. Perfectionism and eating disorders: Current status and future directions. Clin Psychol Rev
2007, 27:384405
36. F
 ranco-Paredes K, Mancilla-Diaz JM, Vazquez-Arevalo R,
Lopez-Aguilar X, Alvarez-Rayon G. Perfectionism and eating disorders: a review of the literature. Eur Eat Disord Rev
2005, 13:6170
37. C
 ockell SJ, Hewitt PL, Seal B, Sherry S, Goldner EM, Flett
G et al. Train and self-presentational dimensions of perfectionism among women with anorexia nervosa. Cognit Ther
Res 2002, 26:745758

71

41. A
 rpin-Cribbie CA, Cribbbie RA. Psychological correlates
of fatigue: Examining depression, perfectionism, and auto
matic negative thoughts. Personal Individ Differ 2007, 43:
13101320
42. B
 latt SJ. The destructiveness of perfectionism: Implications
for the treatment of depression. Am Psycholog 1995, 50:
10031020
43. H
 ewitt PL, Dyck D. Perfectionism, stress, and vulnerability to
depression. Cognit Ther Res 1986, 10:137142
44. H
 ewitt PL, Flett GL, Weber C. Dimensions of perfectionism
and suicide ideation. Cognit Ther Res 1994, 18:439460
45. S
 orotzkin, B. Understanding and treating perfectionism in
religious adolescents. Psychotherapy 1998, 35:8795
46. S
 pence JT, Robbins AS. Workaholism: Definition, Measu
rement, and Preliminary Results. J Personal Assessm 1992,
58:160178
47. R
 haume J, Freeston MH, Dugas MJ, Letarte H, Ladouceur
R. Perfectionism, responsibility and obsessive-compulsive
symptoms. Behav Res Ther 1995, 33:785794
48. M
 cCown WG, Carlson G. Narcissism, perfectionism, and
self-termination from treatment in outpatient cocain users. J
Ration-Emot Cognit Ther 2004, 22:325336

38. V
 ohs KD, Voelz ZR, Pettit, JW, Bardone AM, Katz J, Abramson
LY et al. Perfectionism, body dissatisfaction, and self-esteem:
An interactive model of bulimic symptom development. J Soc
Clin Psychol 2001, 20:476497
39. S
 teele A, Corsini N, Wade TD. The interaction of perfectionism, perceived weight status, and self-esteem to predict
bulimic symptoms: The role of "benigh" perfectionism. Behav
Res Ther 2007, 45:16471655
40. B
 eck AT. Depression: Clinical, experimental and theoretical
aspects. Harper and Row, New York, 1967

: . , ,
19, 141 21 ,
T.: +30 210-28 53 577