Perfectionism and Adolescent Mental Health: Models of Risk and Resilience

Background: Perfectionism can relate to mental health and is thought to develop during adolescence, a period in which many mental health problems first emerge. Perfectionism literature, however, relies on adult-derived models of perfectionism, failing to consider alternative presentations of perfectionism during adolescence. Additionally, although perfectionism has been described as transdiagnostic, few studies have explored this quality through consideration of multiple disorders in a unified sample.
Aims: Our study aimed to (1) explore the factor structure of two prominent measures, the Child-Adolescent Perfectionism Scale (CAPS) and the Clinical Perfectionism Questionnaire (CPQ), in an adolescent population and (2) use data modelling techniques to examine the relationships between discrete types of perfectionism and three mental health disorders in this developing population.
Methods: A large-scale survey design incorporating validated self-report questionnaires was used. 507 Scottish adolescents (272 females, 233 males; age range: 12.24-15.50 years) completed the CAPS and CPQ alongside measures of depression, anxiety, and eating disorder risk. Exploratory and confirmatory factor analyses were conducted to identify robust factor structures of the CAPS and CPQ in adolescents. Path analyses using structural equation modelling were then performed to identify unique relationships between perfectionism and mental health variables.
Results: The CAPS was found to have a 3-factor structure, using 17-items, reflecting socially-prescribed perfectionism, self-oriented perfectionism-criticism, and self-oriented perfectionism-striving. The CPQ had a 2-factor structure, using 7-items, reflecting perfectionistic strivings and perfectionistic concerns. Unique models were established for each mental health disorder, demonstrating diverse relationships between perfectionism factors and mental health problems. Only perfectionistic concerns were found to be transdiagnostic to all three disorders.
Conclusions: This study highlights the differential ways in which perfectionism factors can act as risk or resilience factors for mental illness during adolescence. Our findings may inform future development of mental health or perfectionism prevention and intervention programmes targeted at adolescents.