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When Does Conscientiousness Become Perfectionism? Traits, Self-Presentation Styles, and Cognitions Suggest a Persistent Psychopathology

2007; Frontline Medical Communications; Volume: 6; Issue: 7 Linguagem: Inglês

1537-8276

Paul L. Hewitt, Gordon L. Flett,

Personality Disorders and Psychopathology

Mr. C is a 50-year-old professional writer who recently made a serious suicide attempt. At his initial session, Mr. C was hesitant to discuss his situation and reason for attending. He did, however, bring a copy of his resume so the therapist could get to know him quickly. [ILLUSTRATION OMITTED] He said he had been depressed for a long time, especially since he found an error in one of his published works. His confidence and writing abilities seemed to decline after this discovery, his career took a downturn, and ultimately he was fired from his position. He described often being at odds with his supervisors at work, whom he saw as critical and condescending. He was mortified by his job loss and did not inform his wife or friends of his firing. Mr. C had always been a bit of a loner, and after losing his job he further distanced himself from others. He began drinking heavily to avoid the pain of letting everyone down. His wife, family, and friends were shocked at the suicide attempt and expressed dismay that Mr. C had not confided in anyone. Mr. C describes himself as being perfectionistic throughout his life and never being quite good enough in any of his pursuits. This leads to self-recriminations and persistent feelings of shame. Far from being a positive attribute, is a neurotic personality style that can result in serious psychopathology, including relationship problems, depression, anorexia nervosa, and suicide. Determining a patient's perfectionistic traits is essential when evaluating those who seek treatment specifically for this distressing behavior as well as patients in treatment for other issues who may have a perfectionistic personality. Accurately assessing can help you predict and forestall noncompliance, assess suicide risk, determine appropriate treatment and identify circumstances under which a patient might be particularly vulnerable to relapse. This article describes: * 3 traits of * 3 dimensions of perfectionistic self-presentation * perfectionistic cognitions * useful self-report tools for clinical practice * effective treatments. Characteristics of Although initially was viewed as self-related cognitions, recent models suggest it incorporates intrapersonal and interpersonal dimensions. (1) A person with has a marked need for absolute perfection for the self and/or others in many--if not all--pursuits that is strongly rooted in his or her intrapersonal and interpersonal worlds. Other characteristics of include: * equating self-worth or esteem with performance * self-punishment in failure and a lack of satisfaction in success * maintaining and needing to strive for unrealistic expectations * unrealistic criteria for success and broad criteria for failure. Some clinicians have suggested that may be adaptive, (2) but adaptive perfectionism is more likely a reflection of conscientiousness or achievement striving (Table 1). Although can involve rumination, it is much broader than simply having an obsessional cognitive style. We define as a neurotic personality style involving perfectionist traits, self-presentation styles, and cognitions that is a core vulnerability factor for a variety of psychological, physical, achievement, and relationship problems (Table 2). (1,3) 3 traits. Three traits of reflect the desire for the self or others to be perfect: * self-oriented -- a requirement for the self to be perfect * other-oriented -- a requirement for others to be perfect * socially prescribed -- a perception that others require perfection of oneself. Each of these traits is associated with different Axis I and Axis II disorders, which we outline below. …