A Social Clinical Perspective on Perfectionism in Disordered Eating Behaviour

ABSTRACTAll over Australia, disordered eating rates are increasing. Decades of research have indicated that perfectionism is a key risk factor for disordered eating behaviour. While there remains some debate about the specific facets of perfectionism, there is general agreement that perfectionism can be delineated based on the perceived source: self-oriented perfectionism (i.e., “I must be perfect”) and socially prescribed perfectionism (i.e., “They require me to be perfect”). Conceptually, this overlaps with social psychology. Specifically, this mirrors traditional social identity approaches of how individuals integrate personal identity content with social identity content. However, to date no research has used a social psychological approach to understand how perfectionism comes about, how it may lead to disordered eating behaviour, and thereby imply how social psychology could aid in therapeutic approaches to reduce perfectionism. In this thesis, I argue that self-oriented perfectionism and socially prescribed perfectionism are analogous to personal identity content and social identity content. Across five papers, I present evidence for this social identity approach to perfectionism in disordered eating. Firstly, I present the Consolidated Perfectionism Model to explain how self-oriented perfectionism and socially prescribed perfectionism can be considered from a social identity perspective, integrating cross cultural, clinical, and sociocultural perspectives on perfectionism in disordered eating. Secondly, I present qualitative evidence suggesting that self-oriented perfectionism is absorbed through intrapersonal factors, and socially prescribed perfectionism is in fact a self-control norm transmitted through “fat talk.” Third, through two correlational studies, we find that perfectionism pressure does appear to relate to thin ideal beliefs, but in another study, low self-control was related to disordered eating above body dissatisfaction. Fourthly, I present data that suggests socially prescribed perfectionism relates to disordered eating through negative urgency (a facet of self-control), indicating that disordered eating behaviour is driven by a negative reaction to socially prescribed perfectionism norms present within the immediate social environment. Fifth and finally, I present evidence that we can reduce socially prescribed perfectionism by manipulating the context of health messages to counter perfectionism. We conclude by discussing how this new perspective can add to therapies designed to reduce perfectionism. This thesis adds to social psychological theory by further presenting evidence that the social identity approach has utility in changing toxic group-based beliefs. However, it also has implications for clinical psychology, by presenting evidence that the use of explicit social psychological frameworks may add to traditional clinicalapproaches. Overall, this thesis presents strong evidence for the use of social psychology approaches to clinical disorders, especially in disordered eating.