Investigating the utility of a self-schema model of perfectionism in understanding anorexia nervosa

Abstract

This research describes and evaluates a self-schema perfectionism model in understanding anorexia nervosa (AN) . Female AN patients (n = 105) and university students (n = 297) completed self-report questionnaires pertaining to perfectionism, eating disorder pathology, psychopathology, and self-schema perfectionism in the domain of weight and shape. Also, adolescent girls in treatment together for AN (n = 7) were interviewed individually about inpatient relational experiences. Self-schema perfectionism was initially a unique predictor of dietary restraint, controlling for trait perfectionism measures (Hewitt & Flett, 1991), accounting for a larger proportion of unique dietary restraint variance for nonclinical women (38.1% versus 8.1%). Second, compared to nonclinical women, women with AN exerted more effort pursuing weight/shape standards, evaluated their performance more favourably, and had higher striving intention (an index of raised weight/shape standards). Self-schema perfectionism and exerting effort were significant predictors of dietary restraint for both groups. Raising standards did not have explanatory utility. Third, when physical appearance comparison was entered into the model, it was a significant predictor of dietary restraint for women with AN, for who self-schema perfectionism lost its predictive utility. Physical appearance comparison was not a significant predictor of dietary restraint in nonclinical women, for who self-schema perfectionism retained its predictive utility. Quantitative and qualitative findings, together, indicated that self-schema perfectionism has limited utility in understanding dietary restraint in AN and cannot be recommended to inform treatment. Whereas dietary restraint in nonclinical women may relate to self-concept, in women with AN, dietary restraint and broader body-related attitudes and behaviour may be influenced greatly by relational and contextual factors.