Perfectionism in anorexia nervosa: Variation by clinical subtype, obsessionality, and pathological eating behavior

Objective: The purpose of this study was to examine the role of perfectioni sm as a phenotypic trait in anorexia nervosa and its relevance across clini cal subtypes of this illness. Method: The Multidimensional Perfectionism Scale and the perfectionism subs cale of the Eating Disorder Inventory were administered to 322 women with a history of anorexia nervosa who were participating in an international, mu lticenter genetic study of anorexia nervosa. All participants were addition ally interviewed with the Yale-Brown Obsessive Compulsive Scale and the Yal e-Brown-Cornell Eating Disorder Scale. Mean differences on dependent measur es among women with anorexia nervosa and comparison subjects were examined by using generalized estimating equations. Results: Persons who had had anorexia nervosa had significantly higher tota l scores on the Multidimensional Perfectionism Scale than did the healthy c omparison subjects. In addition, scores of the anorexia subjects on the Eat ing Disorder Inventory-2 perfectionism subscale exceeded Eating Disorder In ventory-2 normative data. For the anorexia nervosa participants, the total score on the Multidimensional Perfectionism Scale and the Eating Disorder I nventory-2 perfectionism subscale score were highly correlated. Total score on the Multidimensional Perfectionism Scale was also significantly related to the total score and the motivation-for-change subscale score of the Yal e-Brown-Cornell Eating Disorder Scale. Conclusions: These data show that per fectionism is a robust, discriminatin g characteristic of anorexia nervosa. Perfectionism is likely to be one of a cluster of phenotypic trait variables associated with a genetic diathesis for anorexia nervosa.