Cited by 146Eating Disorders and BehaviorsPerfectionism, Procrastination, Anxiety StudiesBody Image and Dysmorphia Studies

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Perfectionism in anorexia nervosa: A 6–24 month follow-up study

Sutandar‐Pinnock, Kalam, Blake Woodside, D., Carter, Jacqueline C., Olmsted, Marion P., Kaplan, Allan S.·2003·International Journal of Eating Disorders

DOI 10.1002/eat.10127

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Abstract

Objective This study examined the relationship between perfectionism and outcome in anorexia nervosa (AN). Method Seventy-three patients received inpatient treatment for AN. Participants completed the Eating Disorder Inventory (EDI) at admission to (n = 55), at discharge (n = 27), and at a median of 15.9 months (n = 49) after inpatient treatment. At follow-up, participants also completed the Multidimensional Perfectionism Scale (MPS) and their scores were compared with those of healthy controls. Results EDI Perfectionism was associated with illness status. A lower EDI Perfectionism score at admission was associated with a better response to treatment, which was subsequently associated with better outcome at follow-up. Both the good and poor outcome groups had significantly higher MPS total perfectionism scores than healthy controls. Discussion The EDI measures an aspect of perfectionism that is sensitive to illness status, whereas the MPS is less dependent on clinical state and may reflect a common personality trait that persists with remission of disease.

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The dimensions of perfectionism
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“In addition, perfectionism has been found to impact treatment outcome, being predictive of poorer treatment prognosis and higher treatment attrition rate (Bizeul et al., 2001; KeskiRahkonen et al., 2014; Sutandar-Pinnock et al., 2003).”
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Intolerance of uncertainty and repetitive negative thinking: transdiagnostic moderators of perfectionism in eating disorders
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“Furthermore, high levels of per-fectionism appear to be a negative predictor of treatment outcomes, especially in patients with anorexia nervosa [11, 12].”
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Internal consistency, test-retest reliability and construct validity of the Frost Multidimensional Perfectionism Scale
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Psychological variables impacting weight gain rapidity in adolescents hospitalized for eating disorders.
Phillips, R., Stewart, S., Presnell, K. E., Simmons, A., Kennard, B., Liss, D. S., & Setliff, S. (2010) · European eating disorders review · doi:10.1002/erv.998 · Cited by 11
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“All in all, our findings are only partially in line with studies proposing perfectionism as hampering treatment outcome (Mitchell et al., 2013; Sutandar-Pinnock et al., 2003).”
Result
Personality disorder traits, obsessive ideation and perfectionism 20 years after adolescent-onset anorexia nervosa: a recovered study
Gárriz, M., Andrés-Perpiñá, S., Plana, M. T., Flamarique, I., Romero, S., Julià, L., & Castro‐Fornieles, J. (2020) · Eating and Weight Disorders - Studies on Anorexia Bulimia and Obesity · doi:10.1007/s40519-020-00906-7 · Cited by 16
Improving mealtimes for patients and staff within an eating disorder unit: understanding of the problem and first intervention during the pandemic—an initial report
Gardner, L., & Trueman, H. (2021) · BMJ Open Quality · doi:10.1136/bmjoq-2021-001366 · Cited by 9
Psychological Profiles of Women with a Past or Present Diagnosis of Anorexia Nervosa
Bachner-Melman, R., Zohar, A., Kremer, I., & Ebstein, R. (2007) · The Internet Journal of Mental Health · doi:10.5580/1a20 · Cited by 8
“Several studies have shown that personality traits such as novelty seeking (30), and perfectionism (31, 32) are in fact predictive of prognosis.”
Background
Perfectionism and low self- esteem across the continuum of eating disorders in adolescent girls from Buenos Aires
Rutsztein, G., Scappatura, M. L., & Murawski, B. (2014) · Revista Mexicana de Trastornos Alimentarios/Mexican Journal of Eating Disorders · doi:10.1016/s2007-1523(14)70375-1 · Cited by 9
Neuroticism and clinical course of weight restoration in a meal-based, rapid-weight gain, inpatient-partial hospitalization program for eating disorders
Fischer, L. K., Schreyer, C. C., Coughlin, J. W., Redgrave, G., & Guarda, A. (2017) · Eating Disorders · doi:10.1080/10640266.2016.1241056 · Cited by 7
“Perfectionism, a trait associated with neuroticism (Enns, Cox, Sareen, & Freeman, 2001) has also been shown to be predictive of treatment outcome at follow-up in AN (Sutandar-Pinnock et al., 2003).”
Background
Variability in College Student Suicide
Stephenson, J., Belesis, M. P., & Balliet, W. E. (2005) · Journal of College Student Psychotherapy · doi:10.1300/j035v19n04_02 · Cited by 19
The Mediator Effect of Personality on the Relationship Between Symptomatic Impairment and Treatment Outcome in Eating Disorders
Muzi, L., Tieghi, L., Franco, A., Rugo, M. A., & Lingiardi, V. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.688924 · Cited by 8
“, 2006) that tend to persist after ED recovery (von Ranson et al., 1999; Sutandar-Pinnock et al., 2003).”
Background
The Depiction of Female Models in Sport Television Commercials in the United States by Degree of Slenderness: An Appraisal
Peterson, R. T., Xu, B., & Limbu, Y. B. (2009) · Journal of Promotion Management · doi:10.1080/10496490902881997 · Cited by 6
“Further, research has found an association between perfectionism motives and anorexia/bulimia ( Sutandar-Pinnock et al, 2003 ).”
Background
Cognitive bias modification for perfectionism and intolerance of uncertainty: A randomized controlled trial
Tör‐Çabuk, K., & Koç, V. (2024) · PsyCh Journal · doi:10.1002/pchj.742 · Cited by 6
The relationship between perfectionism and discounting measures
Wainwright, K., & Romanowich, P. (2016) · Personality and Individual Differences · doi:10.1016/j.paid.2016.06.042 · Cited by 3
Utilité d’un carnet de suivi quotidien dans la thérapie de l’anorexie mentale
Monthuy-Blanc, J., Ninot, G., Morin, A., Pauzé, R., Guillaume, S., Rouvière, N., & Campredon, S. (2008) · doi:10.1016/j.jtcc.2008.10.005 · Cited by 5
“[14] Sutandar-Pinnock K, Woodside BD, Carter JC, Olmsted MP, Kaplan AS.”
Background
Autistic traits and perspective taking in youths with anorexia nervosa: an exploratory clinical and eye tracking study
Fantozzi, P., Billeci, L., Muratori, P., Maestro, S., Muratori, F., Chakrabarti, B., & Calderoni, S. (2024) · Journal of Eating Disorders · doi:10.1186/s40337-024-01075-z · Cited by 6
“Perfectionism represents a risk and maintenance factor for AN [81, 82] and is also configured as a predictor of worse prognosis and frequent dropouts in the treatment [83, 84].”
Background
Cognitive and Interpersonal Factors in Adolescent Inpatients with Anorexia Nervosa: A Network Analysis
Delaquis, C. P., Godart, N., Fatseas, M., & Berthoz, S. (2023) · Children · doi:10.3390/children10040730 · Cited by 4
“Items are rated on a five-point Likert scale and demonstrate sound psychometric properties in patients with AN [51].”
Background
Perfectionism as Possible Predictor for Treatment Success in Mindfulness-Based Cognitive Therapy and Metacognitive Training as Third-Wave Treatments for Obsessive-Compulsive Disorder
Claus, N., Miegel, F. S., Jelinek, L., Landmann, S., Moritz, S., Külz, A. K., Rubel, J. A., & Cludius, B. (2023) · Cognitive Therapy and Research · doi:10.1007/s10608-023-10361-0 · Cited by 5
Perfectionism in eating disorders: Are long-term outcomes influenced by extent and changeability in initial perfectionism?
Petersson, S., Brudin, L. H., Clinton, D. N., Perseius, K., & Norring, C. E. A. (2018) · Journal for Person-Oriented Research · doi:10.17505/jpor.2018.01 · Cited by 3
El papel del perfeccionismo en la insatisfacción corporal, la influencia sociocultural del modelo de delgadez y los síntomas de trastorno del comportamiento alimentario
Franco‐Paredes, K., Díaz, J. M. M., Arévalo, R. V., Rayón, G. Á., & Aguilar, X. L. (2010) · Universitas Psychologica · doi:10.11144/javeriana.upsy10-3.ppic · Cited by 6
Classifying symptom change in eating disorders: clinical significance metrics for the Change in Eating Disorder Symptoms Scale.
Hwang, A. D., & Spangler, D. L. (2016) · Eating Behaviors · doi:10.1016/j.eatbeh.2015.12.003 · Cited by 3
Eating Disorders: an Overview
Watkins, B. (2011) · Wiley eBooks · doi:10.1002/9781119998402.ch2 · Cited by 3
A Study on the Mediating Effects of Job-stress on the Relationship between the Female College Students' Self-oriented Perfectionism and Binge Eating
Lee, Y.-R., & Kim, N.-J. (2015) · The Journal of the Korea Contents Association · doi:10.5392/jkca.2015.15.01.233 · Cited by 2
Zur Auswirkung der Angst anorektischer Patientinnen auf die allgemeine Befindlichkeit
Persch, F. (2008) · OPen Access Repositorium der Universität Ulm (OPARU) (Ulm University) · doi:10.18725/oparu-1614 · Cited by 1
Thirty-year outcome of anorexia nervosa: healthcare use and disability
Dobrescu, S. R., Dinkler, L., Gillberg, I. C., Gillberg, C., Råstam, M., Bolin, K., & Wentz, E. (2025) · The British Journal of Psychiatry · doi:10.1192/bjp.2025.10494
“44,45 One possible reason why individuals with premorbid perfectionism use less healthcare is that they may follow treatment recommendations more closely, making them less likely to relapse.”
Perfectionism as Possible Predictor for Treatment Success: Preliminary Data From Metacognitive Training for Depression and Suicidal Ideation in an Inpatient Sample
Claus, N., Scheunemann, J., Arlt, S., Peth, J., Gallinat, J., Cludius, B., & Jelinek, L. (2025) · Journal of Clinical Psychology · doi:10.1002/jclp.70027
“…various disorders, such as anxiety disorders (Ashbaugh et al. 2007; Mitchell et al. 2013), eating disorders (Bizeul et al. 2001; De Cuyper et al. 2019; Sutandar ‐ Pinnock et al. 2003; Welch et al. 2020), and obsessive ‐ compulsive disorder (Chik et al. 2008; Kyrios et al. 2015; Manos et al. 2010).”
Anorexie mentale et EMDR : un cas clinique
Zaccagnino, M., Cussino, M., Callerame, C., Civilotti, C., & Fernández, I. (2018) · Journal of EMDR Practice and Research · doi:10.1891/1933-3196.12.4.e64
Discriminatory mechanism of anorexic and binge eating behaviors of young adult women: Focusing on the multidimensional concept of perfectionism and difficulties in emotion regulation
Lee, S., & 오미영 (2016) · Korean Journal of Health Psychology · doi:10.17315/kjhp.2016.21.2.009

Authors: Sutandar‐Pinnock, K., Blake Woodside, D., Carter, J. C., Olmsted, M. P., & Kaplan, A. S.
Affiliations: University Health Network (CA)
ORCID: Carter, Jacqueline C.
Olmsted, Marion P.
Kaplan, Allan S.
Venue: International Journal of Eating Disorders
Publisher: Wiley
Published: 2003-02-25
Volume: 33
Issue: 2
Pages: 225-229
ISSN: 0276-3478 (ISSN-L)
1098-108X
DOI: 10.1002/eat.10127
OpenAlex: W2141028945
Cited by: 146
References: 0
Citations by year: 2025: 3 · 2024: 4 · 2023: 4 · 2022: 2 · 2021: 5 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 6 · 2016: 11 · 2015: 7 · 2014: 13 · 2013: 8 · 2012: 7
FWCI: 7.85
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: International Journal of Eating Disorders (publishedVersion)
PubMed (publishedVersion)
Library and Archives Canada (Government of Canada) (submittedVersion)
TSpace (University of Toronto) (submittedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
Social Sciences › Psychology › Clinical Psychology › Perfectionism, Procrastination, Anxiety Studies
Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
Keywords: perfectionism, anorexia nervosa, treatment outcomes, inpatient care, Eating Disorder Inventory, Multidimensional Perfectionism Scale, personality traits, remission
MeSH terms: Adult, Anorexia Nervosa, Female, Follow-Up Studies, Humans, Male, Personality Disorders, Surveys and Questionnaires, Severity of Illness Index

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Perfectionism in anorexia nervosa: A 6–24 month follow-up study

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