Category: Eating Disorders
Perfectionistic self-presentation (i.e., underlying need to proclaim/display perfection and avoid displaying and/or disclosing imperfection) is a risk factor for eating disorders (EDs), particularly anorexia nervosa (AN). Retrospective childhood reports of perfectionism are associated with later development of EDs. Moreover, perfectionistic self-presentation is correlated with dietary restriction, and is found at higher rates in women with AN than psychiatric and healthy controls. However, it is unclear what mechanism underlies the relation between perfectionistic self-presentation and excessive dietary restriction/AN. One potential contributing factor is social anxiety. Indeed, perfectionistic self-presentation is also a risk factor for Social Anxiety Disorder (SAD). SAD is highly comorbid with EDs (55%), with most individuals reporting SAD onset in childhood prior to the development of AN. Thus, perfectionistic self-presentation may be a risk factor for the development of excessive dietary restriction/AN through social anxiety. The current study examined relations between perfectionistic self-presentation, measured by the Perfectionistic Self-Presentation Scale, social anxiety, captured by Social Phobia Scale-6, and AN pathology (i.e., dietary restriction, excessive exercise, purging, body dissatisfaction), assessed by the Eating Pathology Symptoms Inventory, in a large community sample (N = 419; M age = 39.9, SD = 12.9; 67.1% female). Structural equation modeling was conducted to test whether Perfectionistic Self-Presentation was indirectly related to AN through social anxiety symptoms. Perfectionistic Self-Presentation was directly related to Social Anxiety (β = 0.58, p < .001), Dietary Restriction (β = 0.30, p < .001), Excessive Exercise (β = 0.24, p < .001), Purging (β = 0.23, p < .001), and Body Dissatisfaction (β = 0.49, p < .001). Social Anxiety completely explained the relation between Perfectionistic Self-Presentation and Dietary Restriction and Purging (β = 0.19, 95% CI [0.09, 0.29]; β = 0.27, 95% CI [0.17, 0.36], respectively), and partially explained the relation between Perfectionistic Self-Presentation and Body Dissatisfaction (β = 0.17, 95% CI [0.10, 0.24]). No indirect effect of Social Anxiety was found for Excessive Exercise (β = 0.06, 95% CI [-0.03, 0.149]). When the indirect effects of Social Anxiety were included in the model, there were still direct effects of Perfectionistic Self-Presentation on Body Dissatisfaction and Excessive Exercise (β = 0.32, 95% CI [0.20, 0.44]; β = 0.18, 95% CI [0.05, 0.33], respectively).These findings help elucidate the relation between perfectionism and disordered eating by suggesting a novel mechanism by which perfectionistic self-presentation influences AN pathology.