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The Association between the Idea of Perfectionism and Seven Psychotic Disorders

The world is developing at a rapid pace, but the idolization of how one should look has become more of issues. The societal acceptance of certain aspect of human body, more and more women are becoming conscious about their body and how they look. In order to achieve that standard, they often have thoughts and behavior which does not benefit their health. Anorexia or bulimia nervosa is one of the food disorders which are initiated as a result of consciousness about body imaging. Women develop these disorders in order to achieve to lose weight and be thin. These women usually have the idea of perfectionism in their mind, and it leads to food disorder when women have low self-esteem or are dissatisfied with their body.

The primary of the study was to explore the association between the idea of perfectionism and seven psychotic disorders. Another aim of the study was to determine the extent to which the aspects of perfectionism are associated with anorexia nervosa and bulimia nervosa (Bulik et al., 2003). The study was carried out nationwide on the female twin who was born between the year 1934 and 1974. The data of the twin females were taken from population-based twin registry from Virginia. There were four interview rounds for the selected twin between the years 1988 to 1997. In the year 1999, a set of questionnaires were mailed to approximately 3050 female twins and 49.5 percent making 1510 female twins returned the filled questionnaire. A total of 1010 female twins were the participants in the study, and these were the females who had the diagnostics characteristics from the interview rounds and have returned the filled questionnaire. All the participant were from the Caucasian origin, and the mean age of the participants was 42.5 years with the standard deviation of 8.2 (Bulik et al., 2003).

The questionnaire was the primary tool for the study, and it has included the 12 items from the multimedia dimension perfection scale. The multimedia perfection scale has a total of six sections which are concerns for the mistake, doubt about the actions, personal standards of the individuals, organization, parental criticism and parental expectations (Bulik et al., 2003). However, for the case of this study, only four sections which were focusing on individual characteristics were included. Data from the interviews were used for the diagnostic purposes, and other psychiatrists, as well as substance abuse disorders, were measured using the standardized which is the Structured Clinical Interview for DSMIII-R with exceptions of definitions and other criteria.

Participant’s’ right was taken into account such as before face-face interview rounds written informed consent was taken from the participant and before telephonic interviews verbal informed consent was taken from the participants. The data was taken from the studies which were ethically approved by Virginia Commonwealth University Institutional Review Board and the Western Institutional Review Board. The data were analyzed using the logistic regression. Dependent variables were the psychotic disorders which were the part of the study, and the perfectionism scale was considered as the independent variable of the study. The data was controlled for the other variables which can impact the result of anorexia and bulimia nervosa.

Part B-Findings and conclusion:

The result shows that among all the psychiatric disorders depression, any kind of phobia and generalized anxiety disorder have the highest prevalence with 30.3 percent for depressions, 29.2 percent for phobia and 22.9 percent for anxiety disorders (Bulik et al., 2003). Anorexia nervosa and bulimia nervosa prevalence was the lowest among all groups because it accounts for only 3 and 9 percent respectively of the participants included in the study. The study also showed that concerns over the mistake was associated with significantly high odds of anorexia nervosa and bulimia nervosa. Similarly doubts about actions were associated with both food disorders, panic disorders, generalized anxiety disorders and phobias. A regression model was run to predict anorexia nervosa and bulimia nervosa and result which was observed was that concern over mistake was the only significant predicted variable for bulimia nervosa with beta estimate of 0.41 and p-value of 0.01 (Bulik et al., 2003).

Overall the study concluded that there was a significant association between perfectionism scale and the occurrence anorexia nervosa and bulimia nervosa. Concerns over mistakes which was a subscale in perfectionism scale has significant association with both food disorders as it measures the negative reaction of the individuals about their mistake and in this way individual consider their mistakes as failures. The results was also reconfirmed by multivariate regression model that this subscale has strong association with eating disorders. The study has some limitation such as the data collection was not prospective and other disorders which can impact the eating disorders such as obsessive-compulsive orders were not considered in the study. Also, the response rate for the study was less than 50 percent (Bulik et al., 2003).

Part c-Critique:

Overall the study has provided some significant association and insight on the eating disorder but the study has not be describe comprehensively. From the start the study has a great introduction but the method section was not robust. The introduction section meet the standardized criteria for the quantitative study but the methods section has some aspects or sections missing. For example, the study design, how the participant were selected, what was the exclusion and inclusion criteria was not mentioned in the method section of the study. The section is also missing on the operational definitions. For example, in the start of the result section it is mentioned that education of the participants was considered but non information on the level of the education and other aspects. Till the middle, the reader was not aware about the design of the study and later it was mentioned that data was taken from the other studies.

The result section of the study also has not structure such as what were the demographic characters of the study, initial results and other aspects. The information provided in almost all the sections of the study is confusing and is just there with no coherence. Reader who has not sound knowledge about other studies, logistic regression or even the disorders cannot comprehend the results or information provided in the study. The information provided on the scales which were used to measure the variables was not present in the study. Also, the discussion section does not have the strengths of the study and only limitations were defined. In short, the study has provided the insight on the relationship between perfectionism and two eating disorders and even though it is mentioned that it is a brief report but it lacks proper structure and explanation in some sections for understanding of the results.


Bulik, C. M., Tozzi, F., Anderson, C., Mazzeo, S. E., Aggen, S., & Sullivan, P. F. (2003). The relation between eating disorders and components of perfectionism. American Journal of Psychiatry, 160(2), 366–368. doi:



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