(PS7-12) Bridging Perfectionism and Disordered Eating Symptoms: Findings from a Perfectionism Intervention Trial

Perfectionism is a risk factor for the development and maintenance of disordered eating symptoms. Clinical perfectionism is hypothesized to contribute to disordered eating by way of individuals holding perfectionistic standards for themselves which can be applied to weight, shape, and eating behavior. Given that perfectionism appears to be involved in the etiology and maintenance of disordered eating, cognitive-behavioral perfectionism interventions have been effective in reducing perfectionism and disordered eating symptoms in clinical samples. However, despite preliminary support for interventions targeting perfectionism, the mechanism for how such interventions impact disordered eating symptoms has yet to be fully elucidated. Clarifying these mechanisms may inform the development of perfectionism interventions that prevent disordered eating symptoms. The network theory of psychopathology provides a theoretical framework that may be useful in uncovering the specific ways that aspects of perfectionism connect to disordered eating. The current study builds upon cross-sectional studies by assessing bridge symptom centrality (symptoms that connect different types of psychopathology) between perfectionism and disordered eating symptoms before, during, and at the completion of a perfectionism intervention. These longitudinal analyses allow us to understand whether the interconnections among perfectionism dimensions and disordered eating symptoms change throughout treatment. Participants (N=167) were college students (80.9% female, 84.4% white) with elevated perfectionism who completed a 4-week cognitive bias modification–interpretation retraining for perfectionism. Perfectionism and disordered eating symptoms were assessed at baseline, mid-treatment, and post-treatment. We used network analysis to estimate networks at each time point. Bridge symptoms were indicated by bridge expected influence, where higher values indicate stronger connections between symptom clusters. We also used multilevel linear regressions to assess how perfectionism symptoms predicted disordered eating symptoms throughout the intervention. The perfectionism element of discrepancy (i.e., a mismatch between one’s standards and one’s perceived performance) had the highest bridge expected influence between disordered eating and perfectionism symptoms at all timepoints. Further, higher discrepancy scores uniquely predicted elevated disordered eating symptoms throughout the intervention. The discrepancy element of perfectionism may be a specific route through which perfectionism impacts disordered eating symptoms. Discrepancy between the ideal self and the actual self is psychologically uncomfortable and often triggers a desire to lessen the discrepancy. One method of lessening this discrepancy may be via disordered eating, especially when people hold high appearance-related standards. Perfectionism interventions that specifically target discrepancy may reduce disordered eating symptoms.