Doctor of Philosophy in Psychology (PhD)
Parenting, attachment, and perfectionism: A test of the Perfectionism Social Disconnection Model in Children and Adolescents
Young Chinese men and women living in Canada frequently report lower levels of sexualresponse and behaviour compared to their Euro-Caucasian peers. These differences are likelyrelated to cultural factors and acculturation, but has not been well-integrated into more generalmodels of sexual response regulation. The current investigation used the dual control model toorganize and better understand these patterns in three studies in university men and women ofChinese and Euro-Caucasian descent. The first study examined whether dual control processes ofsexual excitation and inhibition were applicable to between-group ethnic differences in sexualresponse and behaviour. Lower sexual excitation explained a significant proportion of thedifference in mean sexual response and activity between Chinese and Euro-Caucasian women,and this effect was mediated by sexual attitudes. Sexual attitudes was separately associated withhigher sexual inhibition and lower dyadic sexual response and activity in Chinese compared toEuro-Caucasian men. The second study examined the association of heritage and mainstreamacculturation with sexual excitation, inhibition, attitudes, response, and activity among theChinese individuals. For heterosexual men and women, mainstream acculturation was theprimary predictor of sexuality variables, while heritage acculturation had a moderating role.Exploratory analyses for non-heterosexual Chinese men and women were also conducted; eachsexual orientation group displayed different patterns of associations between acculturationfactors and sexuality variables. The third study examined whether between-group differences insexual excitation and inhibition were associated with sexual dysfunctions, asexuality, or sexualabstinence. The results did not conclusively suggest more dysfunction in Chinese women, butdid suggest more dysfunction in Chinese men. Abstinence versus engagement in partnered sexhad a moderation role on other outcomes. Theoretical implications for understanding the role ofivChinese culture, and culture in general, in regulating sexual response and behaviours werediscussed for all three studies. Clinical implications for treatment of sexual concerns in youngChinese men and women were also discussed.
Perfectionism has been identified as a core vulnerability and maintenance factor in myriad psychopathologies and additionally appears to obstruct the course of improvement from the treatment of that psychopathology. The Perfectionism Social Disconnection Model posits that perfectionism is related to various negative outcomes through the mediating effects of social disconnection. When applied to the therapy realm, one would expect that perfectionism impedes the formation and growth of therapy relationships and that this then leads to worse outcomes from psychotherapy (e.g. less symptomatic improvement). Much of what is known about perfectionism in the context of psychotherapy comes from a series of papers stemming from a single study, the Treatment of Depression Collaborative Research Program (TDCRP, Elkin et al., 1989). These papers support the notion that perfectionism impairs both therapeutic alliance and therapeutic outcomes. This dissertation seeks to evaluate the Perfectionism Social Disconnection Model in the context of psychotherapy and to extend what is known about the relationships between perfectionism, therapy relationship quality, and therapy outcomes beyond the context of individual group treatment of depression using contemporary, empirically validated multidimensional measures of perfectionism. Furthermore, previous studies addressing these issues have mostly conceptualized perfectionism as a static measure. It is unknown if treatments that lead to decreases in perfectionism also improve therapy relationship quality and if those changes account for better therapeutic outcomes. The current paper addresses these questions in a group of 71 patients taking part in a group psychodynamic-interpersonal psychotherapy treatment designed to address issues related to perfectionism. Hypotheses were that 1) pre-treatment perfectionism would be negatively related to initial therapy relationship quality, 2) decreases in perfectionism would be accompanied by increases in therapy relationship quality, and 3) that changes in therapy relationship quality would account for the relationship between decreases in perfectionism and better therapy outcomes. In the current study, these hypotheses were not supported. These null results are discussed in the context of a literature that suggests that perfectionism is related to both worse treatment outcomes and to interpersonal difficulties both in therapy and non-therapy contexts.
The study investigates the associations among perfectionistic self-presentation, interpersonal difficulties, and the process of group therapy based on predictions from the Perfectionism Social Disconnection Model. The study aims to determine whether perfectionistic self-presentation negatively impacts the group therapy process generally and on change over the course of the treatment block. The study also aims to determine whether interpersonal difficulties intervene on the negative associations among perfectionistic self-presentation and group therapy processes. Sixty-nine patients within nine groups attending the Southdown Institute and receiving intensive psychodynamic interpersonal group treatment participated in the study. Patients completed the Perfectionistic Self-Presentation Scale (PSPS; Hewitt et al., 2003), the Inventory of Interpersonal Problems (IIP; Horowitz et al., 1988), the Impact Message Inventory (IMI; Kiesler & Schmidt, 1993) - patient ratings of therapists, the California Psychotherapy Alliance Scales - Group (CALPAS-G; Marmar et al., 1989), and the Curative Climate Inventory (CCI; Furhiman et al., 1986) over the course of one week of daily group therapy. Multilevel modeling analyses were used to analyze direct effects among perfectionistic self-presentation facets and alliance scales and climate factors, as well as indirect effects through interpersonal variables. Perfectionistic self-presentation facets were associated negatively with total alliance and patient contribution scales of the alliance, and positively with interpersonal problems. Perfectionistic self-presentation facets were not associated with change in alliance over the course of the treatment block, with climate factors, or with patients' ratings of therapists' interpersonal impact. Findings suggest that perfectionistic self-presentation influences interpersonal problems and the process of group therapy; however, there was no support for an indirect and intervening role for interpersonal variables in the associations among perfectionistic self-presentation and therapeutic group processes.
Perfectionism is a multidimensional personality variable linked to a variety of maladaptive consequences and developmentally rooted in early interpersonal attachments. This has been hypothesized to predispose perfectionistic individuals to more maladaptive outcomes in response to being socially excluded. The current project reviews extant literature on the Comprehensive Model of Perfectionism described by Paul Hewitt, Gordon Flett, and colleagues, its developmental antecedents, and a review of specific vulnerability, diathesis-stress and perfectionism social disconnection models that explain perfectionistic vulnerability to stress, including social exclusion. Hypotheses regarding a moderating effect of perfectionism on cognitive and affective reactions to social exclusion were generated based on the aforementioned models. Using two undergraduate student samples, we exposed participants to a laboratory-based social exclusion experience (Cyberball) under controlled circumstances and performed a comprehensive pre- and post-task assessment of their affective and cognitive experience using a combination of explicit and implicit measures. Results indicated that concern over mistakes, perfectionistic cognitions, perfectionistic self-promotion, and nondisplay of imperfection dimensions of perfectionism were the strongest moderators of the experience of social exclusion in that individuals high on these dimensions experienced amplified post-Cyberball shame, anger, rejection, and self-critical affect and increased negative self-related thoughts, and decreased interdependence. Nondisclosure of imperfection in contrast predicted reduced rejected affect in response to social inclusion. Results are discussed in the context of extant literature in perfectionism and social exclusion domains, and in light of diathesis-stress literature and the Perfectionism Social Disconnection Model, as well as the hypothesized interpersonal underpinnings of perfectionistic behaviour.
The relationship between trait perfectionism and suicide behaviours (see Hewitt, Flett, Sherry, & Caelian, 2006; O’Connor, 2007 for reviews) has been reported in many studies and there is very strong evidence that one interpersonal component of perfectionism, socially prescribed perfectionism (i.e., the perception that others require perfection of oneself) is particularly relevant in suicide ideation and attempt among psychiatric adolescents as well as clinical and nonclinical adults (e.g., Enns et al., 2001). However, few studies have examined the mechanism by which trait perfectionism is associated with suicidality. Hewitt and Flett (1993, 2002) suggested that perfectionism can play a moderating role in producing psychopathology by enhancing or exacerbating the aversiveness of congruent or ego-involving stressful events (i.e., Specific Vulnerability Hypothesis). Perfectionistic behaviour also can play a mediating role in its association with psychopathology by contributing to the generation of stress (i.e., Stress Generation Model). Hence, the general purpose of this paper was to examine whether perfectionism generates and interacts with life stress in influencing suicide ideation measured concurrently as well as longitudinally. The current study measured perfectionism traits, stress, depression, hopelessness, and suicide ideation among 437 community adults (mean age=58.6, men=175) six months apart. Consistent with the Specific Vulnerability Hypothesis (Hewitt & Flett, 1993), a significant Perfectionism x Stress interaction was found for self-oriented perfectionism (i.e., striving relentlessly to perfectionistic personal standards) and achievement stress in predicting Time 2 suicide ideation among female participants even after controlling for Time 1 suicide ideation and depression. Socially prescribed perfectionism, however, also interacted significantly with achievement stress to predict Time 2 suicide ideation among female participants, hence providing partial support for Specific Vulnerability Hypothesis. Furthermore, mediational analyses via bootstrapping indicated that stress (i.e., achievement stress, interpersonal stress) mediated the relationship between socially prescribed perfectionism and subsequent levels of suicide ideation for both genders. Together, the current findings support the notion that certain perfectionism traits can act as vulnerability factors that enhance or generate stresses in influencing risk of suicide ideation. Implications of the present findings for understanding the perfectionism-suicide link and assessment and treatment for perfectionistic patients are discussed.