title: Perfectionism, weight and shape concerns, and low self-esteem: Testing a model to predict bulimic symptoms.
abstract: Previous studies have tested multivariate models of bulimia pathology development, documenting that a confluence of perfectionism, body dissatisfaction, and low self-esteem is predictive of disordered eating. However, attempts to replicate these results have yielded controversial findings. The objective of the present study was to test an interactive model of perfectionism, weight and shape concerns, and self-esteem in a sample of patients affected by Eating Disorder (ED). One-hundred-sixty-seven ED patients received the Structured Clinical Interview for DSM-IV Axis I (SCID-I), and they completed the Eating Disorder Examination Questionnaire (EDE-Q), the Rosenberg Self-Esteem Scale (RSES), and the Multidimensional Perfectionism Scale (MPS-F). Several mediation analysis models were fit to test whether causal effects of concern over weight and shape on the frequency of bulimic episodes were mediated by perfectionism and moderated by low levels of self-esteem. Contrary to our hypotheses, we found no evidence that the causal relationship investigated was mediated by any of the dimensions of perfectionism. As a secondary finding, the dimensions of perfectionism, perceived criticism and parental expectations, were significantly correlated with the presence of bulimic symptoms. The validity of the interactive model remains controversial, and may be limited by an inadequate conceptualization of the perfectionism construct.
authors.affiliation: Cognitive Psychotherapy Clinical Centre, Via delle Porte Nuove, 10, 50144, Florence, Italy. Electronic address: carmelo.lamela@scuolacognitivafirenze.it.
authors.forename: Carmelo
authors.initials: C
authors.lastname: La Mela
authors.affiliation: Cognitive Psychotherapy Clinical Centre, Via delle Porte Nuove, 10, 50144, Florence, Italy. Electronic address: marzioma@katamail.com.
authors.forename: Marzio
authors.initials: M
authors.lastname: Maglietta
authors.affiliation: Cognitive Psychotherapy Clinical Centre, Via delle Porte Nuove, 10, 50144, Florence, Italy. Electronic address: saverio.caini@gmail.com.
authors.forename: Saverio
authors.initials: S
authors.lastname: Caini
authors.affiliation: Dipartimento Salute Mentale, ASL 11 Empoli. Electronic address: giuliano.casu@usl11.toscana.it.
authors.forename: Giuliano P
authors.initials: GP
authors.lastname: Casu
authors.affiliation: Cognitive Psychotherapy Clinical Centre, Via delle Porte Nuove, 10, 50144, Florence, Italy; Dipartimento Salute Mentale, ASL 11 Empoli. Electronic address: stefanolucarelli@hotmail.com.
authors.forename: Stefano
authors.initials: S
authors.lastname: Lucarelli
authors.affiliation: Cognitive Psychotherapy Clinical Centre, Via delle Porte Nuove, 10, 50144, Florence, Italy. Electronic address: morisara1981@gmail.com.
authors.forename: Sara
authors.initials: S
authors.lastname: Mori
authors.affiliation: "Studi Cognitivi", Post-graduate Cognitive Psychotherapy School, Foro Buonaparte, 57, 20121, Milan, Italy. Electronic address: gm.ruggiero@studicognitivi.net.
authors.forename: Giovanni Maria
authors.initials: GM
authors.lastname: Ruggiero
mesh_terms: D000328:Adult; D001828:Body Image / Q000523:psychology*; D002032:Bulimia / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D010549:Personal Satisfaction; D010551:Personality; D015203:Reproducibility of Results; D012649:Self Concept; D055815:Young Adult
keywords: Body dissatisfaction; Bulimic symptoms; Eating disorders; Perfectionism; Self-esteem