Table 2.
Included relevant articles (N = 15) examining association between nonsuicidal self-injury and perfectionism.
| References | Country | Design | Age Group | No. of Participants | Terminology for Self-Injurious Behavior | Measurement of Self-Injurious Behavior | Measurement of Perfectionism | Main Results |
|---|---|---|---|---|---|---|---|---|
| Nock and Prinstein (79) | USA | Cross-sectional, clinical sample, psychiatric inpatient | Age range: 12–17 years, M = 14.7 (SD = 1.4) | N = 89 (23 boys, 66 girls 74.15%) psychiatric inpatients, adolescent | Self-mutilative behavior (SMB) | Functional Assessment of Self-Mutilation (FASM) | Child and Adolescent Perfectionism Scale (CAPS) | Socially prescribed perfectionism was related to the social negative and social positive reinforcement functions of SMB. Self-oriented perfectionism had no relationships with SMB functions. |
| Yates et al. (47) | USA | Cross-sectional and longitudinal, community sample | n.a. | Cross-sectional sample of 9–12th graders (N = 1, 036, 51.9% girls, 538 girls, 498 boys), longitudinal sample from the 6th through 12th graders: (N = 245, 53.1% girls, 130 girls, 115 boys). | NSSI | Functional Assessment of Self-Mutilation (FASM) | Parental criticism scale from the Frost Multidimensional Perfectionism Scale (FMPS) | Parental criticism predicts NSSI in both cross-sectional and the longitudinal samples. Youth alienation toward parents emerged as a relevant process underlying this pathway. |
| Hoff and Muehlenkamp (80) | USA | Cross-sectional, community sample | M = 19.82 years (SD = 2.86) | N = 165 undergraduate students (24.7% male, 75.3% female) (56 with a history of NSSI and N = 109 control subjects with no history of NSSI) | NSSI | Deliberate Self-Harm Inventory (DSHI) | Frost Multidimensional Perfectionism Scale (FMPS) | Participants with NSSI significantly differ from no-NSSI participants on three perfectionism subscales. Individuals with NSSI reported significantly higher score on concern over mistakes and parental criticism and significantly lower on organization subscales of FMPS. |
| Claes et al. (73) | Belgium | Cross-sectional, clinical sample, ED patient | Age range: 14–42 years, M = 21.5 years (SD = 6.23) | N = 95 ED patients (women) | NSSI | Self-Injury Questionnaire (SIQ) | Frost Multidimensional Perfectionism Scale (FMPS) | ED patients with NSSI reported significantly higher levels of parental criticism and evaluative concerns perfectionism (ECP) compared with ED patients without NSSI. ECP was positively related to the self-punishment, self-torturing and cry-for-help functions of NSSI. PC was negatively related to cry-for-help function of NSSI. ECP was found to mediate the association between parental criticism and NSSI symptoms. There was no relationship between PSP and NSSI. |
| Fujimori et al. (74) | Japan | Cross-sectional, both clinical and community sample | ED + SIB sample: M = 24.3 years (SD = 5.6), ED + no SIB sample: M = 26.9 years (SD = 7.9), healthy control group: M = 19.5 years (SD = 1.2) | Clinical sample: N = 80 female ED patients (ED + SIB: n = 25, ED+ no SIB: n = 55), healthy control sample: N = 120 female university students | Self-injurious behavior (SIB) | SIB were established through own developed questions. | Perfectionism subscale from the Eating Disorder Inventory | Perfectionism score was significantly higher for the ED + SIB group compared to the ED/no SIB and control groups. |
| Flett et al. (81) | Canada | Cross-sectional, community sample | M = 18.89 years (SD = 2.30) | N = 319 university students (112 men, 207 women 64.9%) | Deliberate self-harm (DSH) | Deliberate Self-Harm Inventory (DSHI), Self-Harm Inventory (SHI) | Multidimensional Perfectionism Scale (MPS), The Frost Multidimensional Perfectionism Scale (FMPS) | Increased self-harm in men had negative relationship with other-oriented perfectionism. Increased self-harm in women was related to increased parental criticism and SPP. |
| Miskey et al. (82) | USA | Cross-sectional, community sample | M = 19.10 years (SD = 2.05) | N = 292 undergraduate students (62.3% women) | NSSI cutting | Deliberate Self-Harm Inventory (DSHI) | Perfectionism Inventory (PI) | NSSI cutting duration was associated positively with perfectionistic rumination. NSSI cutting onset age was positively correlated with concern over mistakes, and need for approval scales of PI. Frequency of NSSI cutting was predicted by perfectionistic rumination, organization, and low concern over mistakes (accounting for 31% of the variance). |
| Luyckx et al. (75) | Belgium | Cross-sectional, both clinical and community sample | Community sample: M = 15.95 years (SD = 1.30), psychiatric sample: M = 28.09 years (SD = 9.84) | Community sample: N = 348 female high school students, psychiatric sample: N = 131 female psychiatric patients (80 ED, 51 BPD) | NSSI | Self-Injurious Questionnaire-Treatment Related (SIQ-TR) | Perfectionism subscale from the Eating Disorder Inventory-2 | According to hierarchical logistic regression analysis, perfectionism was associated with a significantly greater likelihood of engaging in NSSI in female adolescent sample. |
| Eichen et. al. (83) | USA | Cross-sectional, community sample | Age range 18–25 years, M = 20.61 years (SD = 1.97) | Community sample, women (N = 508) | NSSI | Functional Assessment of Self-Mutilation (FASM) | Perfectionism subscale from the Eating Disorder Inventory-2 | There was no significant difference between the score of perfectionism across four groups: no NSSI/Suicidal Ideation, NSSI-only, Suicidal Ideation-only, and NSSI/Suicidal Ideation. |
| Varela-Besteiro et al. (84) | Spain | Cross-sectional, clinical sample | Age range 12–17 years, M = 14.74 years (SD = 1.53) | Adolescents with ED, N = 109; 87.2% female (n = 95), 12.8% (n = 14) male. | NSSI | Based on clinical interview | Child and Adolescent Perfectionism Scale (CAPS) | NSSI group of ED patients had significantly higher scores as compared to the non-NSSI ED group (without self-injurious behavior) on all EDI-2 perfectionism scales and on the CAPS total score. |
| Kaur and Martin (85) | Australia | Cross-sectional, community sample | Age range: 19–36 years, M = 23.1 years (SD = n.a) | Postgraduate medical students, N = 260 (139 males and 121 females, 46.5%) | NSSI | Deliberate Self-Injury Questionnaire | Frost Multidimensional Perfectionism Scale (FMPS) | Participants with NSSI compared to those without NSSI reported higher scores on perfectionism total score, on parental expectations, on concern over mistakes, on doubts about action. The largest effect has concern over mistakes. Maladaptive perfectionism was also significantly higher in NSSI group. |
| Vieira et al. (76) | Portugal | Cross-sectional, clinical sample | Age range: 14–49 years, M = 22.12 years (SD = 6.31) | ED female outpatients, N = 245 | NSSI | Oxford Risk Factor Interview for Eating Disorder | Oxford Risk Factor Interview for Eating Disorder: subject's mental health domain—perfectionism subdomain. | There is no relationship between perfectionism and NSSI among ED patients. |
| Lucas et al. (86) | USA | Cross-sectional, community sample | Age range: 18-46 years, M = 19.6 years (SD = 3.12) | N = 386 college students (267 females 69, 2%, 116 males 30, 8%) | NSSI | The Self-Harm Inventory (SHI) | Frost Multidimensional Perfectionism Scale (FMPS) | FMPS dimensions (concern over mistakes, parental expectation, parental criticism, doubts about action) were positively associated with NSSI. According to results of hierarchical regression analysis, perfectionism (concern over mistakes dimension) is a significant predictor of NSSI. |
| Chang et al. (87) | USA | Cross-sectional, community sample | Age range: 18–25 years, M = 20.2 years (SD = 1.61) | N = 287 women college students | NSSI | The Self-Harm Inventory (SHI) | Frost Multidimensional Perfectionism Scale (FMPS) | Perfectionism was found to predict additional unique variance in NSSI, even after accounting for sexual assault history. Evaluative concerns dimension is the most consistent unique predictor of NSSI. |
| Newman et al. (88) | USA | Cross-sectional, community sample | Age range: 18–27 years, M = 18.9 (SD = 1.19) | N = 410 undergraduate psychology students (77.1% female) | Self-harm | One item from the Nonsuicidal Self-Injury Assessment Tool (NSSI-AT) | Perfectionism Inventory (PI), Perfectionistic Cognitions Inventory (PCI) | With principal components analysis four different profiles of perfectionism were defined: obsessive, constructive, non-perfectionist, motivated. Profiles of perfectionism were significantly associated with differences in self-harm. |