Is perfectionism a risk factor for adolescent body dysmorphic symptoms? Evidence for a prospective association

The current study tested the hypothesis that perfectionism is a risk factor for the development of body dysmorphic disorder (BDD), as proposed by prevailing cognitive behavioural models. School students aged 14-16 years completed questionnaires 6 months apart (Time 1: N = 302; Time 2: N = 68) assessing perfectionism, BDD symptoms, and anxiety and depression. Robust regression models tested concurrent and prospective associations between perfectionism and BDD symptoms, with and without adjustment for coexisting anxiety and depression. Total perfectionism was positively associated with concurrent BDD symptoms, even when controlling for coexisting anxiety and depression. Moreover, total perfectionism predicted changes in BDD symptoms between Time 1 and Time 2. Examination of perfectionism subscales indicated that only self-oriented perfectionism, not socially-prescribed perfectionism, predicted BDD symptoms concurrently and prospectively while controlling for coexisting psychopathology. This study provides preliminary evidence for self-oriented perfectionism being a risk factor for the development of BDD in youth. If replicated, these findings could highlight the potential value of targeting self-oriented perfectionism in prevention and early intervention programs for BDD.