Maladaptive Perfectionism, Impostor Phenomenon, and Suicidal Ideation Among Medical Students

Suicide is a leading cause of death for young adults, and medical students experience elevated rates of suicide and suicidal ideation. The present study uses mediation analysis to explore relationships between suicidal ideation and two dysfunctional mindsets common among medical students: maladaptive perfectionism, high standards accompanied by excessive self-criticism, and impostor phenomenon, pervasive feelings of inadequacy despite evidence of competence and success.

Two hundred and twenty-six medical students at a single institution completed an online survey which assessed maladaptive perfectionism, impostor phenomenon, and suicidal ideation. After calculating measures of association between all study variables, linear regression was conducted to establish the relationship between maladaptive perfectionism and suicidal ideation. To evaluate whether impostor phenomenon mediated the relationship between maladaptive perfectionism and suicidal ideation as hypothesized, a series of regression models were constructed and the regression coefficients were examined. The statistical significance of the indirect effect, representing the mediated relationship, was tested using bootstrapping.

Significant positive associations between maladaptive perfectionism, impostor phenomenon, and suicidal ideation were observed. Impostor phenomenon score was found to mediate the relationship between maladaptive perfectionism and suicidal ideation.

Medical students who exhibit maladaptive perfectionism are at increased risk for feelings of impostor phenomenon, which translates into increased risk for suicide. These results suggest that an intervention targeted at reducing feelings of impostor phenomenon among maladaptive perfectionists may be effective in reducing their higher risk for suicide. However, interventions promoting individual resilience are not sufficient; systemic change is needed to address medicine's "culture of perfection."