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In a cross sectional study we examined the dimensions of perfectionism and perfectionistic self-presentation in patients with social phobia. We also examined associations between perfectionism and self-report of anxiety and depression with fear of negative evaluation. Thirty patients with a diagnosis of social phobia and 30 community volunteers completed two measures of trait perfectionism, fear of negative evaluation and measures of anxiety and depression. The clinical sample had overall higher levels of perfectionism and had greater fear of negative evaluation, social anxiety, trait anxiety and depression than the community sample. The clinical sample had significantly higher concern over mistakes, doubts over actions, parental criticism (F-MPS, Frost et al., 1990) and scored higher for non-display of imperfection on the Perfectionistic Self Presentation Scale (PSPS; Hewitt et al., 2003). The two groups did not differ on other dimensions of perfectionism, or on both measures of perfectionism. The two measures of perfectionism were positively correlated. There was a significant correlation between trait perfectionism and Brief Fear of Negative Evaluation scale (BFNE). The paper discusses the importance of examining perfectionism in social phobia.

The hallmark of social phobia (SP) is a marked fear of social or performance situations, fear of scrutiny and negative evaluation and the avoidance of situations in which these fears are triggered (APA, 1994). It is the third most common psychiatric disorder (Kessler et al., 1994) with a poor rate of spontaneous remission (Bruce et al., 2005). The lifetime prevalence of SP ranges from 2.4% to 13%. Co-morbidity rates for SP are high and include other anxiety disorders, mood disorders, substance dependence and bulimia nervosa (Federoff and Taylor, 2001 and Kessler et al., 1999). The onset of SP is typically early although people with SP seek treatment much later when they experience impairment in social and occupational roles. Persons with SP are excessively concerned with possible errors they may make in social situations and predict rejection or loss of status as a result of their behaviours. Fear of negative evaluation (FNE) is a core feature of SP and is associated with heightened negative affect and interpersonal awareness (Beck et al., 1985 and Harb et al., 2002). It reflects the tendency to focus selectively on evidence of failure and to be self-critical. In order to avoid possible failure, persons with SP set unrealistically high standards for themselves (Clark and Wells, 1995 and Rapee and Heimberg, 1997). These personally demanding standards are motivated largely by a fear of failure and need to impress, which in turn leads to avoidance and hyper vigilance (Eysenck, 1997 and Hamachek, 1978). Alden et al. (1994) suggest that persons with SP may actually set lower standards than their actual potential and may continually underestimate themselves. Clinical evidence suggests that perfectionism is relevant to SP (Heimberg, 1996 and Juster et al., 1996). Perfectionism refers to the desire to achieve the highest standards of performance, in combination with unduly critical evaluations of one's performance (Frost et al., 1990). It is a multidimensional personality trait, with both adaptive and maladaptive aspects (Hewitt and Flett, 1991). The first multidimensional measure of perfectionism was developed by Frost et al. (1990) and consists of six dimensions that include concern over mistakes, doubts about actions, parental expectations, personal standards, parental criticism, and organization. Perfectionism has been identified as a vulnerability factor in the development of depression (Chang and Sanna, 2001, Hewitt and Flett, 1991 and Hewitt et al., 1996), and other psychological problems such as hopelessness, suicidality, (Hewitt et al., 1998 and O’Connor and O’Connor, 2003), eating disorders (Minarik and Ahrens, 1996), obsessive–compulsive disorder and other anxiety disorders (Antony et al., 1998). Perfectionistic self-presentation (PSP) is yet another dimension of perfectionism that includes an interpersonal aspect (Hewitt et al., 2003). PSP includes an excessive need to appear perfect in the eyes of others, with distinct, stable dimensions of, perfectionistic self–promotion i.e., proactively promoting a perfect image, non-disclosure of imperfection i.e., concern over verbal disclosures of imperfection and non-display of imperfection i.e., concern over behavioural displays of imperfection (Hewitt et al., 2003). Although the two aspects of trait perfectionism overlap to a certain degree, they are considered to be conceptually distinct from each other and both function as vulnerabilities in the development of emotional problems (Dunkley et al., 2003). Research suggests that perfectionism is much more likely to develop in families where parental anxiety concerning social interactions is high and need for others’ approval is excessively emphasized (Bruch et al., 1989 and Juster et al., 1996). Asian American samples report higher personal standards, strict parental control, lack of open communication with parents, and higher educational expectations and emotional alienation than their Caucasian peers (Kawamura et al., 2002). Patients with SP report a higher concern over mistakes, doubts of one's action and parental criticism than community controls and patients with panic disorder (Juster et al., 1996 and Saboonchi et al., 1999). However, this has been relatively less researched in comparison to other psychiatric conditions and there are no cross-cultural comparisons. The clinical implications of perfectionism and its role in maintenance of anxiety disorders and SP in particular, have received relatively less attention. High levels of clinical perfectionism that includes personally demanding standards with self-criticality hampers the progress of therapy and maintains negative affect through excessive self-criticality (Shafran et al., 2002). Perfectionism and interpersonal aspects of perfectionism have been previously studied in western populations and largely in non-clinical samples and limit generalization of findings to other populations (Hewitt et al., 2003 and Juster et al., 1996). In the Asian Indian setting, perfectionism has been explored in a few recent studies on university samples (Slaney et al., 2000). The cross-cultural aspects of perfectionism have been inadequately addressed in clinical samples. The need to examine cognitive features such as FNE in association with trait perfectionism has also been emphasized (Antony et al., 1998). The purpose of this study was to examine the dimensions of perfectionism patients with SP in an Asian Indian setting. We also examined associations between trait perfectionism and anxiety, depression, and FNE. Perfectionism, particularly its interpersonal aspects, is likely to be influenced by socio-cultural factors. To our knowledge there are no published studies examining trait perfectionism in a clinical sample in this cultural context. The findings of such a study would contribute to a cross-cultural understanding of perfectionism in SP.