We examined differences in perfectionism between burned-out employees (n = 77), depressed employees (n = 29), anxiety-disordered employees (n = 31), employees with comorbid disorders, that is, a combination of clinical burnout, depression, or anxiety disorder (n = 28), and individuals without clinical burnout, depression disorder, or anxiety disorder (clinical control group; n = 110). The results suggest that setting high personal standards per se is not associated with clinical disorders. In contrast, maladaptive aspects of perfectionism, including perceived discrepancy between standards and performance and socially prescribed perfectionism, were related to clinical disorders, and in particular to comorbidity.
Although no definition of perfectionism has been formally agreed upon, the centrality of high personal standards is evident (Flett and Hewitt, 2002 and Slaney et al., 2002). Several researchers have demonstrated that setting high personal standards (Slaney et al., 2002) or self-oriented perfectionism (Flett & Hewitt, 2002), was positively associated with positively valenced variables such as self-esteem, problem-focused coping, career satisfaction, and physical health (e.g., Bieling et al., 2004a, Enns and Cox, 2002, Slaney et al., 2002 and Stoeber et al., 2009). Similarly, in goal-setting research, high standards of performance have typically been found to be associated with focused attention, effort, and persistence, all of which are likely to enhance work motivation and job performance (Locke & Latham, 1990). Therefore, we argue and will demonstrate that, relative to their occurrence in a clinical control group, only maladaptive characteristics of perfectionism are prevalent among employees diagnosed with clinical disorders, and in particular among individuals with comorbid disorders.
Specifically, not high standards per se, but individuals’ perceptions that they consistently fail to meet their personal standards, henceforth referred to as perceived discrepancy ( Slaney et al., 2002), may elevate levels of distress, and lead to the development of clinical disorders. Several studies consistently report that perceived discrepancy is associated with negative adjustment indicators such as lack of self-esteem, worry, and psychological distress (e.g., Slaney et al., 2001 and Van Yperen and Hagedoorn, 2008). A perceived discrepancy between standards and criteria of success in meeting those standards is distressing because it interferes with people’s basic need for competence and the need to actually succeed in getting what they want ( Ellis, 2002 and Ryan and Deci, 2002).
Similarly, the perception that others are imposing high standards on the self (i.e., socially prescribed perfectionism) has typically been found to be associated with a variety of negative outcomes, including depressive symptomatology, fear of negative evaluation, and negative affect (e.g., Flett and Hewitt, 2002 and Stoeber et al., 2009). In contrast to personally adopted high standards, socially imposed high standards create concerns about others’ criticism and expectations ( Clara et al., 2007 and O’Connor et al., 2007). Focusing on others’ high standards tends to raise a want to a necessity which is irrational and self-defeating, and accordingly, may decrease one’s sense of self-efficacy and self-esteem, increase psychological distress, and, ultimately, leads to clinical disorders (cf., Ellis, 2002).
The assumed links between clinical disorders, including comorbidity, on the one hand, and maladaptive characteristics of perfectionism, on the other, are discussed below.
1.1. Burnout
From the beginning, burnout (for the five common elements of burnout, see Table 1) was associated with perfectionism (Freudenberger, 1974). However, to our knowledge, there are no studies among employees that link dimensions of perfectionism to clinical burnout. Maladaptive aspects of perfectionism, including the perception of consistently failing to meet one’s own standards and a chronic concern about others’ criticism and expectations, may however lead to the development of severe burnout symptoms ( Clara et al., 2007 and Stoeber and Otto, 2006). Employees with a clinical burnout meet the criteria of the ICD-10 (i.e., the 10th revision of the International Statistical Classification of Diseases and Related Health Problems) equivalent of job- or work-related neurasthenia ( Schaufeli, Bakker, Schaap, Kladler, & Hoogduin, 2001). That is, for the diagnosis clinical burnout, the listed symptoms (see Table 1) have to be present each day for at least 6 months. Table 1 also shows that the elements of burnout are very similar to the criteria for neurasthenia in ICD-10 and those for an undifferentiated somatoform disorder. In the DSM-IV (i.e., Diagnostic and Statistical Manual of Mental Disorders, 4th edition), undifferentiated somatoform disorder includes neurasthenia, which was abandoned as a separate category ( Hickie, Hadzi-Pavlovic, & Ricci, 1997).
