پیش بینی مشکلات خوردن در بین مردم چینی مالزیایایی: نقش افتراقی کمال گرایی مثبت و منفی

Positive and negative perfectionism (measured by the Positive and Negative Perfectionism Scale; PANPS) are found to have differential roles in predicting eating problems. This study translated and back-translated the PANPS into Chinese and then examined whether its factor structure was comparable to the original PANPS. The relationships between positive and negative perfectionism (using Chinese PANPS) and eating problems were also evaluated. Malaysian Chinese (N = 205) adults completed the Chinese PANPS, Eating Disorder Inventory (EDI) and Marlowe-Crowne Social Desirability Scale. Principal Component Analysis showed the two-factor solution of the Chinese PANPS accounted for 33.42% of the total variance, which was comparable to previous studies. Hierarchical multiple regressions revealed that negative perfectionism significantly predicted all eating disorder symptoms for females, but not drive for thinness and body dissatisfaction for males. Conversely, positive perfectionism significantly predicted lower total EDI scores, lower ineffectiveness and lower interpersonal distrust, but only predicted lower body dissatisfaction among females. In conclusion, negative perfectionism was consistently associated with eating problems whereas positive perfectionism might be a potentially adaptive factor, confirming the distinctive roles each played in the development of eating problems, even in a non-Western population.

Among the common bio-socio-cultural factors, perfectionism has been documented as an important “trans-diagnostic” process that contributes to the development, maintenance and recovery of eating disorders (Bardone-Cone et al., 2007, Egan et al., 2011, Fairburn et al., 2003 and Pearson and Gleaves, 2006). Perfectionists often strain themselves toward unrealistically high standards and measure their self-worth in terms of their accomplishments (Burns, 1980). While evidence has shown that perfectionism is multidimensional (Frost et al., 1990 and Hewitt and Flett, 1991), other studies have confirmed Hamachek’s (1978) suggestion of two major types –“normal” and “neurotic” – of perfectionism (see Stoeber & Otto, 2006 for a review). The former is described as more beneficial and the latter as reflecting more detrimental aspects of perfectionism. Derived from learning theory, a dual process model – “positive perfectionism” and “negative perfectionism” – was proposed (Slade and Owens, 1998 and Terry-Short et al., 1995). Positive Perfectionism is defined as perfectionistic behavior driven by the desire to achieve favorable outcomes (e.g., achieving high standard for one’s pleasure), while Negative Perfectionism is perfectionistic behavior driven by the goal to prevent adverse consequences (e.g., achieving high standard to avoid disapproval from others). Consistent with this model, research has demonstrated the differential roles of positive and negative perfectionism using the Positive and Negative Perfectionism Scale (PANPS) whereby negative perfectionism is associated with more psychopathology among clinical and non-clinical groups (Haase et al., 1999, Haase et al., 2002 and Terry-Short et al., 1995). This is also in line with various findings that found associations between eating pathology and the maladaptive or neurotic aspects of perfectionism (Altug et al., 2000 and Mitzman et al., 1994). Similar studies have explored the perfectionism-eating attitudes relation among other cultural groups, e.g., Chinese (Chan & Owens, 2006) and Korean (Chan, Ku, & Owens, 2010) immigrants in New Zealand where negative perfectionism was consistently found to be related to eating disordered symptoms. This underscored the fact that negative perfectionism was a salient characteristic for those who exhibit problematic eating behaviors. In contrast, positive perfectionism was related to less eating pathology and lower levels of psychological correlates of eating disorders (Chan and Owens, 2006 and Chan et al., 2010), demonstrating that positive perfectionism might be an adaptive characteristic that contributes to beneficial psychological outcomes. Overall, these findings have reinforced the delineation of positive and negative perfectionism, suggesting that negative perfectionism significantly contributed to severe disturbances in eating attitudes and behaviors, even in non-Western populations; whereas positive perfectionism might reduce the risk of developing eating disorders. The reason why negative perfectionism may be particularly relevant to eating disorder symptoms is because individuals with high negative perfectionism may disallow the display of imperfections and shortcomings by focusing on readily quantifiable dimensions, such as body appearances (Bardone-Cone et al., 2007). These individuals, thus, tend to hold excessive concerns on the social evaluation of their appearances. To them, minor flaws in body image may remind them of their failure to live up to the expectations of perfection (Frost et al., 1990 and Hewitt et al., 1995). This in turn brings about self-criticism and weakening of self-efficacy, thus elevating negative emotions that can lead to depression or anxiety. Positive perfectionists, however, have better adaptive coping skills and are able to self-regulate their eating habits in a healthier way (Haase et al., 2002). Even though they may fall short of their high expectations at times, the relatively higher self-esteem may prevent them from being dissatisfied with their body images (Slade and Owens, 1998 and Stoeber and Otto, 2006). Disordered eating has typically been regarded as a ‘Western-bound syndrome’, affecting only people in developed, Western countries. Recent evidence has, however, shown growing concern in people of diverse ethnic/cultural backgrounds and socioeconomic status, including European Caucasian, African-American, Asian-American, Chinese, Indian and Arabs (Al-Subaie, 2000, Altabe, 1998, Bhugra et al., 2000 and Lee and Lee, 2000). Particularly, prevalence of eating disorder in Asian populations are increasing (Cummins et al., 2005 and Lai, 2000). Malaysia is one of the fastest-growing developing Asian countries that is exposed to modern urbanization and globalization. A predisposition towards an acceptance of the contemporary notions of slimness and ‘fat phobia’ beliefs has emerged (Lee and Lee, 2000 and Mellor et al., 2009). Some studies have found that Malaysians were terrified at the thought of being overweight and wanted to be thinner though they were of normal weight (Edman and Yates, 2004, Mellor et al., 2009, Pon et al., 2004 and Swami and Tovée, 2005). Meals-skipping was the most commonly reported weight control regime (Pon et al., 2004) and this drive for thinness may eventually manifest into potentially deadly eating disorders. Although Malaysia is ethnically heterogeneous, of particular concerns are the Chinese, due to substantial empirical evidence indicating a high rate of body dissatisfaction, disordered-eating and body change behaviors among this Asian subgroup (Lai, 2000, Lee and Lee, 2000 and Xu et al., 2010). Thinness is gradually valued by Chinese culture, therefore, it was predicted that Malaysian Chinese would be prone to unhealthy eating habits in their quest for an ideal body image. Past studies have addressed the relationships between factors such as BMI, gender differences, socio-cultural influence, separation anxiety, self-satisfaction, and disordered eating attitudes of Malaysians (Edman and Yates, 2004 and Gan et al., 2011). However, the role of positive and negative perfectionism in explaining eating problems among this population remains unknown. The PANPS has been widely utilized and translated into different languages (Besharat, 2009 and Seidah et al., 2002). However, there is no published standardized Chinese version given the large number of people coming from Chinese speaking background. Hence, developing the Chinese version of PANPS is needed. The purpose of this study was, therefore, to: (1) translate and back-translate the PANPS into Chinese and to examine whether its factor structure was comparable to the original; and (2) evaluate the relationship between positive and negative perfectionism and eating problems among Malaysian Chinese using the Chinese PANPS. It was hypothesized that high negative perfectionism would predict higher total EDI scores as well as each EDI subscale. Conversely, high positive perfectionism would predict lower total EDI scores, ineffectiveness and interpersonal distrust.