E-ISSN : 2733-4538
The purpose of this study was to examine the integrative effects of maladaptive perfectionism, negative affect, and negative urgency on bulimic symptoms in young women. Although negative affect and personality variables, such as maladaptive perfectionism and negative urgency have been studied as risk factors for bulimic symptoms, relatively little is known about underlying mechanisms by which these factors may conjointly lead to the development of bulimic symptoms. The current study therefore examined an integrative model of bulimic symptoms, including both personality and affect variables simultaneously. Specifically, maladaptive perfectionism was hypothesized as an antecedent of negative affect, and negative urgency was hypothesized as a mediator or a moderator between negative affect and bulimic symptoms. A total of 174 female college students completed a series of self-report inventories assessing maladaptive perfectionism, negative affect, negative urgency, and bulimic symptoms. The results indicated that negative affect and negative urgency sequentially mediated the effect of maladaptive perfectionism on bulimic symptoms. Additionally, negative urgency mediated the effect of maladaptive perfectionism on bulimic symptoms without its association with negative affect, and the direct effect of maladaptive perfectionism on bulimic symptoms was also significant. Based on these findings, the implications and limitations of this study were discussed.
Agras, W. S., & Telch, C. F. (1998). The effects of caloric deprivation and negative affect on binge eating in obese binge-eating disordered women. Behavior Therapy, 29, 491-503.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American Psychiatric Publishing.
Anestis, M. D., Smith, A. R., Fink, E. L., & Joiner, T. E. (2009). Dysregulated eating and distress: Examining the specific role of negative urgency in a clinical sample. Cognitive Therapy and Research, 33, 390-397.
Bardone-Cone, A. M. (2007). Self-oriented and socially prescribed perfectionism dimensions and their associations with disordered eating. Behaviour Research and Therapy, 45, 1977-1986.
Bardone-Cone, A. M., Abramson, L. Y., Vohs, K. D., Heatherton, T. F., & Joiner, T. E. (2006). Predicting bulimic symptoms: An interactive model of self-efficacy, perfectionism, and perceived weight status. Behaviour Research and Therapy, 44, 27-42.
Bardone-Cone, A. M., Wonderlich, S. A., Frost, R. O., Bulik, C. M., Mitchell, J. E., Uppala, S., & Simonich, H. (2007). Perfectionism and eating disorders: Current status and future directions. Clinical Psychology Review, 27, 384-405.
Bardone-Cone, A. M., Brownstone, L. M., Higgins, M. K., Harney, M. B., & Fitzsimmons-Craft, E. E. (2012). Predicting difficulties controlling overeating and drinking when experiencing negative affect in undergraduate women. Journal of Social and Clinical Psychology, 31, 1051-1073.
Bardone-Cone, A. M., Wonderlich, S. A., Frost, R. O., Bulik, C. M., Mitchell, J. E., Uppala, S., & Simonich, H. (2007). Perfectionism and eating disorders: Current status and future directions. Clinical Psychology Review, 27, 384-405.
Baumeister, R. F., Bratslavsky, E., Muraven, M., & Tice, D. M. (1998). Ego depletion: Is the active self a limited resource?. Journal of personality and social psychology, 74, 1252.
Berg, K. C., Crosby, R. D., Cao, L., Peterson, C. B., Engel, S. G., Mitchell, J. E., & Wonderlich, S. A. (2013). Facets of negative affect prior to and following binge-only, purge-only, and binge/purge events in women with bulimia nervosa. Journal of abnormal psychology, 122, 111-118.
Bieling, P. J., Israeli, A. L., & Antony, M. M. (2004). Is perfectionism good, bad, or both? Examining models of the perfectionism construct. Personality and individual differences, 36, 1373-1385.
Boone, L., Claes, L., & Luyten, P. (2014). Too strict or too loose? Perfectionism and impulsivity: The relation with eating disorder symptoms using a person-centered approach. Eating behaviors, 15, 17-23.
Boone, L., Soenens, B., & Braet, C. (2011). Perfectionism, body dissatisfaction, and bulimic symptoms: The intervening role of perceived pressure to be thin and thin ideal internalization. Journal of Social and Clinical Psychology, 30, 1043-1068.
Boone, L., Soenens, B., Braet, C., & Goossens, L. (2010). An empirical typology of perfectionism in early-to-mid adolescents and its relation with eating disorder symptoms. Behaviour Research and Therapy, 48, 686-691.
Byeon, J., & Lee, J. (2016). The effects of positive and negative affect on binge eating behavior of high school students: Moderating effects of impulsivity based on UPPS-P model. Korean Journal of Clinical Psychology, 35, 784-796.
Castro‐Fornieles, J., Gual, P., Lahortiga, F., Gila, A., Casulà, V., Fuhrmann, C., ..., & Toro, J. (2007). Self‐oriented perfectionism in eating disorders. International Journal of Eating Disorders, 40, 562-568.
Cooper, Z., & Fairburn, C. G. (2011). The evolution of “enhanced”cognitive behavior therapy for eating disorders: Learning from treatment nonresponse. Cognitive and Behavioral Practice, 18, 394-402.
Corstorphine, E., Waller, G., Ohanian, V., & Baker, M. (2006). Changes in internal states across the binge-vomit cycle in bulimia nervosa. The Journal of Nervous and Mental Disease, 194, 446-449.
Chua, J. L., Touyz, S., & Hill, A. J. (2004). Negative mood-induced overeating in obese binge eaters: An experimental study. International Journal of Obesity, 28, 606-610.
Crosby, R. D., Wonderlich, S. A., Engel, S. G., Simonich, H., Smyth, J., & Mitchell, J. E. (2009). Daily mood patterns and bulimic behaviors in the natural environment. Behaviour Research and Therapy, 47, 181-188.
Culbert, K. M., Lavender, J. M., Crosby, R. D., Wonderlich, S. A., Engel, S. G., Peterson, C. B., ..., & Fischer, S. (2016). Associations between negative affect and binge/purge behaviors in women with anorexia nervosa: Considering the role of negative urgency. Comprehensive Psychiatry, 66, 104-112.
Cyders, M. A., & Coskunpinar, A. (2011). Depression, impulsivity and health-related disability: A moderated mediation analysis. Journal of Research in Personality, 45, 679-682.
Cyders, M. A., & Smith, G. T. (2008). Emotion-based dispositions to rash action: Positive and negative urgency. Psychological Bulletin, 134, 807-828.
Cyders, M. A., Smith, G. T., Spillane, N. S., Fischer, S., Annus, A. M., & Peterson, C. (2007). Integration of impulsivity and positive mood to predict risky behavior: Development and validation of a measure of positive urgency. Psychological Assessment, 19, 107-118.
Davis-Becker, K., Peterson, C. M., & Fischer, S. (2014). The relationship of trait negative urgency and negative affect to disordered eating in men and women. Personality and Individual Differences, 56, 9-14.
Dunkley, D. M., Blankstein, K. R., Masheb, R. M., & Grilo, C. M. (2006). Personal standards and evaluative concerns dimensions of “clinical” perfectionism: A reply to Shafran et al.(2002, 2003) and Hewitt et al.(2003). Behaviour Research and Therapy, 44, 63-84.
Dunkley, D. M., Zuroff, D. C., & Blankstein, K. R. (2003). Self-critical perfectionism and daily affect: Dispositional and situational influences on stress and coping. Journal of Personality and Social Psychology, 84, 234-252.
Engel, S. G., Boseck, J. J., Crosby, R. D., Wonderlich, S. A., Mitchell, J. E., Smyth, J., ..., & Steiger, H. (2007). The relationship of momentary anger and impulsivity to bulimic behavior. Behaviour Research and Therapy, 45, 437-447.
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy, 41, 509-528.
Fairburn, C. G., Marcus, M, D., & Wilson, G. T. (1993). Cognitivebehavioral therapy for binge eating and bulimia nervosa: A comprehensive treatment manual. In C. Fairburn, & G. Wilson (Eds.). Binge Eating: Nature, Assessment and Treatment (pp. 361-404). New York : Guilford Press.
Fischer, S., Peterson, C. M., & McCarthy, D. (2013). A prospective test of the influence of negative urgency and expectancies on binge eating and purging. Psychology of Addictive Behaviors, 27, 294-300.
Fox, J. R., & Froom, K. (2009). Eating disorders: A basic emotion perspective. Clinical Psychology & Psychotherapy, 16, 328-335.
Friedman, M. A., Wilfley, D. E., Pike, K. M., Striegel‐Moore, R. H., & Rodin, J. (1995). The relationship between weight and psychological functioning among adolescent girls. Obesity Research, 3, 57-62.
Frost, R. O., Heimberg, R. G., Holt, C. S., Mattia, J. I., & Neubauer, A. L. (1993). A comparison of two measures of perfectionism. Personality and Individual Differences, 14(1), 119-126.
Frost, R. O., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449-468.
Goldschmidt, A. B., Wonderlich, S. A., Crosby, R. D., Engel, S. G., Lavender, J. M., Peterson, C. B., ..., & Mitchell, J. E. (2014). Ecological momentary assessment of stressful events and negative affect in bulimia nervosa. Journal of Consulting and Clinical Psychology, 82, 30-39.
Gonzalez, V. M., Reynolds, B., & Skewes, M. C. (2011). Role of impulsivity in the relationship between depression and alcohol problems among emerging adult college drinkers. Experimental and Clinical Psychopharmacology, 19, 303-313.
Gustafsson, S. A., Edlund, B., Kjellin, L., & Norring, C. (2009). Risk and protective factors for disturbed eating in adolescent girls–aspects of perfectionism and attitudes to eating and weight. European Eating Disorders Review, 17, 380-389.
Haedt-Matt, A. A., & Keel, P. K. (2011). Revisiting the affect regulation model of binge eating: A meta-analysis of studies using ecological momentary assessment. Psychological Bulletin, 137, 660-681.
Han, K. (1993). Multidimensional Perfectionism – Concept, Measurement, and Relation with Maladjustment. (Unpublished doctoral dissertation). Korea University, Seoul, Korea.
Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York, NY: The Guilford Press.
Heatherton, T. F., & Baumeister, R. F. (1991). Binge eating as escape from self-awareness. Psychological Bulletin, 110, 86-108.
Hersen, M., Turner, S. M., & Beidel, D. C. (Eds.). (2011). Adult psychopathology and diagnosis. Hoboken, New Jersey: John Wiley &Sons.
Hewitt, P. L., & Flett, G. L. (1991). Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology. Journal of Personality and Social Psychology, 60, 456-470.
Hewitt, P. L., Flett, G. L., & Ediger, E. (1995). Perfectionism traits and perfectionistic self-presentation in eating disorder attitudes, characteristics, and symptoms. International Journal of Eating Disorders, 18, 317-326.
Hewitt, P. L., Flett, G. L., & Ediger, E. (1996). Perfectionism and depression:Longitudinal assessment of a specific vulnerability hypothesis. Journal of Abnormal Psychology, 105, 276-280.
Hohlstein, L. A., Smith, G. T., & Atlas, J. G. (1998). An application of expectancy theory to eating disorders: Development and vali dation of measures of eating and dieting expectancies. Psychological Assessment, 10, 49-58.
Hyun, J. (1992). The Effect of Perfectionism and Evaluative Threat on the Performance of Task. (Unpublished master’s thesis). Yonsei University, Seoul, Korea.
Jeon, J. (2011). Relation between negative urgency and binge eating. (Unpublished master’s thesis). Seoul National University, Seoul, Korea.
Karyadi, K. A., & King, K. M. (2011). Urgency and negative emotions:Evidence for moderation on negative alcohol consequences. Personality and Individual Differences, 51, 635-640.
Kaye, W. H., Gendall, K. A., Fernstrom, M. H., Fernstrom, J. D., McConaha, C. W., & Weltzin, T. E. (2000). Effects of acute tryptophan depletion on mood in bulimia nervosa. Biological Psychiatry, 47, 151-157.
Lavender, J. M., Green, D., Anestis, M. D., Tull, M. T., & Gratz, K. L. (2015). Negative affect, negative urgency, thought suppression, and bulimic symptoms: A moderated mediation analysis in a sample at‐risk for bulimic symptoms. European Eating Disorders Review, 23, 246-250.
Lavender, J. M., Utzinger, L. M., Cao, L., Wonderlich, S. A., Engel, S. G., Mitchell, J. E., & Crosby, R. D. (2015). Reciprocal associations between negative affect, binge eating, and purging in the natural environment in women with bulimia nervosa. Journal of Abnormal Psychology, 125, 381-386.
Lee, H. (2001). The Mediating Effect of Self-Esteem and Self-Control on the Relationship between Perfectionism and Bulimia Nervosa. (Unpublished master’s thesis). Gangwon University, Chuncheon, Korea.
Lee, H., Kim, E., Lee, M. (2003). A validation study of Korea ositive and Negative Affect Schedule: The PANAS scales. Korean Journal of Clinical Psychology, 22, 935-946.
Lee, S. (2004). The effect of body rating in self-appraisal, body dissatisfaction, perfectionism and impulsivity on anorexic and bulimic behavior. (Unpublished doctoral dissertation). Yonsei University, Seoul, Korea.
Lim, S. (2014). The Effects of Negative Urgency, Negative Affect and Emotional Dysregulation on Binge Eating and Self Harm Behavior:In Terms of the UPPS-P Model. (Unpublished doctoral dissertation). The Catholic University of Korea, Seoul, Korea.
Lim, S., & Lee, Y. (2014). A Korean validation of the UPPS-P impulsive behavior scale in college students. Korean Journal of Clinical Psychology, 33, 51-71.
Loth, K. A., Goldschmidt, A. B., Wonderlich, S. A., Lavender, J. M., Neumark‐Sztainer, D., & Vohs, K. D. (2016). Could the resource depletion model of self‐control help the field to better understand momentary processes that lead to binge eating?. International Journal of Eating Disorders, 49, 998-1001.
Mauler, B. I., Hamm, A. O., Weike, A. I., & Tuschen-Caffier, B. (2006). Affect regulation and food intake in bulimia nervosa:Emotional responding to food cues after deprivation and subsequent eating. Journal of Abnormal Psychology, 115, 567-579.
Miller, J., Flory, K., Lynam, D., & Leukefeld, C. (2003). A test of the four-factor model of impulsivity-related traits. Personality and Individual Differences, 34, 1403-1418.
Oltmanns, T. F., & Emery, R. E. (2012). Abnormal psychology (7th ed., pp. 278-299). Boston, Massachusetts: Pearson.
Pang, R. D., Farrahi, L., Glazier, S., Sussman, S., & Leventhal, A. M. (2014). Depressive symptoms, negative urgency and substance use initiation in adolescents. Drug and Alcohol Dependence, 144, 225-230.
Pearson, C. A., & Gleaves, D. H. (2006). The multiple dimensions of perfectionism and their relation with eating disorder features. Personality and Individual Differences, 41, 225-235.
Pennesi, J. L., & Wade, T. D. (2016). A systematic review of the existing models of disordered eating: Do they inform the development of effective interventions?. Clinical Psychology Review, 43, 175-192.
Polivy, J., & Herman, C. P. (1985). Dieting and binging: A causal analysis. American Psychologist, 40, 193-201.
Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36, 717-731.
Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40, 879-891.
Racine, S. E., Keel, P. K., Burt, S. A., Sisk, C. L., Neale, M., Boker, S., & Klump, K. L. (2013). Exploring the relationship between negative urgency and dysregulated eating: Etiologic associations and the role of negative affect. Journal of Abnormal Psychology, 122, 433-444.
Rice, K. G., Ashby, J. S., & Slaney, R. B. (1998). Self-esteem as a mediator between perfectionism and depression: A structural equations analysis. Journal of Counseling Psychology, 45, 304.
Sherry, S. B., & Hall, P. A. (2009). The perfectionism model of binge eating: Tests of an integrative model. Journal of Personality and Social Psychology, 96, 690-709.
Sherry, S. B., Sabourin, B. C., Hall, P. A., Hewitt, P. L., Flett, G. L., & Gralnick, T. M. (2014). The perfectionism model of binge eating: Testing unique contributions, mediating mechanisms, and crosscultural similarities using a daily diary methodology. Psychology of Addictive Behaviors, 28, 1230-1239.
Smith, G. T., Fischer, S., Cyders, M. A., Annus, A. M., Spillane, N. S., & McCarthy, D. M. (2007). On the validity and utility of discriminating among impulsivity-like traits. Assessment, 14, 155-170.
Smith, M. C., & Thelen, M. H. (1984). Development and validation of a test for bulimia. Journal of Consulting and Clinical Psychology, 52, 863-872.
Smyth, J. M., Wonderlich, S. A., Heron, K. E., Sliwinski, M. J., Crosby, R. D., Mitchell, J. E., & Engel, S. G. (2007). Daily and momentary mood and stress are associated with binge eating and vomiting in bulimia nervosa patients in the natural environment. Journal of Consulting and Clinical Psychology, 75, 629-638.
Son, E. (2013). The mediation effects of interpersonal discrepancy, perceived social support, and depression in the relation of socially-prescribed perfectionism and binge eating among college women. The Korean Journal of Counseling and Psychotherapy, 25, 309-330.
Song, H. (2015). The effects of maladaptive perfectionism on anxiety:State locus control as a moderator. (Unpublished master’s thesis). Sungkyunkwan university, Seoul, Korea.
Steele, A., Corsini, N., & Wade, T. D. (2007). The interaction of perfectionism, perceived weight status, and self-esteem to predict bulimic symptoms: The role of ‘benign’perfectionism. Behaviour Research and Therapy, 45, 1647-1655.
Stice, E. (2001). A prospective test of the dual-pathway model of bulimic pathology: mediating effects of dieting and negative affect. Journal of Abnormal Psychology, 110, 124-135.
Stice, E. (2002). Risk and maintenance factors for eating pathology:A meta-analytic review. Psychological Bulletin, 128, 825-848.
Striegel-Moore, R. H., Silberstein, L. R., & Rodin, J. (1986). Toward an understanding of risk factors for bulimia. American Psychologist, 41, 246-264.
Thelen, M. H., Farmer, J., Wonderlich, S., & Smith, M. (1991). A revision of the Bulimia Test: The BULIT—R. Psychological Assessment:A Journal of Consulting and Clinical Psychology, 3(1), 119-124.
Waller, G., Babbs, M., Milligan, R., Meyer, C., Ohanian, V., & Leung, N. (2003). Anger and core beliefs in the eating disorders. International Journal of Eating Disorders, 34, 118-124.
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063-1070.
Whiteside, S. P., & Lynam, D. R. (2001). The five factor model and impulsivity: Using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669-689.
Wonderlich, S. A., Crosby, R. D., Joiner, T., Peterson, C. B., Bardone- Cone, A., Klein, M., ..., & Kolden, G. (2005). Personality subtyping and bulimia nervosa: Psychopathological and genetic correlates. Psychological Medicine, 35, 649-657.
Yoon, H. (1996). The relatlonships amomg binge eating behavior, depressive symptoms, and attributional style. (Unpublished master’s thesis). The Catholic University of Korea, Seoul, Korea.