Perfectionism as a mediator of psychological distress: Implications for addressing underlying vulnerabilities to the mental health of medical students

Abstract

Objective

Medical students have personalities that are often shown to be perfectionistic. Perfectionism can manifest as maladaptive and lead to psychological distress. This study examined the mediating role of perfectionism on the association between personality trait profiles and levels of psychological distress.

Methods

First-year medical students completed a questionnaire containing measures of personality, perfectionism (Concern over Mistakes: CoM), stress, anxiety and depression. Latent profile analysis classified students based on their personality traits and identified a profile vulnerable to psychological distress. Structural equation models examined the mediation effects of perfectionism on the relationship between the vulnerable personality profile and distress.

Results

The sample totalled 376 (84% response). The vulnerable personality profile was highest in Harm Avoidance, lowest in Self-Directedness, and significantly correlated with the highest Perfectionism-CoM. High Perfectionism-CoM was associated with the highest levels of stress, anxiety and depression. Perfectionism-CoM was a significant mediator for the relationship between personality and higher levels of psychological distress.

Conclusion

Certain personality profiles are predisposed to psychological distress such as anxiety, stress and depression. Perfectionism, as a mediator between personality and psychological distress, may be a target strategy to help increase students’ self-acceptance, and self-awareness of their perfectionistic tendencies and lower their vulnerability to poor mental health.

Keywords:

• Medical education research
• student support
• trends
• continuing
• medicine

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Glossary

Maladaptive perfectionism: ‘evaluative concern’. Perfectionism that is self-defeating. It relates to a high concern over making mistakes, setting unrealistic standards and goals, and constant comparison to others. People with maladaptive perfectionism tend to be highly self-critical and often have a persistent sense of inadequacy which can lead to negative attitudes and emotional distress.

Adaptive perfectionism: ‘achievement striving’. Perfectionism that is healthy and normal. It relates to an intense effort that is put forth to achieve a certain goal. People with adaptive perfectionism set high but realistic standards and do not compare themselves to others or resort to harsh self-criticism when their standards are not reached.

Additional information

Notes on contributors

Diann S. Eley

Diann S. Eley, MSc, PhD, is a Professor and Director of MD Research in the Office of Medical Education, Faculty of Medicine at the University of Queensland.

Vikas Bansal

Vikas Bansal, BscH, MD candidate 2020, is a 4th year medical student at the University of Queensland. His background is in psychology, statistical analysis and database creation. His interests are in rural medicine, gastroenterology, cardiology, internal medicine and medical education.

Janni Leung

Janni Leung, PhD, Epidemiology, is an early career researcher. Her background is in biostatistics, public health, sociology, and psychology. Her current research takes an epidemiological approach to study mental health and associated behaviours in the population.