Perfectionism may be a risk factor for serious alcohol use disorders

Summary: A study finds a link between the personality trait of perfectionism and severe alcohol use disorder.

Author: Alcoholism Research Society

Perfectionistic traits – higher self-criticism and unrealistic standards leading to isolation – are associated with severe alcohol use disorder (AUD), according to the first study directly comparing patients with AUD to a control group in good health.

Perfectionists strive for unrealistic performance standards and are prone to self-criticism. These goals generate feelings of failure and, if they cannot meet the standards they believe others expect of them, a social disconnect.

Perfectionism is known to increase vulnerability to stress and depression, but its role in severe AUD has not been fully studied.

Some evidence suggests that perfectionist young adults drink less frequently than their peers. Some other studies have shown that perfectionism coexists with high impulsivity and reduced impulse control, factors implicated in AUD, and that perfectionists may self-medicate with alcohol in an attempt to overcome anxiety. social or feelings of inadequacy.

For a study in Alcoholism: clinical and experimental researchBelgian researchers explored associations between perfectionist traits and severe AUD.

The investigators worked with 65 adults with severe AUD who were undergoing inpatient detox and 65 healthy adults matched for sex and age. Participants completed questionnaires assessing three dimensions of perfectionism.

Self-focused perfectionism involves setting exaggerated performance standards for oneself (e.g., “One of my goals is to be perfect in everything I do”). Socially prescribed perfectionism is generated by the perceived expectations of others (e.g., “people expect nothing less than perfection from me”).

Other-oriented perfectionism involves setting high standards for others (eg, “I have high expectations for people who are important to me”).

The researchers also assessed participants’ depressive symptoms, state anxiety (transient anxiety experienced in a specific situation), and trait anxiety (anxiety that generalizes to a person’s broad experience). The researchers used statistical analysis to look for links between these factors.

Patients with severe AUD reported higher depressive symptoms and trait anxiety. They also exhibited higher self-focused and socially-focused perfectionism than controls, although the two groups were similar in other-focused perfectionism.

Severe AUD was linked to unrealistic personal standards and heightened sensitivity to the expectations of others, even after controlling for the role of depressive symptoms and anxiety, but not being demanding of others.

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Patients with severe AUD reported higher depressive symptoms and trait anxiety. Image is in public domain

This is consistent with what is known of self-related and interpersonal factors in severe AUD, such as lowered self-esteem, tendency to blame oneself, and discrepancy between the ideal self and the actual self. .

Perfectionists might perceive an exaggerated gap between their own high standards and alcohol-related consequences, fearing academic or career failure.

The study results also suggest that self-focused perfectionism in severe AUD is higher in men and more educated people. They also support previous evidence that perfectionism is associated with lower daily alcohol consumption among moderate drinkers.

Given the potential role of perfectionism in the development and maintenance of severe AUD, this could be a valuable treatment target, the researchers concluded.

They recommend further investigation into the different dimensions of perfectionism in AUD, including whether high perfectionism reduces treatment efficacy and the causal links between perfectionism, impulsivity, and self-blame.

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About this research on alcohol use disorders

Author: Press office
Source: Alcoholism Research Society
Contact: Press Office – Alcoholism Research Society
Image: Image is in public domain

Original research: Access closed.
“Greater self-directed and socially prescribed perfectionism in severe alcohol use disorder” by Pierre Maurage et al. Alcoholism: clinical and experimental research


Greater self-directed and socially prescribed perfectionism in severe alcohol use disorder


Perfectionist individuals present exaggerated performance standards, generating a constant search for perfection and a strong tendency to self-criticism. The dominant models distinguish three dimensions of perfectionism: namely, self-oriented, socially prescribed and other-oriented. Perfectionism is a factor of vulnerability to psychopathological disorders, but its role in severe alcohol use disorder (SAUD) remains unexplored.


Sixty-five recently detoxified patients with SAUD and 65 matched controls completed a questionnaire of perfectionism (the Hewitt Multidimensional Perfectionism Scale), along with measures of psychopathology.


SAUD was associated with greater self-oriented and socially prescribed perfectionism, with no group differences on other-oriented perfectionism. This differential pattern persisted when controlling for levels of depression and anxiety, and there was no correlation with alcohol consumption.


This specific perfectionist profile is consistent with those of previous studies showing lower self-report (eg, higher feelings of guilt and reduced self-esteem) and impaired social cognition (eg, unrealistic social norms and greater social isolation) at SAUD. Given its potential role in the development and maintenance of SAUD, perfectionism may be an attractive therapeutic target in patients with this disorder.

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