|dc.description.abstract||This thesis explored conceptual and pathological issues of perfectionism within the
developmental period of adolescence. Quantitative and qualitative methodological
approaches were utilised in the study of both general and clinical adolescent
populations. Overall, the thesis aimed to provide an empirically driven account of
adolescent perfectionism within a clinical context.
Introductory chapters discuss adolescent development and mental health,
developmental theories of perfectionism, and adolescent expressions of perfectionism.
Historical and conceptual developments in perfectionism theory are critically discussed
before the current conceptualisations used in adolescent research are identified and
The findings of a systematic review examining associations between perfectionism,
mental illness, and treatment outcomes in clinical adolescent populations are reported.
PRISMA guidelines and pre-specified qualitative assessment criteria were utilised.
Sixteen studies were included in the review. Good quality research indicates that
socially-prescribed perfectionism relates to suicide and depression. Lower quality
research suggests that self-oriented perfectionism has a role in eating disorders. Studies
of eating disorder, depression, and chronic fatigue syndrome treatment all indicate that
perfectionism negatively impacts on outcomes for these adolescent groups but the effect
is less consistent in suicidal adolescents
A questionnaire-based survey of 507 Scottish adolescents (272 females, 233 males; age
range: 12.24-15.50 years) was conducted to explore the relationships of perfectionism
and clinical perfectionism to mental health risk in the general adolescent population.
Exploratory and confirmatory factor analyses were performed on the Child-Adolescent
Perfectionism Scale (CAPS) and the Clinical Perfectionism Questionnaire (CPQ). The
identified factor structures of these measures were then used to examine risk for
depression, anxiety, and eating disorders in adolescents. Path analyses using structural
equation modelling identified unique paths between varied facets of adolescent
perfectionism and mental health disorders. Perfectionistic concerns, measured by the
CPQ, was found to be transdiagnostic for all three disorders in adolescents.
A focus group study of clinician perspectives of adolescent perfectionism was conducted
and analysed through thematic analysis. The results highlighted similarities and
differences between clinician-perspectives and published conceptual models. The study
also revealed some of the issues clinicians face in their clinical work with clinical
adolescent perfectionists. The study provided a reference framework to inform the
development of the final study.
With the aim of developing a novel conceptualisation of perfectionism in adolescent
clinical populations, a grounded theory study of sixteen adolescents diagnosed with an
eating disorder was conducted. Semi-structured, individual interviews were conducted
and methodically analysed according to grounded theory methodology to explore the
young peoples’ experiences of perfectionism. A novel framework for adolescent clinical
perfectionism is proposed based on the findings of this study. The framework
encapsulates a developmentally relevant construction of perfectionism as it is
experienced by these young people.
The thesis findings are related to associated literature regarding mental health problems
in adolescents and conceptualisations of perfectionism. Implications for clinical
intervention are suggested. Future directions for the field of adolescent clinical
perfectionism are proposed. The unique contribution of this thesis to the wider
adolescent perfectionism literature is discussed.||en