Psychology in the Schools, Vol.

51(9), 2014 
C 2014 Wiley Periodicals, Inc.
View this article online at wileyonlinelibrary.com/journal/pits DOI: 10.1002/pits.21792

A PROPOSED FRAMEWORK FOR PREVENTING PERFECTIONISM AND PROMOTING

RESILIENCE AND MENTAL HEALTH AMONG VULNERABLE CHILDREN
AND ADOLESCENTS
GORDON L. FLETT
York University

PAUL L. HEWITT
University of British Columbia

Recent findings suggest that perfectionism is highly prevalent among children and adolescents, and
perfectionism can be quite destructive in terms of its links with anxiety, depression, and suicide.
In this article, we provide an overview of recent research illustrating the costs and consequences
of perfectionism among children and adolescents. We also highlight the heterogeneity that exists
among perfectionists and the need for a complex, nuanced approach to assessment and prevention
that reflects the achievement and interpersonal concerns of perfectionists. We then summarize
past research on the prevention of perfectionism and show that perfectionism is pernicious and
resistant to change. Accordingly, interventions must be tailored to address the cognitive and emo-
tion regulation vulnerabilities of perfectionists and their meta-cognitive beliefs about ability, the
self, and the meaning of failure. We conclude by discussing why it is essential to proactively
design and implement preventive programs with specific components designed to enhance re-
silience and reduce levels of risk among perfectionists. We outline several themes that should be
incorporated in preventive and intervention efforts designed to address the needs of vulnerable
perfectionists. C 2014 Wiley Periodicals, Inc.

In many respects, the existing literature on perfectionism in children and adolescents parallels
the general research literature on perfectionism. There is now extensive evidence indicating that
perfectionism in children and adolescents is multidimensional, and various perfectionism dimensions
are implicated in a wide range of adjustment difficulties in children and adolescents. Although the
focus has been primarily on children and adolescents in school settings, higher levels of perfectionism
have been found among children and adolescents with clinically diagnosed anxiety (Mitchell, Newall,
Broeren, & Hudson, 2013), depression (Huggins, Davis, Rooney, & Kane, 2008), and obsessive-
compulsive disorder (Soreni et al., 2014). Links have also been established with suicide ideation
and the wish to die (Boergers, Spirito, & Donaldson, 1998). Perfectionism also predicts aberrant
behaviors, such as bulimic tendencies (Bento et al., 2010), compulsive exercise (Goodwin, Haycraft,
& Meyer, 2014), and self-mutilation (Nock & Prinstein, 2005).
Overall, a wealth of compelling evidence attests to the potential destructiveness of perfectionism
in young people (see Flett & Hewitt, 2012). Dysfunctional perfectionism among younger people
is an important public health issue for our society, resulting in a growing need for an urgent and
coordinated response. Accordingly, this article outlines a framework for school-based preventive
interventions designed to reduce levels of perfectionism and increase levels of resilience among
children and adolescents. In the following sections, we have outlined the primary reasons for
proactive prevention and identified key themes and vulnerabilities among perfectionists that need to
be addressed in tailored prevention programs delivered in school settings.

Gordon Flett was supported by the Canada Research Chair Program, and funding was provided by the Faculty of
Health, York University.
Correspondence to: Gordon Flett, LaMarsh Centre for Child and Youth Research, Technology Enhanced Learning
Building, 5022K, York University, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada. E-mail: gflett@yorku.ca

899
900 Flett and Hewitt

T HE A SSESSMENT OF M ULTIDIMENSIONAL P ERFECTIONISM

We begin our discussion by providing an overview of perfectionism from an assessment
perspective. Two themes are emphasized in this segment of our article. First, perfectionism is
assessed in children and adolescents with various measures that overlap to some extent, but they are
not equivalent. Clear differences exist in how perfectionism is conceptualized (see Flett & Hewitt,
2002), and these differences are reflected in the items of the four scales used most often in school-
aged populations: (1) the Frost Multidimensional Perfectionism Scale (FMPS; Frost, Marten, Lahart,
& Rosenblate, 1990), (2) the Child-Adolescent Perfectionism Scale (CAPS; Flett, Hewitt, Boucher,
Davidson, & Munro, 1997), (3) the Almost Perfect Scale-Revised (APS-R; Slaney, Rice, Mobley,
Trippi, & Ashby, 2001), and (4) the Adaptive/Maladaptive Perfectionism Scale (AMPS; Rice &
Preusser, 2002).
The 35-item FMPS has five trait dimensions, including high personal standards, concern over
mistakes, doubts about actions, parental expectations, and parental criticism; concern over mistakes
and doubts about actions in children and adolescents have been linked consistently with maladjust-
ment. The FMPS was designed for adults and has not been adapted for children. Also note that a sixth
factor, the organization dimension was dropped due to its low correlations with other dimensions.
The 22-item CAPS reflects the conceptualization outlined in one of our initial articles (see
Hewitt & Flett, 1991). The CAPS has subscales assessing self-oriented perfectionism and socially
prescribed perfectionism. Self-oriented perfectionism reflects the tenacious striving for extreme
personal standards. Socially prescribed perfectionism is the perception that others demand perfection
from one’s self. The CAPS is one of the most widely used self-report measures.
The APS-R was not designed specifically for children, but it has been used in various studies.
This two-factor scale is similar to the CAPS and FMPS in that it also has a personal standard subscale.
The other subscale measures “the perceived discrepancy or difference between the standards one has
for oneself and one’s actual performance” (Slaney et al., 2001, p. 133). People with high standards but
low self-reported discrepancy are considered “adaptive perfectionists.” Those with high standards
and a large discrepancy are considered “maladaptive perfectionists,” with a chronic sense of falling
short of their high standards.
The AMPS was created for use with children. It has four factors: sensitivity to mistakes,
contingent self-esteem, compulsiveness, and need for admiration. Two subscales seem to directly
tap perfectionism (compulsiveness, sensitivity to mistakes), whereas the other subscales reflect
themes implicated in the development of perfectionism: the need for acceptance and recognition,
and the sense that self-worth comes from being perfect.
The second theme is that regardless of how perfectionism is conceptualized and assessed, we
have found in our work with the CAPS that there is substantial heterogeneity and differences among
perfectionistic children. The differences among perfectionistic children were described eloquently by
Adelson (2007), a teacher of academically talented fourth-grade students. Five types of perfectionists
were distinguished: (1) the driven “Academic Achiever,” who must achieve 110%; (2) the “Risk
Evader,” with the all-or-nothing approach who lacks the confidence to try new things; (3) the
“Aggravated Accuracy Assessor,” who must achieve exactness and is fixated on “re-dos”; (4) the
“Procrastinating Perfectionist,” paralyzed by fears and self-doubts that impair the ability to start or
finish work; and (5) the “Controlling Image Manager,” who wants to be perfect and be regarded as
perfect. These children will avoid situations and learning opportunities that could reveal inadequacies
in ways that reflect the perfectionistic self-presentational style described by Hewitt and associates
(2003, 2011).
Given the variability that exists among children and adolescent perfectionists, various per-
fectionism measures should be used when possible to establish the profile of perfectionism when
assessing an individual child or adolescent. Interventions must then be individualized and tailored
Psychology in the Schools DOI: 10.1002/pits
 The Prevention of Perfectionism 901

to address the unique factors that are involved. Our intervention approach reflects our overarching
emphasis on the need to consider perfectionism from an interpersonal perspective (Hewitt & Flett,
1991). Certain dimensions (i.e., socially prescribed perfectionism) directly reflect this interpersonal
orientation, but equally important are the unmet interpersonal needs for affection and safety, and
associated self-concept and identity issues that are at the root of many perfectionistic tendencies. The
need to consider interpersonal issues points to the need to build resilience in various life domains.
Vulnerable perfectionists need to develop emotional self-regulation capabilities and build resilience
to academic setbacks by promoting grit and academic buoyancy. But equally important is fostering
relational resilience to help cope with interpersonal challenges.

W HY D O W E N EED TO P REVENT P ERFECTIONISM ?

Before we describe a framework for preventing perfectionism and promoting resilience, we
outline the main reasons why prevention of perfectionism is needed. We maintain that the three
most compelling reasons for reducing perfectionism and promoting resilience are: (1) dysfunctional
perfectionism is quite prevalent, perhaps increasingly so, among young people; (2) perfectionistic
youth are particularly unlikely to seek help; and (3) perfectionism is associated with a heightened
risk of suicide among adolescents. Each of these issues is discussed in the following sections.

The High Prevalence of Perfectionism

When various perfectionism types are evaluated in studies involving cluster analyses, perfection-
ists invariably outnumber nonperfectionists. Collectively, extant data point to a possible epidemic of
dysfunctional perfectionism among younger people. Consider, for instance, a study by Rice, Ashby,
and Gilman (2011) of perfectionism types in 875 adolescents. Analyses of APS-R item responses
yielded four clusters of perfectionists and nonperfectionists, with 255 deemed to be maladaptive
perfectionists (29.1% of the total) and 234 (26.7%) deemed to be adaptive perfectionists. Thus,
about 3 in 10 had maladaptive perfectionism. Maladaptive perfectionism is also quite prevalent in
research with the FMPS. An Australian study found that 96 of 409 adolescent girls (slightly under 1
in 4) were classified as having unhealthy perfectionism, whereas 207 girls had “healthy perfection-
ism” (Hawkins, Watt, & Sinclair, 2006). Unhealthy perfectionism was also detected in about 1 in
4 (26.6%) of the 380 children in a study from China (Chan, 2009).
Maladaptive perfectionism among younger people seems ubiquitous, and children and youth
from disadvantaged backgrounds are clearly not immune to these pressures. A study of 661 early
adolescents from mostly African American, low-income families found that the high perfectionism
group (i.e., high levels of socially prescribed, self-striving, and self-critical perfectionism) accounted
for 41% of the sample. That is, about 2 in 5 participants were highly perfectionistic (Herman, Trotter,
Reinke, & Ialongo, 2011). Moreover, the early adolescents in this group had more internalizing,
depression-like symptoms and were rated most negatively by their teachers on inattentiveness,
hyperactivity, and peer interaction, despite having significantly higher grades.
Compelling new data emerged from one of the few longitudinal studies to allow for comparisons
of rates of perfectionism over time. Three subsamples of gifted Czech adolescents were assessed
5 years apart (see Portesova & Urbanek, 2013). Analyses of the participants assessed in 2010 (vs.
those assessed in 2005 and 2000) yielded two new discoveries: (1) the identification of an emergence
of a unique subtype described as “a ‘pervasive’ type of unhealthy perfectionism” (Portesova &
Urbanek, 2013, p. 1116); and (2) clear indications according to cohort comparisons that, at least in
the Czech Republic, levels of unhealthy perfectionism seem demonstrably on the rise.
These related lines of investigation converge to suggest that problematic perfectionism is
widespread among young people, and it may be increasing in prevalence. Is this perfectionism

Psychology in the Schools DOI: 10.1002/pits

902 Flett and Hewitt

contributing to the high prevalence of anxiety and depression among children and adolescents in
school settings? This pervasiveness of maladaptive perfectionism is disconcerting, especially given
that it is associated with two other negative factors (i.e., a negative help-seeking orientation and
elevated suicide risk) that are discussed next.

The Unwillingness to Seek Help

Unfortunately, there are indications that when help is needed, many perfectionists are simply
not willing to seek it, and this is a reflection of the perfectionistic self-presentational style and the
need for self-conscious perfectionists to maintain “a front.” Research by DeRosa, Flett, and Hewitt
(2014) evaluated this theme in 132 high school students by showing that facets assessed by the
Perfectionistic Self-Presentation Scale, such as the nondisclosure of imperfections, were associated
with negative help-seeking attitudes and trait self-concealment. These data suggest that students
who are preoccupied with needing to seem perfect will not seek help when it is required, in part,
because the act of seeking help can be regarded as an open admission of failure and of not being
perfect. Flett and Hewitt (2013) described in detail this tendency for distressed, perfectionistic youth
who are skilled self-presenters to “fly under the radar.” That is, they are hiding behind a façade of
apparent invulnerability that masks their unbearable pain (see Flett & Hewitt, 2013).

Perfectionism and Suicide Risk

The hidden psychological and social pain of countless young perfectionists is disconcerting
in light of growing evidence that links perfectionism in young people with suicide risk. The need
for vigilant assessment of perfectionism and suicide risk is suggested by empirical research, legal
investigations, and public policy initiatives. In June 2008, the Flemish Centre for Suicide Prevention
in Belgium issued an emergency public appeal after six teenagers attempted suicide in a 2-week
period, with only two surviving. The appeal was focused on young people struggling with the
pressures of not achieving perfection. Teachers and parents were asked to be particularly vigilant
and alert to the despair of perfectionistic teens suffering from low self-esteem.
Many other case examples have implicated perfectionism in the suicides of young people.
Psychological autopsies conducted with the parents of 33 boys and young men who took their own
lives documented that 71.4% of those who committed suicide had exceedingly high demands and
expectations (Tornblom, Werbart, & Rydelius, 2013). It was also noted that many boys and young
men hid behind masks that made it difficult, if not impossible, to detect their suicidal intentions and
vulnerability. This theme is revisited in a later segment of this article.
These descriptive analyses accord with the results of empirical investigations that have estab-
lished links between perfectionism and suicidal tendencies in adolescents. A study with clinical
and community samples of adolescents in Puerto Rico found that a composite perfectionism factor
derived from adolescent and parent reports was clearly elevated among adolescents with suicidal
behaviors or thoughts (Jones, Ramirez, Davies, Canino, & Goodwin, 2008). Perfectionism was
also associated with suicidal thoughts in a rare longitudinal study by Jacobs et al. (2009), who
assessed 439 clinically depressed adolescents before and during treatment. Perfectionism was asso-
ciated significantly with suicide ideation at all three assessment timepoints (baseline and after 6 and
12 weeks of treatment). Perfectionism also impeded treatment progress. That is, although the sample
of participants as a whole improved, this was not evident among the most perfectionistic and de-
pressed adolescents; depressed adolescents with baseline perfectionism scores at the 90th percentile
or higher were especially likely to still have elevated suicide ideation after 12 weeks of treatment.
These data attest to the pernicious link between extreme perfectionism and psychological distress.
Indeed, even when treatment interventions yield reductions in perfectionism and associated symp-

Psychology in the Schools DOI: 10.1002/pits

 The Prevention of Perfectionism 903

toms of anxiety, it is still the case that children with elevated perfectionism have poorer treatment
outcomes (see Mitchell et al., 2013).
The results from several studies with adolescents converge to suggest that socially prescribed
perfectionism is a risk factor in suicidal tendencies and self-harm (e.g., Hewitt, Newton, Flett, &
Callander, 1997; O’Connor, Rasmussen, & Hawton, 2012). When 45 nonsuicidal adolescents and
55 adolescents in a suicidal behavior group (e.g., mild or more potentially lethal suicide attempt) in
inpatient treatment in Israel were compared, the participants in the suicide group had significantly
higher levels of socially prescribed perfectionism and dependency (see Freudenstein et al., 2012).
Similarly, in a sample of 55 adolescent psychiatric patients, socially prescribed perfectionism was
associated significantly with suicide potential, even after controlling for predictors such as depression
and hopelessness (Hewitt, Caelian, Chen, & Flett, in press). Finally, a separate investigation found
that both trait socially prescribed perfectionism and perfectionistic self-presentation were associated
with greater suicide potential in child and adolescent psychiatric outpatients (Roxborough et al.,
2012).
Our sense is that children and adolescents who are exposed to significant internal and ex-
ternal pressures to be perfect are substantially at risk for suicide, especially when socially pre-
scribed perfectionism is combined with other well-known risk factors (also see Flett, Hewitt, &
Heisel, in press). A profound sense of shame and defeat and feelings of hopelessness are common
among demoralized perfectionists who feel they have failed. Given the tendency to hide behind a
façade, extensive assessment is critical whenever a child or adolescent who is highly perfectionistic
seems to be doing exceptionally well in ways that seem incongruous with prevailing stressors and
challenges.

A F RAMEWORK FOR P ROACTIVE A SSESSMENT AND I NTERVENTION

Fortunately, a recent trend in the perfectionism literature is the emergence of research that
evaluates the effectiveness of preventive interventions. In this section, we provide a brief overview
of the research conducted thus far. Substantial progress has been made, but a key caveat must
be noted—initial findings from intervention studies suggest that an explicit focus on reducing
perfectionism and associated factors can indeed be effective (Wilksch, Durbridge, & Wade, 2008);
however, less successful are general prevention programs without an explicit and extensive focus on
perfectionism (see Coughlin & Kalodner, 2006; McVey, Davis, Tweed, & Shaw, 2004).
For instance, McVey and associates (2004) had girls in Grade 6 placed in either a control group
or an intervention group that received a six-session intervention. The six themes addressed were (1)
media influences, (2) enhancing self-esteem, (3) body size acceptance, (4) healthy living, (5) stress
management, and (6) positive relationships. Perfectionism was not an extensive focus. Both the
intervention and control groups had significant reductions in self-oriented and socially prescribed
perfectionism, but because perfectionism decreased for both groups, these results were interpreted
appropriately as a temporal effect, not an intervention effect.
Two studies by Wilksch and Wade are quite informative when considered together. Wilksch
and Wade (2013) showed that participation in the Life Smart program (e.g., eight obesity prevention
lessons, including managing perfectionistic thinking, managing emotions, getting proper sleep, and
coping with peer teasing) yielded decreases among adolescent girls in some variables (e.g., shape and
weight concerns) but did not lower levels of perfectionism. Mean scores for concern over mistakes
did not change by the end of the program.
This recent study contrasts with an earlier study by Wilksch, Durbridge, and Wade (2008)
with a more explicit focus on reducing perfectionism. Participants were assigned randomly to one
of three conditions: a control condition, a media literacy treatment condition, or a perfectionism
treatment condition. The perfectionism program occurred over eight sessions, structured as follows:

Psychology in the Schools DOI: 10.1002/pits

904 Flett and Hewitt

(1) What is perfectionism; (2) What’s bad about being too good (perfectionism vs. the pursuit of
excellence); (3) What leads to and maintains perfectionism; (4) How to challenge the thinking
that feeds perfectionism; (5) Changing behavior: Rewards, incentives, and redefining success; (6)
Reframing failure: Making mistakes is good; (7) Coping with perfectionism; and (8) The final
wrap-up (including class presentations and the take-home message).
The participants in the perfectionism intervention group included 17 participants deemed to be
at high risk for developing an eating disorder. Levels of perfectionism were measured with two FMPS
subscales (i.e., concern over mistakes and personal standards). Analyses showed that the perfection-
ism intervention yielded significant reductions in both perfectionism dimensions, with the strongest
effect at the 3-month follow-up post-intervention found for the concern over mistakes dimension.
The perfectionism intervention group, when compared with the media literacy intervention group,
also had lower scores on the personal standards dimension. Supplementary analyses indicated that
the high-risk participants benefitted the most from the perfectionism intervention. Eight high-risk
participants in this treatment condition had clinically significant reductions (57%), as did 8 low-risk
participants (35% of the low-risk participants). The results represent clear evidence of the potential
usefulness of programs that focus explicitly on reducing levels of perfectionism. At the same time,
almost half of the high-risk participants who received the perfectionism intervention did not show
signs of clinically significant change.
An earlier pilot study by Wilksch and associates (2008) focused on preventing eating disorder
symptoms in 20 girls with type 1 diabetes. Participants had two 4-hour group intervention sessions,
and the themes addressed included an explicit focus on perfectionism. Assessments at the 1 month,
post-intervention follow-up showed reductions in personal standards and concern over mistakes.
However, the absence of a control group limits any strong conclusions.
Essau, Conradt, Sasagawa, and Ollendick (2012) examined whether perfectionism could be
reduced as part of their broader investigation of the effectiveness of the FRIENDS program as a
cognitive-behavior program for the treatment and prevention of anxiety (see Barrett, Lowry-Webster,
& Turner, 2000). The FRIENDS Program has some elements designed to combat perfectionism,
including removing self-critical thoughts, learning to engage in self-reward for partial successes,
and learning how to be aware of and cope with somatic anxiety cues (Barrett & Sonderegger,
2005). Children in the intervention group, relative to those in the no-intervention control group,
had significant decreases in self-oriented perfectionism, but not in levels of socially prescribed
perfectionism (Essau et al., 2012). Supplementary analyses found that reductions in overall trait
perfectionism mediated intervention-related decreases in anxiety.
Even when some success is achieved, current evidence suggests that implemented interven-
tions tend to reduce but do not ameliorate perfectionism (see Nobel, Manassis, & Wilansky-Traynor,
2012). The persistence of perfectionism was also suggested in recent work evaluating The Aussie
Optimism: Positive Thinking Skills Program. This program is designed to develop various cognitive
and behavioral strategies that prevent symptoms of depression and anxiety in children (see Rooney,
Hassan, Kane, Roberts, & Nesa, 2013). Perfectionism was the focus in some initial analyses of data
from this project (see Huggins et al., 2008). In total, 786 children participated, with 409 children re-
ceiving the intervention and 377 children in the control group. The use of a computerized diagnostic
program led to the identification of 50 children (25 boys, 25 girls) meeting criteria for depressive dis-
order. These 50 children had significantly higher levels of both self-oriented and socially prescribed
perfectionism, relative to children who were not clinically depressed. Importantly, after controlling
for gender and prevention program participation, elevated socially prescribed perfectionism still
predicted higher post-intervention levels of depression. Thus, extensive, multifaceted interventions
focused directly on perfectionism, and its precursors are needed to eliminate the negative impacts
of perfectionism.

Psychology in the Schools DOI: 10.1002/pits

 The Prevention of Perfectionism 905

K EY T HEMES IN B UILDING R ESILIENCE AND P REVENTING P ERFECTIONISM

This final segment of our article focuses on themes that should be addressed when developing
programs to combat perfectionism. Some readers, including many perfectionists, will no doubt object
to our notion that perfectionism should be prevented, based on their conviction that perfectionism
can be a form of positive striving and certain goals require an absolute level of striving. Some authors
have gone so far as to suggest that we need to promote adaptive perfectionism (e.g., Fong & Yuen,
2014). Indeed, one intervention study conducted with gifted adolescents tried unsuccessfully to use
an affective curriculum to increase adaptive perfectionism (i.e., high personal standards) while de-
creasing maladaptive perfectionism at the same time (see Mofield & Chakraborti-Ghosh, 2010). We
feel that recommendations to boost adaptive perfectionism should be held in reserve for two reasons.
First, adaptive perfectionism may not prove to be adaptive in the long run; more longitudinal research
is needed. Moreover, an overwhelming reliance on self-report in the perfectionism literature means
that a proportion of those deemed to have “adaptive perfectionism” are likely characterized by the
grandiosity and inflated self-views that can become a destructive form of narcissistic perfectionism
(for a review, see Flett, Sherry, Hewitt, & Nepon, in press). Second, the recommendation to promote
adaptive perfectionism is at variance with our concerns about the potential costs associated with
self-oriented perfectionism. Extreme self-oriented perfectionism has several inherent features that
limit its adaptiveness, including rigid and inflexible thinking, an abiding fear of failure, an excessive
self-focus, and a propensity to react poorly following mistakes and setbacks. The relentless pursuit of
absolute perfection can also develop into extreme workaholism, and students who are too concerned
with making mistakes are prone to academic burnout and low engagement (Shih, 2012).
Because we have conceptualized self-oriented perfectionism as a vulnerability factor activated
during times of stress and failure (see Hewitt & Flett, 1991, 2002), we continue to argue that this type
of perfectionism is more costly than it is beneficial in most instances. Given the potential costs linked
with self-oriented perfectionism, it seems reasonable to reduce levels of self-oriented perfectionism
so that it becomes a healthy excellence striving built on thoughts such as “sometimes, good enough
is good enough!” But attempts to prevent self-oriented perfectionism must be grounded in certain
realities. Some vulnerable people have an entrenched perfectionistic temperament that is difficult if
not impossible to counteract (Strober, 2004). Another possibility is that self-oriented perfectionists
have become rigidly perfectionistic in an attempt to get a sense of control and to cope with adverse
life experiences; in these instances, attempts to change such a core aspect of identity as needing to
be perfect may be too distressing and threatening for certain perfectionistic children or adolescents.
However, extreme perfectionists should still benefit from elements of a prevention program designed
to build resilience and neutralize the tendency for perfectionists to feel responsible for everything
and be highly critical of themselves. There is clear value in addressing the perfectionism itself as
well as the precursors of perfectionism.
Because vulnerable perfectionists are highly focused on their limitations, flaws, and imper-
fections and they can be defensive, hypersensitive to criticism and prone to social anxiety (Flett,
Coulter, & Hewitt, 2012), prevention programs should adopt a positive psychology focus and em-
phasize the development of competencies within a universal program that is offered to all children,
youth, and adolescents. This approach is in keeping with research on the promotion of positive youth
development and risk prevention efforts focused on developing strengths and potential strengths.
Guerra and Bradshaw (2008) highlighted the need to establish five core competencies: (1) a posi-
tive sense of self, (2) self-control, (3) decision-making skills, (4) a moral system of belief, and (5)
prosocial connectedness. Four of these five competencies are clearly relevant to children and youth
prone to develop perfectionism and two competencies (i.e., a positive sense of self and prosocial
connectedness) are particularly central to promoting the well-being of perfectionistic young people.

Psychology in the Schools DOI: 10.1002/pits

906 Flett and Hewitt

Prosocial connectedness serves to meet unmet interpersonal needs but also limits the self-focused
attention and self-consciousness inherent in feeling a pressure to be perfect.
Specific elements of the ideal prevention program are outlined in the following sections. Our
proposed framework has a focus on perfectionism itself (lowering standards and the perceived
importance of being a perfectionist), but it also seeks to promote more positive reactions and
responses when the perfectionist has fallen short of the perfectionistic ideal. This focus on reducing
negative reactions is in keeping with developing coping and emotional self-regulation skills that can
act as buffers.

Lowering Standards and the Importance of Being Perfect

The first component of our proposed prevention program is aimed directly at reducing the
standards of perfectionists and the perceived importance of achieving impossible standards. Simply
heightening awareness of the costs of perfectionism and providing perfectionists with feedback
about their own perfectionism can be beneficial in lowering emotional reactivity and psychological
distress (see Aldea, Rice, Gormley, & Rojas, 2010). Thus, substantial benefits may come from a
brief presentation that describes the various costs of perfectionism (e.g., health and interpersonal
relationship consequences) and that highlights the distinction between striving for perfection versus
striving for excellence. This educational focus is best delivered in a group format that minimizes the
self-consciousness of individual perfectionists. Because perfectionism is focused on performance
outcomes, any discussion of the “downside” of perfectionism should also illustrate how perfectionism
can actually hurt rather than help performance and achievement. Research on gifted and nongifted
children shows little positive role for perfectionism in leading to higher achievements as assessed
with objective measures (see Stornelli, Flett, & Hewitt, 2009), and there are some indications that
while conscientious striving promotes positive achievement, extreme perfectionism can do just the
opposite (e.g., Sherry, Hewitt, Sherry, Flett, & Graham, 2010).
Albert Ellis (2002) argued that perfectionism is particularly dysfunctional when it becomes
irrationally important and reflects the belief that perfection must be obtained at all costs. Research
has confirmed that people with high levels of trait perfectionism place greater importance on the
attainment of personal and social standards (Hewitt & Flett, 1991). Accordingly, prevention efforts
need to include a focus on decreasing the perceived importance of being perfect and on not internal-
izing perfectionistic ideals. A potentially useful approach here is to adopt the techniques from the
eating disorder field developed to prevent the internalization of thin-ideal body type. Dissonance-
based eating disorder prevention programs have had substantial impact (see Stice, Rohde, Gau, &
Shaw, 2009). Activities designed originally to highlight the costs and dangers of accepting the thin
body-image ideal can be amended to highlight the costs and dangers of trying to be perfect in general.
These activities can include writing letters to future students that warn them of the costs of trying to
be perfect, holding group discussions, and actually practicing positive responses to situations where
there is exposure to pressures to be perfect.

Seeing Failures as Pathways to Success: Attributional Retraining and Fostering a Growth

Mindset
It is important to reduce the level and significance of perfectionistic standards; it is also.
important to promote a healthy cognitive orientation built on cognitively reappraising failures to
reduce negative self-evaluations and the tendency to overgeneralize when making inferences about
permanent deficits in the self. Perfectionists are often high in self-blame (Hewitt & Flett, 1991),
and they tend to have an inflated sense of personal responsibility. Attributional retraining can be
effective in building resilience and self-esteem while countering the tendency to automatically

Psychology in the Schools DOI: 10.1002/pits

 The Prevention of Perfectionism 907

attribute negative outcomes to relatively permanent aspects of the self and instead make attributions
to less threatening external causes (see Toland & Boyle, 2008). Attributional retraining efforts have
also improved motivation and actual performance (Toland & Boyle, 2008).
Ideally, attempts to promote more positive cognitive styles should include a direct focus on
limiting the degree of ruminative thinking. Perfectionism in children is associated with ruminative
brooding about negative feelings and rumination about needing to be perfect (Flett, Coulter, Hewitt,
& Nepon, 2011). Instruction focused on learning to identify this type of thinking and distract oneself
from brooding about not being perfect and not feeling perfect will go a long way toward countering
the destructiveness of perfectionism.
On a related note, another key focus in developing a more positive cognitive orientation is
promoting the growth-oriented mindset. Carol Dweck and colleagues have shown the clear benefits
of having a growth mindset that promotes mastery striving versus a less adaptive fixed mindset
that promotes helplessness in the face of stressors and threats (see Dweck, 2012; Yeager & Dweck,
2012). Recent work indicates that the growth mindset can be developed with respect to beliefs about
intellectual ability but also with respect to beliefs about emotion-regulation capabilities (Romero,
Master, Paunesku, Dweck, & Gross, in press). The growth mindset in the context of perfectionism
is characterized by seeing failures and mistakes as typical and expected, and reframing failures as
important opportunities for new learning. Perfectionists with a fixed mindset need to start endorsing
a view of the self as a lifelong learner who is continually developing and building up strengths
and capabilities; that is, mistakes and errors are not catastrophic but instead signal opportunities for
growth and implementing adaptive self-regulation.
The need to promote a growth mindset among perfectionists was shown by Chan (2012). In
a sample of Chinese gifted students, analyses showed that the APS-R high standards subscale was
associated jointly with a fixed mindset and a growth mindset, but the most robust association (r =
.41) was between the fixed mindset and the APS-R discrepancy subscale. Chan concluded that a
fixed mindset is a key element of unhealthy perfectionism.
More research is clearly needed on the role of mindsets in perfectionism. Perfectionists may
be quite amenable to growth mindset promotion efforts that build an emphasis on the importance of
focusing on effort and taking an incremental, process orientation. This orientation seems especially
essential for those children and adolescents who feel they must be “effortlessly perfect,” and they
do realize that great accomplishments often come only after a series of setbacks and failures.

Strengthening the Self: Promoting Self-Acceptance and Self-Compassion to Counter

Self-Criticism
The axiom “Nobody is perfect” should be a source of comfort for most people because even
when they make horrendous mistakes, they can always remind themselves in a self-compassionate
way that they are only human. It should be reassuring to cognitively reflect on the fact that everybody
has flaws and shortcomings. Unfortunately, the very people who are perhaps most in need of
remembering that no one is perfect are perfectionists and they tend to be among the people who are
least likely to be self-compassionate. The close ties between perfectionism and harsh self-criticism
are demonstrated poignantly by Blatt (1995), in his description of three highly accomplished but
self-critical perfectionists who committed suicide. These individuals responded to setbacks and
mistakes with intense self-criticism and an apparent paucity of self-compassion.
This tendency to be highly self-critical is also evident in children and adolescents. Donaldson,
Spirito, and Farnett (2000) showed in 68 adolescents undergoing treatment following a history
of suicide attempt that self-criticism was linked jointly with socially prescribed and self-oriented
perfectionism. More recently, Flett, Hewitt et al. (2012) found in a sample of 105 adolescents that

Psychology in the Schools DOI: 10.1002/pits

908 Flett and Hewitt

trait self-criticism and automatic self-critical thoughts were clearly associated with self-oriented
perfectionism, socially prescribed perfectionism, and perfectionistic rumination.
This self-criticism and lack of self-acceptance point to a need to develop a capacity for self-
compassion. Links between dysfunctional perfectionism and self-compassion have been found in
emerging adolescents (see Neff, 2003), and we believe that developing the capacity to be self-
compassionate is vitally important in protecting the well-being of “emerging perfectionists.” For
some, the notion of being kind to oneself will be totally at odds with their negative self-views.
Thus, trying to promote a positive stance toward the self may be met with some resistance. A useful
approach here is to use exercises that promote being compassionate to others and then make the case
that being compassionate to the self is just as important and is quite deserved.
Recent evidence suggests that interventions can yield lasting increases in self-compassion and
well-being (e.g., Neff & Germer, 2013). Various aspects of these interventions can be implemented
easily with adolescents, and there are certain features (e.g., developing self-compassion in the context
of challenging interpersonal relationships) that should help buffer the impact of the interpersonal
pressure and relationship conflict. The promotion of self-compassion as a substitute for self-criticism
was part of the remarkable program implemented in June 2014 at the Oxford High School for Girls.
It was part of a campaign called “Goodbye Little Miss Perfect” that was implemented proactively
to address the pressures inherent in striving to be perfect.

Stress Inoculation and Stress Management

Hewitt and Flett (2002) have outlined several stress mechanisms that operate in perfectionism.
Not surprisingly, perfectionists can lead very stressful lives, leading to the exacerbation of health
problems. Accordingly, our proposed prevention framework also includes a focus on stress reduction
and stress management as part of a broader discussion of striving for life balance. In many respects,
the perfectionistic lifestyle seems in opposition to a mindful approach to life that includes a focus
on being rather than doing and experiencing life in the here-and-now rather than doing things and
always striving.
A focus on stress management is essential for those vulnerable children and adolescents who are
actually exposed in their daily lives to high parental expectations and harsh parental criticism. Hewitt
and Flett (2002) have outlined various ways in which perfectionists often create more stressful lives
for themselves (e.g., persisting on unsolvable problems, creating interpersonal conflict by directing
other-oriented perfectionism toward others). An emphasis on avoiding self-generated stress can be
incorporated easily into a prevention program that promotes the metacognitive message that it is
best to focus on what is controllable in one’s life.

Family-Focused School-Based Prevention

Finally, it was noted earlier that attempts to prevent perfectionism must be grounded in certain
life realities. Ideally, attempts to promote resilience and reduce perfectionism will engage parents
in this process. Parents who are excessively demanding, overcontrolling, and critical must learn to
temper these destructive tendencies in light of the overwhelming amount of evidence attesting to
the dangers and risks associated with socially prescribed perfectionism. But in keeping with our
focus on developing competencies, parents can also have a positive influence in many ways. That
is, parents can model appropriate, calm responses after committing a mistake or experiencing a
failure. Parents can also play a vital role in promoting key meta-cognitive messages, such as the
need for self-compassion and the fact that no one is perfect. Because perfectionism tends to run in
families, school-based efforts to reduce perfectionism and lessen its impact will be undermined if
the messages received in the family context are at odds with the themes being expressed at school.

Psychology in the Schools DOI: 10.1002/pits

 The Prevention of Perfectionism 909

S UMMARY
In the current article, we summarized evidence suggesting that the prevalence of perfectionism
is quite high among children and adolescents. Moreover, we outlined a prevention framework
with various components designed to reduce levels of perfectionism while boosting resilience and
enhancing coping and self-regulation efforts. Schools are natural places for this work to take place.
Themes such as not needing to be perfect and seeing oneself from a growth mindset perspective
can become part of the prevailing school culture. It is also important to find ways to embed these
messages in the school curriculum. There is now impressive work showing that the mathematics
curriculum can be modified to promote a growth mindset instead of a fixed mindset (e.g., Boaler,
2013). Attempts to foster a growth mindset in mathematics seem ideally suited to the needs of
perfectionistic students who are obsessing about getting the correct answer and avoiding errors.
The unwillingness of certain perfectionists to disclose their imperfections suggests that per-
fectionists can be high in self-stigma when they need help. It is important to convey as part of any
prevention program that people who seek help are not weak, and there is no reason to stigmatize
oneself or other people. We have also found that perfectionists of various ages can become socially
isolated and often feel socially disconnected. These feelings are magnified among children and youth
with strong needs to be included and recognized. This sense of being alone can be countered by
providing information about the prevalence of perfectionism and providing opportunities for young
people to be authentic and share their experiences and concerns without fear of judgment. One
possibility is moderated online discussions of personal and social pressures to be perfect.
On a final note, we have found that the narrative approach is a particularly powerful way of
getting messages through to young people. Two types of narratives have a role to play here. The
life accounts of many famous but troubled perfectionists can serve as effective cautionary tales that
highlight the costs incurred by those who are striving for great accomplishments. But even more
impactful are the compelling stories of young people who have developed amazing resilience and
grit to the extent that they have been able to overcome seemingly overwhelming and inescapable
life challenges. These tales are bound to provide a much-needed sense of hope and optimism to the
young person who is grappling with socially prescribed perfectionism and the enormous pressures
of growing up in today’s society.

R EFERENCES
Adelson, J. L. (2007). A “perfect case study”: Perfectionism in academically talented fourth graders. Gifted Child Today, 30,
14 – 20.
Aldea, M. A., Rice, K. G., Gormley, B., & Rojas, A. (2010). Telling perfectionists about their perfectionism: Effects
of providing feedback on emotional reactivity and psychological symptoms. Behaviour Research and Therapy, 48,
1194 – 1203.
Barrett, P. M., Lowry-Webster, H., & Turner, C. (2000). FRIENDS program for children: Participants workbook. Brisbane:
Australian Academic Press.
Barrett, P. M., & Sonderegger, R. (2005). Anxiety in children—FRIENDS Program. In A. Freedman (Ed.), Encyclopedia of
cognitive behavior therapy (pp. 42 – 45). New York, NY: Springer.
Bento, C., Pereira, A. T., Maia, B., Marques, M., Soares, M. J., Bos, S., . . . Macedo, A. (2010). Perfectionism and eating
behaviour in Portuguese adolescents. European Eating Disorders Review, 18, 328 – 337.
Blatt, S. J. (1995). The destructiveness of perfectionism. American Psychologist, 50, 1003 – 1020.
Boaler, J. (2013). The mindset revolution that is reshaping education. Forum, 55, 143 – 152.
Boergers, J., Spirito, A., & Donaldson, D. (1998). Reasons for adolescent suicide attempts: Associations with psychological
functioning. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 1287 – 1293.
Chan, D. W. (2009). Dimensionality and typology of perfectionism: The use of the Frost Multidimensional Perfectionism
Scale with Chinese gifted students in Hong Kong. Gifted Child Quarterly, 53, 174 – 187.
Chan, D. W. (2012). Life satisfaction, happiness, and the growth mindset of healthy and unhealthy perfectionists among
Hong Kong Chinese gifted students. Roeper Review, 34, 224 – 233.

Psychology in the Schools DOI: 10.1002/pits

910 Flett and Hewitt

Coughlin, J. W., & Kalodner, C. (2006). Media literacy as a prevention intervention for college women at low- or high-risk
for eating disorders. Body Image, 3, 35 – 43.
DeRosa, T., Flett, G. L., & Hewitt, P. L. (2014). Personality vulnerabilities, negative help-seeking attitudes, and self-
concealment in high school students. Manuscript in preparation.
Donaldson, D., Spirito, A., & Farnett, E. (2000). The role of perfectionism and depressive cognitions in understanding
the hopelessness experienced by adolescent suicide attempters. Child Psychiatry and Human Development, 31, 99 –
111.
Dweck, C. S. (2012). Mindsets and human nature: Promoting change in the Middle East, the schoolyard, the racial divide,
and willpower. American Psychologist, 67, 614 – 622.
Ellis, A. E. (2002). The role of irrational beliefs in perfectionism. In G. L. Flett & P. L. Hewitt (Eds.), Perfectionism: Theory,
research, and treatment (pp. 217 – 229). Washington, DC: American Psychological Association.
Essau, C. A., Conradt, J., Sasagawa, S., & Ollendick, T. H. (2012). Prevention of anxiety symptoms in children: Results from
a universal school-based trial. Behavior Therapy, 43, 450 – 464.
Flett, G. L., Coulter, L.-M., & Hewitt, P. L. (2012). The Perfectionistic Self-Presentation Scale—Junior Form: Psychometric
properties and association with social anxiety. Canadian Journal of School Psychology, 27, 136 – 149.
Flett, G. L., Coulter, L.-M., Hewitt, P. L., & Nepon, T. (2011). Perfectionism, rumination, worry, and depressive symptoms
in early adolescents. Canadian Journal of School Psychology, 26, 159 – 176.
Flett, G. L., & Hewitt, P. L. (2002). Perfectionism and maladjustment: An overview of theoretical, definitional, and treatment
issues. In G. L. Flett & P. L. Hewitt (Eds.), Perfectionism: Theory, research, and treatment (pp. 5 – 31). Washington,
DC: APA.
Flett, G. L., & Hewitt, P. L. (2012). Perfectionism and cognitive factors in distress and dysfunction in children and adolescents:
Introduction to the special issue. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 30, 53 – 61.
Flett, G. L., & Hewitt P. L. (2013). Disguised distress in children and adolescents “Flying under the radar”: Why psychological
problems are underestimated and how schools must respond. Canadian Journal of School Psychology, 28, 12 – 27.
Flett, G. L., Hewitt, P. L., Boucher, D. J., Davidson, L. A., & Munro, Y. (1997). The Child-Adolescent Perfectionism Scale:
Development, validation, and association with adjustment. Unpublished manuscript.
Flett, G. L., Hewitt, P. L., Demerjian, A., Sturman, E. D., Sherry, S. B., & Cheng, W. (2012). Perfectionistic automatic
thoughts and psychological distress in adolescents: An analysis of the Perfectionism Cognitions Inventory. Journal of
Rational-Emotive and Cognitive-Behavior Therapy, 30, 91 – 104.
Flett, G. L., Hewitt, P. L., & Heisel, M. J. (in press). The destructiveness of perfectionism revisited: Implications
for the assessment of suicide risk and the prevention of suicide. Review of General Psychology. Retrieved from
http://dx.doi.org/10.1037/gpr00000011.
Flett, G. L., Sherry, S. B., Hewitt, P. L., & Nepon, T. (in press). Understanding the narcissistic perfectionists among us:
Grandiosity, vulnerability, and the quest for the perfect self. In A. Besser (Ed.), Handbook of psychology of narcissism:
Diverse perspectives. New York, NY: Nova Science Publishers.
Fong, R. W., & Yuen, M. (2014). Perfectionism and Chinese gifted learners. Roeper Review, 36, 81 – 91.
Freudenstein, O., Valevski, A., Apter, A., Zohar, A., Shoval, G., Nahshoni, E., . . . Zalsman, G. (2012). Perfectionism,
narcissism, and depression in suicidal and nonsuicidal adolescent inpatients. Comprehensive Psychiatry, 53, 746 – 752.
Frost, R., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research,
14, 449 – 468.
Goodwin, H., Haycraft, E., & Meyer, C. (2014). Psychological risk factors for compulsive exercise: A longitudinal investi-
gation of adolescent boys and girls. Personality and Individual Differences, 68, 83 – 86.
Guerra, N. G., & Bradshaw, C. P. (2008). Linking the prevention of problem behaviors and positive youth development:
Core competencies for positive youth development and risk prevention. In N. G. Guerra & C. P. Bradshaw (Eds.), Core
competencies to prevent problem behaviors and promote positive youth development. New Directions for Child and
Adolescent Development, 122, 1 – 17.
Hawkins, C. C., Watt, H. M. G., & Sinclair, H. E. (2006). Psychometric properties of the Frost Multidimensional Perfectionism
Scale with Australian adolescent girls: Clarification of multidimensionality and perfectionist typology. Educational and
Psychological Measurement, 66, 1001 – 1022.
Herman, K. C., Trotter, R., Reinke, W. M., & Ialongo, N. (2011). Developmental origins of perfectionism among African
American youth. Journal of Counseling Psychology, 58, 321 – 334.
Hewitt, P. L., Blasberg, J. S., Flett, G. L., Besser, A., Sherry, S., Caelian, C. M., . . . Birch, S. (2011). Perfectionistic self-
presentation in children and adolescents: Development and validation of the Perfectionistic Self-Presentation – Junior
form. Psychological Assessment, 23, 125 – 142.
Hewitt, P. L., Caelian, C. F., Chen, C., & Flett, G. L. (in press). Perfectionism, stress, daily hassles, hopelessness, and suicide
potential in depressed psychiatric adolescents. Journal of Psychopathology and Behavioral Assessment.
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.

Psychology in the Schools DOI: 10.1002/pits

 The Prevention of Perfectionism 911

Hewitt, P. L., & Flett, G. L. (2002). Perfectionism and stress in psychopathology. In G. L. Flett & P. L. Hewitt (Eds.),
Perfectionism: Theory, research, and treatment (pp. 255 – 284). Washington, DC: American Psychological Association
Press.
Hewitt, P. L, Flett, G. L, Sherry, S. B., Habke, M., Parkin, M., Lam, R. W., . . . Stein, M. B. (2003). The interpersonal
expression of perfectionism: Perfectionistic self-presentation and psychological distress. Journal of Personality and
Social Psychology, 84, 1303 – 1325.
Hewitt, P. L., Newton, J., Flett, G. L., & Callander, L. (1997). Perfectionism and suicide ideation in adolescent psychiatric
patients. Journal of Abnormal Child Psychology, 25, 95 – 101.
Huggins, L., Davis, M. C., Rooney, R., & Kane, R. (2008). Socially prescribed and self-oriented perfectionism as predictors
of depressive diagnosis in preadolescents. Australian Journal of Guidance and Counselling, 18, 182 – 194.
Jacobs, R. H., Silva, S. G., Reinecke, M. A., Curry, J. F., Ginsburg, G. S., Kratochvil, C. J., & March, J. S. (2009). Dysfunctional
Attitudes Scale perfectionism: A predictor and partial mediator of acute treatment outcome among clinically depressed
adolescents. Journal of Clinical Child and Adolescent Psychology, 38, 803 – 813.
Jones, J., Ramirez, R. R., Davies, M., Canino, G., & Goodwin, R. D. (2008). Suicidal behaviors among adolescents in Puerto
Rico: Rates and correlates in clinical and community samples. Journal of Clinical Child and Adolescent Psychology,
37, 448 – 455.
McVey, G. L., Davis, R., Tweed, S., & Shaw, B. F. (2004). Evaluation of a school-based program designed to improve body
image satisfaction, global self-esteem, and eating attitudes and behaviors: A replication study. International Journal of
Eating Disorders, 36, 1 – 11.
Mitchell, J. H., Newall, C., Broeren, S., & Hudson, J. L. (2013). The role of perfectionism in cognitive behaviour therapy
outcomes for clinically anxious children. Behaviour Research and Therapy, 51, 547 – 554.
Mofield, E. L., & Chakraborti-Ghosh, S. (2010). Addressing multidimensional perfectionism in gifted adolescents with the
affective curriculum. Journal for the Education of the Gifted, 33, 479 – 513.
Neff, K. (2003). Development and validation of a scale to measure self-compassion. Self and Identity, 2, 223 – 250.
Neff, K. D., & Germer, G. K. (2013). A pilot study and randomized controlled trial of the Mindful Self-Compassion Program.
Journal of Clinical Psychology, 69, 28 – 44.
Nobel, R., Manassis, K., & Wilansky-Traynor, P. (2012). The role of perfectionism in relation to an intervention to reduce
anxious and depressive symptoms in children. Journal of Rational-Emotive and Cognitive-Behavior Therapy, 30, 77 – 90.
Nock, M. K., & Prinstein, M. J. (2005). Contextual factors and behavioral functions of self-mutilation among adolescents.
Journal of Abnormal Psychology, 114, 140 – 146.
O’Connor, R. C., Rasmussen, S., & Hawton, K. (2012). Distinguishing adolescents who think about self-harm from those
who engage in self-harm. British Journal of Psychiatry, 200, 330 – 335.
Portesova, S., & Urbanek, T. (2013). Typology of perfectionism in a group of mathematically gifted Czech adolescents over
one decade. The Journal of Early Adolescence, 33, 1116 – 1144.
Rice, K. G., Ashby, J. S., & Gilman, R. (2011). Classifying adolescent perfectionists. Psychological Assessment, 23, 563 –
577.
Rice, K. G., & Preusser, K. J. (2002). The Adaptive/Maladaptive Perfectionism Scale. Measurement and Evaluation in
Counseling and Development, 34, 210 – 222.
Romero, C., Master, A., Paunesku, D., Dweck, C. S., & Gross, J. J. (in press). Academic and emotional functioning in middle
school: The role of implicit theories. Emotion.
Rooney, R., Hassan, S., Kane, R., Roberts, C. M., & Nesa, M. (2013). Reducing depression in 9–10 year old children in low
SES schools: A longitudinal universal randomized controlled trial. Behaviour Research and Therapy, 51, 845 – 854.
Roxborough, H., Hewitt, P. L, Kaldas, J., Flett, G. L., Caelian, C., Sherry, S., & Sherry, D. L. (2012). Perfectionistic self-
presentation, socially prescribed perfectionism, and suicide in youth: A test of the perfectionism social disconnection
model. Suicide and Life-Threatening Behavior, 42, 217 – 233.
Sherry, S. B., Hewitt, P. L., Sherry, D. L., Flett, G. L., & Graham, A. R. (2010). Perfectionism dimensions and research
productivity in psychology professors: Implications for understanding the (mal)adaptiveness of perfectionism. Canadian
Journal of Behavioural Science, 42, 273 – 283.
Shih, S.-S. (2012). An examination of academic burnout versus work engagement among Taiwanese adolescents. Journal of
Educational Research, 105, 286 – 298.
Slaney, R. B., Rice, K. G., Mobley, M., Trippi, J., & Ashby, J. S. (2001). The Almost Perfect Scale–Revised. Measurement
and Evaluation in Counseling and Development, 34, 130 – 145.
Soreni, N., Streiner, D., McCabe, R., Bullard, C., Swinson, R., Greco, A., . . . Szatmari, P. (2014). Dimensions of perfectionism
in children and adolescents with obsessive-compulsive disorder. Journal of the Canadian Academy of Child and
Adolescent Psychiatry, 23, 136 – 143.
Stice, E., Rohde, P., Gau, J., & Shaw, H. (2009). An effectiveness trial of a dissonance-based eating disorder prevention
program for high-risk adolescent girls. Journal of Consulting and Clinical Psychology, 77, 825 – 834.

Psychology in the Schools DOI: 10.1002/pits

912 Flett and Hewitt

Stornelli, D., Flett, G. L., & Hewitt, P. L. (2009). Perfectionism, achievement, and affect in children: A comparison of students
from gifted, arts, and regular programmes. Canadian Journal of School Psychology, 24, 267 – 283.
Strober, M. (2004). Managing the chronic, treatment-resistant patient with anorexia nervosa. International Journal of Eating
Disorders, 36, 245 – 255.
Toland, J., & Boyle, C. (2008). Applying cognitive behavioural methods to retrain children’s attributions for success and
failure in learning. School Psychology International, 29, 286 – 302.
Tornblom, A. W., Werbart, A., & Rydelius, P.-A. (2013). Shame behind the masks: The parents’ perspectives on their sons’
suicides. Archives of Suicide Research, 17, 242 – 261.
Wilksch, S. M., Durbridge, M. R., & Wade, T. (2008). A preliminary controlled comparison of programs designed to reduce
risk of eating disorders targeting perfectionism and media literacy. Journal of the American Academy of Child and
Adolescent Psychiatry, 47, 939 – 947.
Wilksch, S. M., Starkey, K., Gannoni, A., Kelly, T., & Wade, T. (2008). Early intervention in the real world: Interactive
programme to enhance protective factors for eating disorders in girls with type 1 diabetes. Early Intervention in
Psychiatry, 7, 315 – 321.
Wilksch, S. M., & Wade, T. D. (2013). Life Smart: A pilot study of a school-based program to reduce the risk of both eating
disorders and obesity in young adolescent boys and girls. Journal of Pediatric Psychology, 38, 1021 – 1029.
Yeager, D. S., & Dweck, C. S. (2012). Mindsets that promote resilience: When students believe that personal characteristics
can be developed. Educational Psychologist, 47, 302 – 314.

Psychology in the Schools DOI: 10.1002/pits