Are perfectionism dimensions risk factors for bulimic symptoms? A meta-analysis of longitudinal studies

Background: Case histories, theoretical accounts, and empirical studies suggest an important relationship between perfectionism and bulimic symptoms. However, whether perfectionism confers vulnerability for bulimic symptoms is unclear. Objective: To address this, we conducted a meta-analysis testing if socially prescribed perfectionism, concern over mistakes, doubts about actions, personal standards, self-oriented perfectionism and EDI-perfectionism predict increases in bulimic symptoms over time. Method: Our literature search yielded 12 longitudinal studies for inclusion. Samples were composed of adolescents, undergraduates, and community adults. Results: Meta-analysis using random effects models showed perfectionistic concerns and EDI-perfectionism, but not perfectionistic strivings, had positive relationships with follow-up bulimic symptoms, after controlling for baseline bulimic symptoms. Conclusion: Results lend credence to theoretical accounts implicating perfectionism in the development of bulimic symptoms. Our review of this literature also underscored the need for additional longitudinal studies that use multisource designs and that assess perfectionism as a multidimensional construct.