Perfectionism may be a risk factor for severe alcohol use disorder

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

Author: Society for Research on Alcoholism

Perfectionistic traits—high self-criticism and unrealistic standards that lead to isolation—are associated with severe alcohol use disorder (AUD), according to the first study directly comparing patients with AUD to healthy controls.

Perfectionists strive for unrealistic performance standards and are prone to self-criticism. These goals create a sense of failure and – if they do not meet the standards expected by others – social alienation.

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

Some evidence suggests that perfectionist youth drink less than their peers. Some other studies have shown that perfectionism co-occurs with high impulsivity and decreased impulse control, factors associated with AUD, and that perfectionistic individuals may self-medicate with alcohol to cope with social anxiety or feelings of inadequacy.

To study Alcoholism: A Clinical and Experimental StudyResearchers in Belgium investigated the relationship between severe AUD and perfectionistic personality.

The investigators worked with 5 inpatients suffering from acute detoxification and 6 sex-age-matched healthy adults with AUD. Participants completed questionnaires assessing three dimensions of perfectionism.

Self-focused perfectionism involves exaggerated performance standards set for oneself (eg, “One of my goals is to be perfect in everything I do”). Socially prescribed perfectionism stems from the expectations of others (eg, “People expect me to be perfect”).

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

The researchers also assessed the participants’ depressive symptoms, state anxiety (temporary anxiety that occurs in a specific situation), and trait anxiety (anxiety that is generalized to a person’s broader experience). The researchers used statistical analysis to look for relationships between these factors.

Patients with severe AUD reported high depressive symptoms and extreme anxiety. They also showed higher self- and socially-oriented perfectionism than controls, but the two groups were similar in other-oriented perfectionism.

Severe AUD was associated with increased sensitivity to unrealistic personal standards and expectations of others, even after accounting for the role of depressive symptoms and anxiety, but not demandingness of others.

Patients with severe AUD reported high depressive symptoms and extreme anxiety. Image is in the public domain

This is consistent with what is known about self-related and interpersonal factors in severe AUD, such as low self-esteem, tendency to self-blame, and differentiation between people’s ideal and actual self.

Perfectionist individuals may experience an exaggerated gap between their high standards and the consequences of alcoholism, fearing academic or professional failure.

The findings of the study also show that self-oriented perfectionism is higher among more educated men and people with severe AUD. They also support previous evidence that perfectionism is associated with lower daily alcohol consumption in moderate drinkers.

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

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

See also

It shows the brain

This is about alcohol use disorder research news

Author: Press service
A source: Society for Research on Alcoholism
The connection: Press service – Society for the Study of Alcohol
Photo: Image is in the public domain

Original research: Closed access.
Pierre Morage et al. Alcoholism: clinical and experimental studies


Self-focused and socially prescribed perfectionism in severe alcohol use disorder


Perfectionist individuals display exaggerated performance standards, constantly seeking perfection and tending to be self-critical. Dominance models distinguish three dimensions of perfectionism: namely, self-focused, socially prescribed, and other-focused. Perfectionism as a vulnerability factor for psychopathology, but its role in severe alcohol use disorder (SAUD) remains unexplored.


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


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


This specific perfectionist profile is consistent with previous research showing lower self-esteem (e.g., self-blame and lower self-esteem) and impaired social cognition (e.g., unrealistic social standards and greater social isolation) in SAUD. Given its potential role in the development and maintenance of SAUD, perfectionism may be a valuable treatment target for patients with this disorder.

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