Clinical perfectionism in anorexia nervosa: associations with eating disorders' specific symptomatology and general psychological symptoms in Italian young adult women

Existing literature has consistently identified perfectionism as a core feature of anorexia nervosa (AN). However, much of the research has focused primarily on its association with eating disorder-related symptoms. At the same time, less attention has been paid to understanding how perfectionism affects the overall psychological functioning of individuals with eating disorders, and in particular AN. The present study aimed at investigating the association between perfectionism and both eating disorder-specific symptomatology and general psychological symptoms in a sample of young adult Italian women diagnosed with AN. Methods: Thirty-five Italian females diagnosed with AN (mean age ± SD: 21.9 ± 4.18 years; mean body mass index: body mass index ± SD: 14.5 ± 1.77 kg/m2) were consecutively recruited at the Division of Eating and Nutrition Disorders, Istituto Auxologico Italiano, IRCCS, Piancavallo-Verbania, a third-level clinical centre for the rehabilitation of obesity and eating disorders located in northern Italy. Once informed about the research, screened for inclusion/exclusion criteria, and enrolled, participants were asked to complete the Eating Disorder Inventory—third edition, the Symptoms Checklist-90 revised, and the Frost Multidimensional Perfectionism Scale to collect demographic and clinical variables of interest for the study. Three hierarchical linear regression models were tested to explore the role of perfectionism in both eating disorder-specific symptomatology and general psychological symptoms. Results: The analyses showed a significant influence of perfectionism in all tested models, suggesting that perfectionism was significantly associated with both eating disorder-specific symptomatology and general psychological symptoms in a sample of young adult Italian women diagnosed with AN. Conclusions: The findings of this study provide further support for the role of perfectionism in the psychopathology of eating disorders, particularly among young adult women with AN. Consistent with prior research, perfectionism was associated with both disorder-specific symptoms and broader psychological symptoms. Notably, its association remained robust even after controlling for key variables such as age and body mass index, underscoring its potential as an independent risk factor. These data cannot be made publicly available as they include sensitive information, but they can be made available upon reasonable request of interested researchers to the corresponding author, who will forward a data transfer agreement request to the relevant Ethical Committee. Requests can be addressed to Dr. Alessandro Sartorio (sartorio@auxologico.it).