The Cardinal Edge


Arts and Research Showcase 2023


Concern Over Mistakes and Emotion Regulation Skills are Uniquely and Synergistically Associated with Eating Disorder Symptoms in Adolescence

Madison Ortman*, Mattison J. Hale*, Aleena Saifullah*, Sara Clark*, Taylor Porter*, Maritza Lazo B.A. *, Caroline Christian M.S. †, Claire E. Cusack M.A.†, Rachel Butler, Ph.D., Cheri A. Levinson, Ph.D. †

*Authors contributed equally to this work. † Provided supervision.

University of Louisville, Department of Psychological and Brain Sciences

Perfectionism and emotion dysregulation are transdiagnostic risk and maintenance factors implicated in eating disorders (EDs). Specifically, increased perfectionism and poorer emotional regulation skills have been associated with increased risk for ED behaviors and symptom severity. Though perfectionism and emotional regulation difficulties are implicated in EDs in adults, little is known about the associations across EDs, perfectionism, and emotional regulation difficulties in adolescents. In the current study, we analyzed the relationship between three unique perfectionism dimensions (e.g., concern over mistakes, parental criticism, pure personal standards), emotional regulation skills, and their interaction on ED symptoms severity. We found a significant relationship between concern over mistakes and ED symptoms (p < .001), a significant relationship between emotion regulation difficulties and ED symptoms (p < .001), and a significant relationship between their interaction and ED symptoms (p = .018). Parental criticism and pure personal standards were not associated with ED symptom severity, when accounting for emotion regulation difficulties (ps > .05). A simple slopes analysis revealed the relationship between concern over mistakes and ED symptom severity was strengthened for those with average to poor emotion regulation skills, but not for individuals with high emotion regulation skills. Thus, it is important to assess for ED symptoms among adolescents with elevated emotion regulation difficulties and perfectionism symptoms, as greater challenges with emotion dysregulation may exacerbate the relationship between perfectionism and ED symptoms.