Clinical Perfectionism and Disordered Eating: A Cross-Sectional Study and an Exploratory Case Series of a Perfectionism-Focused Group Intervention

Clinical perfectionism is associated with disordered eating, but the roles of self-compassion and emotion regulation difficulties in this association warrant further investigation. This study examined these relationships in a cross-sectional sample and described the delivery of a perfectionism-focused group intervention and changes observed during the intervention period in an exploratory case series. Study 1 recruited a convenience sample of 317 adults through university online platforms and social media, who completed self-report measures of clinical perfectionism, self-compassion, emotion regulation difficulties, and disordered eating. Regression-based serial mediation analysis examined the indirect associations between clinical perfectionism and disordered eating through self-compassion and emotion regulation difficulties. Clinical perfectionism was positively associated with disordered eating, with a standardized direct effect of 0.282 after accounting for the mediators. The standardized serial indirect effect through lower self-compassion and greater emotion regulation difficulties was 0.094 (95% bootstrap CI [0.049, 0.147]), whereas neither indirect effect through a single mediator had a confidence interval excluding zero. Study 2 was an exploratory, uncontrolled case series of six participants enrolled in a six-session perfectionism-focused group program incorporating self-compassion components. Attendance varied, and one participant withdrew and subsequently received individual counseling and written materials. Mean pre–post changes were −12.50 points in FMPS-assessed perfectionism (95% CI [−18.12, −6.88]), −1.02 in disordered eating (95% CI [−1.88, −0.16]), and 3.33 points in self-compassion (95% CI [0.04, 6.63]). A sensitivity analysis excluding the participant who withdrew showed a similar direction of change, although the 95% CI for self-compassion included zero. Interview accounts described perceived increases in cognitive flexibility and reductions in self-criticism. Together, the studies identify associations warranting further investigation and provide participant feedback to inform intervention refinement. Longitudinal and controlled studies are needed to establish causal mechanisms and intervention efficacy.