Perfectionism and Social Anxiety

In this column, I will be exploring the link between perfectionism and social anxiety by doing a literature review in order to find where perfectionism comes in for individuals with social anxiety disorder (SAD); another aim is to comment on the current research on the subject and make suggestions on where research should be headed next.

First, we must define both what perfectionism and social anxiety are. The definition of SAD, according to The Diagnostic and Statistical Manual of Mental Disorders, (American Psychiatric Association, 2013) is: a significant and lasting fear of social situations which might cause embarrassment from the individual’s perspective. At some point in their lives, more than 13% of the populace meet the diagnostic criteria for the disorder according to a finding by Kessler (as cited in Rapee & Heimberg, 1997 pg. 741). Individuals with SAD are highly doubtful of their social performance, and expect themselves to make critical errors in social settings (Juster, Heimberg, Frost, Holt, Mattia, & Faccenda, 1996). They are fearful of being socially inappropriate and coming off as unintelligent (Juster et al,, 1996). Individuals with social anxiety are more susceptible to depression (Schneier, Johnson, Hornig, Liebowitz & Weisman; Stein, Tancer, Gelernter, Vittone & Uhde), substance abuse (Kushner, Sher & Beitman; Schneier, Johnson, Hornig, Liebowitz & Weissman), and also show significantly lower levels of socialisation compared to the general populace (Dodge, Heimberg, Nyman & O’Brien; Turner et al.) (as cited in Rapee & Heimberg, 1997, pg. 741). Individuals with SAD seem to automatically assume that others around them are highly critical of them according to Leary, Kowalski and Campbell (as cited in Rapee & Heimberg, 1997, pg. 742), and they also pay greater attention to negative feedback from others, or rather social cues they perceive as negative, which means that they have a negative bias (Rapee & Heimberg, 1997). This seems to be supported by the recent findings of Segal, Kessler and Anholt (2015), who found that on top of a negative attentional bias, which makes individuals with SAD focus more on negative or threatening aspects of social stimuli, they also seem to have a maladaptive fashion of processing information in the working memory as well. They also greatly desire and value the positive evaluations of others according to Rapee and Heimberg (1997), which is a clear manifestation of socially prescribed perfectionism. Now that we’ve mentioned it, we should define what perfectionism is:

While there are many different definitions and conceptualisations of perfectionism, we will touch upon only two. The first definition and scale, also the one that will be referred to most frequently in this paper is Hewitt and Flett’s Multidimensional Perfectionism Scale (MPS-H) (1991).

There are three dimensions to it:

  1. Self-Oriented Perfectionism: Setting unrealistically high standards for oneself and evaluating one’s own behaviour in a highly critical and strict manner.
  2. Other-Oriented Perfectionism: Setting unrealistically high standards for other people, especially one’s important acquaintances, such as a husband, wife, or one’s offspring

  3. Socially Prescribed Perfectionism: Imagining that other people have unrealistically high expectations of the individual.

This 3rd dimension is the most vital one for us, and the one we will be focusing on, as it is considered to be the source of anxiety, anger, and depression (Shafran & Mansell, 2001). High levels of socially prescribed perfectionism seem to be well associated with greater loneliness, shyness, fear of criticism, and low self-esteem (Shafran & Mansell, 2001). There are also many studies which indicate that socially prescribed perfectionism is, amongst the three dimensions in MPS, the one most highly associated with psychopathology, and especially social anxiety according to Frost et al. (as cited in Saboonchi & Lundh, 1997, pg. 921) and Hewitt, Flett, Turnbull-Donovan, and Mikail (1991).

In a similar vein, according to Antony et al., SAD, along with obsessive-compulsive disorder, seems to be quite closely linked to perfectionism (as cited in Shafran & Mansell, 2001, p. 892). Socially prescribed perfectionism seems to play a big role in both the development, and the sustenance of SAD, as people who wish to have a perfect impression on others are more likely to feel social anxiety to a greater level (Shafran & Mansell, 2001). Socially prescribed perfectionism, as is remarked by Juster et al., (1996) also has a place in the clinical manifestation of social anxiety.

There is also the Multidimensional Perfectionism Scale (MPS-F) developed by Frost, Marten, Lahart and Rosenblate (1990). It’s a scale that aims to assess different dimensions of perfectionism, which they define as setting excessively high standards of performance that is accompanied by a tendency for self-criticism. The distinct dimensions are personal standards, doubts about actions, parental expectations, organisation, concern over mistakes, and parental criticism. Individuals with social anxiety score high, according to Saboonchi and Lundh (1997) on concern over mistakes, and doubts over actions (along with socially prescribed perfectionism) specifically, and according to Juster et al. (1996) they, alongside the ones listed above, score high on parental criticism (though not parental expectations) as well.

Now that we have talked about the definitions, we can begin to discuss perfectionism’s role in social anxiety. Juster et al. (1996) claim that individuals with social anxiety tend to set impossible social goals for themselves, which they inevitably end up not achieving, which in turn makes them feel as “failures”. For example, they might fear making a public speech because as a point of comparison they take a professional caster, or they might not wish to attend a party because they’re never going to be as lively, fun, and exciting as the most popular, outgoing person there. This kind of comparison that individuals with SAD tend to make is highly unrealistic, as there are no such expectations of them by others, yet they feel there is. This turns into a vicious cycle, because of the impossible to reach goals they set for themselves, they end up failing in their eyes, and because of this failure they experience, they come to believe that they will be failing again in the future, which turns into a self-fulfilling prophecy. Rapee and Heimberg (1997) have developed a model of social anxiety that displays this perfectly. According to them, a particular genetic vulnerability, combined with experiences during one’s earlier life, can cause individuals to perceive social situations as possibly dangerous. When there is a perceived audience around the individual with SAD, they form a mental representation of themselves as seen by the audience, and then compare this to what they think are the audience’s standards, which they believe to be extremely high. Then, the individual has an unrealistic view of the possible consequences of this negative evaluation for not being able to meet the perceived standards, which in turn causes them to feel behavioural, cognitive, and physical symptoms of anxiety. These symptoms become the focus of the individual’s attention, along with external cues from the perceived audience.

As is clear to see, perfectionism plays a huge role here. The anxiety is caused by the perfectionistic standards the individual with SAD supposes the audience to have. What’s interesting to see here is that the perfectionism is transferred to the audience, rather than the individual themselves being the perfectionistic one. It is “they” who are overly perfectionistic and have really high, impossible to attain standards according to the individual with SAD. It could be said that individuals with SAD see everyone else as other-oriented perfectionists.

There are also two other models which seem to be in line with that of Rapee and Heimberg. The first one is Schlenker and Leary’s self-presentation model, according to which social anxiety occurs because the individual wants to make a good impression on others, yet doubts his or her ability to do so (as cited in Saboonchi & Lundh, 1997, pg. 927). The second model is that of Clark and Wells, which is pretty similar, as it talks about the individual’s wish to make a particular impression but feeling insecure about their capacity to do so (as cited in Saboonchi & Lundh, 1997, pg. 927). A common ground of perfectionism and social anxiety could be said to be procrastination. Procrastination is the act of delaying doing something for one reason or another, which allows the avoidance of less than perfect performance (Frost, Marten, Lahart, & Rosenblate, 1990). It’s commonly believed that procrastination is a result of having excessively high standards (Flett, Blankstein, Hewitt, & Koledin, 1992). Individuals with high socially prescribed perfectionism seem to experience a greater fear of failure, and fear of failure is also believed to be a factor that contributes a good amount to procrastination (Flett et al., 1992). In fact, socially prescribed perfectionism seems to play a quite significant role in procrastination according to the results of the study by Flett et al. (1992). This is in keeping with Rapee and Heimberg’s model of social anxiety we have talked about, according to which avoidance of social situations occurs as to not give any room to any mistakes, failures, or ‘imperfect’ outcomes (1997).

An important area in which procrastination manifests itself is academia. According to a study by Flett, Blankstein, Hewitt and Koledin, another by Sadler and Sacks, and yet another by Wernicke, there appears to be a relationship between socially prescribed perfectionism and academic procrastination (as cited in Çapan, 2010, pg. 1666). Socially prescribed perfectionism seems to have a role in test anxiety according to a study by Mills and Blankstein, and another one by Stoeber, Feast, and Hayward (as cited in Eum & Rice, 2011, pg. 168). It also seems to be associated with perceived (as opposed to actual) poor academic performance according to a study by Grzegorek, Slaney, Franze, and Rice, and another study by Rice, Bair, Castro, Cohen, and Hood (as cited in Eum & Rice, 2011, pg. 169). Does this all mean that there’s no positive side to perfectionism, which is highly present in individuals with SAD as we have just seen? While there seems to be evidence for a positive facet of perfectionism, it seems to be only for the self-oriented kind of perfectionism, according to Frost, Heimberg, Holt, Mattia and Neubauer (as cited in Juster et al., 1996, pg. 405), and only as long as the individual is not too much concerned over mistakes, and the criticism, or rather perceived criticism, of others (Stoeber & Otto, 2006). This, however, is very well known not to be the case for individuals with SAD, as they show a lot of concern over mistakes and often doubt their actions (Juster et al., 1996). Another study that supports this finding is that of Lundh and Ost, who found that individuals with SAD scored much higher on concern over mistakes, doubts about Action, parental expectations and parental criticism, whilst their scores on personal standards and organisation did not differ from that of the control group (as cited in Saboonchi & Lundh, 1997, 921-22). Hewitt and Flett also found that while social anxiety was highly correlated with socially prescribed perfectionism, there was no correlation with self-oriented perfectionism (as cited in Saboonchi & Lundh, 1997, 921). So, unfortunately for individuals SAD, thus far there is no evidence in support of a positive aspect to perfectionism that’s manifested in SAD.

Overall, the link between perfectionism and social anxiety is quite clear to see, and there are many studies and papers out there which prove this, without which this paper could not be written in the first place. Individuals with SAD are quite concerned about making mistakes, doubtful of their actions, and desirous to leave a perfect impression on others, as they value the evaluations of themselves by others a lot (Rapee & Heimberg, 1997; Juster et al., 1996). There are so many aspects of perfectionism like these, such as text anxiety, performance anxiety, procrastination, all of which seem to interact with social anxiety in one way or another. As for future research, what could be worked on is the fact that the relationship between perfectionism and social anxiety seems to be correlational for the most part. It might be that social anxiety is caused by perfectionism, or maybe the other way around, that socially prescribed perfectionism happens as a result of social anxiety. Yet another possibility is that there might be a variable that’s underlying both perfectionism and social anxiety. Finding out the actual reason behind the link between perfectionism and social anxiety should be a high priority, as it would do a lot to direct future research in the right direction, and it also might have clinical implications for the treatment of SAD. For example, Rapee and Heimberg (1997) suggest that a method of therapy in which individuals with SAD are encouraged to direct away their attentional resources from their own mental representation, and the audience’s possible negative evaluation could work very well. It sounds quite plausible, and I think more research needs to be done in this light. On top of this, perhaps there could be found a way to transform socially prescribed perfectionism into something healthier, as self-oriented perfectionism seems to have positive attributes to it (e.g., Eum & Rice, 2011; Stoeber & Otto, 2006). Finding ways to accommodate for the distress individuals with SAD feel as a result of socially prescribed perfectionism could also be an important achievement for the future, as test anxiety and procrastination, for example, seems to hinder their academic performance gravely (e.g., Eum & Rice, 2011; Flett et al., 1992).