The relationship of perfectionism to suicide ideation and attempts in a large online sample

Perfectionism is a personality construct hypothesized to increase suicide risk. Previous research observed greater levels of perfectionism among those with histories of suicidal thoughts and behaviors. However, it is unclear whether perfectionism is best conceptualized as a predictor of suicide ideation, suicide attempts among ideators, or both. To answer this question, we recruited a large online US-based sample to examine differences on two self-report measures of perfectionism among participants with (1) a history of suicide attempts (attempters; n = 107), (2) a history of suicide ideation but no history of suicide attempts (ideators; n = 164), and (3) no history of either suicide ideation or suicide attempts (nonsuicidal; n = 194). Medium effect size differences were obtained on two dimensions of perfectionism: Socially Prescribed Perfectionism (d = 0.47) and Nondisplay of Imperfection (d = 0.53) were both higher in ideators compared to nonsuicidal participants. These differences remained statistically significant when controlling for symptoms of depression and anxiety. In contrast, when comparing ideators to attempters, only small to negligible differences were obtained on all dimensions of perfectionism (d range = 0.00-0.26). Our findings suggest that perfectionism is likely associated with the development of suicide ideation, but not the progression from suicide ideation to suicide attempts.