Trying to be perfect in an imperfect world: A person-centred test of perfectionism and health in fibromyalgia patients versus healthy controls

The Stress and Coping Cyclical Amplification Model of Perfectionism in Illness posits, that in the context of a chronic illness, both perfectionistic strivings and concerns contribute to poor health outcomes. Similarly, person-centred models, such as the tripartite model of perfectionism, claim that high levels of both perfectionism concerns and strivings reflect an “unhealthy” perfectionism that takes a toll on well-being. To date there are few comparative tests of these models for physical and mental health outcomes in healthy versus chronically ill individuals. The aim of the current study was to investigate the implications of perfectionism for health by testing how within-person combinations of perfectionism varied in relation to health outcomes, and between fibromyalgia patients (n = 89) and healthy controls (n = 123). Supporting both models, within-person combinations of high perfectionistic strivings and concerns were associated with high stress and poor mental and physical health compared to other within-person combinations. These links were more robust for fibromyalgia patients compared to controls, and stress mediated the association with physical health outcomes only for the fibromyalgia patients. Findings support the value of taking a person-centred approach for understanding how perfectionistic strivings contributes to poor health in the context of chronic illness.