Summary: New research identifies a connection between the personality trait of perfectionism and severe alcohol use disorder.
Author: Research Society on Alcoholism
Perfectionist characteristics—marked self-criticism, rigid and unrealistic personal standards, and the resulting social withdrawal—are linked with severe alcohol use disorder (AUD), according to the first study to directly compare people with severe AUD to a matched healthy control group.
Perfectionism describes a pattern of setting exceptionally high standards for performance and evaluating oneself harshly when those standards are not met. When perfectionist individuals believe others expect flawless results from them, they may experience intense pressure, shame, and social disconnection. These internal and interpersonal dynamics can increase vulnerability to stress and depression, and, as this study suggests, they may also be implicated in severe AUD.
Previous research has offered mixed findings: some studies report that highly perfectionistic young adults drink less frequently than peers, while others find associations between perfectionism, impulsivity, and reduced impulse control—traits that can contribute to problematic drinking. Perfectionistic people may also use alcohol to cope with social anxiety or feelings of inadequacy, but until now, few studies have examined perfectionism directly in people undergoing treatment for severe AUD.
Researchers in Belgium evaluated perfectionist traits in 65 adults undergoing inpatient detoxification for severe AUD and compared them with 65 healthy adults matched for age and sex. Participants completed the Hewitt Multidimensional Perfectionism Scale, which measures three distinct dimensions of perfectionism, and questionnaires assessing depressive symptoms and both state and trait anxiety. Statistical analyses examined associations among perfectionism, mood and anxiety symptoms, and AUD status.
The three measured dimensions were:
- Self-oriented perfectionism: rigid, demanding standards directed at oneself (for example, “One of my goals is to be perfect in everything I do”).
- Socially prescribed perfectionism: the perception that others expect perfection from you (for example, “People expect nothing less than perfection from me”).
- Other-oriented perfectionism: holding unrealistically high standards for other people (for example, “I have high expectations for the people who are important to me”).
Compared with the control group, patients with severe AUD reported higher levels of depressive symptoms and higher trait anxiety. They also scored significantly higher on self-oriented and socially prescribed perfectionism, while scores for other-oriented perfectionism were similar between groups. Importantly, the associations between severe AUD and the two self-related dimensions of perfectionism remained even after controlling for depression and anxiety, indicating these perfectionist traits are linked to AUD independently of mood and anxiety symptoms. No relationship was found between perfectionism dimensions and measures of daily alcohol consumption within the studied sample.
These results align with established findings about self-related and interpersonal difficulties in people with severe AUD, such as lower self-esteem, increased self-blame, and a pronounced mismatch between people’s ideal selves and their perceived actual selves. For perfectionistic individuals, this perceived gap can feel overwhelming: stringent personal standards combined with fear of failing to meet others’ expectations may intensify feelings of inadequacy and isolation, and in some cases contribute to the development or maintenance of problematic drinking.
The researchers also observed that higher self-oriented perfectionism within the severe AUD group was more common among men and among people with higher levels of education. The study further supports previous observations that, among moderate drinkers, perfectionism can be associated with lower daily alcohol consumption—indicating the relationship between perfectionism and alcohol use may differ across the spectrum from moderate drinking to severe disorder.
Given these findings, the authors suggest that perfectionism—particularly self-directed and socially prescribed forms—may be a meaningful target for assessment and intervention in patients with severe AUD. Addressing rigid self-standards, maladaptive self-criticism, and fears about others’ expectations could complement existing treatments and potentially improve outcomes.
The study’s authors recommend further research to clarify how different perfectionism dimensions influence AUD course and treatment response. Key questions include whether high perfectionism reduces treatment effectiveness, how perfectionism interacts with impulsivity and self-blame, and whether interventions that reduce maladaptive perfectionism can help prevent relapse or support recovery.
About this alcohol use disorder research news
Author: Press Office
Source: Research Society on Alcoholism
Contact: Press Office – Research Society on Alcoholism
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Original Research: Closed access. “Greater self‐oriented and socially prescribed perfectionism in severe alcohol use disorder” by Pierre Maurage et al., Alcoholism: Clinical and Experimental Research.
Abstract
Greater self‐oriented and socially prescribed perfectionism in severe alcohol use disorder
Background
Perfectionistic individuals set exaggerated performance standards and frequently engage in harsh self-criticism. Three widely accepted dimensions—self-oriented, socially prescribed, and other-oriented perfectionism—capture these tendencies. While perfectionism is recognized as a vulnerability factor for several psychopathologies, its specific role in severe alcohol use disorder (SAUD) had not been directly investigated prior to this study.
Methods
Sixty-five recently detoxified patients with severe AUD and 65 matched healthy controls completed the Hewitt Multidimensional Perfectionism Scale alongside standard measures of depressive and anxiety symptoms. The study used statistical controls to isolate the relationship between perfectionism dimensions and AUD.
Results
Severe AUD was associated with elevated self-oriented and socially prescribed perfectionism, while other-oriented perfectionism did not differ between groups. These associations persisted after accounting for depression and anxiety, and no direct correlation with the quantity of daily alcohol consumption was observed.
Conclusion
This specific perfectionistic profile—characterized by harsh self-standards and heightened sensitivity to perceived social expectations—matches prior evidence of lowered self-evaluation and impaired social cognition in severe AUD. Considering its potential role in the onset and persistence of severe AUD, maladaptive perfectionism may be a useful focus for clinical assessment and therapeutic intervention in affected patients.