Journal of Psychopathology and Behavioral Assessment, Vol. 14, No.

4, 1992

Perfectionism and Multiphasic Personality

Inventory (MMPI) Indices of Personality Disorder
Paul L. Hewitt, 1,4 Gordon L. Flett, 2 and Wendy Turnbull 3
Accepted." October 8, 1992.

The present research tested the hypothesis that personal and social aspects of
the perfectionism construct are related differentially to indices of personality
disorders. A sample of 90 psychiatric patients was examined with respect to
their scores on the Multidimensional Perfectionism Scale (MPS) and the
personality disorder subscales (PDS) of the Minnesota Multiphasic Personality
Inventory. The MPS provides measures of self-oriented, other-oriented, and
socially prescribed perfectionism, whereas the PDS assess levels of various
personality disorder symptoms. Zero-order and partial correlations indicated
that the perfectionism dimensions of the MPS were related to various subscales
of the PDS and, perhaps more importantly, that the findings vary as a function
of the perfectionism dimension in question. The results are discussed in terms
of the importance of pe~.ectionism in personality disorder symptom patterns.
KEY WORDS: perfectionism; personality disorders.

INTRODUCTION
An emerging issue in the personality literature is the role of trait di-
mensions in personality disorders. A growing number of researchers are
beginning to examine the confluence of personality disorders and five-fac-
tor models of personality (e.g., Costa & McCrae, 1990; Wiggins & Pincus,
1989). This research has confirmed that there is indeed an association be-
tween personality trait and measures of personality disorders. For example,

1University of Winnipeg and Manitoba Adolescent Treatment Centre, Manitoba, Canada.

2York University.
3Brockville Psychiatric Hospital.
4To whom correspondence should be addressed at Department of Psychology, University of
Winnipeg, Winnipeg, Manitoba, Canada, R3B 2E9.

323
0882-2689/92/1200-0323/$6.50/09 1992Plenum PublishingCorporation
324 Hewitt, Flett, and Turnbull

Wiggins and Pincus (1989) demonstrated that neuroticism is associated with

borderline and avoidant tendencies, whereas agreeableness is associated
with the absence of antisocial and paranoid tendencies.
There is little doubt that personality traits and personality disorders
should indeed be related. However, the existing research is limited in that
many traits have not been investigated with respect to personality disorders.
In the present paper, we report a multidimensional investigation of the
association between perfectionism and indices of personality disorders. Re-
cent research on perfectionism as a multidimensional construct has
identified three components: self-oriented perfectionism, other-oriented
perfectionism, and socially prescribed perfectionism (Hewitt & Flett,
1991a). These dimensions have been discussed in detail elsewhere (e.g.,
Hewitt & Flett, 1991b). Briefly, self-oriented perfectionism is a self-related
personality style involving characteristics such as setting and holding unre-
alistic standards, compulsive striving, all-or-none thinking whereby only
attainment of the standards and total failure exist as outcomes, and a ten-
dency to focus on flaws and failures rather than successes.
In contrast, other-oriented perfectionism is an interpersonal dimen-
sion involving highly unrealistic standards and expectations for others,
placing great importance on whether other people attain these standards,
and rewarding others only if and when they attain these standards (Hewitt
& Flett, 1991b). Clearly, both self- and other-oriented perfectionism are
proactive in that the individual either does or does not set standards for
the self or others.
Finally, socially prescribed perfectionism involves perceptions of one's
ability to meet the expectations prescribed by significant others. It entails
the belief or perception that others have unrealistic standards for one's
own behaviors and they will be satisfied only when the standards are at-
tained. Socially prescribed perfectionism is reactive in the sense that the
individual responds to perceived standards imposed by significant others.
There are several reasons to expect that the three dimensions of per-
fectionism may be related to certain personality disorder symptom patterns.
First, at a general level, perfectionism and personality disorders are similar
in that they both consist of personal and social aspects (Hewitt & Flett, 1991b;
Millon, 1969, 1981). Second, it has been suggested that certain personality
disorders incorporate elements of perfectionism: Perfectionism is described
as relevant for individuals with an obsessive-compulsive personality disorder
(American Psychiatric Association, 1987). It is often believed that this disor-
der is characterized primarily by elevated levels of self-oriented perfectionism
(American Psychiatric Association, 1987; Salzman, 1980); however, there are
indications that these individuals may exhibit perfectionism in expecting oth-
Perfectionism and Personality Disorders 325

ers to be perfect and in incorporating unrealistic expectations of others (Hor-

ney, 1950; Ingram, 1982; Millon, 1981; Salzman, 1980).
In addition to obsessive-compulsive tendencies, perfectionism may also
be central to an understanding of narcissism. Several authors have suggested
that individuals with a narcissistic personality disorder have highly unrealistic
expectations for and criticisms of others, suggesting a link with other-oriented
perfectionism. Kernberg (1975) has described a complex interaction in that
narcissistic individuals tend to idealize others, as a form of projection from
a grandiose sense of self, and then react strongly when other people do not
live up to these idealized images. Finally, socially prescribed perfectionism
has been implicated in a number of personality disorders. For example, the
paranoid personality disorder incorporates perceptions that others are threat-
ening and critical, and the avoidant personality disorder involves perceptions
of meeting unrealistic social expectations (see Millon, 1981).
Empirical research in this area has examined the link between the
Multidimensional Perfectionism Scale (MPS; Hewitt & Flett, 1991b) and
indices of personality dysfunction and has shown that the perfectionism
dimensions are associated differentially with personality disorder measures.
Hewitt and Ftett (1991b) administered the MPS and the Millon Clinical
Multiaxial Inventory (MCMI; Millon, 1983) to a sample of psychiatric pa-
tients. The results showed the association between social dimensions of
perfectionism in personality disorder tendencies. Self-oriented perfection-
ism tended not to correlate with the MCMI personality disorder subscales;
however, it was found that other-oriented perfectionism was correlated
positively with several cluster two (i.e., dramatic) symptom patterns. In con-
trast, socially prescribed perfectionism was correlated mainly with cluster
1 (odd/eccentric) and cluster 3 (anxious/fearful) disorders.
Clearly, these data extend and qualify the findings of past studies.
Earlier research was restricted because it examined personality disorders
with unidimensional measures of perfectionism (Broday, 1988; Lohr, Ham-
berger, & Bonge, 1988), and use of the MPS enabled us to obtain a broader
view of perfectionism and personality disorders. At the same time, however,
certain aspects of the specific findings reported by Hewitt and Flett (1991b)
suggest the need for further research, as several findings were not consis-
tent with general beliefs about the nature of specific disorders. For instance,
there is a need to clarify the link between socially prescribed perfectionism
and dependent personality disorder. Past research has shown that socially
prescribed perfectionism is associated with a greater need for social ap-
proval and higher trait levels of dependency (Hewitt & Flett, 1991b, 1992).
Thus, a positive association would be expected between socially prescribed
perfectionism and a measure of dependent personality disorder. Although
there was a positive association between these measures in the Hewitt and
326 Hewitt, Flett, and Turnbull

Flett (1991b) study, this correlation was not significant. Also, the previous
study found no association between obsessive-compulsive personality dis-
order and self-oriented perfectionism. In fact, a negative correlation was
present between obsessive-compulsive personality disorder and socially pre-
scribed perfectionism. Although this finding was unexpected, it was
generally consistent with the results of Broday (1988), who also found nega-
tive correlations between perfectionistic attitude scores and the MCMI
obsessive-compulsive personality disorder measure.
The findings reported above suggest that only some findings are con-
sistent with theoretical expectations regarding perfectionism and
personality disorder tendencies. Although it may be that perfectionism vari-
ables are not relevant in certain personality disorder tendencies or are
related in theoretically unexpected ways, such conclusions may be some-
what premature. For example, both Hewitt and Flett (1991b) and Broday
(1988) used the MCMI as the personality disorder measure. Several authors
have recently called into question the concurrent validity of several of the
subscales of this measure (see McCann, 1989; Morey & Levine, 1988).
Thus, past research that has assessed perfectionism and personality disorder
tendencies must be viewed with caution due to the shortcomings in the
MCMI (Wetzler, 1990).
Because the existing research dealing with perfectionism and personality
disorders has used only the MCMI, the purpose of the present research was
to extend this area of research by examining the association between perfec-
tionism dimensions and personality disorders using the personality disorder
subscales (PDS) of the Minnesota Multiphasic Personality Inventory (MMPI;
Morey, Waugh, & Blashfield, 1985). This measure has been shown to have
adequate validity as a measure of personality disorders (see Morey et al.,
1985) and provided an alternate measure of personality disorder tendencies.
Moreover, because we wanted to assess trait levels or tendencies of the vari-
ous personality disorders, we used a heterogeneous clinical sample. Because
the use of homogeneous samples can result in restricted ranges on certain
subscales (e.g., histrionic tendencies in a sample of diagnosed obsessive-com-
pulsive disordered subjects) that can affect the direction and magnitude of
relationships (see Kline, 1987), a heterogeneous sample was chosen so as to
obtain an adequate range of scores on the measures.

METHOD
Subjects
The subjects were 90 in- and outpatients (42 men, 48 women) from
the Brockville Psychiatric Hospital. All of the subjects were White, and
Perfectionism and Personality Disorders 327

the majority of the sample participated in another study dealing with per-
fectionism and suicide (Hewitt, Flett, & TurnbulI-Donovan, 1992). All
subjects were given a diagnostic interview by one of four staff psychia-
trists. According to DSM-IIIR criteria, the most frequent primary diag-
noses were affective disorders, adjustment disorders, schizophrenia, and
alcoholism. Subjects with less than grade-8 education, current psychotic
symptoms, or organicity were excluded. The mean age of the sample was
35.86 years.

Materials

Multidimensional Perfectionism Scale. The MPS (Hewitt & Flett,

1991b) is a 45-item measure designed to measure three dimensions of
perfectionistic behavior: self-oriented perfectionism, other-oriented per-
fectionism, and socially prescribed perfectionism. Subjects are asked to
rate on a 7-point scale statements such as "One of my goals is to be
perfect in everything ! do" (self-oriented), "If I ask someone to do some-
thing, I expect it to be done flawlessly" (other-oriented), and "Anything
I do that is less than excellent will be seen as poor work by those around
me" (socially prescribed). Hewitt and Flett (1991b) and Hewitt, Flett,
Turnbull-Donovan, and Mikail (1991) presented extensive data support-
ing the reliability, dimensionality, and validity of the MPS in clinical and
nonclinical samples. For example, coefficient alphas range from .79 to
.89 for the three subscales, test-retest reliabilities range from .75 to .80
over 3 months, and subscale intercorrelations range from .25 to .40. Fi-
nally, several studies have demonstrated the validity of the subscales. For
example, each subscale correlates positively with similar constructs and
clinician and significant-other ratings, but not with theoretically dissimilar
constructs (Flett, Hewitt, Blankstein, & Koledin, 1991; Hewitt & Flett,
1991b).
M M P I Personality Disorder Scales. The Personality Disorder subscales
of the MMPI (PDS) were developed using a combined rational and em-
pirical approach (Morey et aL, 1985) based on DSM-III conceptions of
personality disorders. There are 11 subscales measuring cluster 1 (paranoid,
schizotypal, and schizoid), cluster 2 (antisocial, borderline, histrionic, and
narcissistic), and cluster 3 disorders (avoidant, compulsive, dependent, and
passive aggressive). Several studies have demonstrated the reliability
(Morey et al., 1985; Hurt, Clarkin, & Morey, 1990) and the validity (Dubro
& Wetzler, 1989; Dubro, Wetzler, & Kahn, 1988; Morey, Blashfield, Webb,
& Jewell, 1988; Morey & Levine, 1988) of the PDS.
328 Hewitt, Flett, and Turnbull

Table 1. Zero-Order Correlations Between MMPI Personality Disorder and MPS Subscales
Self Other Social M SD

Cluster 1
Paranoid .14 .18* .56"** 9.09 3.92
Schizotypal .08 .14 .47* ** 15.5(I 4.70
Schizoid -.01 .18' .13 7.51 2.27
Cluster 2
Antisocial .02 .19" .25"* 10.52 4.86
Borderline .04 .03 .16 11.00 3.38
Histrionic .13 .18" .15 9.78 2.27
Narcissistic .15 .32"* .05 12.43 3.38
Cluster 3
Avoidant .06 -.10 .32"* 21.72 5.66
Compulsive .07 .21" .28** 9.80 2.72
Dependent -.12 -.28"* .26"* 9.92 3.41
Passive aggressive .01 .23* .37*** 7.76 3.20
M 71.43 53.97 58.49
SD 16.60 13.16 16.51
Note. All correlations were tested using two-tailed tests of significance.
*p < .05.
**p < .01.
***p < .001.

Procedure

T h e subjects were consecutive admissions to several units in a large

psychiatric hospital. E i t h e r the subjects were asked to v o l u n t e e r in a study
of personality a n d distress or, if a p a t i e n t was referred for psychological
assessment, he or she was asked if their a s s e s s m e n t data could be used for
r e s e a r c h purposes. T h u s , all subjects c o m p l e t e d the MPS a n d the M M P I ,
as well as o t h e r m e a s u r e s , e i t h e r as part of a clinical assessment or as part
of a research project. Subjects who did not c o m p l e t e the m e a s u r e s for a
clinical a s s e s s m e n t were paid for their participation. T h e q u e s t i o n n a i r e s
were a d m i n i s t e r e d by e i t h e r a masters-level psychometrist or a research
assistant a n d were c o m p l e t e d on a n individual basis or in small groups.

RESULTS

T h e m e a n s , s t a n d a r d deviations, a n d z e r o - o r d e r c o r r e l a t i o n s of the
M P S a n d the P D S subscales are p r e s e n t e d in T a b l e I. In g e n e r a l , the m e a n s
of the m e a s u r e s from this sample are similar to m e a n s scores from o t h e r
s a m p l e s (e.g., Hewitt et al., 1991; M o r e y et al., 1985).
Perfectionism and Personality Disorders 329

Table II. Partial Correlations Between M M P I Personality Disorder and MPS Subscales
Self Other Social

Cluster 1
Paranoid -. 14 .06 .55" * *
Schizotypal -.14 .03 .47"**
Schizoid -.09 .14 .16

Cluster 2
Antisocial -.14 .16 .24*
Borderline -.03 -.01 .17
Histrionic .05 .15 .05
Narcissistic .06 .33** -.15
Cluster 3
Avoidant -.01 -.18 .34* *
Compulsive -.10 .17 .26*
Dependent -.15 -.33"* .39"**
Passive aggressive -.24* .21 .39***
Note. All correlations were tested using two-tailed tests of significance.
*p < .05.
**p < .01.
***p < .001.

With respect to the correlations involving self-oriented perfectionism,

it can be seen that this perfectionism measure was not correlated signifi-
cantly with any of the PDS subscales. This is consistent with Hewitt and
Flett (1991b), who also found that self-oriented perfectionism was not re-
lated to MCMI subscales.
With respect to other-oriented perfectionism, the results showed that
this perfectionism dimension was correlated positively with subscales from
each of the three clusters, including the paranoid, schizoid, compulsive, and
passive aggressive subscales. Moreover, other-oriented perfectionism was
correlated negatively with the dependency subscale.
Finally, socially prescribed perfectionism was correlated positively
with the paranoid, schizotypal, and antisocial subscale of clusters 1 and 2,
and with all of the subscales of cluster 3.
In order to understand the unique relationships between each of the
perfectionism dimensions and personality disorder subscales, partial corre-
lations were computed. These correlations are presented in Table II and
represent the partial correlation coefficients between each perfectionism
dimension and each personality disorder while controlling for levels of the
other two perfectionism dimensions. It is shown in Table II that self-ori-
ented perfectionism is negatively correlated with the passive aggressive
subscale, whereas other-oriented perfectionism is positively correlated with
the narcissism and negatively with the dependency subscales. Finally, the
330 Hewitt, Flett, and Turnbull

partial correlations involving socially prescribed perfectionism did not differ

substantially from the zero-order correlations, with the predominant finding
that this perfectionism dimension was associated with various personality
disorder indices from clusters 1 and 3.

DISCUSSION
The present study assessed the extent to which three dimensions of
perfectionism are related to personality disorder tendencies in a clinical
sample. In general, our findings indicated that dimensions of perfectionism
may be uniquely relevant in some personality disorder symptom patterns.
Certain results from this study are similar to those reported by Hewitt
and Flett (1991b). For example, there were almost no significant findings
involving self-oriented perfectionism, with the exception of a negative par-
tial correlation between self-oriented perfectionism and passive aggressive
tendencies. Although one might have expected more relationships with self-
o r i e n t e d p e r f e c t i o n i s m , o n e r e a s o n for this may be t h a t t h e
conceptualization of personality disorders tends to focus on interpersonal
behaviors and styles (Benjamin, 1987; Wiggins & Pincus, 1989). In contrast,
self-oriented perfectionism is an intraindividual personality style that cen-
ters on internal standards and personal motivations, and these aspects may
not be represented in the conceptualizations or measures of personality
disorders.
There were also some similarities between this research and past re-
search in terms of the interpersonal perfectionism dimensions. Consistent
with expectations, other-oriented perfectionism was correlated positively
with narcissism and this association remained significant after removing
variance associated with the other perfectionism dimensions. It was also
confirmed that socially prescribed perfectionism was correlated highest with
cluster 1 disorders, such as paranoid tendencies, and with all cluster 3 in-
dices.
On the other hand, some important differences also emerged. Overall,
there was little consistency with respect to other-oriented perfectionism and
personality disorders, with the exception of the link with narcissism. Hewitt
and Flett (1991b) reported several correlations between other-oriented per-
fectionism and dramatic cluster disorders, but these associations were not
detected in the present study. The differences between studies could reflect
the use of different measures in the studies (MCMI vs. MMPI) or be due
to the fact that partial correlations were not calculated by Hewitt and Flett
(1991b). Of course, it may also be that the associations involving other-ori-
ented perfectionism and dramatic cluster disorders (other than narcissism)
are not robust.
Perfectionism and Personality Disorders 331

The findings involving obsessive-compulsive symptoms were also differ-

ent from those of Hewitt and Flett (1991b) and were especially revealing.
Partial correlation analyses indicated that socially prescribed perfectionism
was the only MPS dimension that was uniquely associated with obsessive-
compulsive tendencies. The tendency for patients with obsessive-compulsive
features to report perceptions of imposed standards of perfection is not al-
together surprising (Ingram, 1982). The DSM-IIIR lists an "extreme sensi-
tivity to social criticism" (APA, 1987, p. 355) as indicative of this disorder,
and Millon (1981) discusses the strong need of the compulsive to "incorporate
the strictures of others and submerge all vestiges of individuality" (p. 218).
The more surprising aspect of the current data was the lack of a positive
correlation between self-oriented perfectionism and obsessive-compulsive
symptoms. As noted above, these variables were not correlated by Hewitt
and Flett (1991b). Overall, the findings obtained with the MPS do not ap-
pear to support the DSM-IIIR conceptualization of obsessive-compulsive
personality disorder, which focuses on perfectionism that is derived from
the self. One possible explanation for this lack of support is that perhaps
the MPS self-oriented perfectionism subscale suffers from psychometric
problems that have obscured the expected pattern of results. This inter-
pretation, however, is unlikely, as there is a great deal of research indicating
that all three MPS subscales have adequate degrees of reliability and va-
lidity (e.g., Hewitt & Flett, 1991b; Hewitt et al., 1991). Moreover, recent
research by Frost (1992) also indicates little consistent association between
high personal standards and measures of obsessive-compulsive tendencies.
Frost (1992) found no relation between personal standards and obsessive-
compulsive personality disorder features in either student or community
samples. Also, Broday (1988) used two different measures of self-oriented
perfectionistic beliefs in a clinical sample and found that the expected posi-
tive association b e t w e e n self-oriented p e r f e c t i o n i s t i c beliefs and
obsessive-compulsive personality disorder tendencies was not present. Fi-
nally, a recent study by Livesly, Jackson, and Schroeder (1992) assessed
the factor structure of pathological personality traits in personality disor-
ders with a sample of patients with diagnosed personality disorders. They
found that several items usually associated with the obsessive-compulsive
personality disorder, including perfectionism, were not relevant in the ob-
sessive-compulsive factor. Overall, these studies, with various samples and
measures, seem to indicate that the pursuit of unrealistic self-standards may
not be central to the obsessive-compulsive personality disorder.
The strongest association in this study was obtained between socially
prescribed perfectionism and the paranoid subscale. This is consistent with
conceptualization of socially prescribed perfectionism and it suggests that
the perceived unrealistic expectations of others may underscore the para-
332 Hewitt, Fiett, and Turnbull

noid individual's tendency to view others as threatening. Recent research

on self-consciousness indicates similarly that feelings of being observed and
evaluated are central to understanding paranoia (Fenigstein & V a n a b l e ,
1992).
Our analyses also detected the expected positive association between
socially prescribed perfectionism and dependent personality disorder; how-
ever, this finding was accompanied by a negative association between the
dependent subscale and other-oriented perfectionism. These findings not
only provide support that individuals with dependent personalitydisorders
have a marked need for affection and social approval, and avoid making
demands on others (Millon, 1981), but also highlight the distinction be-
tween the perfectionism dimensions. Similarly, socially prescribed
perfectionism was related to the avoidant subscale but was unrelated to
the schizoid subscale. These data support the idea that individuals with
avoidant disorders may be particularly concerned about the evaluations and
potential criticisms of others (Millon, 1981). Although individuals with
schizoid disorders avoid social interactions, this may be due not to the per-
ception that others impose demanding expectations, but to apathy or
aversion to relationships (Millon, 1981).
The current study is not without limitations. For example, use of a
rather small, heterogeneous sample may allow cautious generalizations to
a general psychiatric population; however, the current findings may not
generalize to specific groups of personality-disordered individuals. In addi-
tion, some have suggested that negative affect may affect the endorsement
of personality measures (Hirschfeld et al., 1983; Reich, 1987), although oth-
ers have not found support for a negative affect confound (Ix)ranger et al.,
1991; Trull & Goodwin, 1992). Future work should assess negative affect
to rule out any potential confound (see Hewitt, Flett, & Turnbull, 1992).
Furthermore, the cross-sectional nature of our design precludes any causal
statements, and this study applies only to symptoms of personality disorder,
and not necessarily to the disorders per se. On the other hand, although
the most frequent primary diagnoses in the sample were from Axis I, having
an Axis I diagnosis does not preclude an Axis 2 diagnosis, nor does it pre-
clude having important trait levels of personality disorders (see DSM-IIIR,
p. 18). The lack of diagnostic specificity in personality disorders suggests
that there is a decided overlap among the diagnostic groups (Reich, 1987;
Tyrer, 1988; Widiger et al., 1991), thus, assessing trait levels of the char-
acteristics of personality disorders may be quite an appropriate strategy.
In summary, the results of this study provided support for the belief
that dimensions of perfectionism may be uniquely involved in personality
disorder tendencies. Consistent with other work, self-oriented perfectionism
was generally not related to personality disorders, whereas the two social
Perfectionism and Personality Disorders 333

perfectionism dimensions were related to a variety of personality disorders.

Thus, holding unrealistic standards for others and believing that others ex-
pect only perfection from oneself appear to be salient factors associated
with certain personality disorder tendencies. These findings support the role
of dispositional social factors in personality disorders and suggest further
that the interpersonal components of perfectionism, in particular, may play
a role in the experience of personality disorders.

ACKNOWLEDGEMENTS
This research was supported by Grant 410-91-1690 from the Social
Sciences and Humanities Research Council of Canada as well as by a grant
from the Research and Program Evaluation Committee, Brockville Psychi-
atric Hospital. The authors wish to thank Jeff Jackson, Amde Teferi,
Aygodan Ugur, and Zul Wallani for referring patients and Marjorie Cous-
ins, Gary Gerber, and Rosemary Smith for their assistance. We would also
like to thank Ross Broughton, Patricia Sutker, and three reviewers for com-
ments on early versions of this paper.

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