Perfectionism and Distress Tolerance as Psychological Vulnerabilities to Traumatic Impact and Psychological Distress in Persons with Psychotic Illness
Bibliographic record
Abstract
Perfectionism has been linked with various indices of maladjustment but has not yet been formally investigated in persons with psychotic illness. There is also a call for more psychological formulations of psychotic illness and related interventions for assisting affected persons, particularly given the relevance of trauma in the development of psychosis. Accordingly, an exploratory study was conducted to evaluate socially prescribed perfectionism, perfectionistic self-presentation, and distress tolerance as psychological vulnerabilities associated with poorer theory of mind, stronger traumatic impact, and worse psychological distress in persons with psychotic illness. A sample of 61 persons with a diagnosed psychotic illness was recruited from a tertiary care organization in Toronto, Canada. Correlational results suggest that, as predicted, higher trait perfectionism and higher perfectionistic self-presentation were associated with lower distress tolerance, more shame, greater stress, and poorer theory of mind. Lower distress tolerance was also associated with elevated stress, shame, and poorer theory of mind. The results also support conceptual overlap among perfectionism, social anxiety, and paranoid ideation in persons with psychotic illness. A trauma-informed person-centered clinical formulation is presented, describing how perfectionism, perfectionistic self-presentation, and low distress tolerance may stem from disrupted attachment experiences and other circumstances with associated traumatic impact. Formulation-based clinical approaches that may benefit affected persons are described. The study results are also contextualized within the broader literatures on psychosis, perfectionism, trauma, and psychotherapy. Finally, future research directions are indicated.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".