I have a good self, that loves skies, hills, ideas, tasty meals, bright colors. My demon would murder this self by demanding that it be a paragon, and saying it should run away if it is anything less.... I have this demon who wants me to run away screaming if I am going to be flawed, fallible. It wants me to think I'm so good I must be perfect. Or nothing. (Sylvia Plath, 1982, p. 176) In this chapter, we provide evidence that perfectionism should be viewed as a vulnerability factor of importance in suicide and present a model of perfectionism and suicide that reflects the importance of interpersonal perfectionistic behavior. Our conceptual and empirical analysis is based on the hypotheses that (a) trait perfectionism dimensions are vulnerability factors linked directly with suicide and (b) trait perfectionism is linked indirectly with suicidal tendencies via its association with life stress and social disconnection. In subsequent sections of this chapter, we report results of research that investigates the link between perfectionism and suicide in a variety of populations. These findings highlight how socially prescribed perfectionism is a particularly robust factor in suicidality. PERFECTIONISM AND SUICIDETo grasp immediately a sense that perfectionism plays an important role in suicidal behavior, at least anecdotally, one has only to read case stud-215

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Research on adults indicates that perfectionistic self-presentation, the interpersonal expression of one's perfection, is associated with a variety of psychopathological outcomes independent of trait perfectionism and Big Five traits. The current article reports on the development and evidence for the validity of the subtest score interpretations of an 18-item self-report measure of perfectionistic self-presentation for children and adolescents. Analyses conducted on data from two clinical samples and one nonclinical sample of children and adolescents found that the Perfectionistic Self-Presentation Scale--Junior Form (PSPS-Jr) reflected a multidimensional model of perfectionistic self-presentation with three subscales: Perfectionistic Self Promotion, Nondisplay of Imperfection, and Nondisclosure of Imperfection. The subscale scores were found to demonstrate internal consistency, and there was good evidence supporting the validity of the interpretation of subscale scores based on this new measure. The subscales were associated with maladaptive outcomes, but were not influenced unduly by biases that included social desirability and differential item functioning by gender. Overall, the PSPS-Jr appears to be a useful measure of the expression of perfection among youths and an important tool in attempting to understand the nature and the consequences of perfectionistic self-presentation in children and adolescents.

The role of interpersonal components of perfectionism in suicide outcomes among youth was assessed and the Perfectionism Social Disconnection Model (PSDM) was tested by determining whether the links between socially prescribed perfectionism (SPP) and perfectionistic self-presentation (PSP) and suicide outcomes are mediated by experiences of social disconnection, as indicated by social hopelessness and being bullied. PSP, trait perfectionism, suicide outcomes, and experiences of being bullied and social hopelessness were measured in 152 psychiatric outpatient children and adolescents. Correlational tests confirmed that PSP and SPP were associated with suicide outcomes and these interpersonal perfectionism components were associated significantly with bullying and social hopelessness. Support was also obtained for the PSDM. The relationship between the PSP facets, particularly nondisplay of imperfections, and suicide outcomes were mediated by being bullied. Additionally, the relationship between all interpersonal components of perfectionism and suicide risk was mediated by social hopelessness. Theoretical and clinical implications of interpersonal components of perfectionism and social disconnection in suicide outcomes for youth are discussed.