Perfectionism, the impostor phenomenon and psychological adjustment in medical, dental, nursing and pharmacy students

Abstract

Extensive attention has been paid over the past three decades to the stressors involved in training in the health professions. Although empirical studies have identified demographic subgroups of students most likely to become distressed during training, less research has been carried out to evaluate the impact of students' personality characteristics on their adjustment. Severe perfectionism is one such personality trait that has been shown to increase the risk for anxiety and depressive disorders in other populations. Another set of personality traits linked to increased psychological problems has been labelled the 'impostor phenomenon', which occurs when high achieving individuals chronically question their abilities and fear that others will discover them to be intellectual frauds. Both perfectionism and the impostor phenomenon would seem to be pertinent factors in the adjustment of health professional students; however, these character traits have not been empirically examined in this population. In the present study psychological distress, perfectionism and impostor feelings were assessed in 477 medical, dental, nursing and pharmacy students. Consistent with previous reports, the results showed that a higher than expected percentage of students (27.5%) were currently experiencing psychiatric levels of distress. Strong associations were found between current psychological distress, perfectionism and impostor feelings within each programme and these character traits were stronger predictors of psychological adjustment than most of the demographic variables associated previously with distress in health professional students. Implications for future research, limitations of this study and clinical recommendations are discussed.

Examination of the Relationship Between Perfectionism and Religiosity as Mediated by Psychological Inflexibility

“…These high-standard environments include sports and exercise (Flett & Hewitt, 2005), education (Parker, 2002), professional achievement (Henning, Ey, & Shaw, 1998), and religion (Ashby & Huffman, 1999).…”

“…Amidst these high standards, it is still possible to distinguish between maladaptive and adaptive forms of perfectionism, and maladaptive perfectionism has been linked to low self-esteem and interpersonal difficulties (Parker, 2002). A survey of medical, dental, pharmacy, and nursing students found greater levels of psychological distress were associated with perfectionism and the imposter phenomenon (Henning et al, 1998), and maladaptive perfectionism was found to predict symptoms of depression and hopelessness in another longitudinal study of medical students (Enns, Cox, Sareen, & Freeman, 2001). …”

Your Best Life: Coping With Emotional Pain in a Demanding Work Environment

“…Conversely, but equally destructive, is perfectionism, which derives from anxiety or self-esteem issues [8]. Perfectionism, and all its attendant negative effects on happiness, is a common consequence to deep feelings of inadequacy [5]. The same perfectionistic tendencies that drive a premedical student to ace all of his or her subjects, also puts them at risk for continual discontent and dissatisfaction.…”

"Like Drinking Water Out of a Fire Hydrant" Medical Education as Transformation: A Naturalistic Inquiry Into the Physician Assistant Student Experience

“…First, there is ample evidence that graduate medical education causes increases in psychological distress (including stress and anxiety) among medical students (Finkelstein, Brownstein, Scott, & Lan, 2007;Henning, Ey, & Shaw, 1998;Schmitter, Liedl, Beck, & Rammelsberg, 2008;Vitaliano, 1988;Vitaliano, Russo, Carr, & Heerwagen, 1984), yet there remains a limited amount of empirical evidence about the effects of this process on PA students (M. H. Brown, 2004;Childers et al, 2012;Glicken & Gray, 1993;Kuhn et al, 2005;O'Brien et al, 2012). Inquiry into whether similar outcomes exist among PA students would improve the understanding of educational practices among PA educators and provide a foundation on which to base informed curricular decisions.…”

“…C. Clark & Zeldow, 1988;Dickstein, Stephenson, & Hinz, 1990;Helmers, Danoff, Steinert, Leyton, & Young, 1997;Roberts, 2010). It is well known that many students experience stress as part of a medical education process (Finkelstein et al, 2007;Henning et al, 1998;Schmitter et al, 2008), and stress has been recognized to have a negative effect on academic performance (Spiegel et al, 1986), health and psychological well-being (Helmers et al, 1997). High rates of stress, anxiety and depression have been reported in numerous articles on medical student mental health (D. C. Clark & Zeldow, 1988;Dahlin, Joneborg, & Runeson, 2005;Dyrbye, Thomas, Huntington et al, 2006;Schwenk, Davis, & Wimsatt, 2010;Vitaliano et al, 1984).…”