Perfectionism,life stress,and suicidal ideation among college students: A protective role of self-compassion

Abstract

Suicidal behavior among South Korean young adults has been a serious social concern. When college students have a maladaptive desire for perfectionism in life, they may experience more significant life stress and, in turn, higher devaluation of their lives. However, not every individual is equally influenced by perfectionism and develops adverse emotional outcomes. Some researchers proposed that self-compassion, being warm and understanding toward oneself rather than ignoring or criticizing oneself, might act as a protective factor against mental health concerns. Therefore, using a sample of 420 Korean college students, this study conducted structural equation modeling to examine self-compassion as a potential protective factor for the mediation effect of life stress in the relationship between maladaptive perfectionism and suicidal ideation. Results supported the hypothesized model, with students with higher self-compassion reporting more negligible adverse impacts of maladaptive perfectionism on suicidal ideation mediated by life stress. Implications and future directions are discussed.

Keywords

Maladaptive perfectionism life stress suicidal ideation self-compassion

Introduction

Suicide is the leading cause of death among Korean young adults in their teens through 30s. While the suicidal rates among middle-aged adults in their 40s and older have declined, the suicide rates among young adults in their 20s have increased over the past 5 years (Statistics Korea, 2021). Specifically, compared to 2019, the suicidal rate of young female adults in their 20s has increased by 16.5% in 2020, while that of young male adults in their 20s increased by 10.2% (Statistics Korea, 2021). Such statistical outcomes suggest the need to identify predictors of suicidal ideation in young adults to prevent its occurrence. Many risk factors, such as maladaptive perfectionism, interpersonal stress, and emotion-oriented coping type have predicted suicidal ideation among Korean college students (Park & Kim, 2018). Specifically, researchers noticed that college students who maladaptively desired to be perfect were more prone to experience higher stress (e.g., Huang & Mussap, 2018; Rice & Van Arsdale, 2010) and risk of suicidal ideation (e.g., Chae & Kim, 2013). These results suggested that stress might explain the relationship between perfectionism and suicidality among college students (e.g., Chang et al., 2004).

Recent literature proposed several protective factors against suicidality, such as social support, self-esteem, school belongingness, and self-compassion (Choi, 2012; Hirsch et al., 2021). Of those protective factors, self-compassion has recently received more attention. Self-compassion is defined as the ability to alleviate pains with a sense of warmth, connection, and concern, and higher levels of self-compassion lead to greater happiness and resilience (Raes et al., 2011). It may contribute to emotional resilience and reduce suicide risk (Rabon et al., 2018). Although identifying and intervening with such risk factors may improve our understanding of suicidal behavior, research and practice mainly focusing on risk factors with little attention to protective factors are limited in developing comprehensive suicide prevention plans (Choi, 2012). Therefore, this study incorporated risk and protective factors to optimize suicide prevention among Korean college students.

Maladaptive perfectionism

Perfectionism has been hypothesized to be related to a variety of psychological problems. Frost et al. (1990) defined perfectionism as “the setting of excessively high standards for performance accompanied by overly critical self-evaluations” (Frost, Heimberg, Hole, Mattia, & Neubauer, 1993, p. 119). Frost et al. (1993) found that maladaptive perfectionism was significantly associated with depressive symptoms and negative affect, with no significant relation to positive affect. Contrarily, adaptive perfectionism was strongly associated with positive affect but not with depressive symptoms or negative affect.

Maladaptive perfectionism and suicidal ideation

Maladaptive perfectionism represents a cognitive preoccupation with living up to the perfect, ideal self, which could fuel a sense of deficiency and hopelessness (Flett et al., 2014). Theoretical models and empirical evidence suggest that maladaptive perfectionism increases the risk for suicidal behaviors (e.g., Baumeister, 1990; O’Connor, 2007). Baumeister’s (1990) “escape from the self” model described that individuals might engage in suicidal behavior to escape from the perceived discrepancy between unrealistic expectations and the ability to meet the expectations. Due to perceived discrepancy, individuals blame themselves as inadequate or incompetent and develop psychological symptoms such as depression, hopelessness, and suicidal ideation.

According to a systematic review of psychological and medical literature, considerable evidence exists for the link between perfectionism and suicidality (O'Connor, 2007). Different dimensions of perfectionism were uniquely associated with suicidal ideation, with maladaptive perfectionism showing its critical role in suicidal ideation. Specifically, socially prescribed perfectionism (SPP), which explains the perceived pressure that significant others have unrealistic standards for them and demand perfection of the self, has been consistently associated with suicidal and self-harm behaviors (e.g., Freudenstein et al., 2012; O'Connor et al., 2010). For example, earlier investigations reported that SPP was a robust predictor of suicidal ideation after controlling for gender, age, depression, and hopelessness (Dean et al., 1996; Hewitt & Flett, 1991). Similarly, among the dimensions of maladaptive perfectionism suggested by Frost and colleagues (1990), Concern over Mistakes (CM) and Doubting of Actions (DA) were consistently linked with suicidal ideation (e.g., Frost & DiBartolo, 2002; Hewitt et al., 2006), while Parental Expectations (PE) and Parental Concern (PC) showed unstable associations with adverse outcomes (Stoeber & Otto, 2006). Collectively, the links between these dimensions of perfectionism (e.g., CM, DA, and SPP) and suicidality show that maladaptive perfectionism can amplify suicidal risk.

The mediating role of life stress

In an effort to identify the underlying mechanism for the perfectionism and suicide link, previous studies suggested that life stress mediated the effects of maladaptive perfectionism on various health indicators such as emotional eating (Wang & Li, 2017), physical health (Molnar et al., 2011), burnout (Garinger et al., 2018), negative affect (Dunkley et al., 2003), and life satisfaction (Chang et al., 2004). For example, Chang et al. (2004) found that life stress mediated the effects of maladaptive perfectionism on affect, life satisfaction, and suicidal ideation. However, no study has yet assessed whether life stress mediates the role of perfectionism in suicidal ideation among Korean college students, suggesting a need to fill the gap in research with the population. Considering that South Korean college students consistently face evaluations by taking examinations and constantly preparing for job interviews in a cultural background with a high unemployment rate, it is predictable that they feel anxious about not living up to the expectations of others and the society (Yang & Kim, 2021).

Maladaptive perfectionism has been consistently linked to increased levels of perceived stress across various cultural groups. Using a sample of U.S. college students, Rice and Van Arsdale (2010) found that maladaptive perfectionists reported significantly higher stress levels than adaptive perfectionists or non-perfectionists. Additionally, Wang and Li (2017) found that negative perfectionism was more strongly associated with increased stress levels among Chinese adults. Another study conducted by Nilsson et al. (2008) reported that perfectionism predicted stress among Asian international college students in the US. A robust association between stress and suicidal ideation has also been well documented in previous literature (Portzky et al., 2005; Wilburn & Smith, 2005). Multiple previous studies suggested that stress was highly predictive of suicidal ideation among South Korean young adults (Chae & Kim, 2013; Kang & Ra, 2013). University students in Korea who experienced more significant stress were more likely to report having suicidal ideation or impulsive suicidal attempts than those with less stress (Chae & Kim, 2013). These findings suggest that the levels of life stress experienced by college students may explain the impact of perfectionism on suicidal ideation.

The protective role of self-compassion

Positive psychology has not informed the current theory and research on maladaptive perfectionism and suicidal ideation (Hirsch et al., 2021). According to the Escape Theory (Baumeister, 1990), maladaptive perfectionists are likely to experience stress when they fail to fulfill their expectations and consequently experience suicidal thoughts as a means to escape from the pain of self-blame. However, not all perfectionists experience high levels of life stress and suicidal ideation, suggesting that possible buffers of the maladaptive perfectionism–suicide link should be examined. Recently, self-compassion has been identified as a potential factor in the maladaptive perfectionism–suicide link.

Previous studies indicated that self-compassion allows individuals to accept the undesirable aspects of self (Neff, 2003; Rabon et al., 2018). In this regard, self-compassion, in the instance of failure or inadequacies, may protect individuals from wanting to escape from the pain of self-blame and engaging in suicidal thoughts. To decrease suicide risk among vulnerable perfectionists, critical considerations for prevention programs should move beyond promoting healthy psychosocial environments where mistakes are permitted. Another key consideration should be whether maladaptive perfectionists have established a positive psychological orientation that can protect them from being too critical toward themselves and developing escaping (self-harming) thoughts. Thus, promoting resilience to minimize the adverse impacts of maladaptive perfectionism on psychological distress and suicidal thoughts needs greater attention.

Research questions and hypotheses

This study aimed to answer two primary research questions: (1) Will life stress mediate the relationship between maladaptive perfectionism and suicidal ideation? (2) Will self-compassion affect the mediated relation between maladaptive perfectionism, life stress, and suicidal ideation?

First, we hypothesized that maladaptive perfectionism would be associated with more significant stress, which would be associated with higher suicidal ideation. We also hypothesized that the mediated relation would be weaker among students with higher self-compassion than those with lower self-compassion.

Methods

Participants

A total of 420 university students from one private university participated in this study in Seoul, Korea. The mean age of the sample was 21.63 years (SD = 2.61 years). The sample was characterized by its gender ratio (64.3% female) and year in school (22.1% freshman, 26.1% sophomores, 25.2% juniors, and 26.6% seniors). Of the total sample, 22.4% were Protestants, 11.2% were Catholics, 7.6% were Buddhists, and 56.5% had no religious affiliation.

Procedures

Data were collected during the Fall semester of 2020. Instructors from the College of Social Sciences were contacted to obtain permission to recruit the study’s participants from their classes. Full-time academic students majoring in Social Sciences were recruited. A majority of them were taking 15 to 18 academic credits per semester. Once approval was granted, trained researchers distributed an information letter describing the study. All subjects gave their informed consent for inclusion before participating in the study. Those who opted to participate filled out the survey in paper and pencil format during class.

Measures

Maladaptive perfectionism

To measure maladaptive perfectionism (perfectionist concerns), the survey included subscales from the Frost and colleagues’ maladaptive perfectionism scales (FMPS, 1990) and Hewitt and Flett’s maladaptive perfectionism scales (HMPS, 1991). The survey items for maladaptive perfectionism in this study consisted of 13 items from the FMPS, including nine items on CM (e.g., “People will probably think less of me if I make a mistake”) and four items on DA (e.g., “I usually have doubts about the simple everyday things I do”), as well as five items from the HMPS on SPP (e.g., “The better I do, the more is expected from me”). These three subtypes were specifically chosen to construct the maladaptive perfectionism scale in this study considering previous research outcomes. CM and DA were found to have positive correlations with suicidal ideation (Frost & DiBartolo, 2002; Hamilton & Schweitzer, 2000; Hewitt et al., 2006), while other subscales such as PE and PC did not show consistent results (Stoeber & Otto, 2006). SPP strongly predicted suicidal ideation after controlling for gender, age, and other mental health states (Dean et al., 1996).

Additionally, SPP from the HMPS would be often included along with a cluster of highly related dimensions from the FMPS to measure maladaptive perfectionism in previous literature (e.g., Dunkley et al., 2003). The respondents rated all items on a five-point response scale (1=strongly disagree to 5= strongly agree). Higher scores indicated higher maladaptive perfectionism. The Cronbach’s alpha coefficient for the current sample was .80.

Life stress

The Revised Life Stress Scale for College Students (RLSS-CS; Chon et al., 2000) measured the frequency of feeling life stress during the past 12 months among college students. This scale consisted of 21 items, including seven academic, economic, and career stress items in a four-point response scale (1 = never to 4 = very often). Higher scores indicated more frequent life stress. The Cronbach’s alpha coefficient for the current sample was .79 for life stress. Other studies of Korean college students also found significant associations with the RLSS-CS and suicidal ideation (e.g., Kim & Chae, 2014), proving its validity for use with the population.

Self-compassion

The Self-Compassion Scale (Neff, 2003) was used to measure self-compassion. The self-compassion scale comprises 26 items with six subscales to measure three general facets of self-compassion: self-kindness versus self-judgment, common humanity versus isolation, and mindfulness versus over-identification in a five-point response scale (1 = almost never to 5 = almost always). Self-kindness is the tendency to treat oneself with understanding and care rather than with harsh self-judgment (e.g., “When I’m going through a very hard time, I give myself the caring and tenderness I need”). Common humanity is concerned with having the ability to recognize that failure is a human experience instead of feeling cut off from others by one’s own failures (e.g., “I try to see my failings as part of the human condition”). Mindfulness is centered on being aware of the present moment in a balanced way rather than over-identifying with one’s emotions (e.g., “When something painful happens, I try to take a balanced view of the situation”). Higher scores indicated higher levels of self-compassion. The Cronbach’s alpha coefficient for the current sample was .80.

Suicidal ideation

The Adult Suicidal Ideation Questionnaire (ASIQ; Reynolds, 1991) measured how often college students thought about committing suicide during the past month. This scale consisted of 25 items in a five-point response scale (1 = very rarely to 5 = almost always) (e.g., “I have felt that ending life is the only way to solve life problems”). The Cronbach’s alpha coefficient for the current sample was .83. Higher scores indicate a higher sense of suicidal ideation. Other studies of Korean college students also found significant correlations between the ASIQ and psychological depression (Kang & Ra, 2013), providing evidence for its validity for use with the population.

Data analysis

A hypothesized model among maladaptive perfectionism, stress, self-compassion, and suicidal ideation was tested using structural equation modeling (SEM) in Amos 23. Model fit was assessed based on several criteria: non-normed fit index (NNFI) (Bentler & Bonett, 1980), comparative fit index (CFI) (Bentler, 1990), and root mean square error of approximation (RMSEA) (Steiger & Lind, 1980). NNFI and CFI are absolute fit indices, with a value closer to 1 indicating an ideal model. Conventionally, NNFI and CFI value greater than 0.90 are considered to indicate a good model fit. RMSEA measures the degree of misfit, with a value smaller than 0.06 indicating a good model fit (Hu & Bentler, 1999). Missing values were dealt with a Full Information Maximum Likelihood (FIML).

Results

Descriptive statistics

The correlations, mean, and standard deviation of the variables in the study are provided in Table 1. According to the guidelines of severe non-normality (i.e., skewness > 3; kurtosis > 10) proposed by West et al. (1995), the normality assumption of all the variables was well met, where the skewness values were less than three, and kurtosis values were less than 10.

Table 1.

Descriptive statistics and intercorrelations for study variables.

	1	2	3	4	5	6	7	8	9	10
1.SPP
2. Concern over mistakes	.66*
3. Doubting of actions	.40*	.68*
4. Academic stress	.18*	.22*	.38*
5. Economic stress	.27*	.18*	.16*	.24*
6. Career stress	.20*	.40*	.44*	.44*	.18*
7. Self-kindness	−.43*	−.65*	−.58*	−.25*	−.13*	−.28*
8. Common humanity	−.40*	−.61*	−.52*	−.30*	−.14*	−.31*	−.73*
9. Mindfulness	−.34*	−.64*	−.54*	−.19*	−.17*	−.32*	−.76*	−.73*
10. Suicidal ideation	.13*	.27*	.33*	.19*	.16*	.22*	−.34*	−.30*	−.28*
M	2.80	2.71	2.72	1.76	1.45	2.09	3.68	2.07	2.55	1.35
SD	0.70	0.79	0.79	0.61	0.60	0.61	0.96	0.94	0.95	0.68

Note. SPP = Socially prescribed perfectionism, * p <.05.

Testing the hypothesized model

We tested two mediation models to assess the plausibility of the hypothesis. The initial structural model reflecting partial mediation was specified, with both direct and indirect paths, from maladaptive perfectionism to suicidal ideation via a mediator (i.e., life stress). The second structural model represented the full mediation model, which did not include the direct effects of maladaptive perfectionism on suicidal ideation. Results indicated that both models showed a good fit for the sample. Specifically, the partial mediational model yielded an overall χ² (202) value of 402.86, with CFI = .954, NNFI = .955, and RMSEA = .062, and the full mediational model yielded an overall χ² (203) value of 412.82, with CFI = .951, NNFI = .941, and RMSEA = .068. The partial mediational model produced better model fit indices. Moreover, a chi-square difference test supported the partial mediational model. Therefore, the partial mediational model was chosen as the final theoretical model (see Figure 1).

Figure 1.

Final model estimation with standardized estimates. Note. * p < 0.05; significant path coefficients are shown in bold line; dotted line = non-significant.

For the current sample, results showed that the mediated effect of life stress in the relationship between maladaptive perfectionism and suicidal ideation varies across the level of self-compassion. Specifically, the total effect of maladaptive perfectionism on the outcome variable for students with lower self-compassion levels was more substantial than for students with higher levels of self-compassion. The bootstrap results indicated that maladaptive perfectionism had a significant indirect relationship with the outcome variable via the mediator (β = .04, p < .05).

Discussion

First, a significant direct influence of maladaptive perfectionism on suicidal ideation was found in the study. Such a finding corroborates numerous previous studies, which concluded that suicidal ideation and behaviors are the critical manifestation of maladaptive perfectionism (Abdollahi & Carlbring, 2017; O’Connor, 2007; Park & Kim, 2018). When those with maladaptive perfectionism are exposed to high expectations combined with little recognition and warmth while having a reduced ability to cope with failures and weaknesses, it leads to higher chances of eventually considering suicidal attempts as a potential “solution” (Kiamanesh et al., 2015). It may be inferred that young adults may consider committing suicide if they have the disposition to set unrealistic expectations towards themselves and fear being critically evaluated on the discrepancy between their authentic selves and the ideal image (Hewitt et al., 1997).

Second, the study showed the partial mediating effect of life stress in the relationship between maladaptive perfectionism and suicidal ideation. It explains how maladaptive perfectionist students being exposed to stressful experiences may indirectly affect suicidal thoughts. Previous studies also have shown how those with a higher level of perfectionism were more likely to experience greater stress levels. Therefore, they suffer severe mental health issues such as self-harm (O’Connor et al., 2010), burnout (D’Souza et al., 2011), and depression (Huang & Mussap, 2018). This implies the mediating role of stress between perfectionism and lowered life satisfaction (Ashby et al., 2012). Provided that stress has been underscored in previous research as having a significant relationship with suicidal ideation (Choi, 2012; Jung et al., 2015; Park & Kim, 2018), the partial mediation of life stress suggested in this study leaves implications for planning intervening strategies. More attention needs to be paid to university students with perfectionist dispositions to be equipped with effective measures to cope with stress positively.

Third, the current finding suggests the potential of self-compassion as a protective factor that may be enhanced to protect the university students from suicidal ideation by feeling as if they do not make up for their idealized standards and face stress in life. Self-compassion involves being kind and understanding toward oneself in the face of failure, recognizing mistakes and failures as part of common humanity, and being mindful of painful thoughts and feelings (Hirsch et al., 2021). This positive orientation toward self may ease the pain of negative self-evaluation and self-blame (Leary et al., 2007; Neff, 2003). Such potential roles of self-compassion is also in line with the suggestions made by a high volume of previous studies (Collett et al., 2016; Hirsch et al., 2021; Park & Lee, 2018; Rabon et al., 2018; You & Yoo, 2021). It may be inferred that alleviating harsh criticism towards oneself and developing a compassionate mindset is sensitive to pain and accepting one’s shortcomings (Jazaieri et al., 2014). Therefore, it contributes to preventing suicidal thoughts of perfectionist university students.

Limitations of the study

Despite the four implications, there remain some limitations. First, the participant group involves university students who attend one private school in Seoul. Such sampling has respondent bias limitations and does not represent the whole population, so future studies may consider involving more students from diverse contexts. Second, the study adopted a cross-sectional research design, which does not ascertain the causal relationships among variables. Future research should take a longitudinal approach to address causality between the variables.

Footnotes

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was partially supported by the Hankuk University of Foreign Studies Research Fund granted to Sukkyung You.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The entire survey was reviewed and approved by a professional panel of educational specialists and school counselors (Project identification code No. CSED-2020-002A). Ethic Committee Name: Center for Social and Emotional Development, Hankuk University of Foreign Studies (Approval Code: CSED-2020-002A).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Preregistration of studies

We did not preregister the research in an independent, institutional registry.

Availability of data and material

Data is available upon request from the corresponding author. The data is not publicly available due to privacy or ethical restrictions.

ORCID iD

Sukkyung You

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