The Clinical Perfectionism Questionnaire: Assess Your Risk and Take Action
When "High Standards" Become Dangerous
Wanting to do well on a test? Healthy. Spending 12 hours on a single math problem because it's "not perfect enough"? Dangerous territory. Professor Tracey Wade developed the Clinical Perfectionism Questionnaire (CPQ) to distinguish between healthy striving and problematic perfectionism.
The Crucial Distinction
Healthy Striving (Excellence-Seeking):
High but achievable standards
Motivation from internal satisfaction
Mistakes are learning opportunities
Can enjoy process and outcome
Knows when "good enough" is sufficient
Clinical Perfectionism:
Impossible standards
Self-worth depends on achievement
Mistakes feel catastrophic
Only cares about perfect outcomes
"Good enough" never feels acceptable
Professor Wade defines clinical perfectionism as "overdependence of self-evaluation on the determined pursuit of personally demanding, self-imposed standards in at least one highly salient domain, despite adverse consequences."
Case Study: Twin Brothers
Jake and Ryan are identical twins, both excellent students.
Jake (Healthy Striving):
Goal: Improve math from B+ to A-
Studies efficiently, seeks help when stuck
Gets A- and feels satisfied
Uses success to motivate next challenge
Ryan (Clinical Perfectionism):
Demands 100% on every math test
Studies until 2 AM, redoes perfect homework
Gets A+ but feels anxious about maintaining it
Success increases pressure for next test
Six Months Later:
Jake: Steady improvement, good mental health, multiple interests
Ryan: Higher grades but depression, gave up other activities, constant anxiety
Understanding the CPQ
The questionnaire measures behaviors like:
"Have you pushed yourself really hard to meet your goals?"
"Have you felt that others would not have thought highly of you if you had not done well?"
"Has concern about failing affected your performance?"
Risk Categories:
Low Risk: High standards but flexible approach
Moderate Risk: Some perfectionist patterns emerging
High Risk: Clinical intervention recommended
What High Scores Mean
A study of 1,287 university students found high perfectionism scores predicted "higher levels of fatigue, anxiety, depression, and hostility." Alarmingly, "31% showed suicidal thoughts in the last year."
High CPQ Scores Predict:
Depression and anxiety
Eating disorders
Academic burnout
Social isolation
Procrastination (despite high standards)
Evidence-Based Interventions
Cognitive Restructuring:
Challenge "all-or-nothing" thoughts
Reality-test perfectionist fears
Cost-benefit analysis of perfectionist behavior
Behavioral Experiments:
Deliberately submit "85% perfect" work
Set strict time limits for tasks
Practice "good enough" in low-stakes situations
Values Clarification:
Identify what truly matters beyond achievement
Separate personal values from perfectionist demands
Rediscover interests beyond performance
Success Story: Sarah's Transformation
Grade 11 student Sarah scored high risk on CPQ:
Self-worth depended entirely on grades
Avoided social activities to study
Panic attacks before tests
Considered herself "failure" despite 92% average
After 6 months of intervention:
Maintained 89% average (only 3% drop)
Joined drama club, made friends
Anxiety decreased significantly
Felt happier and more balanced
When to Seek Help
Red Flags:
Perfectionism interfering with daily life
Avoiding activities due to fear of imperfection
Physical symptoms (insomnia, headaches)
Depression or anxiety symptoms
Thoughts of self-harm
Professional Resources:
School counselors trained in CBT for perfectionism
Psychologists specializing in anxiety
Evidence-based treatments developed by researchers like Professor Wade
Taking Action
If You Score High:
Share results with someone you trust
Try one "good enough" experiment this week
Consider professional support
Remember: perfectionism is learned and can be unlearned
Key Takeaways
Not all high standards are problematic—context matters
Clinical perfectionism is treatable, not a personality flaw
Small thinking changes create big wellbeing improvements
Getting help shows strength, not weakness
Conversation Starters:
"There's a scientific questionnaire that measures dangerous perfectionism"
"Clinical perfectionism is linked to depression and anxiety"
Interested in learning more about psychological assessment and evidence-based interventions? The Deep Thinking with Dr Steven Stolz podcast at https://stevenstolz.com/podcast features in-depth conversations about mental health research and therapeutic approaches.
Bibliography - Post 4
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Clinical perfectionism: A cognitive-behavioural analysis. Behaviour Research and Therapy, 41(7), 773-791.
Rozental, A., Shafran, R., Wade, T., et al. (2017). A randomized controlled trial of Internet-based cognitive behavior therapy for perfectionism including an investigation of outcome predictors. Behaviour Research and Therapy, 95, 79-86.
Shafran, R., Cooper, Z., & Fairburn, C. G. (2002). Clinical perfectionism: A cognitive-behavioural analysis. Behaviour Research and Therapy, 40(7), 773-791.
Wade, T. D. (2022). Clinical perfectionism: Assessment and treatment. Flinders University Research Publications.
Clinical Perfectionism Questionnaire
