Perfectionists May Face Increased Risk for Severe Alcohol Use Disorder

  • Alcohol use disorder is a mental health condition characterized by an ability to stop or control alcohol use despite its negative social health, or occupational impacts.
  • People with this condition may experience mild, moderate, or severe symptoms.
  • New research suggests that personality traits such as perfectionism may increase a person’s vulnerability to severe forms of alcohol use disorder.
  • In the study, scientists found that certain types of perfectionism may play a greater role in the development of severe alcohol use disorder than others.
  • Still, other personality traits and mental health conditions may also be risk factors for the condition.

Alcohol use disorder (AUD) is recognized as a mental health condition by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR). It affects around 14 million adults in the United States and is the third leading preventable cause of death.

A person with AUD may have mild, moderate, or severe forms of the disorder, depending on the number of diagnostic criteria met.

Although there is no primary or dominating individual risk factor for developing AUD, the World Health Organization (WHO) suggests that age, gender, family circumstances, and socioeconomic status may play a role. What’s more, a 2018 study found that people with impaired cognitive control, impulsivity, and negative emotions may be more likely to develop AUD.

According to a new studyrecently published in Alcoholism: Clinical & Experimental Research, traits such as perfectionism and self-criticism — leading to social disconnection — may contribute to an increased risk of developing severe alcohol use disorder (SAUD).

In the study, researchers from Belgium recruited 65 adults with SAUD undergoing inpatient treatment and 65 adults without the condition.

Each participant completed the Hewitt Multidimensional Perfectionism Scale to evaluate three forms of perfectionism. These include:

  • Self-oriented perfectionism: exaggerated performance standards placed on oneself.
  • Socially-prescribed perfectionism: a perception of high expectations coming from other people.
  • Other-orientated perfectionism: setting unrealistically high standards for others.

In addition to perfectionist tendencies, the researchers evaluated symptoms of depression and anxiety in each participant. Specifically, they looked at trait anxiety, which is anxiety related to a person’s broad experience, and state anxiety, a type of anxiety resulting from a specific situation.

After processing the data, scientists discovered that study participants with SAUD reported higher trait anxiety and symptoms of depression than the control group.

According to a press release, when the researchers accounted for anxiety and depressive symptoms, they found that study participants with SAUD exhibited greater self-oriented and socially-prescribed perfectionist traits than the control group. Specifically, they found unrealistic personal standards and increased sensitivity to other people’s expectations.

However, there were no differences in other-oriented perfectionism among both groups.

Furthermore, study data suggests that self-oriented perfectionism in people with SAUD may be more prevalent in males and individuals with more education. By contrast, the researchers found that self-oriented perfectionism was not associated with alcohol misuse among moderate drinkers in the control group.

The researchers noted that these results are consistent with other known self-related and interpersonal risk factors for SAUD. These include:

  • low self-esteem
  • engaging in self-blame
  • impaired social cognition
  • discrepancies between an individual’s view of their actual self and their ideal self

They concluded that SA appears to be directly associated with elevated perfectionism beyond the influence of other cooccurring psychological conditions. They added that future research should examine the various types and degrees of perfectionism and the roles they may play in developing and treating SAUD.

Johnathan M. Sumpter, MBA, MA, LPC-S, director at the University of Dallas Counseling Center (UDCC) and founder and CEO of The Mental Well, supports the theory that perfectionism may lead to alcohol misuse in some people.

“People misuse alcohol to de-stress [or] Relax, numb anxious or depressive feelings, attempt to escape problems, to be disinhibited or to feel freer to do things, to fit in socially or have more fun, or may have some genetic pre-disposition towards alcoholism,” Sumpter told Healthline.

“Perfectionism usually causes stress and negative thoughts [or] emotions. As such, many perfectionistic individuals retreat to alcohol to manage those feelings.”

Sumpter added that how individuals with perfectionist traits perceive perfectionism may also limit their ability to reach out for help with their alcohol use. He said they might feel like they “should” be able to handle their emotions and alcohol use “perfectly” on their own.

According to Dr. Lawrence Weinstein, chief medical officer at American Addiction Centers, one dimension of perfectionism may be more likely to increase the risk of AUD.

Dr. Weinstein explained that “perfectionism has two key dimensions — perfectionistic strivings, which can include pursuing one’s high personal standards — and perfectionistic concerns, which would include self-criticizing behavior as a result of not meeting one’s own high personal standards.”

He noted that multiple studies have made positive associations between self-criticizing perfectionism and alcohol-related problems.

“Perfectionists that intensely and negatively self-criticize often drink in order to cope with negative emotions and self-perception for not achieving personal standards that they’ve set or to conceal behaviors that they deem imperfect,” Weinstein said.

Weinstein told Healthline that certain personality traits other than perfectionism might predict an increased risk of AUD.

Neuroticism, which can present as high impulsivity, anxiety, [or] emotional instability, has a strong association with alcohol use and alcohol misuse,” he said. “Additionally, low levels of conscientiousness, which can present as disinhibition, has also been associated with alcohol dependence.”

Weinstein added that personality traits like extraversion and agreeableness — which may present as high excitement seeking and low trust — have also been predictors of elevated alcohol consumption.

According to Sumpter, shame is also a driving force behind substance use disorders.

“Shame is part of the addictive cycle — internal frustration, fantasizing, obsessing, acting out, loss of control, shame and guilt, cessation of use, and passage of time,” Sumpter said. “The inner critic can disrupt helpful thoughts and push us deeper into each point of the cycle.”

Research shows a link between perfectionist personality traits and severe alcohol use disorder.

A person’s propensity toward negative thinking and self-criticism may lead to excessive drinking to cope, but other personality traits, such as neuroticism, extraversion, agreeableness, and shame may also play a role in severe alcohol consumption.

According to the Belgian researchers, future studies could investigate the causal links between perfectionism and other risk factors of AUD, including impulsivity and self-blame, to better understand how certain personality traits may lead to excessive drinking behaviors.

If you or someone you know may be drinking too much and are in need of support, help is available to get you the treatment you need.

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