Brandelli Yvonne N, Mackinnon Sean P, Chambers Christine T, Parker Jennifer A, Huber Adam M, Stinson Jennifer N, Johnson Shannon A, Wilson Jennifer P
Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada.
Centre for Pediatric Pain Research, IWK Health, Halifax, NS, Canada.
J Pediatr Psychol. 2025 Feb 1;50(2):175-186. doi: 10.1093/jpepsy/jsae100.
Youth with juvenile idiopathic arthritis (JIA) experience elevated rates of internalizing symptoms, although more research is required to understand this phenomenon. Perfectionism, a multidimensional personality trait that involves dimensions such as striving for flawlessness (self-oriented perfectionism) and feeling that others demand perfection (socially-prescribed perfectionism), is a well-known risk factor for internalizing symptoms that has received minimal attention in pediatric populations. Preregistered hypotheses explored the relationships between youth and parent perfectionism and symptoms of depression and anxiety in youth with JIA, as mediated by (a) youth/parent negative self-evaluations and (b) youth self-concealment.
One hundred fifty-six dyads comprised of youth (13-18 years) with JIA and a caregiver completed online questionnaires about trait perfectionism, negative self-evaluations (i.e., pain catastrophizing and fear of pain), self-concealment, and internalizing symptoms.
Positive relationships were observed between parent/youth self-oriented perfectionism and negative self-evaluations, youth self-oriented perfectionism and internalizing symptoms, and youth negative self-evaluations and internalizing symptoms. Parent self-oriented perfectionism was negatively related to youth depression symptoms. Indirect effects were observed for youth self-oriented perfectionism predicting anxiety and depression symptoms through pain catastrophizing (a1b1 = 0.13 and 0.12, 95% CI [.03, .24 and .03, .22], respectively). Exploratory mediations suggested youth socially-prescribed perfectionism might predict internalizing symptoms directly and indirectly through self-concealment.
Youth and parent perfectionism are implicated in the internalizing symptoms of youth with JIA and may manifest through youth negative self-evaluations (e.g., catastrophic thoughts) and self-concealment. While future research is needed, screening for perfectionistic tendencies in this population may help guide assessment, prevention, and treatment efforts.
青少年特发性关节炎（JIA）患者出现内化症状的比率较高，不过仍需开展更多研究来了解这一现象。完美主义是一种多维度的人格特质，涉及追求完美无瑕（自我导向型完美主义）以及感觉他人要求完美（社会规定型完美主义）等维度，是一种已知的内化症状风险因素，但在儿科人群中受到的关注极少。预先登记的假设探讨了青少年和父母的完美主义与JIA青少年的抑郁和焦虑症状之间的关系，中介变量为（a）青少年/父母的负面自我评价和（b）青少年的自我隐瞒。
156对由患有JIA的青少年（13 - 18岁）及其照顾者组成的二元组完成了关于特质完美主义、负面自我评价（即疼痛灾难化和疼痛恐惧）、自我隐瞒和内化症状的在线问卷。
观察到父母/青少年的自我导向型完美主义与负面自我评价、青少年的自我导向型完美主义与内化症状、青少年的负面自我评价与内化症状之间存在正相关关系。父母的自我导向型完美主义与青少年的抑郁症状呈负相关。观察到青少年的自我导向型完美主义通过疼痛灾难化预测焦虑和抑郁症状的间接效应（a1b1分别为0.13和0.12，95%置信区间为[.03, .24]和[.03, .22]）。探索性中介分析表明，青少年的社会规定型完美主义可能直接和通过自我隐瞒间接预测内化症状。
青少年和父母的完美主义与JIA青少年的内化症状有关，可能通过青少年的负面自我评价（如灾难化思维）和自我隐瞒表现出来。虽然未来还需要开展研究，但对该人群进行完美主义倾向筛查可能有助于指导评估、预防和治疗工作。
