The current study examined the associations among dimensions of perfectionism, Type A behavior, self-efficacy, distress, and health symptoms in high school students. A sample of 73 high school students (34 boys, 39 girls) completed measures of self-oriented perfectionism, socially prescribed perfectionism, Type A behavior, self-efficacy, depressive symptoms, and psychosomatic symptoms. Correlational analyses found that self-oriented perfectionism was marginally related to Type A behavior. Students with elevated levels of depressive symptoms were also characterized by self-oriented perfectionism, Type A behavior, low self-efficacy, and health symptoms. In addition, health symptoms were linked with low self-efficacy. Simultaneous entry of several variables into a regression analysis found that significant unique predictors of depression were low self-efficacy and elevated selforiented perfectionism. Similarly, a regression analysis found that low self-efficacy and high self-oriented perfectionism were unique predictors of health symptoms. The findings highlight the distinctions between the perfectionism and the Type A constructs, and support self-regulation models of depression and physical symptoms that include an emphasis on excessive perfectionistic standards and low self-efficacy. We discuss the need for preventive interventions designed for perfectionistic adolescents with low self-efficacy.