The relationship between perfectionism and symptoms of depression in medical school applicants

Abstract

Background The association between perfectionism and depression in the medical profession can ultimately influence physicians’ performance negatively. In medical students, especially maladaptive perfectionism is connected with distress and lower academic performance. The expression of perfectionism and symptoms of depression at the time of medical school application is not known. Therefore, we explored perfectionism and symptoms of depression in participants of multiple mini-interviews for medical school admission and investigated possible differences between applicants who were eventually admitted or rejected. Methods After the multiple mini-interviews admission procedure at Hamburg Medical School in August 2018, 146 applicants filled out a questionnaire including sociodemographic data and the following validated instruments: Multidimensional Perfectionism Scale by Hewitt and Flett (MPS-H), Multidimensional Perfectionism Scale by Frost (MPS-F), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7), and a 10-item version of the Big Five Inventory (BFI-10). The two groups of admitted and rejected applicants were compared and the correlation between symptoms of depression and perfectionism further explored. Results The admitted applicants were significantly more extrovert and had lower depression scores compared to the rejected applicants. In both groups, the composite scales of Adaptive Perfectionism (r = .21, p = .011) and Maladaptive Perfectionism (r = .43, p < .001) as well as their components correlated significantly with the PHQ-9 results. Maladaptive Perfectionism accounted for about 18% of variance in the PHQ-9 score. Conclusions Rejected medical school applicants who participated in a multiple mini-interviews admission procedure showed higher levels of depression symptoms than admitted applicants. The degree of depressive symptoms can be partly explained by Maladaptive Perfectionism scores. Since coping in medical school and in postgraduate medical education require robust mental health, perfectionism questionnaires could be an additional tool in medical school selection processes.

Elevated psychological distress in undergraduate and graduate entry students entering first year medical school

“…If students are entering the course with distress it is important to consider whether initial screening of candidates for psychological distress is appropriate [ 33 ]. It has been suggested that the addition of psychological screening may allow for selection of more resilient medical students [ 34 – 36 ]. Psychological screening is used in other high stress jobs such as police, military, and airline pilots [ 37 , 38 ].…”

Parenting Style and Emotional Distress Among Chinese College Students: A Potential Mediating Role of the Zhongyong Thinking Style

“…The diathesis-stress model could help explain why Zhongyong thinking could be related to college student’s emotion. Based on the diathesis-stress model, individuals with some personality traits, such as poor self-esteem ( Nguyen et al, 2019 ), low self-directedness and cooperativeness ( Lim et al, 2018 ), low agreeableness ( Roman et al, 2019 ), and high perfectionism ( Bußenius and Harendza, 2019 ), may predispose them to develop more depression and anxiety symptoms. Results from two cross-sectional studies demonstrated that Chinese adults with high level of Zhongyong thinking style had few depressive and anxiety symptoms ( Zhan et al, 2013 ; Yang et al, 2016 ).…”

Need for cognitive closure, tolerance for ambiguity, and perfectionism in medical school applicants

“…At the Medical Faculty of Hamburg University, the selection process for medical school applicants includes a natural science test (HAM-Nat) in a first step [8] and multiple mini-interviews (HAM-Int) in a second step [9,10] besides high school grade point averages. We already detected that rejected applicants who participated in the multiple mini-interviews (HAM-Int) showed higher levels of depressive symptoms than admitted applicants [11]. This can be partly explained by maladaptive perfectionism [11], which is an important finding becausein contrastadaptive perfectionism [12] has been described to be highest in medical school applicants admitted by their grade point average only [13].…”

“…We already detected that rejected applicants who participated in the multiple mini-interviews (HAM-Int) showed higher levels of depressive symptoms than admitted applicants [11]. This can be partly explained by maladaptive perfectionism [11], which is an important finding becausein contrastadaptive perfectionism [12] has been described to be highest in medical school applicants admitted by their grade point average only [13]. Furthermore, adaptive perfectionism shows a general decrease during undergraduate medical studies independent of the admission procedure [14].…”

“…Hence, studies with medical school applicants are needed to investigate aspects which are relevant for physicians to perform well in their job for a functional health care system and to stay healthy at the same time [2,26,27]. Especially personality aspects like perfectionism, ambiguity tolerance, and need for cognitive closure [2,11,17,28] could be desirable targets in medical student selection to measure applicants' capacity for adapting and coping with uncertainty and decision making. Currently, these personality aspects are not included in our multiple mini-interviews, which measure psychosocial competencies such as empathy, communication skills, and self-regulation [8,10].…”