Perfectionism and Chronic Pain: A Scoping Review.

Abstract

Objectives: Perfectionism has been implicated in psychological and health problems, but its role in chronic pain remains unclear. This scoping review aimed to map and summarize quantitative evidence of associations between perfectionism and pain-related outcomes.

Design: Scoping review conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR).

Data sources: PubMed, CINAHL, APA PsycINFO and Scopus.

Review/analysis method: Peer-reviewed, quantitative English-language studies examining perfectionism and chronic or recurrent pain were eligible. Two reviewers independently screened records, extracted data, and completed Joanna Briggs Institute critical appraisal tools. Findings from 15 studies were summarized narratively.

Results: Maladaptive perfectionism was generally associated with greater pain intensity, functional interference, and adverse cognitive-affective and somatic outcomes. A few studies reported inverse associations, such that greater maladaptive perfectionism was associated with lower pain intensity or less pain catastrophizing. Adaptive perfectionism was examined less often and showed mixed findings. Its unique effects were typically weaker, indirect, or no longer significant after accounting for maladaptive perfectionism or covariates.

Conclusions: Perfectionism, particularly maladaptive facets, appears more often to function as a vulnerability than a resource in chronic pain. However, conclusions remain tentative because the evidence base is heterogeneous, predominantly cross-sectional, and inconsistent in some areas. Research has also focused disproportionately on maladaptive dimensions, limiting understanding of adaptive perfectionism.

Nursing practice implications: Assessing perfectionism-related tendencies may help clinicians identify patients at risk for cognitive-affective distress, maladaptive activity patterns, and functional interference, supporting more individualized chronic pain assessment and intervention development.