The Role of Perfectionism and Parental Expectations in the School Stress and Health Complaints of Secondary School Students

1 The role of perfectionism and parental expectations in the school stress and health complaints of secondary school students. Díez, Marta; Jiménez-Iglesias, Antonia; Paniagua, Carmen, and García-Moya, Irene. Department of Developmental and Educational Psychology, Universidad de Sevilla, Spain Marta Díez: https://orcid.org/0000-0001-5171-0668 Antonia Jiménez-Iglesias: https://orcid.org/0000-0001-6262-4001 Carmen Paniagua: https://orcid.org/0000-0002-8953-736X Irene García Moya: https://orcid.org/0000-0002-5377-315X Correspondence concerning this article should be addressed to Marta Díez, Departamento de Psicología Evolutiva y de la Educación. C/ Camilo José Cela s/n. 41018, Seville (Spain). Email: [email protected] Funding: This research was supported by grant PID2019-105463RA-I00 funded by MCIN/AEI/ 10.13039/501100011033. Marta Díez and Carmen Paniagua have received financial support from the European Social Fund and Junta de Andalucía (Call 2019, line 2, Paidi 2020). Irene García-Moya’s work is supported by grant RYC-2017-21626, funded by MCIN/AEI/10.13039/501100011033 and FSE “El FSE invierte en tu futuro”. 2 The role of perfectionism and parental expectations in the school stress and health complaints of secondary school students. Abstract Although perfectionism and parental expectations have an important role in school stress, their joint influence has not been evaluated nor have analyses taken a multidimensional perspective of school stress into consideration. The aims of this study were to analyse the role of self-oriented perfectionism and parental expectations in school stress, and to explore their potential moderation effect in the associations between school stress and health complaints. Sample consisted of 4,768 secondaryschool students (52.1% girls; M = 13.74) from 54 high schools in Andalusia (Spain), and school stress was measured using ASQ-S questionnaire. Results show that high self-oriented perfectionism and parental expectations were significantly associated with higher school stress. In addition, the three variables were significantly associated with health complaints, and self-oriented perfectionism moderated the relationship between stress of school-leisure conflict and health complaints. These findings should be taken into consideration for future research and interventions aimed at reducing school stress. Keywords: school stress; self-perfectionism; parental expectations; secondary school; adolescence. INTRODUCTION School is a primary source of stress for adolescents (Anniko et al., 2019; Wuthrich et al., 2020), ahead of other important stressors such as conflicts with parents, fitting in 3 with peers, or romantic relationships (Anniko et al., 2019). Accordingly, data from PISA show that 66% of students are stressed about poor grades, 55% feel anxious about school tests, and 37% feel tense when studying (OECD, 2019). Research exploring differences by sex, age, and socioeconomic status consistently find higher levels of school stress in girls than in boys (McKay et al., 2004; Moreno et al., 2020; Östberg et al., 2015; Schraml et al., 2011), in older versus younger adolescents (Inchley et al., 2020; Moreno et al., 2020), and in students with a lower socioeconomic status compared to those with a higher socioeconomic status (Xu et al., 2021). In addition, school stress has increased over time in Europe and North America (Löfstedt et al., 2020). Increases in school pressure, in turn, may help explain increases in adolescent health complaints (Cosma et al., 2020). Prior research confirms the association between school stress and health complaints (e.g. Haugland et al., 2003; Högberg et al., 2021; Moksnes & Espnes, 2020), identifying a higher association in girls than in boys (Redmond et al., 2022). Furthermore, Bor et al.’s (2014) systematic review on mental health prevalence studies shows an increase in mental health problems in children and adolescents in the 21st century compared to the 20th century, especially in internalized symptoms (anxiety, feeling low, feeling nervous, psychosomatic problems, etc.) among adolescent girls. Next, we summarize previous research on the influence of perfectionism and parental expectations on school stress and health complaints. Despite the general attention to this topic, research that has explored both perfectionism and parental expectations is relatively scarce, and to our knowledge no previous study has explored these variables while adopting a multidimensional assessment of school stress. For those reasons, this study aims to analyse the role of perfectionism and parental expectations in school 4 stress, as well as the associations of these variables with health complaints in secondary school students. The research proposes two specific aims: 1) To examine the role of self-oriented perfectionism and parental expectations on different types of students’ school stress (stress of school performance, stress of future uncertainty and stress of school leisure conflict), controlling the effects of sex, grade, and socioeconomic status. 2) To explore the possible moderator effect of self-oriented perfectionism and parental expectations in the relationship between types of school stress and health complaints. Perfectionism and its links with school stress and health complaints Perfectionism is “a multidimensional personality disposition characterized by striving for flawlessness and setting exceedingly high standards of performance accompanied by overly critical evaluations of one’s behavior” (Stoeber, 2018, p.3). The most common and accepted measures for perfectionism were developed towards the end of the 20th century by two different research teams. Frost et al. (1990) propose a predominantly self-focused model with six dimensions: concern over mistakes, doubts about actions, personal standards, parental criticism, parental expectations, and organization. On the other hand, Hewitt and Flett (1991) consider perfectionism to be a multidimensional construct including intra- and inter-personal content. Their scale has three dimensions: self-oriented perfectionism (establishing excessive personal standards and rigorously evaluating one’s own behavior); other-oriented perfectionism (expectations of perfection that one has for others); and socially prescribed perfectionism (a perception that other people expect them to be perfect and that others are harsh and punitive judges). The present research focuses on self-oriented perfectionism (Hewitt & Flett, 1991). 5 Two main models should be considered when trying to understand the links between personality variables and stress processes: stressor exposure and stressor reactivity (Bolger & Zuckerman, 1995). If one assumes a differential exposure model, personality is hypothesized to affect stress experiences by increasing exposure to specific stressors. Another possibility, referred to as the differential reactivity model, does not place the emphasis on the role of personality in exposure to stressors, but rather considers personality variables as potential moderators of the role of stressors on health outcomes. Given that exposure to school stressors is common among students in compulsory education, the differential reactivity model is particularly relevant in this context as a way to understand whether personality characteristics such as perfectionism may moderate the effects of school stressors on students’ health outcomes. In fact, higher levels of perfectionism have been associated with increased distress (Flett, Panico et al., 2011), and with school stress and maladjustment (Flett et al., 2016) in adolescents. Moreover, perfectionism is one factor considered to contribute to developing and maintaining anxiety disorders in children and adolescents (Affruniti & Woodruff-Borden, 2014), and generalized anxiety disorders in adults (Santanello & Gardner, 2007). Perfectionism is therefore a risk factor for certain adaptation difficulties among students such as anxiety, depression, and suicidal ideation (e.g. Flett, Coulter et al., 2011). Nevertheless, mental health in general and anxiety in particular are complex phenomena, meaning that several other factors besides perfectionism contribute to its development and maintenance (e.g., school stress; Cosma et al., 2020). Moreover, as noted above, perfectionism is multidimensional, with some types of perfectionism being associated with negative health outcomes (see e.g. passive perfectionism in Moore et al., 2010; and self-critical perfectionism in Levine et al., 2019), whereas others have been associated with better health outcomes (e.g., active perfectionism in Moore et al. (2010). 6 Despite that, if we focus on maladaptive perfectionism, it has been associated with chronic forms of cognitive perseveration, such as rumination, which activates the stress response and affects health problems (Flett et al., 2016). Research has found high levels of psychosomatic symptoms in adults with high levels of perfectionism that experience situations that threaten their self-esteem (Organista & Miranda, 1991). Likewise, studies have shown that University students with high levels of perfectionism tend to suffer health-related problems when exposed to stressful situations, such as fatigue (Dittner et al., 2011) and headaches (Bottos & Dewey, 2004). Therefore, chronic exposure to the stress that perfectionists experience –due to their constant efforts, internal pressures, and tendency towards rumination– can be considered a direct health risk (Molnar et al., 2018). To the best of our knowledge, few studies have focused on the relationship between perfectionism and psychological health in non-clinical samples of children and adolescents, and the scant existing research found that higher levels of perfectionism were associated with more psychological distress (e.g. O´Connor et al., 2010). However, there is a lack of consensus regarding the association between self-oriented perfectionism (the focus of this study) and wellbeing. Whereas some studies find an association between self-oriented perfectionism and psychological maladjustment and health symptoms during adolescence (e.g. Flett, Panico et al., 2011), research on university students associate self-oriented perfectionism with adaptive perfectionism and positive effects for emotional health (e.g. Cox et al., 2002; Enns et al., 2002). Parental expectations and its links with school stress and health complaints Parental expectations are defined as parents’ beliefs or judgements regarding their children’s future achievements (Glick & White, 2004), and are considered to have both direct and indirect influence on the child’s academic performance (Zhan, 2006). The 7 association between parental involvement and academic achievement has been thoroughly studied (Yamamoto & Holloway, 2010), and found to be stronger when assessments of parental involvement include parental expectations about academic achievement (Wilder, 2014). Similarly, parental expectations –along with educational style– were found to have the highest impact on student educational outcomes, ahead of other factors such as setting rules and parental involvement in extracurricular activities (Jeynes, 2007). Parental expectations also play an important role in adolescent school stress (e.g., Ang & Huan, 2006) and school-related burnout (Kiuru et al., 2008). Various empirical studies show that high academic demands from school and family are associated with a higher risk of stress-related health problems (e.g. Eriksson & Sellström, 2010; Laftman & Modin, 2012). Although parental expectations can help children develop the necessary skills for achieving academic goals, they can also have negative consequences if such expectations are unrealistic (Kaplan et al., 2001). In fact, studies show that high parental expectations increase adolescent academic stress (Ciciolla et al.2017; Leonard et al. 2015; Talha et al., 2020). Moreover, prioritizing academic achievements ahead of emotional health seems to have a negative effect on adolescent wellbeing, especially in middle-class families (Ciciolla et al., 2017; Luthar et al., 2013). Along the same lines, Agliata and Renk (2009) found an association among discrepancies that adolescents perceive between parental expectations and their performance, and high levels of anxiety, depression, and distress. Research by Ma et al. (2018) also found a significant association between high parental expectations and adolescent depression. Study hypotheses 8 Based on the state of the art described throughout this section (e.g. Ciciolla, et al., 2017; Bolger & Zuckerman, 1995; Flett et al., 2016; Talha et al., 2020), the following hypotheses guide the present study: 1) Self-oriented perfectionism and high parental expectations will be significantly associated with higher level of school stress. However, those associations may vary depending on the type of school stress. 2) The three types of school stress will be significantly associated with increased health complaints. 3) Self-oriented perfectionism and parental expectations may moderate the relationship between school stress types and health complaints. METHOD Participants The sample included 4,768 secondary school students (47.9% boys, 52,1% girls) aged 11 to 17 years (M = 13.74; SD = 1.30). In the Spanish secondary-school system, 24.58% of students were in 1st grade (12-13 years-old), 27.12% in 2nd grade (13-14 years-old), 23.13% in 3rd grade (14-15 years-old) and 25.16% in 4th grade (15-16 years-old). Students in the study sample attended one of 54 schools in Andalusia (an autonomous community in southern Spain) that participated in project EASE –a project focused on studying school stress in secondary education– during the 2020-2021 academic year. The sample was selected through multistage sampling by conglomerates using the schools as the main sampling units. A representative sample of 3,725 students were randomly selected from 45 schools considering school type (state vs. private) and geographic area (differentiating between the 8 provinces of Andalusia). Given that data collection took place during the COVID-19 pandemic, there was concern that the situation in the classrooms might negatively affect recruiting. Specifically, during the 9 data collection period, there were peaks in infection rates, which in some schools resulted in interruptions of face-to-face lessons for specific class groups, lower attendance, etc. As a contingency plan in case those challenges significantly discouraged school participation, an additional sample of 1043 students from 9 schools were selected using convenience sampling in order to avoid possible difficulties that could affect research viability. These students were included in the general sample due to their similarities, both in demographics (sex, age, and socioeconomic status) and level of school stress. Measures In addition to self-reported sex (boy/girl), grade (grade 1/grade 2/grade 3/grade 4), and socioeconomic status (high/low), the following measures were used: School stress: School stress was measured using the ASQ-S (Anniko et al., 2018), a short version of the revised Adolescent Stress Questionnaire-ASQ2 (Byrne et al., 2007). Students reported how stressful they found different situations to be in the past 6 months. The subscales on stress of school performance (e.g. having to study things you don´t understand), stress of future uncertainty (e.g. concern about your future) and stress of school-leisure conflict (e.g. not getting enough time for leisure) were used. The sum score was calculated for each of the subscales (3 items per scale), with higher scores indicating higher levels of the examined type of school stress. McDonald’s omega was .768 for stress of school performance, .858 for stress of future uncertainty, and .750 for stress of school-leisure conflict. Self-oriented perfectionism: Six items (e.g. I want to be the best at everything I do) were selected from the self-oriented perfectionism scale from the Child-Adolescent Perfectionism Scale (CAPS) (Flett et al., 2016). The mean score was calculated, with 16 who perceive parental expectations to be unachievable may suffer negative consequences (Ciciolla et al., 2017), coinciding with prior research that found a relationship between parental criticism and adolescent somatic symptoms (Horwitz et al., 2015). In addition, self-oriented perfectionism was found to be associated with health complaints, as in previous research (O´Connor et al., 2010). Furthermore, perfectionism moderated the relationship between stress of school-leisure conflict and health complaints. Specifically, our results for the role of self-oriented perfectionism in the case of stress of school-leisure conflict are consistent with the differential reactivity model (Bolger & Zuckerman, 1995), given that stress of school-leisure conflict was associated with more health complaints only for adolescents reporting high perfectionism. In contrast, the differential reactivity model was not supported by our results about stress of school performance and stress of future uncertainty. 17 Strengths and limitations This study has some limitations that should be considered. First, only self-oriented perfectionism was examined. Although self-oriented perfectionism contributed significantly to explaining school stress and health complaints, incorporating other perfectionism scales –such as other oriented-perfectionism, and socially prescribed perfectionism (Hewitt & Flett, 1991)– may offer a more comprehensive explanation. Nonetheless, our study analyses the role of parental expectations, which is considered to be relevant factor in other models of perfectionism (Frost et al., 1990). Second, a high levels of explanation was achieved for health complaints, the level of explanation of perfectionism and parental expectations on school stress was low, calling for the need to incorporate other family and personality factors in future research on school stress. The achieved level of explanation when considering the moderation effect of perfectionism in the associations between stress of school-leisure conflict and health complaints was also small, which must be taken into consideration when interpreting this finding. Finally, directionality in the associations cannot be established due to the study’s crosssectional design. Future research can contribute to expand these findings and explore longitudinal associations between the examined variables, thereby providing additional light on the directionality of the associations reported in the present study. Despite these limitations, this study contributes to a deeper understanding of school stress and health complaints in secondary school students. Results indicate that selforiented perfectionism associates with higher school stress and health complaints, and it also moderates the relationship between stress of school-leisure conflict and health complaints. Furthermore, high parental expectations are significantly associated with higher levels of school stress and more health complaints. 18 Implications These findings can be useful for developing interventions aimed at reducing adolescent school stress, which, considering its high level in secondary school (Anniko et al., 2019; Wuthrich et al., 2020) and the negative implications for adolescent wellbeing (e.g. Haugland et al., 2003; Högberg et al., 2021; Moksnes & Espnes, 2020), should be an educational priority. Also, from a research perspective, it is important that the multidimensional nature of school stress is considered in future research, that may also contribute to provide additional insights in the described moderation effects. Conclusion One of the main findings from this study was that high parental expectations were associated higher school stress, with the magnitude of the association being very similar for the three school stress types. The role of self-oriented perfectionism was similarly important for stress of future uncertainty, and showed a lower-magnitude association with stress of school-leisure conflict. Stress of school performance showed the strongest association with health complaints, with parental expectations and stress of future uncertainty also contributing to explaining health complaints. 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