Psico-USF, Bragança Paulista, v. 27, n. 1, p. 73-85, jan./mar.

2022 73

Cross-cultural adaptation of the Clinical Perfectionism Questionnaire (CPQ) for Brazilians

Luiz Fellipe Dias da Rocha1

José Augusto Evangelho Hernandez1
Eliane Mary de Oliveira Falcone1
Marcelo Leonel Peluso¹
¹Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brasil

Abstract
The goals of this paper are the cross-cultural adaptation and psychometric properties evaluation of the Brazilian version of
the Clinical Perfectionism Questionnaire (CPQ), a scale that measures the tendency of a person to pursue self-demanding stan-
dards and the subjective consequences provided by achieving them or not. The original instrument was translated to Portuguese
and back-translated to English. The preliminary version was judged by one of the authors of the instrument and by Brazilian
specialists, producing content validity indicators. The final version was applied to a sample of 250 Brazilian undergraduate
students, aged from 18 to 60 years old (M=24.9, SD=8.63), mostly female (76%). In the Exploratory Factor Analysis, data have
revealed a bidimensional structure, and the other psychometric properties, such as internal consistency and validity regarding
other variables, have shown adequate to the instrument. Additional analyses of unidimensional congruence reinforced the
multidimensionality of the measure.
Keywords: perfectionism; personality traits; translation; test validity; psychometrics.

Adaptação Transcultural do Clinical Perfectionism Questionnaire (CPQ) para brasileiros

Resumo
Os objetivos deste artigo são a adaptação transcultural e a avaliação das propriedades psicométricas da versão brasileira do
Clinical Perfectionism Questionnaire (CPQ), escala que avalia a tendência de a pessoa perseguir elevados padrões de exigência autoim-
postos e as consequências subjetivas decorrentes de alcançá-los ou não. O instrumento original foi traduzido para o português
e retrotraduzido para o inglês. A versão preliminar foi julgada por um dos autores do instrumento e por especialistas brasileiros,
gerando indicadores de validade de conteúdo. A versão final foi aplicada em uma amostra de 250 estudantes universitários
brasileiros, com idades entre 18 e 60 anos (M = 24,9, DP = 8,63), majoritariamente do sexo feminino (76%). Na análise fato-
rial exploratória, os dados revelaram uma estrutura bidimensional, e as demais propriedades psicométricas, como consistência
interna e validade em relação a outras variáveis, mostraram-se adequadas para o instrumento. Análises adicionais de congruência
unidimensional reforçaram a multidimensionalidade da medida.
Palavras-chave: perfeccionismo, traços de personalidade, tradução, validade do teste psicometria

Adaptación transcultural del Clinical Perfectionism Questionnaire (CPQ) para brasileños

Resumen
Los objetivos de este artículo son la adaptación transcultural y la evaluación de las propiedades psicométricas de la versión
brasileña del Clinical Perfectionism Questionnaire (CPQ), una escala que evalúa la tendencia de la persona a perseguir altos niveles de
exigencia autoimpuestos y las consecuencias subjetivas resultantes de alcanzarlos o no. El instrumento original fue traducido al
portugués y retrotraducido al inglés. La versión preliminar fue juzgada por uno de los autores del instrumento y por expertos
brasileños, generando indicadores de validez de contenido. La versión final se aplicó a una muestra de 250 estudiantes universi-
tarios brasileños, con edades comprendidas entre los 18 y los 60 años (M=24,9, DS=8,63), en su mayoría mujeres (76%). En el
análisis factorial exploratorio, los datos revelaron una estructura bidimensional, y las demás propiedades psicométricas, como la
consistencia interna y la validez en relación con otras variables, resultaron adecuadas para el instrumento. Análisis adicionales de
congruencia unidimensional reforzaron la multidimensionalidad de la medida.
Palabras clave: perfeccionismo; rasgos de personalidad; traducción; validez del test; psicometría.

The attention paid to perfectionism has been Shafran, Cooper, & Fairburn, 2002). Furthermore, the
growing, especially because this variable has been presence of perfectionism has been pointed out as an
highlighted as a transdiagnostic process, that is, a set obstacle for the treatment of several mental disorders,
of cognitive or behavioral aspects that perform an for example, impairing the well-succeeded engagement
important role in the etiology, maintenance and course of the patient (Egan et al., 2011; Shafran et al., 2002).
of several psychopathological states (Egan, Wade, & Perfectionism might be defined as a personality
Shafran, 2011; Egan, Wade, Shafran, & Antony, 2014; trait characterized by the setting of high self-demanding
Disponível em www.scielo.br http://dx.doi.org/10.1590/1413-82712022270106
74 Rocha, L. F. D. & cols. Cross-cultural adaptation of the CPQ

standards and effort towards perfection achievement the relationship between perfectionism and psycho-
(i.e., flawless state), in general, accompanied by self- pathology verify the single effect of each one of the
criticism (Stoeber, 2018). In this context, a perfectionist dimensions (Limburg et al., 2016; Stoeber, 2020).
individual has demanding criteria for defining one’s suc- Similar results have been found by another meta-
cess, strives to achieve high standards and avoid failures analysis that investigated the longitudinal relation
– or what is judged as failure – and makes critical evalu- between perfectionism and depression symptoms in
ations about one’s behavior and self-worth. 10 studies with different samples (Smith et al., 2016).
Although, several times, perfectionism is referred After the depression symptoms control at the baseline,
in singular, an increasing number of studies suggests both PS and PC revealed a little effect over depression
that its components are divided into two correlated symptoms throughout time. However, after the PC
dimensions, named, hegemonically, Perfectionistic control at the baseline, PS no longer predicted depres-
Strivings (PS) and Perfectionistic Concerns (PC) (Stoe- sion symptoms, indicating that PS granted vulnerability
ber, 2018). The first covers cognitions and behaviors to depression symptoms through PC’s overlap.
related to setting high self-demanding standards and Another meta-analysis verified the relationship
pursuing them, while the second includes cognitions between perfectionism and anxiety symptoms in 11
and behaviors concerning imperfections and their longitudinal studies with different samples (Smith,
negative consequences (Stoeber, 2018, 2020). In other Vidovic, Sherry, Stewart, & Saklofske, 2018). The
words, the PS dimension is based on the perfection PC dimension and, to a minor extent, PS predicted
expectation and motivation to do as best, whereas the an increase in anxiety symptoms throughout time.
PC dimension is connected to the fear of failing and Notwithstanding, observed effects were of marginal-
to the motivations to avoid the error (Slade & Owens, small magnitude after the anxiety symptoms control
1998; Stoeber, 2020). Even though it may seem, initially, at the baseline.
that one dimension is positive and another negative, this Since perfectionism has been associated with
must be an empirical question, that is, whether and to a range of psychopathological indicators, besides
what degree the dimensions of perfectionism are adap- being able to create obstacles in the psychotherapeu-
tive or maladaptive depends on researches that relate it tic treatment and holds two dimension with distinct
to other variables. relations with psychopathological outcomes, assessing
In this sense, one of the main contributions of it accurately is essential to the advance of scientific
the bi-dimensional perspective of perfectionism is knowledge concerning this field and the development
the finding that each dimension presents distinct rela- of an Evidence-Based Practice in Psychology. Among
tionships with the psychopathological symptoms and the available instruments to evaluate perfectionism, the
conditions (Stoeber, 2020). A meta-analysis performed Clinical Perfectionism Questionnaire (CPQ) (Fairburn,
with 284 empirical studies – mostly cross-sectional – Cooper, & Shafran, 2003) is detached.
revealed that both perfectionistic dimensions were The CPQ was developed aiming at the measure-
positively correlated to psychopathological outcomes ment of perfectionism through a cognitive-behavioral
(i.e., mental disorders, symptoms of mental disorders conceptualization, in which this construct is defined as
and outcomes related to psychopathology, as suicidal a subordination of self-worth to the capacity of achiev-
ideation and general psychological distress) (Lim- ing self-imposed and high levels of demands (Shafran
burg, Watson, Hagger, & Egan, 2016). It means, the et al., 2002). Thus, according to the cognitive processing
higher the levels of PS and PC, the higher the levels of clinical perfectionism, reaching high self-demanding
of psychological maladjustment indicators. Never- standards grants self-worth, whereas not reaching them
theless, single effect values of PC have shown to be evokes thoughts about being a failure as a person (Fair-
superior to those of PS, after these dimensions’ over- burn et al., 2003; Shafran et al., 2002). Based on this,
lap control (β ≤ 0.70 and β ≤ 0.25, respectively). The the 12 items of CPQ measure the tendency of a person
authors concluded, therefore, that PS are less related to pursue self-demanding standards and the subjective
to psychopathology when compared to PC, and both consequences provided by achieving them or not (Egan
perfectionistic dimensions are positively correlated et al., 2014).
between each other, what tends to inflate the relation The main differential of CPQ is that it seeks to
of PS with psychopathology indicators. This way, it measure core characteristics of perfectionism (Shafran
is necessary that studies addressing the analysis of et al., 2002). For Shafran et al. (2002), many items from
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 Rocha, L. F. D. & cols. Cross-cultural adaptation of the CPQ 75

other scales do not evaluate integral elements of perfec- In another sample composed by patients with Eat-
tionism, but assess related constructs, as beliefs about ing Disorders, Prior et al. (2018) tested, through CFA,
other people´s standards and the perception that others three models of CPQ: unidimensional, two oblique
pressure the individual to be perfect. In addition, CPQ factors and bifactor. Fit was revealed as poor for the
was built on the basis of a clinically-based construct first two models, and the bifactor model was not able
of perfectionism, that is, it captures the core psycho- to converge. After the exclusion of items 2 and 8, a
pathological aspects of perfectionism, as morbid fear bifactor model presented good fit to data: a global fac-
of failure, dichotomous thinking (i.e., operationaliza- tor with 10 items and a specific factor (PS) with seven
tion of standards in the form of rules that are either items.
met or not), and selective abstraction (i.e., paying more Similarly, Howell et al. (2020) compared the
attention to negative perfectionism-relevant informa- unique factor, two factors and bifactor models with
tion than to positive information). scores from the 10-item version of CPQ (i.e., without
Although clinical perfectionism has been theo- items 2 and 8). The results also provided bigger support
retically conceptualized as unidimensional by Shafran to the bifactor model, with a global and two specific
et al. (2002), validity studies that investigated the latent factors. Additional analyses were performed in order
structure of CPQ are not consensual regarding the to verify whether the instrument is predominantly uni-
number of factors. The majority of studies with differ- dimensional. Out of the four indicators generated to
ent samples found the presence of two similar factors that end, two (i.e., Omega and H Coefficient) indicated
to PS and PC dimensions (Dickie, Surgenor, Wilson, a predominance of the global factor, while the other
& McDowall, 2012; Egan et al., 2016; Moloodi, Pour- two (i.e., Percent uncontaminated correlations and
shahbaz, Mohammadkhani, Fata, & Ghaderi, 2017; explained common variance) did not confirm the uni-
Stoeber & Damian, 2014). It is, one factor comprises dimensionality of the instrument.
the items related to demanding standards, while the In summary, the factorial structure of CPQ is not
other embraces the items regarding failure and its con- consensual. Most studies found two dimensions, as well
sequences. However, more recent studies have found a as from other instruments that measure perfectionism.
global factor for the instrument in addition to specific According to the results of these studies, PS and PC
factors through bifactor approach (Howell, Anderson, measured by the CPQ are two different factors, how-
Egan, & McEvoy, 2020; Prior et al., 2018). ever related to one another — correlations between
Dickie et al. (2012), through principal compo- 0.23 and 0.48 (Dickie et al., 2012; Egan et al., 2016;
nents analysis (PCA) and varimax rotation, found the Stoeber & Damian, 2014). Some items presented sub-
two mentioned factors. Nevertheless, items 8 (“to do stantial factor loading in both factors (i.e., 1 ‘pushing
just enough to get by”) and 7 (“to judge oneself on oneself really hard to meet goals’, 7 ‘judging oneself
the basis of the ability to achieve high standards”) were on the basis of the ability to achieve high standards’
removed due to low item-total correlation and cross- and 8 ‘doing just enough to get by’), indicating a non-
loading, respectively. PCA from Stoeber and Damian discriminative capacity (Dickie et al., 2012; Egan et al.,
(2014) found similar results, but with four out of the 12 2016; Stoeber & Damian, 2014).
items presenting crossloading. These researchers per- In another direction, two recent studies found that
formed an Exploratory Factor Analysis (EFA) and the the bifactor model has indicated good fit to data based
results also revealed two factors, but the crossloadings on CFA in some cases, which suggests the coexistence
on items 7 and 8 persisted. of specific and global factors (Howell et al., 2020; Prior
Egan et al. (2016), through EFA, carried out two et al., 2018). In this sense, the two specific factors of
studies: one with a non-clinical sample and the other the CPC (i.e., PS and PC) could be combined into a
with a sample of individuals with Eating Disorders. general factor that holds all items.
Solutions of two factors for CPQ were extracted in Besides factorial structure analysis, reverse items
both studies, but items 1, 7 and 8 presented crossload- (i.e., 2 ‘tendency to focus on what one has achieved,
ing. Internal Consistency of the measure was adequate, rather than on what one have not achieved’ and 8)
as well as the discriminative capacity between the clinical demonstrated little impact on the global score through
and non-clinical samples. Moloodi et al. (2017), through the CITC calculation, suggesting that they do not con-
Confirmatory Factor Analysis (CFA), have found simi- tribute significantly to the CPQ global score (Dickie
lar results regarding CPQ psychometric properties. et al., 2012; Moloodi et al., 2017; Stoeber & Damian,
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76 Rocha, L. F. D. & cols. Cross-cultural adaptation of the CPQ

2014). The factors’ internal consistency has shown to the original version of the scale, minding the original
be acceptable through Cronbach’s alpha in all validity meaning.
studies (0.69 ≤ α ≥ 0.80). A study investigated the tem- Stage 3 - Back-translation: the consensual version
poral stability of the instrument, finding moderate rates was back-translated to the original language by a Por-
of reliability (Dickie et al., 2012). tuguese proficient translator, whose maternal language
As proposed by Shafran et al. (2002), CPQ aims is English, completely unfamiliar with the original
to capture the most central and pathological elements scale and without previous knowledge of Psychology
of the perfectionism, through a cognitive-behavioral or Health Science. The back-translated version was,
conceptualization. In this sense and considering that then, sent to the original scale authors, towards check-
perfectionism (or at least one of its factors) is transdi- ing whether the items were reflecting the same content
agnostic, this instrument can be used as an important than the originals.
clinical indicator for the prevention and treatment of Stage 4 - Committee Approach: the preliminary
several mental disorders. However, as it was observed, version of the instrument in Portuguese was submit-
some questions remain open regarding its psychomet- ted to five qualified judges’ evaluation (psychologists,
ric properties, especially its factorial structure. Thus, in doctors in Psychology and with theoretical and prac-
order to contribute to the fulfillment of gaps previously tical Clinical Psychology expertise). These judges
mentioned, the goals of this paper are the cross-cultural classified each item through a Likert-type scale from
adaptation (Study 1) and psychometric properties eval- 1 (“very little”) to 5 (“very much), regarding language
uation (Study 2) of the Brazilian version of the CPQ. clarity, theoretical relevance, and practical pertinence.
From these scores, the Content Validity Coefficient
Study 1 (Hernández Nieto, 2002) for each item (CVCitem) and
The present study aims at the cross-cultural adap- the instrument as a whole (CVCtotal) was calculated.
tation of the CPQ with 12 items for Brazilians, which The error calculation for each item was also per-
consists in its translation to Portuguese and its content formed in order to eliminate possible biases from the
validity verification. judges. Hernández Nieto (2002) recommended that
acceptable CVC’s must present values equal or supe-
Methods rior than 0.80, which indicates 80% of concordance
among the judges.
In consonance with scientific literature about Stage 5 – Discussion Groups: three discussion
instruments cross-cultural adaptation (Pacico, 2015; groups were organized with undergraduate students in
Pasquali, 2013), the following stages have been pursued: order to evaluate the items’ semantics. Each item was
Stage 1 - Forward Translation: the translation from presented and the participants described, with their
the original language (i.e., English) to Portuguese was own words, what they understood. The items that
performed by two English proficient translators, whose showed consensus related to the comprehension were
maternal language is Brazilian Portuguese. The first maintained.
translator is a psychologist with clinical expertise and
was informed about the scale’s purpose. The second Results and Discussion
was neither informed about the construct measured
by the instrument, nor is a professional from Psychol- Concerning the CVCtotal, the language clarity was
ogy or Health Science. This translator is called a ‘naïve 0.94, the theoretical relevance was 0.98 and the practi-
translator’ and is employed in order to offer a language cal pertinence was 0.98, indicating satisfactory content
that is closer to the general population, since there is validity. Basically, all items in portuguese reached CVCitem
no influence from the knowledge area. The translations superior to 0.80 on the three rated dimensions, sug-
were performed independently. gesting high concordance among the evaluators. The
Stage 2 - Synthesis: both versions of the scale, only exception was item 8, regarding language clarity
produced in the previous stage, were compared by a dimension (CVCitem = 0.76). In this case, the item was
committee composed of the first author, his doctoral reformulated according to the judges’ suggestions. In
advisor and the doctoral students from his research the next step, all items presented good and consensual
group aiming at a consensus version. This prelimi- comprehension among the participants of the discus-
nary version was, then, compared item by item with sion groups, not requiring, therefore, alterations.
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 Rocha, L. F. D. & cols. Cross-cultural adaptation of the CPQ 77

Study 2 provided sieve. The total score of the scale is obtained

After the stage of content validity, the CPQ was by the simple addition of individual scores. The higher
responded by a university sample and the scores were the score, the higher the tendency of the participant
submitted to the statistical analysis, in order to exam- to respond to questions biased. At the cross-cultural
ine the instrument’s psychometric properties, such as adaptation to Brazilian samples (Ribas, Seidl-de-
factor structure, internal consistency and validity in Moura, & Hutz, 2004), the short version exhibited a
relation to other variables. Once the present research KR20 = 0.70 and a very strong correlation with the
is part of a larger range of studies, the same database entire scale (r = 0.90, p < 0.001).
of Rocha, Hernandez, and Falcone (2021) has been Lastly, the Depression, Anxiety and Stress Scales
analyzed applying different research questions and dif- – Short Form (DASS-21) by Lovibond and Lovibond
ferent analytical approaches, as suggested by Fine and (1995), adapted to the Brazilian population by Vignola
Kurdek (1994) and by Kirkman and Chen (2011). and Tucci (2004), was employed. It is a self-report instru-
ment composed of 21 items equally divided among the
Methods Depression, Anxiety and Stress subscales. The respon-
dent must indicate how much each one was related to
Participants his/her reality during the last week. The answers are
Thus, 250 Brazilian undergraduate students par- given in a Likert-type scale, from “Did not apply to me
ticipated of this study, with ages from 18 to 60 years old at all” (0) and “Applied to me very much, or most of
(M = 24.9, SD = 8.63), being 76% of female sex (n = the time” (3). The analyses of the psychometric prop-
190), 23.2% of male sex (n = 58), 0.4% trans woman (n erties performed by Rocha et al. (2021) revealed good
= 1) and 0.4% neutral (n = 1). Regarding marital status, convergent validity, internal consistency and temporal
84.8% declared to be single (n = 212), 13.6% married reliability indicators for the scale in the employed sam-
(n = 34), 1.2% divorced or separated (n = 3) and 0.4% ple. It is possible to identify three specific factors (i.e.,
widowed (n = 1). Related to the original region of the depression, anxiety and stress) and a general factor (i.e.,
respondents, 88.8% are from the southeast region of negative affectivity) for the DASS-21 latent structure,
the country (n = 222), 9.2% from the south (n = 23), although the measure is predominantly unidimensional
1.6% from northeast (n = 4) and 0.4% from Midwest (Rocha et al., 2021).
(n = 1). From the total of participants, 77 responded to
the instrument again between 25 and 39 days from the Procedures
first collection day (M = 30.64, SD = 2.71). After approval of the project by the Ethics in
Research Committee of the institution to which this
Instruments study is attached, an online questionnaire was cre-
The CPQ adapted in the Study 1 was applied. The ated through Google Forms, containing the Written
instrument is composed of 12 items that examine the Informed Consent Form (WICF) and the research
frequency of some behaviors and cognitions related instruments. The invitation to participate in the proj-
to perfectionism in the last 30 days (e.g., In the last ect was made through social media (e.g., Facebook)
30 days, did anyone tell you that your standards were and e-mails to university professors, requesting the
too high?). The respondent must indicate the answer forwarding of the form link to their students. The
through a Likert-type scale from 1 (Not one time) to 4 form was available for completion between Decem-
(All the time). Items 2 and 8 are reversed. ber 2018 and June 2019. Respondents took an average
It was also applied the Marlowe-Crowne Social of 12 minutes and 44 seconds to complete the form.
Desirability Scale – short version. The scale proposes The resource of mandatory responses was used for all
to measure the participants’ propensity to respond items, which prevented the form from being returned
biased to the questions presented, according to which with missing values.
is more socially acceptable or approved. It is com- After agreeing with the WICF and fulfilling the
posed of 13 items that portray culturally desirable instruments, the participant was asked about the inter-
behaviors, but, unlikely, in which the person must est in taking part in the second stage of the research
indicate whether the item describes her/him (true or posteriorly. If yes, the email should be given to future
false). The answer given in each sentence is analyzed contact. For those participants who informed the
and turned into a “0” or “1” score, according to a e-mail address, the same form was sent again to be
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78 Rocha, L. F. D. & cols. Cross-cultural adaptation of the CPQ

answered a second time with an average of 30 days Social Desirability measure would indicate that respon-
after the first reply. dents are not answering with complete honesty, but
according to what is socially desirable (i.e., response
Data Analysis bias) (Costa & Hauck Filho, 2017; Kwak, Holtkamp, &
Data collected from the CPQ were inserted at Kim, 2019). In contrast, low correlations between them
the statistical software SPSS (version 23). Initially, indicate that Social Desirability is not a primary factor
the scores multivariate and univariate distribution explaining the CPQ answers.
analyses were performed, in order to verify data dis- Bivariate and partial correlations of the CPQ
tribution. In the next stage, the Corrected Item-Total scores with DASS-21 scores were also performed in the
Correlation (CITC) of each item was investigated first and second application waves for the purpose of
(i.e., the correlation of each item with the sum of the generating more indicators of validity evidence in rela-
remaining items), replicating Dickie et al. (2012) and tion to other variables. Partial correlations collaborate
Stoeber and Damian (2014). The CITC corresponds to verify the relation between two variables, removing
to an indicator applied to verify if each item con- the influence from a third one (Dancey & Reidy, 2018).
tributes significantly to the global score of the scale, The use of DASS-21 as validity criteria was opted for
recommending values above 0.30 (Streiner, Norman, two reasons: (1) other instruments validated to measure
& Cairney, 2015). perfectionism in Brazilians were not found, and (2) the
Furthermore, it was employed the Factor software literature about the relationship between perfectionism
(version 10.10.01) in order to perform Exploratory Fac- and negative affectivity is enormous (e.g., Limburg et
tor Analysis (EFA). Polychoric Correlation Matrix and al., 2016; Smith et al., 2016; Smith, Saklofske, Yan, &
Robust Diagonally Weighted Least Squares (RDWLS) Sherry, 2017), allowing comparisons.
extraction method with Promax rotation were applied.
The decision about the number of factors to be Results
retained was made through Parallel Analysis, with a
random permutation of observed data (Timmerman & The scores’ multivariate distribution analysis
Lorenzo-Seva, 2011). In addition, the unidimensional- showed a non-normal distribution, once Mardia’s Coef-
ity of data was tested, as originally proposed by Shafran ficient was 3.21 (standardized = 1.14). Nevertheless,
et al. (2002), through the calculation of Unidimensional variables’ univariate distribution analysis revealed asym-
Congruence (UniCo), Explained Common Variance metry values < ± 0.70 and kurtosis < ±1.1, which does
(ECV) and Mean of Item Residual Absolute Loadings not represent an extreme normality violation (Tabach-
(MIREAL) indicators. For the instrument’s conception nick & Fidell, 2018).
as essentially unidimensional, UniCo and ECV values When analyzing CITC, item 8 presented a correla-
must be superior to 0.95 and 0.85, respectively, and the tion coefficient near zero with total corrected (r = 0.02)
MIREAL value must be inferior to 0.30 (Ferrando & and item 2 presented low correlation (r = -0.15). All
Lorenzo-Seva, 2018). other items presented CITC coefficients between 0.31
The internal consistency was calculated through (item 12) and 0.54 (item 5). It suggests that only items 2
Composite Reliability and Cronbach’s alpha coef- and 8, both reversed, do not contribute significantly to
ficients. It is suggested 0.70 as cutoff for these the CPQ total score.
indicators (Hair, Black, Babin, Anderson, & Tatham, Regarding the factor analysis, Kaiser-Meyer-
2009; Streiner et al., 2015). The instrument’s temporal Olkin (KMO) measure exhibited an index of 0.75 and
stability was checked through test-retest method, calcu- Bartlett’s sphericity test of χ2(66) = 571, p < 0.001, both
lating the Intraclass Correlation Coefficient (ICC) and indicating data adequacy of this sample for factorializa-
its Confidence Intervals (CI 95%). ICC values inferior tion. Parallel Analysis recommended an extraction of
to 0.50 indicate poor reliability, between 0.50 and 0.75, two factors (Table 1). All items loaded substantially in
moderate, and between 0.75 and 0.90, good reliability one of the two dimensions (loading ≥ 0.42), except
(Koo & Li, 2016). item 8, that did not present significant loadings in
In order to seek validity evidence based on rela- any factors (Table 2). The solution of two factors was
tion to other variables, bivariate correlations of the responsible for 66.56% of ECV. The factors presented
CPQ scores and Social Desirability scores were per- moderate and positive correlation between each other
formed. Moderate-high correlations of CPQ with (r = 0.37). Testing the factor structure designed by
Psico-USF, Bragança Paulista, v. 27, n. 1, p. 73-85, jan./mar. 2022
 Rocha, L. F. D. & cols. Cross-cultural adaptation of the CPQ 79

Shafran et al. (2002) and found by Howell et al. (2020), and construct validity in relation to other variables
UniCo and ECV values were 0.75 and 0.66, respectively, were investigated.
while the MIREAL value was 0.33, recommending the Similarly to what was found by Dickie et al. (2012)
instrument should not be treated as a predominantly and Stoeber and Damian (2014), reversed items (i.e.,
unidimensional measure. 2 and 8) demonstrated low contribution to total score
Concerning reliability indicators, Composite Reli- through CITC calculation. Although some authors
ability and Cronbach’s alpha values for both factors include positive and negative items attempting to reduce
were superior to the cutoff (Table 2), indicating accept- the acquiescence bias, doing so in an unbalanced man-
able internal consistency. Test-retest temporal stability ner, as in the case of CPQ, might reduce the quality of
revealed ICC values of 0.70 (CI 95% between 0.56 – the instrument (Roszkowski & Soven, 2010).
0.80) to Factor 1 (i.e., PS dimension) and 0.59 (CI 95% A possible explanation for this occurrence is that
between 0.42 – 0.72) to Factor 2 (i.e., PC dimension), the inclusion of only some negative items in a mostly
suggesting moderate reliability for both factors. positive questionnaire seems to stimulate the tendency
Correlations with the Social Desirability variable of a misinterpretation by the respondents, because he/
were near zero and not significant to Factor 1 and weak she is being requested to shift gears in the cognitive
and significant to Factor 2 (Table 2), demonstrating processing a few times, what tends to create a response
good validity evidence based on relation to other vari- bias (Roszkowski & Soven, 2010). Thereby, the homo-
ables. Bivariate correlations of the CPQ factors with geneity of the measure will be impaired, decreasing the
DASS-21 scores collected at the first wave were supe- internal consistency indicators.
rior to Factor 2 in comparison to Factor 1 (Table 2). The Although some authors, as Dickie et al. (2012) and
correlation value between Factor 1 and DASS-21 scores Shu et al. (2019), have removed items 2 and 8 based on
considerably decreased after Factor 2 overlap control, the low CITC coefficient, we decided to keep them in
through partial correlations (Table 2). Similarly, both subsequent analysis for two main reasons: to investigate,
CPQ factors at the first wave correlated significantly to in a Brazilian sample, the factorial structure of the CPQ
DASS-21 scores at the second wave (Table 3), being including all 12 items and to avoid losing potentially
Factor 2 coefficients superior to Factor 1. When con- relevant information — especially in the case of item
trolling negative affectivity symptoms at the first wave 2 that measures selective abstraction, a core character-
through partial correlations, the coefficients consider- istic in the conceptualization of clinical perfectionism.
ably decreased (Table 3), however, Factor 2 continued In order to increase participation of items 2 and 8 on
presenting week correlations. CPQ total score, future studies might turn them into
direct items from its content’s alteration.
Discussion Related to CPQ latent structure, EFA suggested a
two factors solution with the exclusion of item 8 due
The present study analyzed the CPQ’s psy- to the non-saturation in any of the two factors. Items
chometric properties with a sample of Brazilian that are similar to the PS dimension (i.e., setting high
undergraduate students. Generally, item analysis, fac- standards and pursuing them) loaded in the first factor,
torial structure, internal consistency, temporal stability while items that are similar to the PC dimension (ie.,

Table 1.
Parallel Analysis Results
Percentage of variance Percentage of variance explained
Factors
explained of real data of random data (CI95%)
1 35.8191* 19.6082
2 19.6510* 17.0101
3 9.5389 14.9861

Note. *The number of factors to be retained is two, since two factors of real data present % of variance explained greater than random data.
Psico-USF, Bragança Paulista, v. 27, n. 1, p. 73-85, jan./mar. 2022
80 Rocha, L. F. D. & cols. Cross-cultural adaptation of the CPQ

Table 2.
Factor structure of the Clinical Perfectionism Questionnaire (CPQ)
Items F1 F2
3. Alguém lhe disse que seus padrões de exigência são muitos elevados? 0.70 -0.08
10. Você acha que as pessoas te consideraram perfeccionista? 0.68 -0.16
11. Você continuou tentando alcançar seus padrões de exigência, mesmo que para isso tenha que ter 0.63 -0.05
aberto mão de algumas coisas?
6. Você aumentou seus padrões de exigência por achá-los fáceis demais? 0.45 0.16
9. Você checou repetidamente o quão bom você é em atingir seus padrões de exigência (por exemplo, 0.44 0.15
comparando seu desempenho ao dos outros)?
7. Você avaliou seu valor com base em sua habilidade de atingir seus elevados padrões de exigência? 0.44 0.23
1. Você se pressionou muito para atingir seus objetivos? 0.42 0.19
4. Você se sentiu um fracasso como pessoa por não ter conseguido atingir seus objetivos? -0.03 0.87
5. Você teve medo da possibilidade de não alcançar seus padrões de exigência? 0.15 0.75
12. Você evitou pôr sua capacidade à prova por medo de falhar? -0.1 0.62
2. Você focou no que alcançou, ao invés de focar no que você não conseguiu alcançar? 0.28 -0.54
8. Você fez estritamente o que era necessário? 0.19 -0.15
Explained Common Variance 4.85 (66.6%) 2.45 2.40
Cronbach’s Alpha 0.73 0.71
Composite Reliability 0.74 0.79
Bivariate Correlations
Social Desirability -0.03 -0.30*
Depression 0.20* 0.65*
Anxiety 0.35* 0.45*
Stress 0.43* 0.53*
Negative Affectivity 0.36* 0.62*
Partial Correlations
Depression 0.01 0.63*
Anxiety 0.26* 0.38*
Stress 0.34* 0.47*
Negative Affectivity 0.24* 0.57*

Note. Factor loadings > 0,32 in bold. Extraction Method: RDWLS. Promax Rotation. *p<0.01. F1 = Perfectionistic Strivings. F2 = Perfectio-
nistic Concerns.

regarding mistakes and their consequences) loaded in loadings in both factors, what may have happened due
the second one. In international studies, similar results to the Polychoric Correlation Matrix and the extraction
were found with university, adults and clinical samples method used in the present study.
(Dickie et al., 2012; Egan et al., 2016; Moloodiet al., The unidimensional predominance of the scale
2017; Stoeber & Damian, 2014). Nevertheless, differ- was not corroborated. There is evidence that traditional
ently from these studies, no item presented significant general fit indices tend to favor bifactor models over
Psico-USF, Bragança Paulista, v. 27, n. 1, p. 73-85, jan./mar. 2022
 Rocha, L. F. D. & cols. Cross-cultural adaptation of the CPQ 81

Table 3.
Correlations between the CPQ first wave and DASS-21 second wave
Bivariate Correlations Partial Correlations
Factor 1 Factor 2 Factor 1 Factor 2
Depression 0.17 0.58** 0.07 0.20
Anxiety 0.32** 0.50** 0.15 0.25*
Stress 0.29* 0.44** 0.01 0.22*
Negative Affectivity 0.29* 0.58** 0.07 0.23*
Note. *p < 0.05. **p < 0.01. F1 = Perfectionistic Strivings. F2 = Perfectionistic Concerns.

other models (Gignac, 2016), as found by Howell et al. between these factors is under control. It suggests that,
(2020) and Prior et al. (2018) in the case of CPQ. Thus, regarding depression, anxiety and stress symptoms, hav-
it is necessary to assess the robustness of the global fac- ing high self-demanding standards, pushing oneself to
tor using additional statistical indices. The results found reach them and evaluating the self-worth according to
by the present study reinforce the bi-dimensional struc- the ability to achieve them are less harmful perfection-
ture of perfectionism measured by CPQ. istic traits than being afraid of not reaching demanding
Reliability indexes of CPQ factors, through Com- standards, feeling a failure as a person for not achieving
posite Reliability and Cronbach’s alpha coefficients, them and avoiding being tested.
were satisfactory and similar to the ones obtained by As suggested by Shafran et al. (2002), reaching
other studies (Dickie et al., 2012; Egan et al., 2016; high self-demanding standards grants self-worth (i.e., PS
Moloodiet al., 2017; Stoeber & Damian, 2014). The dimension), whereas not reaching them evokes thoughts
reliability represented by the temporal stability of two about being a failure as a person (i.e., PC dimension),
CPQ factors presented moderate indexes, suggesting and, in the last case, it generates, consequently, more
that the assessed constructs did not vary considerably psychopathological indicators. PS dimension can be
in the studied intervals, as found by Dickie et al. (2012). seen as goal-oriented mindset that motivates a person
Near zero and weak values of the correlations to search for resources and rewards, as achieving high
between CPQ and social desirability grant good con- standards. On the other hand, PC dimension can be
struct validity evidence based on relation to other seen as a threat-oriented mindset that motivates fight,
variables of the instrument. Low correlations with social flight or avoidance behaviors in face of dangerous situ-
desirability indicate that the participants’ responses to ations (real or imagined), as avoiding being a failure.
the instrument are little subject to what is socially desir- The second one has been shown to be more associated
able, demonstrating a less biased and more accurate with depression, anxiety, and stress symptoms.
assessment of the variable of interest (Costa & Hauck However, both dimensions can interact with each
Filho, 2017; Kwak et al., 2019). Thus, what is expected other and the PS traits might be used as a strategy to
is that social desirability does not substantially influence try to avoid negative consequences of PC, what tend to
the responses that participants indicate in the instru- inflate the relation of PS with psychopathology indica-
ments used, as it did not occur in the present study for tors (see Stoeber, Madigan, & Gonidis, 2020). In this
responses to the CPQ. regard, an individual may pursue high standards (con-
The CPQ factors also showed validity evidence cerning PS dimension) in order to feel safe and avoid
based on relation to other variables when analyzing its the feeling of inferiority (concerning to PC dimension),
correlations with psychopathological indicators, cross- for example. Thereby, it is necessary to measure both
sectionally and longitudinally. Just as found by other dimensions and control their overlap when compar-
studies (Limburg et al., 2016; Smith et al., 2016; Smith ing with other variables for the purpose of finding the
et al., 2018), PS are less related to psychopathology single effect of each of them, as indicated by Limburg
in comparison with PC, especially when the overlap et al. (2016) and Stoeber (2020).
Psico-USF, Bragança Paulista, v. 27, n. 1, p. 73-85, jan./mar. 2022
82 Rocha, L. F. D. & cols. Cross-cultural adaptation of the CPQ

Final Considerations reliability and validity of the clinical perfectionism

questionnaire in eating disorder and community
In summary, current results indicate that the CPQ samples. Behavioural and Cognitive Psychotherapy,
presented content validity, factorial validity, internal 44(1), 79-91. doi: 10.1017/S1352465814000629
consistency, temporal stability, and construct validity in Egan, S. J., Wade, T. D., & Shafran, R. (2011). Perfec-
relation to other variables with Brazilian participants. tionism as a transdiagnostic process: A clinical
EFA found the presence of two correlated factors, being review. Clinical psychology review, 31(2), 203-212. doi:
these similar to those the literature denominates as Per- 10.1016/j.cpr.2010.04.009
fectionistic Strivings and Perfectionistic Concerns. It is
important to emphasize that unidimensionality indica- Egan, S. J., Wade, T. D., Shafran, R., & Antony, M. M.
tors did not bear the instrument unidimensionality. As (2014). Cognitive-behavioral treatment of perfectionism.
well as in international studies using different scales, New York: Guilford Publications.
the Perfectionistic Strivings dimension was less associ- Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). The
ated with negative affectivity symptoms in comparison Clinical Perfectionism Questionnaire. Unpublished
with the Perfectionistic Concerns dimension, especially manuscript, Department of Psychiatry, University
when the overlap between them was under control. of Oxford, UK.
It is noteworthy, however, that the present study
shows some limitations with respect to the non-proba- Ferrando, P. J., & Lorenzo-Seva, U. (2018). Assessing
bilistic sample, exclusively composed of undergraduate the quality and appropriateness of factor solutions
and mostly female, which might hinder generalizations and factor score estimates in exploratory item fac-
tor analysis. Educational and Psychological Measurement,
to the population. It is suggested for future researches
78, 762-780. doi: 10.1177/0013164417719308
to investigate the CPQ validity with a wider sample and
with different characteristics from the one presented, Fine, M. A., & Kurdek, L. A. (1994). Publishing mul-
such as with adults, elderly and, mainly, clinical samples. tiple journal articles from a single data set: Issues
Another limitation is the large age range of the sample and recommendations. Journal of Family Psychology,
used, taking different phases and different social pres- 8(4), 371-379. doi: 10.1037/0893-3200.8.4.371
sures that could have a different impact on perfectionist
Gignac, G. E. (2016). The higher-order model imposes
cognitions and behaviors. Moreover, the scale applied
a proportionality constraint: That is why the bifac-
to assess psychopathology indicators is a symptoms tor model tends to fit better. Intelligence, 55, 57-68.
screening questionnaire and not a mental disorders doi: 10.1016/j.intell.2016.01.006
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conceived within these limits. Hair, J. F., Black, W. C., Babin, B. J., Anderson, R. E., &
Tatham, R. L. (2009). Análise multivariada de dados
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 Rocha, L. F. D. & cols. Cross-cultural adaptation of the CPQ 85

About the authors:

Luiz Fellipe Dias da Rocha is a psychologist, master and doctoral student in Social Psychology at the State Uni-
versity of Rio de Janeiro (UERJ). Currently, he is a member of the board of directors of the Cognitive Therapy
Association of the State of Rio de Janeiro (ATC-Rio) and develops teaching and research activities in the areas of
Cognitive-Behavior Therapy, Positive Psychology and Psychological Evaluation.
ORCID: http://orcid.org/0000-0001-9337-894X
E-mail: [email protected]

José Augusto Evangelho Hernandez is a psychologist, master and PhD in Development Psychology (UFRGS).
Currently, he is a professor of the Graduate Program in Social Psychology at the State University of Rio de Janeiro
(PPGPS-UERJ), develops teaching and research activities in the areas of intimate relationships, gender and construc-
tion and adaptation of psychology measures and coordinates the Psychology Measures Laboratory (LABMEDI).
ORCID: http://orcid.org/0000-0001-9402-7535
E-mail: [email protected]

Eliane Mary de Oliveira Falcone is a professor of the Graduate Program in Social Psychology at the State Uni-
versity of Rio de Janeiro (PPGPS-UERJ). PhD in Clinical Psychology at São Paulo University (USP). Specialist in
Cognitive Therapy by the Beck Institute. President of the Brazilian Federation of Cognitive Therapies (FBTC) in the
2003-2005 management and founder of the Brazilian Journal of Cognitive Therapies (RBTC). Therapist certified by
the FBTC.
ORCID: http://orcid.org/0000-0002-9670-8999
E-mail: [email protected]

Marcelo Leonel Peluso is an undergraduate student in Psychology at the State University of Rio de Janeiro (UERJ).
ORCID: https://orcid.org/0000-0002-3669-3561
E-mail: [email protected]

Contact:

Universidade do Estado do Rio de Janeiro

Rua São Francisco Xavier, nº 524, sala 2.145, bloco F – Maracanã
Rio de Janeiro-RJ, Brasil
CEP: 20550-900
Psico-USF, Bragança Paulista, v. 27, n. 1, p. 73-85, jan./mar. 2022