Associations Between Perfectionism Behaviors And Menstrual Dysfunction In Female High School Cross-Country Runners

Recent studies have shown a high prevalence of menstrual dysfunction (MD) in female high school distance runners. Several psychological behaviors, including disordered eating, have been associated with MD. Perfectionism factors, which can be adaptive or maladaptive, have been suggested to contribute to the increased likelihood of MD. PURPOSE: To examine associations between perfectionism behaviors and prevalence of MD in female high school cross-country runners. METHODS: A retrospective study of 35 female runners (age: 15.7 ± 1.2y) during an interscholastic cross-country season. Prior to the start of the season, each runner completed the Sport Multidimensional Perfectionism Scale-2 (Sport MPS-2). The Sport MPS-2 is composed of six subscales, including personal standards (PS), organization (O), concerns over mistakes (COM), doubts about actions (DAA), perceived parental pressure (PPP), and perceived coach pressure (PCP). Of these, PS and O were examined to identify adaptive behaviors known as personal strivings (PStrv); while COM, DAA, PPP, and PCP were measured to identify maladaptive behaviors known as personal concerns [PC]. Each runner also completed a questionnaire about menstrual history, other personal characteristics, and average weekly running mileage; then had their height and weight measured on a standard stadiometer. Logistic regression was used to determine associations between MD (primary amenorrhea, oligomenorrhea, or secondary amenorrhea during the past year) and the six Sport MPS-2 subscales individually, as well as PStrv and PC. RESULTS: Twelve runners (34.3%) reported MD during the past year. After adjusting for body mass index and weekly running mileage during the prior summer, runners with higher COM were twice as likely (Adjusted odds ratio = 2.22, 95% CI: 1.1-4.9; p = 0.048) to report having MD during the past year. No associations were found for the other six subscales, or combined PC or PS behaviors (all p > 0.05). CONCLUSIONS: Female high school runners who exhibited greater COM (a maladaptive perfectionistic behavior) appear more likely to report MD during the past year. While preliminary, these findings suggest COM behaviors should be addressed (e.g., educational or intervention program) to help reduce the prevalence of MD among female high school cross country runners.