{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:39:45Z","timestamp":1787027985121,"version":"build-2736575974"},"reference-count":74,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Center of Excellence for Nursing Scholarship, CECRI, Rome Italy","award":["2.22.8"],"award-info":[{"award-number":["2.22.8"]}]},{"name":"Center of Excellence for Nursing Scholarship, CECRI, Rome Italy","award":["1.24.3"],"award-info":[{"award-number":["1.24.3"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["EJIHPE"],"abstract":"<jats:p>Background: Perfectionism is a growing concern among university students, who face high expectations, demanding workloads, and complex academic tasks. These pressures often lead to stress, negatively impacting performance, well-being, and career trajectories. Existing measures of perfectionism and related stress lack focus on their causes and relevance to students. Methods: This study developed and psychometrically tested an inventory assessing the causes (ROOTS), manifestations (MPS-R), and stress (IPSS-R) related to perfectionism. A multicenter cross-sectional online survey was conducted across multiple Italian universities with 469 students. The ROOTS tool was developed, and the MPS and IPSS were adapted following established guidelines. Content validity was examined, and pilot testing was performed. Confirmatory factor analyses tested three-factor models with a second-order factor for each instrument. Construct validity and reliability were also assessed. Results: The ROOTS, MPS-R, and IPSS-R demonstrated strong structural and construct validity, with acceptable reliability. Significant correlations highlighted the interconnectedness of perfectionism\u2019s causes, manifestations, and stress. Conclusions: The Perfectionism Inventory offers a comprehensive tool for identifying causes, manifestations, and consequences of perfectionism in university students. It can help educators and policymakers develop strategies to mitigate its impact on mental health and academic success. Future research should explore its applicability in other populations.<\/jats:p>","DOI":"10.3390\/ejihpe15060094","type":"journal-article","created":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T20:39:36Z","timestamp":1748205576000},"page":"94","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Development and Psychometric Testing of Perfectionism Inventory to Assess Perfectionism and Academic Stress in University Students: A Cross-Sectional Multi-Centre Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5998-476X","authenticated-orcid":false,"given":"Michela","family":"Piredda","sequence":"first","affiliation":[{"name":"Research Unit Nursing Science, Department of Medicine and Surgery, Campus Bio-Medico di Roma University, Via Alvaro Del Portillo, 21, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5581-4114","authenticated-orcid":false,"given":"Alessio","family":"Lo Cascio","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University of Rome \u201cTor Vergata\u201d, Via Montpellier, 1, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8680-711X","authenticated-orcid":false,"given":"Anna","family":"Marchetti","sequence":"additional","affiliation":[{"name":"Research Unit Nursing in Palliative Care, Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro Del Portillo, 200, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4458-5165","authenticated-orcid":false,"given":"Laura","family":"Campanozzi","sequence":"additional","affiliation":[{"name":"Research Unit of Bioethics and Humanities, Campus Bio-Medico di Roma University, Via Alvaro del Portillo, 21, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Pellegrino","sequence":"additional","affiliation":[{"name":"Research Unit Nursing in Palliative Care, Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro Del Portillo, 200, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1625-2248","authenticated-orcid":false,"given":"Marina","family":"Mondo","sequence":"additional","affiliation":[{"name":"Department of Pedagogy, Psychology and Philosophy, University of Cagliari, Via Is Mirrionis, 1, 09123 Cagliari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giorgia","family":"Petrucci","sequence":"additional","affiliation":[{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7829-3654","authenticated-orcid":false,"given":"Roberto","family":"Latina","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Piazza Delle Cliniche, 2, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0507-0158","authenticated-orcid":false,"given":"Maddalena","family":"De Maria","sequence":"additional","affiliation":[{"name":"Department of Life Health Sciences and Health Professions, Link Campus University, Via Del Casale di San Pio V, 44, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4659-1569","authenticated-orcid":false,"given":"Rosaria","family":"Alvaro","sequence":"additional","affiliation":[{"name":"Department of Biomedicine and Prevention, University of Rome \u201cTor Vergata\u201d, Via Montpellier, 1, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Grazia","family":"De Marinis","sequence":"additional","affiliation":[{"name":"Research Unit Nursing Science, Department of Medicine and Surgery, Campus Bio-Medico di Roma University, Via Alvaro Del Portillo, 21, 00128 Rome, Italy"},{"name":"Research Unit Nursing in Palliative Care, Department of Medicine and Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro Del Portillo, 200, 00128 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.evolhumbehav.2020.07.015","article-title":"Beyond WEIRD: A review of the last decade and a look ahead to the global laboratory of the future","volume":"41","author":"Apicella","year":"2020","journal-title":"Evolution and Human Behavior"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"53","DOI":"10.12928\/ijemi.v5i1.9396","article-title":"Factors affecting student drop out behavior: A systematic review","volume":"5","author":"Banaag","year":"2024","journal-title":"International Journal of Educational Management and Innovation"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1007\/s00127-008-0345-x","article-title":"The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students","volume":"43","author":"Bayram","year":"2008","journal-title":"Social Psychiatry and Psychiatric Epidemiology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2055102915596714","DOI":"10.1177\/2055102915596714","article-title":"Examining perceptions of academic stress and its sources among university students: The Perception of Academic Stress Scale","volume":"2","author":"Bedewy","year":"2015","journal-title":"Health Psychology Open"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.jad.2014.10.054","article-title":"The prevalence and correlates of depression, anxiety, and stress in a sample of college students","volume":"173","author":"Beiter","year":"2015","journal-title":"Journal of Affective Disorders"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1037\/1082-989X.3.4.424","article-title":"Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification","volume":"3","author":"Bentler","year":"1998","journal-title":"Psychological Methods"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1080\/03075070903216643","article-title":"Changes in undergraduate students\u2019 psychological well-being as they progress through university","volume":"35","author":"Bewick","year":"2010","journal-title":"Studies in Higher Education"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"702","DOI":"10.1177\/0734282916653701","article-title":"The importance of item wording: The distinction between measuring high standards versus measuring perfectionism and why it matters","volume":"34","author":"Blasberg","year":"2016","journal-title":"Journal of Psychoeducational Assessment"},{"key":"ref_9","unstructured":"Brancato, G., Macchia, S., Murgia, M., Signore, M., Simeoni, G., Blanke, K., Korner, T., Nimmergut, A., Lima, P., Paulino, R., and J\u00fcrgen, H.-Z. (2006). Handbook of recommended practices for questionnarie development and testing in European statistical systems, European Statistical System. Available online: https:\/\/www.istat.it\/en\/files\/2013\/12\/Handbook_questionnaire_development_2006.pdf."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1177\/0049124192021002005","article-title":"Alternative ways of assessing model fit","volume":"21","author":"Browne","year":"1992","journal-title":"Sociological Methods & Research"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1016\/j.paid.2014.12.001","article-title":"Preoccupied attachment, need to belong, shame, and interpersonal perfectionism: An investigation of the perfectionism social disconnection model","volume":"76","author":"Chen","year":"2015","journal-title":"Personality and Individual Differences"},{"key":"ref_12","unstructured":"Cohen, J. (1988). Statistical power analysis for the behavioral sciences, Erlbaum."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2307\/2136404","article-title":"A global measure of perceived stress","volume":"24","author":"Cohen","year":"1983","journal-title":"Journal of Health and Social Behavior"},{"key":"ref_14","unstructured":"Taylor, E., Verhulst, F., Wong, J. C. M., and Yoshida, K. (2020). Trends in child and adolescent mental health prevalence, outcomes, and inequalities. Mental health and illness of children and adolescents, Springer."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1037\/bul0000138","article-title":"Perfectionism is increasing over time: A meta-analysis of birth cohort differences from 1989 to 2016","volume":"145","author":"Curran","year":"2019","journal-title":"Psychological Bulletin"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1037\/bul0000347","article-title":"Young people\u2019s perceptions of their parents\u2019 expectations and criticism are increasing over time: Implications for perfectionism","volume":"148","author":"Curran","year":"2022","journal-title":"Psychological Bulletin"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1080\/03075079.2017.1340445","article-title":"Evaluating the perceived stress scale among UK university students: Implications for stress measurement and management","volume":"44","author":"Denovan","year":"2017","journal-title":"Studies in Higher Education"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"921","DOI":"10.1016\/S0191-8869(01)00202-1","article-title":"Adaptive and maladaptive perfectionism: Developmental origins and association with depression proneness","volume":"33","author":"Enns","year":"2002","journal-title":"Personality and Individual Differences"},{"key":"ref_19","first-page":"1","article-title":"Suicide in the world: An overview of prevalence and its risk factors","volume":"8","author":"Ferreira","year":"2015","journal-title":"International Archives of Medicine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1080\/1034912X.2019.1626006","article-title":"School refusal in students with low academic performances and specific learning disorder. The role of self-esteem and perceived parental psychological control","volume":"67","author":"Filippello","year":"2020","journal-title":"International Journal of Disability, Development and Education"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Flett, G. L., and Hewitt, P. L. (2015). Measures of perfectionism. Measures of personality and social psychological constructs, Elsevier Academic Press.","DOI":"10.1016\/B978-0-12-386915-9.00021-8"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1177\/0734282919881928","article-title":"Reflections on three decades of research on multidimensional perfectionism: An introduction to the special issue on further advances in the assessment of perfectionism","volume":"38","author":"Flett","year":"2020","journal-title":"Journal of Psychoeducational Assessment"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1177\/0734282916651381","article-title":"The child\u2013adolescent perfectionism scale: Development, psychometric properties, and associations with stress, distress, and psychiatric symptoms","volume":"34","author":"Flett","year":"2016","journal-title":"Journal of Psychoeducational Assessment"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1007\/s12144-011-9103-4","article-title":"Perfectionism, type a behavior, and self-efficacy in depression and health symptoms among adolescents","volume":"30","author":"Flett","year":"2011","journal-title":"Current Psychology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1007\/BF01172967","article-title":"The dimensions of perfectionism","volume":"14","author":"Frost","year":"1990","journal-title":"Cognitive Therapy and Research"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1117","DOI":"10.1037\/pspp0000411","article-title":"Because excellencism is more than good enough: On the need to distinguish the pursuit of excellence from the pursuit of perfection","volume":"122","author":"Gaudreau","year":"2022","journal-title":"Journal of Personality and Social Psychology"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1037\/0022-3514.60.3.456","article-title":"Perfectionism in the self and social contexts: Conceptualization, assessment, and association with psychopathology","volume":"60","author":"Hewitt","year":"1991","journal-title":"Journal of Personality and Social Psychology"},{"key":"ref_28","unstructured":"Hewitt, P. L., Flett, G. L., and Mikail, S. F. (2017). Perfectionism: A relational approach to conceptualization, assessment, and treatment (pp. xv, 336), The Guilford Press."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1037\/1040-3590.3.3.464","article-title":"The multidimensional perfectionism scale: Reliability, validity, and psychometric properties in psychiatric samples","volume":"3","author":"Hewitt","year":"1991","journal-title":"Psychological Assessment"},{"key":"ref_30","first-page":"86","article-title":"The relationship between self-compassion and multidimensional perfectionism levels and influencing factors in nursing students","volume":"8","author":"Aydin","year":"2017","journal-title":"Journal of Psychiatric Nursing"},{"key":"ref_31","unstructured":"Hoyle, R. H. (1995). The structural equation modeling approach: Basic concepts and fundamental issues. Structural equation modeling: Concepts, issues, and applications, Sage Publications, Inc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1080\/10705519909540118","article-title":"Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives","volume":"6","author":"Hu","year":"1999","journal-title":"Structural Equation Modeling"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1002\/smi.2465","article-title":"College student stressors: A review of the qualitative research","volume":"29","author":"Hurst","year":"2013","journal-title":"Stress and Health: Journal of the International Society for the Investigation of Stress"},{"key":"ref_34","first-page":"146","article-title":"Effect of perceived academic stress on students\u2019 performance","volume":"7","author":"Khan","year":"2013","journal-title":"FWU Journal of Social Sciences"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"109474","DOI":"10.1016\/j.paid.2019.06.017","article-title":"Adverse parenting and perfectionism: A test of the mediating effects of attachment anxiety, attachment avoidance, and perceived defectiveness","volume":"150","author":"Ko","year":"2019","journal-title":"Personality and Individual Differences"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","article-title":"A guideline of selecting and reporting intraclass correlation coefficients for reliability research","volume":"15","author":"Koo","year":"2016","journal-title":"Journal of Chiropractic Medicine"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1177\/0016986220969396","article-title":"Perfectionism and the imposter phenomenon in academically talented undergraduates","volume":"65","author":"Lee","year":"2021","journal-title":"Gifted Child Quarterly"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1002\/jclp.22435","article-title":"The relationship between perfectionism and psychopathology: A meta-analysis","volume":"73","author":"Limburg","year":"2017","journal-title":"Journal of Clinical Psychology"},{"key":"ref_39","first-page":"157","article-title":"Academic stress inventory of students at universities and colleges of technology","volume":"7","author":"Lin","year":"2009","journal-title":"World Transactions on Engineering and Technology Education"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Liu, X., Ping, S., and Gao, W. (2019). Changes in undergraduate students\u2019 psychological well-being as they experience university life. International Journal of Environmental Research and Public Health, 16, (16).","DOI":"10.3390\/ijerph16162864"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1080\/00223891.2021.1905651","article-title":"The short forms of the hewitt and flett\u2019s multidimensional perfectionism scale: Which factor structure better fits Italian data?","volume":"104","author":"Lombardo","year":"2022","journal-title":"Journal of Personality Assessment"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1037\/1082-989X.4.1.84","article-title":"Sample size in factor analysis","volume":"4","author":"MacCallum","year":"1999","journal-title":"Psychological Methods"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/S2215-0366(19)30188-9","article-title":"Prevalence of non-suicidal self-harm and service contact in England, 2000\u201314: Repeated cross-sectional surveys of the general population","volume":"6","author":"McManus","year":"2019","journal-title":"The Lancet Psychiatry"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1884","DOI":"10.1007\/s12144-019-0132-8","article-title":"Psychometric evaluation of three versions of the Italian perceived stress scale","volume":"40","author":"Mondo","year":"2021","journal-title":"Current Psychology"},{"key":"ref_45","unstructured":"Muth\u00e9n, L. K., and Muth\u00e9n, B. (2017). Mplus user\u2019s guide, Muth\u00e9n & Muth\u00e9n. [8th ed.]."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1037\/pas0000942","article-title":"Does perfectionism or pursuit of excellence contribute to successful learning? A meta-analytic review","volume":"32","author":"Osenk","year":"2020","journal-title":"Psychological Assessment"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1080\/02673843.2019.1596823","article-title":"The impact of stress on students in secondary school and higher education","volume":"25","author":"Pascoe","year":"2020","journal-title":"International Journal of Adolescence and Youth"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4236\/psych.2021.121001","article-title":"A systematic review on the psychological effects of perfectionism and accompanying treatment","volume":"12","author":"Patterson","year":"2021","journal-title":"Psychology"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1037\/a0036175","article-title":"Ethnic variations between Asian and European Americans in interpersonal sources of socially prescribed perfectionism: It\u2019s not just about parents!","volume":"6","author":"Perera","year":"2015","journal-title":"Asian American Journal of Psychology"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"459","DOI":"10.1002\/nur.20199","article-title":"Is the CVI an acceptable indicator of content validity? Appraisal and recommendations","volume":"30","author":"Polit","year":"2007","journal-title":"Research in Nursing & Health"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Raykov, T., and Marcoulides, G. A. (2010). Introduction to psychometric theory, Routledge.","DOI":"10.4324\/9780203841624"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jad.2012.11.026","article-title":"Interventions to reduce stress in university students: A review and meta-analysis","volume":"148","author":"Regehr","year":"2013","journal-title":"Journal of Affective Disorders"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/s11336-008-9102-z","article-title":"Coefficients alpha, beta, omega, and the glb: Comments on Sijtsma","volume":"74","author":"Revelle","year":"2009","journal-title":"Psychometrika"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Sirois, F. M., and Molnar, D. S. (2016). Perfectionism in academic settings. Perfectionism, health, and well-being, Springer International Publishing.","DOI":"10.1007\/978-3-319-18582-8"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1080\/00220671.2015.1108278","article-title":"Factors related to taiwanese adolescents\u2019 academic procrastination, time management, and perfectionism","volume":"110","author":"Shih","year":"2017","journal-title":"Journal of Educational Research"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1037\/pas0000137","article-title":"A combined analysis of the frost multidimensional perfectionism scale (fmps), child and adolescent perfectionism scale (CAPS), and almost perfect scale\u2014Revised (APS-R): Different perfectionist profiles in adolescent high school students","volume":"27","author":"Sironic","year":"2015","journal-title":"Psychological Assessment"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1177\/01454455980223010","article-title":"A dual process model of perfectionism based on reinforcement theory","volume":"22","author":"Slade","year":"1998","journal-title":"Behavior Modification"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1080\/07481756.2002.12069030","article-title":"The revised almost perfect scale","volume":"34","author":"Slaney","year":"2001","journal-title":"Measurement and Evaluation in Counseling and Development"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1111\/jopy.12333","article-title":"The perniciousness of perfectionism: A meta-analytic review of the perfectionism-suicide relationship","volume":"86","author":"Smith","year":"2018","journal-title":"Journal of Personality"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1177\/1073191111411663","article-title":"Clarifying the construct of perfectionism","volume":"19","author":"Stairs","year":"2012","journal-title":"Assessment"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1111\/ap.12127","article-title":"The university stress scale: Measuring domains and extent of stress in university students","volume":"51","author":"Stallman","year":"2016","journal-title":"Australian Psychologist"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1007\/s10862-013-9397-7","article-title":"How other-oriented perfectionism differs from self-oriented and socially prescribed perfectionism","volume":"36","author":"Stoeber","year":"2014","journal-title":"Journal of Psychopathology and Behavioral Assessment"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1007\/s10862-015-9485-y","article-title":"How other-oriented perfectionism differs from self-oriented and socially prescribed perfectionism: Further findings","volume":"37","author":"Stoeber","year":"2015","journal-title":"Journal of Psychopathology and Behavioral Assessment"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.paid.2017.01.041","article-title":"Perfectionism and well-being: A positive psychology framework","volume":"111","author":"Suh","year":"2017","journal-title":"Personality and Individual Differences"},{"key":"ref_65","unstructured":"Tabachnick, B. G., and Fidell, L. S. (2019). Using multivariate statistics, Pearson Education, Inc.. [7th ed.]."},{"key":"ref_66","first-page":"130","article-title":"Mindfulness in classroom: Effect of a mindfulness-based relaxation class on college students\u2019 stress, resilience, self-efficacy and perfectionism","volume":"53","author":"Vidic","year":"2019","journal-title":"College Student Journal"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","article-title":"The strengthening the reporting of observational studies in epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"12","author":"Altman","year":"2014","journal-title":"International Journal of Surgery"},{"key":"ref_68","first-page":"127","article-title":"Perfectionism as a predictor of anxiety in foreign language classrooms among Russian college students","volume":"18","author":"Wang","year":"2018","journal-title":"Journal of Educational, Cultural and Psychological Studies (ECPS Journal)"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1177\/0193945916685712","article-title":"Influence of social support and self-efficacy on resilience of early career registered nurses","volume":"40","author":"Wang","year":"2018","journal-title":"Western Journal of Nursing Research"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"36","DOI":"10.3928\/01484834-20221109-03","article-title":"Clinical stress and clinical performance in prelicensure nursing students: A systematic review","volume":"62","author":"Welch","year":"2023","journal-title":"Journal of Nursing Education"},{"key":"ref_71","unstructured":"World Medical Association (2024, December 10). WMA Declaration of Helsinki\u2014Ethical principles for medical research involving human participants 2024, Available online: https:\/\/www.wma.net\/policies-post\/wma-declaration-of-helsinki\/."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1111\/j.1467-839X.2008.00253.x","article-title":"Culture-specific personality correlates of anxiety among Chinese and Caucasian college students","volume":"11","author":"Xie","year":"2008","journal-title":"Asian Journal of Social Psychology"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1007\/s12144-018-9950-3","article-title":"The positive and negative rumination scale: Development and preliminary validation","volume":"39","author":"Yang","year":"2020","journal-title":"Current Psychology"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1177\/0146621605278814","article-title":"Estimating generalizability to a latent variable common to all of a scale\u2019s indicators: A comparison of estimators for \u03c9h","volume":"30","author":"Zinbarg","year":"2006","journal-title":"Applied Psychological Measurement"}],"container-title":["European Journal of Investigation in Health, Psychology and Education"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2254-9625\/15\/6\/94\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:39:27Z","timestamp":1760031567000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2254-9625\/15\/6\/94"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,23]]},"references-count":74,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6]]}},"alternative-id":["ejihpe15060094"],"URL":"https:\/\/doi.org\/10.3390\/ejihpe15060094","relation":{},"ISSN":["2254-9625"],"issn-type":[{"value":"2254-9625","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,23]]}}}