The Effect of Perfectionism on Relative Deprivation among Nursing Students: The Role of Interpersonal Sensitivity and Resilience

For nursing students

Study summary

Nursing school can feel like a pressure cooker of grades, clinical evaluations, and constant comparison with classmates. A 2024 study published in Psychology in the Schools examined why some nursing students feel more short-changed than others, a feeling researchers call "relative deprivation": the sense that you are getting less than you deserve compared with the people around you. The researchers, led by Yueming Ding and colleagues, wanted to know whether perfectionism plays a role in that feeling, and if so, how.

The study surveyed 682 nursing students from two universities in Henan Province, China. Using a cross-sectional design, students completed questionnaires measuring their demographic background, perfectionism, relative deprivation, interpersonal sensitivity (how strongly a person notices and reacts to others' opinions, criticism, and social cues), and resilience (the capacity to adapt and recover from stress). The researchers used Pearson's correlation analysis and the PROCESS macro, a regression-based technique for testing mediation and moderation, to map out how these variables related to one another.

One of the most useful things about the study is that it distinguishes between two forms of perfectionism. Adaptive perfectionism describes high personal standards paired with a healthy tolerance for imperfection: striving for excellence without falling apart when things go wrong. Maladaptive perfectionism, in contrast, is rigid and self-critical, an all-or-nothing mindset in which anything short of flawless feels like failure. This distinction mattered a great deal for the results.

The researchers found that adaptive perfectionism was not significantly associated with relative deprivation. In other words, students who simply held themselves to high standards did not necessarily feel shortchanged relative to their peers. Maladaptive perfectionism told a different story. It was significantly and positively correlated with interpersonal sensitivity, relative deprivation, and, somewhat counterintuitively, resilience — a correlation the study reported but did not fully explain, so it should be read cautiously rather than as evidence that self-critical perfectionism somehow "builds" resilience.

Digging deeper, the study found that interpersonal sensitivity acted as a mediator between maladaptive perfectionism and relative deprivation, meaning that maladaptive perfectionism appears to increase relative deprivation partly because it first heightens a student's sensitivity to how others see them, and that heightened sensitivity then feeds feelings of being unfairly treated or left behind. This mediation pathway accounted for about 41% of the total effect linking maladaptive perfectionism to relative deprivation, a substantial share.

The researchers also tested whether resilience changed the strength of these relationships, a technique called moderation. They found that resilience moderated both the first half of the mediation pathway (the link between maladaptive perfectionism and interpersonal sensitivity) and the direct path (the link between maladaptive perfectionism and relative deprivation). This suggests that a student's capacity to bounce back from setbacks can either buffer or amplify how strongly perfectionistic tendencies translate into interpersonal sensitivity and feelings of deprivation, depending on where a student falls on that resilience continuum.

Putting it together, the authors argue that maladaptive perfectionism, interpersonal sensitivity, and low resilience form an interlocking cluster that can leave nursing students feeling shortchanged relative to their classmates, a feeling that other research has linked to stress, burnout, and lower well-being. Because relative deprivation is about perception and comparison rather than objective circumstances, the study suggests that targeted interventions aimed at reducing maladaptive perfectionistic thinking, easing excessive interpersonal sensitivity, and building resilience could help reduce these feelings among nursing students.

For students, the takeaway is not that striving for excellence is harmful; adaptive perfectionism was not linked to relative deprivation at all. The concern is the rigid, self-critical version of perfectionism, especially when paired with high sensitivity to others' judgments and lower resilience. Recognizing your own patterns around comparison, criticism sensitivity, and recovery from setbacks may be a useful first step, and programs that build resilience skills, such as stress management, cognitive reframing, and peer support, may be worth seeking out if these patterns feel familiar.

It is worth remembering that this is a single cross-sectional study conducted with nursing students in China using self-report questionnaires, so the findings describe associations rather than proven cause-and-effect, and may not generalize directly to nursing programs in other countries, including Canada.

For educators

Teaching and appraisal notes

This cross-sectional study (Ding et al., 2024, Psychology in the Schools) examined the relationships among perfectionism, relative deprivation, interpersonal sensitivity, and resilience in a sample of 682 nursing students from two universities in Henan Province, China. The design allows instructors to introduce students to moderated mediation analysis, a statistical approach increasingly common in nursing education and psychology research, using a topic (academic pressure and social comparison) that resonates directly with student experience.

Methodologically, the study relied on self-report questionnaires for perfectionism, relative deprivation, interpersonal sensitivity, and resilience, analyzed via Pearson's correlation and Hayes' PROCESS macro. This macro is widely used in nursing and health-professions education research to test whether a third variable explains (mediates) or changes the strength of (moderates) a relationship between two other variables. Faculty using this article for a research-methods seminar could walk students through the logic of a moderated mediation model: interpersonal sensitivity as the mediator between maladaptive perfectionism and relative deprivation, and resilience as the moderator of both the first-stage path and the direct path.

The substantive findings are clinically and pedagogically relevant. Adaptive perfectionism, high standards paired with tolerance for imperfection, was not significantly correlated with relative deprivation, whereas maladaptive perfectionism, rigid, self-critical, all-or-nothing standards, was positively correlated with interpersonal sensitivity, relative deprivation, and resilience. Interpersonal sensitivity mediated 41.07% of the total effect between maladaptive perfectionism and relative deprivation, indicating a substantial indirect pathway. Resilience moderated both the maladaptive-perfectionism-to-interpersonal-sensitivity path and the maladaptive-perfectionism-to-relative-deprivation direct path, suggesting it functions as a buffering or amplifying factor depending on students' resilience level.

For nurse educators, this study offers a useful frame for discussing the psychological pressures nursing programs can place on students, including competitive grading, high-stakes clinical evaluation, and comparison with peers, and how individual differences in perfectionistic style, sensitivity to social feedback, and resilience shape students' subjective sense of being treated unfairly relative to classmates. This has implications for student support services, mentoring, and curriculum design: interventions that target maladaptive perfectionistic cognitions (for example, cognitive-behavioral approaches challenging all-or-nothing thinking), reduce excessive interpersonal sensitivity (feedback literacy, self-compassion training), and build resilience (stress-inoculation training, peer mentoring, reflective practice) may reduce relative deprivation and downstream correlates such as burnout and disengagement.

Discussion in class should emphasize appraisal limits: this is a single cross-sectional study using self-report instruments in a Chinese undergraduate nursing sample, which restricts causal inference and generalizability to other cultural or curricular contexts, including Canadian nursing programs. The metadata available for this article did not include effect sizes beyond the reported mediation proportion, confidence intervals, or the full names and psychometrics of the instruments used, so instructors should direct students who want to appraise the study rigorously to retrieve the full text (Psychology in the Schools, Vol. 61, Issue 4, pp. 1360-1374; DOI 10.1002/pits.23116) via their institutional library rather than relying on the abstract alone. This article pairs well with related work on perfectionism and interpersonal sensitivity in nursing students for a broader unit on student mental health and resilience-building curricula.