Relationship of Perfectionism and Body Image Concern in Individuals Demanding Cosmetic Dental Restorations: The Mediating Roles of Psychological Inflexibility and Cognitive Fusion

Abstract

Background: Perfectionism is increasingly recognized as a contributing factor in the decision to pursue cosmetic dental restorations, yet its psychological pathways remain insufficiently studied. Objectives: The present study examined the association between perfectionism and body image concern among individuals seeking such treatments, focusing on the mediating effects of psychological inflexibility and cognitive fusion. Methods: A cross-sectional study was conducted with 195 adults (mean age = 31.71 ± 9.71 years) in Sanandaj, Iran. Participants completed validated instruments assessing perfectionism, body image concern, psychological inflexibility, and cognitive fusion. Statistical analyses included independent t-tests, Pearson’s correlations, and mediation analyses using Sobel tests within a structural equation modeling framework. A Bonferroni-adjusted significance threshold of P < 0.001 was applied. Results: Perfectionism demonstrated significant positive correlations with body image concern (r = 0.443, P < 0.001), psychological inflexibility (r = 0.610, P < 0.001), and cognitive fusion (r = 0.483, P < 0.001). Psychological inflexibility fully mediated the relationship between perfectionism and body image concern, whereas cognitive fusion acted as a partial mediator. Model fit indices supported the adequacy of the proposed relationships. Conclusions: The findings suggest that perfectionism contributes to body image concern both directly and indirectly through increased psychological inflexibility and cognitive fusion. Incorporating psychological screening and targeted interventions, such as acceptance and commitment therapy (ACT), into cosmetic dental care may help address unrealistic expectations and improve treatment satisfaction.