Nearly a decade of research has shown that high achieving students are at elevated risk for serious adjustment problems \u2014 including internalizing and externalizing symptoms and substance use. In this study, we examine the relationship among three types of risk factors, including parent expectations and criticism, self-reported perfectionism, and daily stressors, and internalizing symptoms, rule-breaking behaviors, and substance use.

Perfectionism and daily stressors (e.g., relationship stress and hours of sleep) were significantly associated with internalizing symptoms and rule-breaking behaviors for both males and females across schools. Our findings suggest that there may be a unique interplay among perfectionism, relationship stress, and hours of sleep for students attending high achieving schools. Future research should attempt to tease apart the interactions among these risk factors and determine whether interventions should address them as separate, modifiable dimensions or treat them in a holistic manner.