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The present controlled study examined anorexic and psychological characteristics of female ballet dancers, who by career choice must focus on thinness, and anorexia nervosa patients. Anorexia nervosa (AN) patients, female ballet (BA) students as well as asymptomatic female controls (AF) were compared with respect to the psychological characteristics: the Drive to Achieve, the Motive to Avoid Failure (Negative Fear of Failure) and the Motive to Achieve (Positive Fear of Failure). The results confirmed previous empirical and clinical findings that the AN group and the BA group can be differentiated from a control group with respect to a heightened Drive to Achieve. However, the Drive to Achieve of AN patients was found to originate in an avoidance of failure (the Negative Fear of Failure), while in BA students this drive was found to stem from a motive to achieve (the Positive Fear of Failure). The findings underline the importance of an evaluation of psychological characteristics in subjects with anorexic symptoms.