Changes in the eating disorder voice over time and the association of voice characteristics at baseline with clinical symptoms in patients with anorexia nervosa

Ludovica Natali, Thomas Ward, Katie Rowlands, Viviana Aya Shepherd, Janet Treasure, Valentina Cardi

Research output: Contribution to journalArticlepeer-review

Abstract

Objective
Patients with eating disorders report the experience of living with an eating disorder voice, a second- or third-person, negative commentary about eating, weight, shape and their implications for self-esteem. Qualitative and cross-sectional studies suggest that the severity and characteristics of the eating disorder voice might play a role in the maintenance of eating disorder symptoms. The goal of this study was to expand the evidence base as to how the eating disorder voice changes over time and whether the characteristics of the voice are associated with changes in eating disorder symptoms during treatment.

Method
Seventy-two patients with anorexia nervosa receiving intensive eating disorder treatment were recruited. They completed self-report measures of eating disorder symptoms, psychological distress and eating disorder voice's severity and characteristics (e.g., malevolence, benevolence and omnipotence) at baseline and approximately 6 months later.

Results
Over time, patients reported lower levels of eating and weight concern (small effect size), shape concern (large effect size) and anxiety (small effect size).

They also reported a reduction in the severity, perceived malevolence (medium effect size) and omnipotence (small effect size) of the eating disorder voice. Greater severity and malevolence of the voice, and lower benevolence at baseline predicted greater reductions in eating disorder symptoms (i.e., restraint and shape concern).

Conclusion
Beliefs about the eating disorder voice (i.e., malevolence) and severity of the voice appear to be malleable to treatment and are associated with a reduction of eating disorder symptoms. The potential of using dialogical approaches to target the eating disorder voice is discussed.
Original languageEnglish
JournalClinical Psychology and Psychotherapy
DOIs
Publication statusPublished - 12 Dec 2023

Fingerprint

Dive into the research topics of 'Changes in the eating disorder voice over time and the association of voice characteristics at baseline with clinical symptoms in patients with anorexia nervosa'. Together they form a unique fingerprint.

Cite this