The development and assessment of a scale to measure the experience of an anorexic voice in anorexia nervosa

Abstract

The anorexic voice (AV) is defined as a critical internal dialogue, which has been implicated in the development and maintenance of anorexia nervosa (AN). Systematic research to explore this further requires a valid and reliable measurement tool. This study aimed to develop and assess the validity of the Experience of an Anorexic VoicE Questionnaire (EAVE-Q). EAVE-Q items were developed and checked for face and content validity through cognitive interviews with seven individuals diagnosed with AN. Participants with a diagnosis of AN (N = 148) completed the EAVE-Q, sociodemographic questions and measures of mood and quality of life to assess internal consistency and construct validity. Forty-nine participants completed the EAVE-Q twice more to assess test-retest reliability. The EAVE-Q had good face and content validity and good acceptability. Principal axis factoring resulted in an 18-item scale organized into five domains with high internal consistency (α = 0.70 to α = 0.85). Domains correlated significantly with eating disorder symptoms, psychological distress, and quality of life. The EAVE-Q did not discriminate between participants on the basis of body mass index. Test-retest reliability was moderate. Although the factor structure of the EAVE-Q requires replication in other AN samples, the EAVE-Q is the first measure of a critical internal dialogue in AN. It is hoped that it will aid future research to increase understanding of AN and the continued development of person-centred treatments.

Phonological working memory is adversely affected in adults with anorexia nervosa: a systematic literature review

“…However, the inherent subvocal nature of this proposed phenomena makes it difficult to systematically capture [ 86 ]. An initial step in resolving this could be through the recently developed Experience of an Anorexic VoicE Questionnaire (EAVE-Q) [ 142 ]. Although the early validity and internal consistency measures of the EAVE-Q have been promising, further re-tests will be necessary to fully determine its reliability.…”

Applying emotion-focused therapy to work with the “anorexic voice” within anorexia nervosa: A brief intervention.

“…The EAVE-Q has recently been developed and measures the presence and significance of an AV in AN. Psychometric properties of the EAVE-Q have been found to be good, with Cronbach’s a = 0.83, test–retest reliability was moderate and construct validity was good (Hampshire et al, 2020).…”

“…The Experience of Anorexic VoicE-Questionnaire (EAVE-Q; Hampshire et al, 2020). The EAVE-Q has recently been developed and measures the presence and significance of an AV in AN.…”

An open invitation to productive conversations about feminism and the spectrum of eating disorders (part 2): Potential contributions to the science of diagnosis, treatment, and prevention

“…Lived experience descriptions of being controlled, and indeed tormented, by such a voice are found throughout the eating disorder treatment literature [ 40 ]. As with most topics in eating disorder research, the “voice” has been explored mostly in the context of restrictive eating disorders and is sometimes referred to as the “anorexic voice” or “Ed” (short for the “ e ating d isorder” voice; [ 41 – 43 ]. The prevalence and personal relevance of “the voice” within eating disorder stories has led to efforts at developing scales to explore how this voice is tied to selfhood amongst people diagnosed with anorexia [ 41 ].…”

“…The concept of “the eating disorder voice” potentially enriches our understanding of what it means to be a person with an eating disorder [ 41 , 42 , 44 ]. However, it is not without its critics [ 29 ], and is unlikely to completely explain the subjective experience of “having” or “living with” an eating disorder.…”