3 - (OP22) Possible Treatment Targets for Working with the Eating Disorder Voice (EDV) Using a Cognitive Behavioral Approach

Adults with an eating disorder have been documented to describe an internal eating disorder voice (EDV). Few studies have examined characteristics of the EDV in American adults that may represent potential treatment targets in cognitive behavioral therapy (CBT). The purpose of this study was to examine characteristics of the EDV found in adults with a diagnosis of an eating disorder that may be helpful to inform CBT treatment planning. Participants in the study were 61 adults (33 women, 27 men, 1 other; Mage = 29.4 years) with a diagnosis of an eating disorder. Participants were provided a standardized definition of the EDV (e.g., Pugh & Waller, 2016), prior to completing an e-survey including demographics, characteristics of the EDV, Eating Disorders Examination Questionnaire (EDE-Q; Fairburn & Beglin, 1994), Beliefs about Voices Questionnaire (BAVQ-R; Chadwick et al., 2000; Strauss et al., 2018), Detail and Flexibility Questionnaire (Dflex; Roberts et al., 2011), and the Obsessive-Compulsive Inventory – Revised (OCI-R; Foa et al., 2002). Most adults (88.3%) with an eating disorder endorsed hearing 2 or more distinct EDVs. Women were significantly more likely to endorse the voice as female, and men were more likely to experience the voice as male. Higher levels of cognitive rigidity and OCD symptoms predicted more persecutory beliefs about the EDV. OCD symptoms were also linked to benevolent beliefs about the EDV. These preliminary results help to inform the CBT treatment planning for eating disorders including possible targets for cognitive restructuring and behavioral experiments as part of a comprehensive treatment in the later stages of recovery from the illness.