Negative Childhood Events and the Development of the Anorexic Voice: A Grounded Theory

Overview

Journal Psychol Psychother

Specialty Psychiatry

Date 2022 Jul 27

PMID 35894418

Authors

Jet Morrison

Marc O Williams

John R E Fox

Affiliations

Soon will be listed here.

Abstract

Background: Many individuals diagnosed with anorexia nervosa (AN) describe their disorder as being represented by an internal 'anorexic voice' (AV). Previous studies have identified associations between eating psychopathology and multifarious forms of adverse life experiences.

Aims: This study explores the relationship between adverse experiences in childhood and the development of the AV.

Materials And Methods: Twelve women who had the experience of the AV in the context of a diagnosis of AN took part in semi-structured interviews. The interview data were analysed using a constructivist grounded theory methodology.

Results: Participants recalled feeling unsafe in a variety of relationships and a theory was constructed in which the AV provides a sense of conditional safety, becoming increasingly hostile and belittling when it is disobeyed, revealing similar characteristics to abusers and bullies in childhood.

Discussion: Findings are related to the broader literature on the link between trauma and eating disorders, and to existing theories of internal voices.

Conclusions: The findings have implications for a trauma-focused approach when working with the AV.

Citing Articles

The Battle Within: A Qualitative Meta-Synthesis of the Experience of the Eating Disorder Voice.

Tragantzopoulou P, Mouratidis C, Paitaridou K, Giannouli V Healthcare (Basel). 2024; 12(22).

PMID: 39595503 PMC: 11594064. DOI: 10.3390/healthcare12222306.

Anorexia Nervosa in Juvenile Systemic Lupus Erythematosus (SLE): A Causality Dilemma.

Grammatikopoulou M, Syrmou V, Lioliopoulou M, Gkiouras K, Simopoulou T, Katsiari C Children (Basel). 2023; 10(4).

PMID: 37189946 PMC: 10137086. DOI: 10.3390/children10040697.

Belief Inflexibility and Cognitive Biases in Anorexia Nervosa-The Role of the Bias against Disconfirmatory Evidence and Its Clinical and Neuropsychological Correlates.

Tenconi E, Meregalli V, Buffa A, Collantoni E, Cavallaro R, Meneguzzo P J Clin Med. 2023; 12(5).

PMID: 36902532 PMC: 10003469. DOI: 10.3390/jcm12051746.

Life Events in the Etiopathogenesis and Maintenance of Restrictive Eating Disorders in Adolescence.

Baradel G, Pratile D, Orlandi M, Vecchio A, Casini E, De Giorgis V Children (Basel). 2023; 10(2).

PMID: 36832506 PMC: 9955930. DOI: 10.3390/children10020376.

A Grounded Theory Construction of the eSports Endogenous Drive Model.

Chen Z, Bu X J Environ Public Health. 2022; 2022:7731127.

PMID: 36213045 PMC: 9546701. DOI: 10.1155/2022/7731127.

References

Molendijk M, Hoek H, Brewerton T, Elzinga B . Childhood maltreatment and eating disorder pathology: a systematic review and dose-response meta-analysis. Psychol Med. 2017; 47(8):1402-1416. DOI: 10.1017/S0033291716003561. View

Higbed L, Fox J . Illness perceptions in anorexia nervosa: a qualitative investigation. Br J Clin Psychol. 2009; 49(Pt 3):307-25. DOI: 10.1348/014466509X454598. View

Mond J, Hay P, Rodgers B, Owen C, Beumont P . Validity of the Eating Disorder Examination Questionnaire (EDE-Q) in screening for eating disorders in community samples. Behav Res Ther. 2004; 42(5):551-67. DOI: 10.1016/S0005-7967(03)00161-X. View

Banerjee R, Dittmar H . Individual differences in children's materialism: the role of peer relations. Pers Soc Psychol Bull. 2007; 34(1):17-31. DOI: 10.1177/0146167207309196. View

Lamoureux M, Bottorff J . "Becoming the real me": recovering from anorexia nervosa. Health Care Women Int. 2005; 26(2):170-88. DOI: 10.1080/07399330590905602. View

Longden E, Madill A, Waterman M . Dissociation, trauma, and the role of lived experience: toward a new conceptualization of voice hearing. Psychol Bull. 2011; 138(1):28-76. DOI: 10.1037/a0025995. View

Loberg E, Gjestad R, Posserud M, Kompus K, Lundervold A . Psychosocial characteristics differentiate non-distressing and distressing voices in 10,346 adolescents. Eur Child Adolesc Psychiatry. 2019; 28(10):1353-1363. PMC: 6785583. DOI: 10.1007/s00787-019-01292-x. View

Tierney S, Fox J . Living with the anorexic voice: a thematic analysis. Psychol Psychother. 2010; 83(Pt 3):243-54. DOI: 10.1348/147608309X480172. View

Henderson Z, Fox J, Trayner P, Wittkowski A . Emotional development in eating disorders: A qualitative metasynthesis. Clin Psychol Psychother. 2019; 26(4):440-457. PMC: 6766861. DOI: 10.1002/cpp.2365. View

10.

Pugh M, Waller G, Esposito M . Childhood trauma, dissociation, and the internal eating disorder 'voice'. Child Abuse Negl. 2018; 86:197-205. DOI: 10.1016/j.chiabu.2018.10.005. View

11.

Rabito-Alcon M, Baile J, Vanderlinden J . Mediating Factors between Childhood Traumatic Experiences and Eating Disorders Development: A Systematic Review. Children (Basel). 2021; 8(2). PMC: 7915652. DOI: 10.3390/children8020114. View

12.

Thakkar R, McCanne T . The effects of daily stressors on physical health in women with and without a childhood history of sexual abuse. Child Abuse Negl. 2000; 24(2):209-21. DOI: 10.1016/s0145-2134(99)00129-5. View

13.

Guillaume S, Jaussent I, Maimoun L, Ryst A, Seneque M, Villain L . Associations between adverse childhood experiences and clinical characteristics of eating disorders. Sci Rep. 2016; 6:35761. PMC: 5090200. DOI: 10.1038/srep35761. View

14.

Kim K, Mennen F, Trickett P . Patterns and correlates of co-occurrence among multiple types of child maltreatment. Child Fam Soc Work. 2017; 22(1):492-502. PMC: 5720384. DOI: 10.1111/cfs.12268. View

15.

Jonson-Reid M, Drake B, Chung S, Way I . Cross-type recidivism among child maltreatment victims and perpetrators. Child Abuse Negl. 2003; 27(8):899-917. DOI: 10.1016/s0145-2134(03)00138-8. View

16.

Postuvan V, Podlogar T, Zadravec Sedivy N, De Leo D . Suicidal behaviour among sexual-minority youth: a review of the role of acceptance and support. Lancet Child Adolesc Health. 2019; 3(3):190-198. DOI: 10.1016/S2352-4642(18)30400-0. View

17.

Pennebaker J, Susman J . Disclosure of traumas and psychosomatic processes. Soc Sci Med. 1988; 26(3):327-32. DOI: 10.1016/0277-9536(88)90397-8. View

18.

Scheller-Gilkey G, Moynes K, Cooper I, Kant C, Miller A . Early life stress and PTSD symptoms in patients with comorbid schizophrenia and substance abuse. Schizophr Res. 2004; 69(2-3):167-74. DOI: 10.1016/s0920-9964(03)00188-9. View

19.

Morrison J, Williams M, Fox J . Negative childhood events and the development of the anorexic voice: A grounded theory. Psychol Psychother. 2022; 95(4):1018-1035. PMC: 9796900. DOI: 10.1111/papt.12416. View

20.

Pugh M, Waller G . Understanding the 'Anorexic Voice' in Anorexia Nervosa. Clin Psychol Psychother. 2016; 24(3):670-676. DOI: 10.1002/cpp.2034. View