(PS6-A8) Examining the Effect of Depression on the Relationship Between Health Behaviors and Body Image Among Childhood Cancer Survivors

Background. Negative body image among adolescent and young adult (AYA) cancer survivors is often a significant finding in studies assessing psychological wellbeing among this population. Negative body image may increase psychological distress, as well as impact intimacy, future family-building goals, and close relationships. Certain health behaviors, such as tobacco use, alcohol use, and physical activity, have been shown to influence body image. In addition to such health behaviors, studies have shown that depression and body image may be related – an important finding, given that rates of depression among childhood cancer survivors surpass, and sometimes double, healthy controls. As such, we propose that depression may influence the relationship between health behaviors and body image. Should we find such a moderating effect, these data would provide a clear pathway for potential development of interventions to target mechanisms of both depression and health behaviors, leading to greater body image among AYA cancer survivors.

Methods. A sample of 153 AYA cancer survivors completed the Body Image Instrument (BII), Patient Health Questionnaire (PHQ-9), and questionnaires assessing health behaviors (tobacco use, alcohol use, and physical activity). Health behaviors were grouped into four categories: tobacco use (30-day use), alcohol use (30-day use), alcohol binge drinking (5+ drinks in a day in the past 30 days), and physical activity (at least 3 days of 20-minute moderate activity and 2 days of strength training, meeting current recommendations). Post-hoc moderation models were used to assess the effect of depression on the relationship between such health behaviors and body image.

Results. Mean age was 21.8 years (SD = 2.55), with 91.5% identifying as White, 3.9% as Black/African American, and 1.3% each of American Indian/Alaska Native and Asian/Pacific Islander. 7.2% identified as Hispanic/Latino. 58.2% of the sample identified as male and 41.8% of the sample as female. Due to low sample size, tobacco use (N = 17) was dropped from further analyses. 80 participants met recommended physical activity guidelines; 112 indicated past-month alcohol use; and 78 indicated binge drinking. Based on our moderation models, there was a clear interaction effect between binge drinking and depression on body competence (B = .0064; SE = .0032; p = .05) and general appearance (B = .0064; SE = .003; p = .04). The interaction of physical activity and depression on others’ reaction to appearance was also significant (B = -.0437; SE = .0215; p = .04).

Conclusion. Depression moderates the relationship between health behavior and body image, but only for certain types of behavior and certain components of body image. As such, our data provide preliminary evidence for eventual intervention development focused on targeting alcohol binge drinking and physical activity in order to increase body image. Future studies should assess alternate health behaviors in order to discern if depression might similarly influence other facets of body image.