(PS6-A4) The Impact of Depressive Symptomatology on Positive and Negative Body Image Dimensions in Adolescents with Eating Disorders

Eating Disorders (ED) have a harmful impact on an individual's physical and mental health, and there is ample evidence of the role of body image (BI) in preventing and treating these disorders (Cook-Cottone, 2015; Levine & Piran, 2004). Additionally, a large body of evidence suggests that the way individuals experience and respond to emotions is a crucial factor in EDs (Haynos & Fruzzetti, 2011) and depression has been identified as a risk factor for their onset and perpetuation, with recent research indicating that symptoms of depression may precede the development of ED symptoms (Goldschmidt et al., 2012; Kenny et al., 2022). However, while several studies have found a relationship between depression or negative emotional states and ED in adolescents, their role and impact on positive and negative body image (BI) dimensions have not been fully explored. The objective of this study was to analyze the effect of depressive symptomatology on the dimensions of both –positive and negative - BI. A sample of 42 Spanish adolescents suffering from ED [Age: M = 15.88, SD = 1.40, range: 13-18 years old; Body Mass Index (BMI): M = 18.30; SD = 2.60; range: 14-27 kg/m²] completed two virtual reality tasks (to assess (a) perceived body size estimation -PBSE-; and (b) ideal body size estimation -IBSE) and questionnaires related to depressive symptomatology (BDI-II; Beck et al., 1996), body dissatisfaction (BSQ; Cooper et al., 1987), body appreciation (BAS-2; Tylka & Wood-Barcalow, 2015), body esteem (BES; Franzoi & Shields, 1984); body compassion (BCS; Altman et al., 2020), body shame (BISS, Duarte et al., 2015) body objectification (OBCS; McKinley & Hyde, 1996), and eating pathology (EDI-3-RF; Garner, 2004). Pearson correlation showed positive significant relationships of BDI-II with the negative dimensions of BI (BSQ, EDI-3-RF, BISS, and OBCS) (r ranging from .45 to .62) and negative significant relationships of BDI-II with positive dimensions of BI (BAS-2, BCS, and BES) (r ranging from -.51 to -.61). In addition, BDI-II positively correlated with PSBE. The results from the multiple regression showed that BDI-II, along with BMI, explained 58.3% of the variance of PSBE. Also, BDI-II (but not BMI) explained between 22.7% and 26% of the variance of negative BI dimensions and between 23% and 34.3% of the positive BI dimensions. In sum, our results show that those ED adolescents with higher levels of depressive symptoms tend to perceive their body as fatter, and show higher levels of body dissatisfaction, body shame, body objectification, and eating pathology, and conversely, show lower levels of body appreciation, body compassion, and body esteem. These findings also indicate that depressive symptoms are a significant predictor of a distorted body size estimation (with BMI) and of both negative and positive dimensions of BI (along with BMI). Overall, this study highlights the importance of addressing depressive symptomatology in the comprehension and treatment of ED, as it appears to be a significant factor in shaping how individuals experience and respond to their BI. Future longitudinal studies should explore whether including depressive symptomatology as a target in the ED treatment would lead to a higher recovery rate and, further promotion of positive BI.