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Tattoos, body piercings, and self-injury: Is there a connection? Investigations on a core group of participants practicing body modification
Psychotherapy Research
Abstract
Reliable psychosocial data about practitioners of body piercing and tattooing are few and controversial. The goal of this study was to reinvestigate the issue by studying a large sample of individuals with body modifications (BMs), focusing on the motives and relations to biographical events. A 55-item anonymous self-report questionnaire was distributed among volunteers of what is considered to be a core group of individuals wearing BMs (N=432). Results show that BMs changed the participants' attitude toward their body considerably, and 34% of all participants reported BM practices in conjunction with decisive biographical events. Twenty-seven percent of the participants admitted self-cutting during childhood. This group differed from the group without self-cutting with respect to several features before, during, and after BM. The rate of medical complications of BM was 16% in the total sample, with a remarkably higher rate (26%) among participants with a history of self-cutting. The data suggest that the significance of BMs ranges from simple peer group imitations to highly informative symptoms of possibly severe psychopathological conditions. In the latter case, BMs sometimes serve as therapeutic substitutes.
... Do podobnego wniosku doszli Liu i Lester (2012), którzy odkryli, że doświadczenie przemocy fizycznej, seksualnej i psychicznej oraz zaniedbania emocjonalne były istotnie związane z posiadaniem kolczyków, tatuaży, skaryfikacji. Inne badania wskazują, że 27% badanych z tatuażami samookaleczało się w dzieciństwie (Stirn, Hinz, 2008). Niniejsze doniesienia wskazują, że część osób tatuujących się mogłaby w ten sposób regulować swoje doświadczenia emocjonalne. ...
... Z powyższego przeglądu wynika, że istnieje wiele niejednoznacznych wniosków płynących z badań populacji osób tatuujących się. Jedne z nich wskazują na związek tatuowania z występowaniem zakłóceń emocjonalnych (Ferguson--Rayport, Griffith, Strauss, 1955;Taylor, 1968;Howell, Payne, Roe, 1971;Buhrich, Morris, 1982;Harry, 1987;Raspa, Cusack, 1990;Kim, 1991;Carroll i in., 2002;Manuel, Retzlaff, 2002;Roberts, Ryan, 2002;Brooks i in., 2003;Nathanson, Paulhus, Williams, 2006;Stirn, Hinz, 2008;Kertzman i in., 2019), inne świadczą o tym, że tatuowanie można traktować jako pozytywną zmianę, wzmacniającą poczucie integralności siebie oraz powodującą wzrost samooceny (Cipolletta, Faccio, Berardi, 2010;Swami, 2011;Mun, Janigo, Johnson, 2012;Swami i in., 2015Swami i in., , 2016. Wydaje się, że oba stanowiska niosą istotne wnioski a redukowanie tatuażu do ewentualnego markera zaburzeń psychicznych stanowi duże uproszczenie. ...
... Należy mieć na uwadze badania przeprowadzone na dużej populacji (N = 2043) przez Stirn, Hinza i Brählera (2006), w których wykazano, że tatuowanie było znacząco skorelowane z postrzeganiem swojego zdrowia psychicznego jako obniżonego. W innym raporcie 27% osób z modyfikacjami ciała samookaleczało się w dzieciństwie (Stirn, Hinz, 2008), a uczestnicy wykorzystywani seksualnie twierdzili, że poprzez tatuowanie chcieli przezwyciężyć trudne doświadczenia (Stirn i in., 2011). Powyższe doniesienia naukowe mogą sugerować związek tatuowania z próbą regulowania trudnych emocji, co wymaga empirycznej weryfikacji. ...
Tattooing is currently one of the most popular forms of body modification. It involves the insertion of pigment under the skin according to a predetermined pattern. This procedure represents a significant interference with one's own skin, which seems to be not indifferent to the individual's psychological world. For many years, psychological research on the population of people with tattoos has focused on finding links between tattooing and the occurrence of psy-chopathology. Nowadays, the positive significance of tattoos is emphasised and it is argued that they are not indicative of an individual's psychological deficits. The aim of this article is to present the current understanding of tattooing and to propose contemporary psychological functions that tattoos may have.
... self-esteem [14], impulsivity [15], substance abuse [16], suicide [17]…), whilst other studies do not find any relationship [18]. In fact, some authors consider that the psychopathological significance of BMs depends on the patient's profile and history, and ranges from no signification to potentially informative of the underlying psychopathology [19]. Also, another question of interest when considering BMs and psychopathology is the nature of the relationship between NSSI and BMs [20]. ...
... Indeed, many studies have suggested that BMs can be used as a mean of emotion regulation (e.g. [19,20,24,25]. For example, Stirn & Hinz (2008) formulated the hypothesis that, in their groups of volunteers wearing BMs, among those who reported having engaged in NSSI in their childhood (27% in their sample), some could use body modifications as a substitute for their autoaggressive behaviors, and some former self-cutters even attributed "therapeutic significance" to their BMs. ...
... [19,20,24,25]. For example, Stirn & Hinz (2008) formulated the hypothesis that, in their groups of volunteers wearing BMs, among those who reported having engaged in NSSI in their childhood (27% in their sample), some could use body modifications as a substitute for their autoaggressive behaviors, and some former self-cutters even attributed "therapeutic significance" to their BMs. ...
Background: Borderline Personality Disorder (BPD) is a potentially severe personality disorder, characterized by difficulties in emotion regulation and control of behaviors. It is often associated with non-suicidal self-injury (NSSI). Borderline personality features have also been linked to body modifications (BMs). However, the prevalence of BMs, the link between BMs and NSSI, and between BMs and several psychopathology dimensions (e.g. borderline severity, emotion regulation, impulsivity …) remains understudied in patients with BPD. This study aims to fill this gap, and to provide further evidence on the link between NSSI and BMs.
Methods: We used data from a psychiatric outpatient center located in Switzerland (n = 116), specialized in the assessment and treatment of BPD patients. Patients underwent several semi-structured interviews and self-report psychometric scales at the arrival, and the data were retrospectively analyzed.
Results: We found that 70.69% of the patients had one piercing or more, and 69.83% were tattooed. The total score of body modifications and the total number of piercings score of piercings were significantly positively associated with NSSI and the SCID BPD total score. The association with the SCID score was mainly driven by the “suicide and self-damaging behaviors” item and the “chronic feeling of emptiness” item. A significant association was found between total number of piercings and emotion dysregulation. On the other hand, the self-reported percentage of body covered by tattoos score was specifically associated with the sensation seeking subscale of the UPPS-P.
Conclusion: This study provides evidence on the prevalence of BMs in BPD patients, and on the link between BMs and NSSI in this population, suggesting a role of emotion regulation in the link between both constructs. These results also suggests that tattoos and piercings may be differentially linked to specific underlying psychological mechanisms. This calls for further considerations of body modifications in the assessment and care of BPD patients.
... self-esteem (14), impulsivity (15), substance abuse (16), suicide (17)…), whilst other studies do not nd any relationship (18). In fact, some authors consider that the psychopathological signi cance of BMs depends on the patient's pro le and history, and ranges from no signi cation to potentially informative of the underlying psychopathology (19). Also, another question of interest when considering BMs and psychopathology is the nature of the relationship between NSSI and BMs (20). ...
... Indeed, many studies have suggested that BMs can be used as a mean of emotion regulation (e.g. (19,20,24,25). For example, Stirn & Hinz (2008) formulated the hypothesis that, in their groups of volunteers wearing BMs, among those who reported having engaged in NSSI in their childhood (27% in their sample), some could use body modi cations as a substitute for their auto-aggressive behaviors, and some former self-cutters even attributed "therapeutic signi cance" to their BMs. ...
... (19,20,24,25). For example, Stirn & Hinz (2008) formulated the hypothesis that, in their groups of volunteers wearing BMs, among those who reported having engaged in NSSI in their childhood (27% in their sample), some could use body modi cations as a substitute for their auto-aggressive behaviors, and some former self-cutters even attributed "therapeutic signi cance" to their BMs. ...
Background
Borderline Personality Disorder (BPD) is a potentially severe personality disorder, characterized by difficulties in emotion regulation and control of behaviors. It is often associated with non-suicidal self-injuries (NSSI). Borderline personality features have also been linked to body modifications (BMs). However, the prevalence of BMs, the link between BMs and NSSI, and between BMs and several psychopathology dimensions (e.g. borderline severity, emotion regulation, impulsivity …) remains understudied in patients with BPD. This study aims to fill this gap, and to provide further evidence on the link between NSSI and BMs.
Methods
We used data from a psychiatric outpatient center located in Switzerland (n = 116), specialized in the assessment and treatment of BPD patients. Patients underwent several semi-structured interviews and self-report psychometric scales at the arrival, and the data were retrospectively analyzed.
Results
We found that 70.69% of the patients had one piercing or more, and 69.83% were tattooed. The total score of body modifications and the total number of piercings score of piercings were significantly positively associated with NSSI and the SCID BPD total score. The association with the SCID score was mainly driven by the “suicide and self-damaging behaviors” item and the “chronic feeling of emptiness” item. A significant association was found between total number of piercings and emotion dysregulation. On the other hand, the self-reported percentage of body covered by tattoos score was specifically associated with the sensation seeking subscale of the UPPS-P.
Conclusion
This study provides evidence on the prevalence of BMs in BPD patients, and on the link between BMs and NSSI in this population, suggesting a role of emotion regulation in the link between both constructs. These results also suggests that tattoos and piercings may be differentially linked to specific underlying psychological mechanisms. This calls for further considerations of body modifications in the assessment and care of BPD patients.
... Strong identification is in line with previous findings on body modifications in general. For example, Stirn & Hinz [58] showed that a majority of those with body modifications chose the statement "I am tattooed / body pierced" (83%) over the statement "I have a tattoo / body piercing" (17%). ...
... Success in life may have been assessed against external factors or the mere passage of time, independently of the piercing. The average age of getting a first piercing is around 19-20 years for women [7,25,58] and it is therefore likely that participants were assessing themselves at ages when they had naturally less vs. more personal and professional achievements in life. Further, there was little self-reported change in clothing style and only a minority of women felt that fortuitous events occurred since their navel piercing. ...
... We speculate that women with navel piercings scored similarly on the BICI as a result of having the navel piercing. This would be in line with the notion that body piercings may be an attempt to enhance one's body image [7,25,58, see also 64]. The BPNPQ indicated that navel piercings can improve women's perception of their own bodies, and this may subsequently result in less engagement in the excessive body surveillant and body avoidant thoughts and behaviours that are measured by the BICI. ...
The present study investigated how women’s body image and body-perceptual processes are affected by navel piercings, an embellishment of the abdominal region women often feel negatively about. We probed perceptual (response times), cognitive (surveys), affective (aesthetic ratings) and neural (event-related potentials, ERPs) facets of (own) body perception. We found that navel piercings are primarily motivated by the desire to enhance one’s body image, and can significantly improve bodily self-perception relative to before and to imagined removal of the piercing. Hence, body image concerns in women with navel piercings were found to be comparable to those of a control group; and their aesthetic ratings of other women’s abdomens only differed, positively, for images depicting navel piercings. ERPs indicated that the sight of navel piercings enhances early structural encoding of bodies as well as late emotional-motivational processes, especially in women with navel piercings. We further found a strong self-advantage in both cortical and behavioural responses during recognition of own and others’ abdomens, especially for images displaying the piercing. Altogether, findings suggest that navel piercings become strongly, and beneficially, integrated into women’s bodily self image. Such piercings may thus be seen as expressions of body care that can protect against self-harming thoughts and behaviours.
... Body modifications were reported to change a person's attitude toward her/his own body. 21 Of a random sample of 432 probands with body modifications (tattoos and/or piercings), 25% reported having better control over their body after piercing. 21 According to another study in 79 adolescent females, the number of piercings increases with negative feelings toward the person's own body. ...
... 21 Of a random sample of 432 probands with body modifications (tattoos and/or piercings), 25% reported having better control over their body after piercing. 21 According to another study in 79 adolescent females, the number of piercings increases with negative feelings toward the person's own body. 22 The objective of the present study was to evaluate personality traits and aspects of body perception in a cohort of adults with oral piercing. ...
... For the BFI, which evaluates personality traits like neuroticism, extraversion, openness to experience, agreeableness, and conscientiousness, the present findings are in contradiction to those of other studies that assessed increased extrover-sion, higher openness, and/or less conscientiousness in bodypierced individuals. 21,28,29 Also, with respect to sensation seeking, measured by SSS, the present (unremarkable) findings are in contrast to the results of several studies that found higher scores for body-pierced persons. 21,22,28,[30][31][32][33] This may be an indicator that, in contrast to body piercing in general, oral piercing is more a fashion trend than an act of agitation. ...
Objectives:
Due to the growing popularity of body modifications, dental practitioners are increasingly confronted with oral piercing and its implications. Successful consultation and subsequent change of patient behavior require an understanding of the patient's personality and the deep reasons that explain this self-injurious behavior. This is the first study evaluating personality traits and aspects of body perception in a cohort of adults with oral piercing.
Method and materials:
Sixty-two individuals with labial and/or tongue piercing completed three validated questionnaires assessing body perception and personality traits (Questionnaire for assessing one's own body; Sensation Seeking Scale; Big Five Inventory Scale). Fisher Exact probability test and Mann-Whitney U test were used to determine differences in frequency data and in psychologic parameters between subgroups.
Results:
Eighteen single- and 44 multiple-pierced individuals completed the study (53 women, 9 men). The odds for being multiple pierced was significantly higher for tongue than for labial piercing (3.89 and 0.63, respectively; P = .003). In all psychologic parameters measured, the sample showed score distributions within reference norms. However, multiple-pierced individuals displayed a significantly lesser feeling of attractiveness, less self-confidence, and more uncertainty/anxiety towards their body than single-pierced probands (P < .05).
Conclusion:
Psychologic characteristics of individuals with oral piercing do not fundamentally differ from those of the average population. Therefore, dental practitioners should focus on the medical and dental implications of oral piercing in the counseling of patients who have or intend to have such done.
... Ernst et al. [16] and Claes et al. [21] suggest that body modifications may serve as a socially acceptable form of altering the body for the sake of regulating aversive emotional states. Among participants subscribing to a tattooing and body modification magazine, those who reported cutting themselves had a greater number of piercings than those who did not cut themselves, were more likely to report being addicted to body modifications, and more frequently reported the expected physical pain as motivation for getting body modifications [22]. However, this study did not evaluate whether there was a linear relationship between the number and surface area of body modifications and the amount or frequency of NSSI. ...
... However, the number of piercings an individual had did significantly explain variance in BPD symptomatology, as hypothesized. These results are consistent with findings from previous studies, in which individuals who reported engaging in NSSI, often related to BPD, had a greater number of piercings [4,22]. However, the lack of correlation between BPD features and tattoos is partly inconsistent with Blay et al. [4]. ...
Many people with BPD (borderline personality disorder) experience emotional dysregulation and thus engage in NSSI (non-suicidal self-injury), potentially in the pursuit of emotional regulation. However, research is lacking on whether body modifications (piercings, tattoos, etc.) are linked to BPD in a similar way to NSSI. In the current study, we hypothesized (1) that body modifications are associated with BPD symptoms, (2) that emotional regulation and self-expression motivations for body modifications specifically account for variance in BPD symptoms, and (3) that NSSI craving correlates with body modification craving. Participants (N = 199, ages 18–67, located in the USA) were surveyed on BPD symptomatology, NSSI craving, emotional regulation abilities, and the presence of body modifications. The extent of tattooing (number of tattoos and percentage of body surface covered) was not significantly associated with BPD symptomatology, but the number of piercings was. Individuals with higher BPD symptomatology were not more likely to report emotional regulation and self-expression as motivations for obtaining body modifications. NSSI craving scores were significantly positively correlated with body modification craving scores. Body modification may be an alternative method of emotional regulation to NSSI in individuals with BPD, which clinicians may want to consider when treating those with BPD and NSSI.
... Additionally, other forms of body modification are considered psychopathological, such as self-cutting and self-injury (De Mello, 2000;Stirn, Hinz, 2008). Moreover, there is an association between body modification and deviant or illegal activities (Deschesnes, Fines, Demers, 2006). ...
... However, it's important to note that body piercing is generally not permitted in prisons, and our data recorded its prevalence before imprisonment. Additionally, although there is an association between body modification and deviant or illegal activities (Deschesnes, Fines, Demers, 2006), other forms of body modification, such as self-cutting and self-injury, are considered psychopathological (Stirn, Hinz, 2008). ...
Body modification encompasses procedures to achieve permanent or temporary alterations of the human body. Tattooing and body piercing have become the most prevalent forms of body modification. It is reported that getting tattoos while in detention is reported to be a common practice. Only a few studies have examined the prevalence of body modification practices in prisoners. The objectives of this study were to determine the prevalence of body modifications (tattoos and body piercing) and self-injuries among child sex offenders in a Greek prison, as well as to identify factors associated with having a tattoo or acquiring one while in prison. One secondary aim was to examine this population's main motives for body modifications and shed new light on their functions. The authors present the results of their original quantitative study (with a sample of 181 imprisoned child sex offenders) and discuss them in comparison to those of other studies.
... Täl laisia toimenpiteitä ovat esimerkiksi tatuoiminen, lävistäminen ja muu kehonmuokkaus, joilla on varsin pitkät perinteet: esimerkiksi Ötzin muu miossa on useita tatuointeja (34), ja Tutankha monin kuolinnaamiossa ja Buddhan patsaissa on kuvattu venytettyjä korvalehtiä (35,36). Aiem massa tutkimuksessa on havaittu jonkinasteista päällekkäisyyttä kehonmuokkauksen ja itsensä vahingoittamisen kanssa (37), mutta valtaosassa kehonmuokkausta motiivit toiminnalle poikkea vat kuitenkin varsin suuresti itsensä vahingoit ta misen tyypillisistä syistä (37,38). Joitain riski käyttäytymisen muotoja, kuten liiallista alkoho linkäyttöä ja riskinottoa liikenteessä, voisi ajatel la myös itsensä vahingoittamisena (39). ...
... Täl laisia toimenpiteitä ovat esimerkiksi tatuoiminen, lävistäminen ja muu kehonmuokkaus, joilla on varsin pitkät perinteet: esimerkiksi Ötzin muu miossa on useita tatuointeja (34), ja Tutankha monin kuolinnaamiossa ja Buddhan patsaissa on kuvattu venytettyjä korvalehtiä (35,36). Aiem massa tutkimuksessa on havaittu jonkinasteista päällekkäisyyttä kehonmuokkauksen ja itsensä vahingoittamisen kanssa (37), mutta valtaosassa kehonmuokkausta motiivit toiminnalle poikkea vat kuitenkin varsin suuresti itsensä vahingoit ta misen tyypillisistä syistä (37,38). Joitain riski käyttäytymisen muotoja, kuten liiallista alkoho linkäyttöä ja riskinottoa liikenteessä, voisi ajatel la myös itsensä vahingoittamisena (39). ...
... Simultaneously, the very same act of tattooing might constitute an attempt to feel more alive when one feels dead inside owing to a limited internal experience (Kinecka 2006;Mirucka and Sakson-Obada 2013). Multiple studies demonstrated a link between tattooing and psychopathology, including self-destructive behavior (Kim 1991;Raspa and Cusack 1990;Roberts and Ryan 2002;Stirn and Hinz 2008;Wycisk 2004;2001). Some research also associates body modification with psychological trauma (Atkinson 2002;Romans et al. 1998;Stirn and Möller 2013). ...
... They view their own body as unattractive, even "defective," necessitating serious modification -which is accomplished via tattoos, a permanent alteration of their appearance. The results of this study also correspond to findings of Stirn and Hinz (2008), which showed a connection between body modification (tattoos, piercings) and self-injury. Twenty-seven percent of participants in this study admitted to self-harm behavior during childhood. ...
Tattoo is a permanent body modification relevant to women’s bodily experiences. Previous studies on the population of tattooers have focused mainly on searching for negative or positive aspects of tattooing, mainly in the field of self-esteem. The aim of this study was to explore the mental body representations of tattooed women during emerging adulthood. Three hundred and twenty-seven women with tattoos, aged 18 to 25 (M = 21.48; SD = 2.05), participated in the study. In the study, we adopted a quantitative research project; the data for analysis was obtained from questionnaires that were completed online between January and March 2021. Women with tattoos completed a survey containing demographic questions, questions regarding their tattoos, the Battery of Tests of Body Self Representations, and the Rosenberg Self-Esteem Scale. Based on that a cluster analysis, we have discovered three types of mental body representations that may characterize them: (1) unstable, (2) disordered, and (3) integrated. The study showed that having a tattoo is associated with experiencing carnality in a specific way.
... Correlations have been reported between having a tattoo(s) and lack of religious affiliation, lower academic qualifications, extended jail time, excessive drinking, recreational drug use, and risk-taking behaviors (Greif, Hewitt, & Armstrong, 1999;Heywood et al., 2012;Laumann & Derick, 2006;Silver, VanEseltine, & Silver, 2009). Survey-based studies suggest a connection between tattooing and a tendency toward self-harm, suicide, eating disorders, and reduced mental health (Birmingham, Mason, & Grubin, 1999;Dhossche, Snell, & Larder, 2000;Stirn & Hinz, 2008;Stirn, Hinz, & Brahler, 2006). However, critiques of quantitative-based studies point out how they fail to capture "the more nuanced reasons that individuals get tattooed as well as the more diverse personalities that undergo the process" (Strohecker, 2011, p. 11). ...
... However, she told me she did not self-harm after Boo's death and partly attributes this to the tattoo: "I can be on the verge and look at the paws and gain strength not to do that because Boo, and now Bailey, would be unhappy." A number of studies found positive correlations between mental illness and tattooing (Birmingham et al., 1999;Dhossche et al., 2000;Stirn et al., 2006), including an association with self-harm (Stirn & Hinz, 2008). However, the correlation need not be symptomatic but rather a mechanism for coping. ...
This paper explores multispecies families and nonhuman kinship through the lens of tattoo narratives, namely those that accompany designs dedicated to a companion animal. Although some tattoos are purely aesthetic, many embody deep personal meanings. Humans use narrative as a tool to endow meaning to experience, and the visual nature of a tattoo invites the telling of a story. Participants in this study were compelled to commemorate a special bond shared with their companion animal in the form of a tattoo. A discourse analysis approach was applied to examine narratives under the framework of “nurture kinship” and the theory of kinship as “mutuality of being,” as well as the role of memorial tattoos in griefwork and the theory of “continuing bonds.” Through embodied story-telling, tattoos can help the bereaved maintain an absent presence with the deceased. This study supports the conclusion that humans can and do form kinship bonds with other animals and that memorial tattoos serve similar functions, regardless of the species of the deceased loved one.
... Adult tattoo users report self-injury behavior more frequently, 16,17 sharing psychological precipitants such as negative thoughts of anxiety, tension, anger, distress or depression and interpersonal difficulties before the act. 16,18 These association has been poorly studied in adolescents, although, research suggests those who acquire permanent tattoos during adolescence, specially at earlier ages (11-16 years), have more risk factors for psychopathology and other negative outcomes and engage more frequently in risky behaviors. ...
... 2,3,27 In our study, the frequency of tattoos by sex (male 2.2% vs. girls 1.6%) showed no significant differences, this result is consistent with other studies in the community and in clinical samples. 4,10,17,20 In contrast, other research shows increased frequency in females. 9,11,[28][29][30][31][32] ...
Objective:
To compare adolescents with non-suicidal self-injury behavior and tattoos [NSSI (T+)] with another group with non-suicidal self-injury behavior without tattoos [NSSI (T-)].
Methods:
Adolescents (n=438) 42.6% males from the community (M=12.3, SD=1.3), completed the Self-Injury Schedule.
Results:
The lifetime prevalence of tattoos performed with the purpose to feel pain was 1.8%. Compared to the NSSI (T-) group, the NSSI (T+) group was significantly more likely to meet the DSM-5 frequency criteria of 5 self-injury events in 1 year, practice more than one method of self-injury, and topography, more suicidal intentionality, more negative thoughts and affective emotions before, during, and after self-injury and more academic and social dysfunction.
Conclusion:
Adolescents from the community who practice tattooing to feel pain, show a distinct phenotype of NSSI. Health professionals and pediatricians should assess tattooing characteristics such as intention (to feel pain), frequency, and presence of non-suicidal self-injury behavior and suicide intentionality.
... Researchers have recognized the value and importance that individual motivations have in tattooing practices [3,6]. Stirn and Hinz [7] observed, however, that there are comparatively few studies that focus upon individuals' social background and motivations for body modifications. Atkinson [8] called tattooing "a contextual and negotiated signifier of identity". ...
... Young adults may utilize tattooing to build upon existing desires to be unique and stand out [13]. Alternately, they may be affected by peer pressure or wanting to fit in [6,7]. Atkinson [8] noted that one participant's tattoo had significance as a marker for an accomplishment, but was simultaneously intended as a religious symbol, as well as a display of masculinity. ...
It is difficult to understand why people would choose to have ink injected under their skin as this means taking themselves a mark that will last longer they remains on this earth. There can be multiple constructions and of them, very common preconception focuses on abnormal characteristics associated with tattooed people, even, historically in many places of the world, “tattoos” were regarded as sign of social marginalization for the lower socio-economic groups as well as for marking criminals. But with the large prevalence that has taken place over the last 20-30 years, it has become main-stream, particularly among young people to present and express their self. Over time it has crossed continents, cut across the class and gender lines, flowed between high and low cultural milieus. Though there are many scholarly articles on tattoo have been found concentrating on American and European context but there is a paucity of documentation from India. Present exploratory research is an attempt to understand motivational dimensions from the lived experiences of the tattooed people in the metropolitan city Kolkata. A qualitative approach was adopted using in-depth interviews. Overall evidences suggested that there are many perceptions prompted people to have “tattoo” ranges from art, individuality, spirituality, memories to affection, fashion, scar hiding, idealizing someone and sometimes even influenced from social media.
... Based on a comparative analysis of genetic data and cultural traditions (such as tattoos) among the peoples of the North Pacific region, the authors propose materials that will help confirm or disprove the similarities or differences of population groups having general forms of body modification, i.e., a similar culture of corporeality. Body modifying (tattoos, piercing, scarification, etc.) are considered as the main concepts of self-identification of a person and related community [10][11][12]. The authors previously identified the features of tattoo genesis, tattoo functions and their meanings, forms of symbolic behavior in the peoples of the Northern Pacific [10,[13][14][15][16][17][18]. ...
... There was a definite impression that the participants felt that the process of gaining a tattoo was a painful one, a view which has resonance with research looking at the links between tattooing and self-injury (Stirn and Hinz, 2008;Tantam and Huband, 2009). Whilst not a major theme within the interviews, two of the participants did mention the pain that is related to gaining a tattoo. ...
This thesis explores the affect visible tattoos on nurses have on the therapeutic relationship. Using photo-elicitation interviews, data was collected and analysed using qualitative thematic analysis. In addition, a content analysis was carried out of almost 90% of dress codes and uniform policies from NHS Trusts in England to gain the organisation view of visible tattoos.
... There is research that suggests that, similar to other forms of self-harm (e.g. cutting), some individuals may use the pain involved with self-mutilation or body modification practices to relieve or control emotional and/or mental pain (Favazza, 1996(Favazza, & 1998Stirn & Hinz, 2008;Stirn, 2003). ...
Suicide is the leading cause of death for men and women under the age 34 years, the leading cause of death for males aged under the age of 44 years and costs our nation over $17 billion every year yet it is largely hidden….
... Other researchers propose that tattooing may be a protective or mitigating practice for suicide ideation and suicide attempts in teens and young adults. (Solis-Bravo et al., 2019;Stirn, 2008). The youth self-report questionnaires, the Children's Depression Inventory, and a detailed semi-constructed inquiry to assess psychiatric and psychosocial variables with body tattooing and piercing were administered to 607 high school students in Istanbul. ...
The present research work titled, ‘A Comparative Study of Mental Health Issues Among Tattooed and Non-Tattooed Young Adults’, is based on the enquiry, could many tattoos, in different parts of the body done over a period of time, an indication of onset of mental illness? Why people willingly inflict pain on their body? Do the young adults who get multiple tattoos on different parts of their body have mental health issues? The objectives of the study wereto study themental health of young tattooed adults with the Hypotheses: a) There will be an effect of tattoos on the mental health of young adults with tattoos on different parts of the body, and b) There will be a significant difference between the mental health of tattooed and non-tattooed young adults and the Variablesbeingtattoo (IV) and mental health (DV). Tool: Mental Health Inventory by Jagdish and A.K. Srivastava (1983) that has 56 questions covering six dimensions i.e., positive self-evaluation (10 questions), perception of reality (8 questions), integration of personality (12 questions), autonomy (6 questions), group-oriented attitudes (10 questions), and environmental mastery (10 questions). The Sample Populationwas 60 young adults between the age range of 18 and 25 years (30 with tattoos on different parts of the body and 30 without tattoos) using purposive sampling and Exploratory Research Design. The statistical analysis was done using Descriptive Statisticst test and correlation. This study clearly indicates that tattooed young adults scored poorly in mental health status.
... Исследователи отмечают, что молодые люди, имеющие татуировки или пирсинг на теле и историю самоповреждений в анамнезе, отличаются от сверстников, не имеющих бодимодификаций, повышенными уровнями импульсивности, депрессии и тревоги, низким потенциалом самооценки и социального функционирования [12]. По данным других авторов, изучавших мотивы модификаций тела на большой выборке молодежи, 27% обладателей модной атрибутики в виде татуировок или пирсинга в подростковом возрасте совершали самопорезы [13]. ...
... For example, research suggests that tattooing and body-piercing may serve as a behavioral substitution for traditional NSSI, serving the same function as NSSI but in such a way that the self-injurious intentions of the behavior are obscured. Specifically, studies have found that a majority of individuals with a history of NSSI reported cessation of or decreases in NSSI following initiation of tattooing and body-piercing (Stirn & Hinz, 2008;Wessel & Kasten, 2014). Likewise, Solís-Bravo et al. (2019) found that individuals with NSSI and tattoos reported greater severity of NSSI and had greater endorsement of all NSSID criteria (including past-year NSSI frequency, negative emotional antecedents, NSSI-related cognitions, and resultant distress/impairment) when compared to individuals with NSSI but no tattoos. ...
Nonsuicidal self‐injury (NSSI) is defined as the deliberate destruction of one's own body tissue without suicidal intent and for purposes not socially sanctioned. However, this definition limits the understanding and assessment of NSSI by excluding a clinically relevant form of NSSI that is both self‐driven and associated with self‐injurious intentions: NSSI by proxy. Specifically, we propose that NSSI by proxy be defined as the intentional destruction of one's own body tissue through the elicitation of another being's (e.g., human, animal) actions, wherein the agency of the person being injured is a critical facet of the behavior. We review the literature supporting the clinical relevance of this behavior, as well as its similarities to traditional NSSI. Next, we propose four behaviors that may be conceptualized as NSSI by proxy, and identify two other behaviors that warrant further investigation. Finally, we identify future directions for research in this area and implications for the assessment and treatment of NSSI.
... Along these lines, a recurring theme in the literature has been emotional regulation and coping with stressful life events [25]. In a previous German investigation, participants described the marking of a stage of life, overcoming adversity, and striving to reclaim control over one's life [26] as motives for the acquisition of piercings and tattoos. ...
Background
Tattoos and piercings are becoming increasingly popular in many countries around the world. Individuals seeking such body modifications have reported diverse psychological motives. Besides purely superficial considerations, tattoos and piercings can also have a deep, personal meaning. For example, they can mark and support the emotional processing of significant life events, including formative experiences from early childhood. However, there is a lack of studies that examine the links of tattoos and piercings with experiences of childhood abuse and neglect in large, population-based samples.
Methods
We investigated the association of reports of childhood abuse and neglect with the acquisition of body modifications (tattoos and piercings) within a representative German community sample. Survey participants (N = 1060; ages 14–44 years) were questioned whether they had tattoos and piercings and filled out the 28-item Childhood Trauma Questionnaire Short Form (CTQ-SF).
Results
Tattoos and piercings were more common among individuals who reported childhood abuse and neglect. The proportion of participants with tattoos and piercings increased as a function of the severity of all assessed types of abuse and neglect (emotional, physical, and sexual abuse; emotional and physical neglect). In logistic regression analyses which included the covariates age, gender, education, and income, the sum of significant kinds of childhood abuse and neglect was positively related to having tattoos and/or piercings (OR = 1.37 [95% CI 1.19–1.58]).
Conclusions
The results corroborate previous research indicating that body modifications could have special significance for individuals who have survived adversity, in particular interpersonal trauma at the hands of caregivers. These findings could inform screening procedures and low-threshold access to psychotherapeutic care.
... However, there are some conflicting results on this point. While some research proposes that teens and young adults with tattoos are at increased risk of suicide attempts and unhealthy practices, some claim that tattoos could be a protective or mitigating factor for suicidal ideation and attempts [63,64]. One study in particular noted that expletive tattoos in a forensic context may be associated with unnatural and violent deaths, and that the study of certain subgroups of tattooed individuals may be useful in discerning specific trends that are unclear if "tattoos" are treated as a homogeneous phenomenon [65]. ...
Tattooing is a permanent form of body art applied onto the skin with a decorative ink, and it has been practiced from antiquity until today. The number of tattooed people is steadily increasing as tattoos have become popular all over the world, especially in Western countries. Tattoos display distinctive designs and images, from protective totems and tribal symbols to the names of loved or lost persons or strange figures, which are used as a means of self-expression. They are worn on the skin as a lifelong commitment, and everyone has their own reasons to become tattooed, whether they be simply esthetic or a proclamation of group identity. Tattoos are representations of one’s feelings, unconscious conflicts, and inner life onto the skin. The skin plays a major role in this representation and is involved in different ways in this process. This article aims to review the historical and psychoanalytical aspects of tattoos, the reasons for and against tattooing, medical and dermatological implications of the practice, and emotional reflections from a psychodermatological perspective.
... Dermatologist dealing with tattooed patients should understand, communicate and counsel about this skin affliction which has psychosocial consequences. 1,20 Medical and infectious complications are also ascribed to all intentional and iatrogenic skin afflictions. 21,22 ...
Intentional skin afflictions are often done as a means of relief from medical disorders as in the case of skin branding or as a means of cosmesis and beautification as in body piercing and tattooing. Such practices often have medical and psychosocial consequences.
An observational study was carried out at a teaching hospital where a total of 36 (20 male and 16 female) consecutive patients with skin affliction which were either intentional and/ or iatrogenic, were included in the study after informed consent.
Medical consultation was done for variety of skin afflictions and their consequences including skin branding (8), tattooing (12), body piercing(4), keloids(9) and hypertrophic scars(3). Abdominal causes of branding like ascites, umbilical hernia, chronic abdominal pain, huge splenomegaly were present in subjects who had undergone skin branding from faith healers. Psychosocial consequences of subjects who came for intervention and advice regarding unwanted tattoo marks and body piercing were Tattoo regrets, Army tattoo Policy, Requirement for job procurement, Relationship Conflicts, Disapproval from Peers, Self disapproval, Body image problems, Parental disapproval and others. Subjects having hypertrophic scars and keloids sought treatment for medical issues like pruritus and fear of carcinogenesis as well as for cosmetic reasons.
Studyingprofileandpsychosocial problems related to intentional/iatrogenic skin problems may give insight for prevention of such consequences in dermatology and medical practice.
... Moreover, there are a few studies which report that there are no relations between having tattoo and suicide (Deschesnes et al., 2006) or tendency to commit violence (Stephens, 2003). On the other hand, most of the studies conducted on tattooing report that there is positive correlation between tattooing and alcohol or substance use (Brooks et al., 2003;Carroll et al., 2002;Claes et al., 2005;Deschesnes et al., 2006;Forbes, 2001;Roberts & Ryan, 2002;Zrno, Frencl, Degmecic, & Pozgain, 2015), suicide (Carroll et al., 2002;Koch, Roberts, Armstrong, & Owen, 2005;Koch, Roberts, Armstrong, & Owen, 2015;Yen et al., 2012), depression (Koch et al., 2015), self-injury (Stirn & Hinz, 2008), disordered eating behavior (Claes et al., 2005), violence (Carroll, Riffenburgh, Roberts, & Myhre, 2002), anger and verbal aggression (Swami et al., 2015), increased sexual activity (Carroll et al., 2002;Koch et al., 2005;Roberts & Ryan, 2002), and personality disorders (Vizgaitis & Lenzenweger, 2019). ...
Perceptions about tattoos have recently undergone a fast change and now they are considered as a popular means of self-expression, especially among adolescents and young adults. In the present qualitative study, it is aimed to understand this change by deeply exploring the decision-making processes about having tattoos, the reasons for having tattoos, and the experiences after having tattoos among university students. Semi-structured interviews were conducted with 24 university students (12 females and 12 males) aged between 18 and 24 years from eight different cities in Turkey. As a result of the thematic analysis, ten sub-themes emerged under three major themes (i.e. “Deciding on having a tattoo”, “Reasons for having a tattoo”, and “Experiences after the tattoo”). Practical suggestions were given to practitioners within the framework of the findings.
... We often notice several people having tattoo in our day to day life. Stirn et al. 1 noted how individuals utilized body modification for specific body sensations, as well as how they experienced and felt about their bodies before and after modification. Mostly hearing the word tattoo the first thing that comes to mind is the process of having a permanent tattoo i.e. by inserting ink beneath the skin, so the question that would commonly come after knowing this is if tattoo is harmful to health or not. ...
... We often notice several people having tattoo in our day to day life. Stirn et al. [1] noted how individuals utilized body modification for specific body sensations, as well as how they experienced and felt about their bodies before and after modification. Mostly hearing the word tattoo the first thing that comes to mind is the process of having a permanent tattoo i.e. by inserting ink beneath the skin, so the question that would commonly come after knowing this is if tattoo is harmful to health or not. ...
For over a last few decades, tattoo is gaining lots of attention especially in the field of body modification within the younger generation in our society. But generally the most important aspect is overlooked while having a tattoo, i.e. the health risks and the awareness related to tattoo. Researchers have stated that many diseases can be transmitted through tattooing if proper hygiene is not maintained. The present study has been carried on, in the metropolitan city Kolkata of West Bengal which seeks to understand the present awareness scenario regarding tattoo in India. A qualitative study using in-depth interview is performed with the individuals including tattoo artists and tattoo owners from two tattoo studios. The study suggests that no proper legal certification of tattoo artist and tattoo parlors in India. In most cases low quality of ink were used and no proper sterilization was there. Unaware of such factors people having craved for getting a cheap tattoo results health risk.
... Rakovic (2012) suggested that unlike cosmetic surgery, which is typically carried out to help people fit in, tattoos are often acquired to help individuals stand out. The permanent and painful nature of tattooing, and the long tradition of social prejudice against tattoos, has influenced medical and legal professionals to consider tattooing as an indicator of deviance and criminality (Stirn & Hinz, 2008). Palermo (2011) stated that tattooing may express conflict with self or society, although research suggests no significant differences between tattooed and non-tattooed individuals on attitudes to authority (Swami, 2012). ...
Objective: With the mainstreaming of tattooing, obtaining multiple tattoos has become increasingly popular. The aim of the current study was to explore in detail the specific motivations and experiences of heavily tattooed individuals.
Method: Six heavily tattooed participants were interviewed in 2016 at the Gold Coast, Queensland. Interpretative Phenomenological Analysis was used to analyse data from semi-structured interviews.
Results: Superordinate themes included rebellion and non-conformity, the skin as canvas, and identity formation. Although participants experienced stigma due to their body art, they reported no regret about becoming tattooed. Tattooing was reportedly used to reflect participant’s personalities and honour their families and experiences. All expressed a high need for uniqueness and a desire to expand their collections.
Discussion: This study elucidates the complex and varied motivations of those who acquire multiple tattoos. Common personality traits were identified, including a high need for uniqueness and low need for conformity. Some gender-specific motivations were also noted that require further research. Findings may assist to mitigate stigma against tattooed persons and inform health professionals who interact with this population.
... We often notice several people having tattoo in our day to day life. Stirn et al. 1 noted how individuals utilized body modification for specific body sensations, as well as how they experienced and felt about their bodies before and after modification. Mostly hearing the word tattoo the first thing that comes to mind is the process of having a permanent tattoo i.e. by inserting ink beneath the skin, so the question that would commonly come after knowing this is if tattoo is harmful to health or not. ...
... Frequently IP users have stated that they wanted to express themselves through IP (Caliendo et al., 2005;Young et al., 2010). In a group study on 432 body modification users, Stirn and Hinz (2008) also recognized that genitally pierced subjects were less likely to relate their piercing to eroticism and sexuality (53%) than subjects with other kinds of piercings and tattoos (92%). In the same study many individuals intended to overcome personal crisis, to regain control over one's life, and to end an old and/or begin a new phase of life by piercing (or tattoo). ...
Body piercing of the genitalia and nipples, called intimate piercing (IP), is an increasingly popular practice. However, research on psychological effects of IP is still scarce. In the present study we assessed the assumption that IP may play a key role in coping with childhood abuse, psychological distress, and body image derogations. An IP sample consisting of 71 female and male participants with at least one genital and/or one nipple piercing was assessed with psychometric tests. Indeed, the IP sample included significantly more subjects with emotional, sexual, and physical childhood abuse as well as emotional and physical neglect experiences, than expected in the German general population. On the contrary, the IP sample did not yield psychological distress symptoms of clinical relevance and showed an average body image profile. The results are discussed in light of trauma-coping strategies.
... Da Hänseleien in der Kindheit negativ mit der Evaluation des eigenen Body Images korrelieren [21], wurde ihre Häufigkeit für beide Gruppen erhoben und verglichen. Da selbstverletzendes Verhalten in Kindheit und Jugend, Risikofreudigkeit und der Umgang mit Aggressionen für andere zunehmend verbreitete körpermodifikatorische Praktiken wie Tattoos und Piercings [17] ...
HintergrundPlastisch-ästhetisch-chirurgische (PÄC-)Operationen nehmen weltweit stetig zu. Dabei ist nach wie vor strittig, wie häufig KlientInnen mit einer PÄC-Operation psychisch erkrankt sind und/oder unbewusst mit der Operation die Lösung psychischer Konflikte anstreben. ZielDie vorliegende Studie untersucht das Vorliegen psychischer Belastungssymptome bei 56 weiblichen PÄC-Aspirantinnen. Sie widmet sich erstmalig Unterschieden von PÄC-Patientinnen mit psychischen Belastungen (MPB) vs. solchen ohne psychische Belastungen (OPB) in ihren Erwartungen an die Operation, im Persönlichkeitsprofil, Körpererleben, der Häufigkeit generalisierter Ängste sowie Aspekten der Vorgeschichte. Materialien und MethodenPsychometrische Testverfahren (BSI, NEO-FFI, FBeK, GAD-7) und ein selbst konstruierter Fragebogen kamen zum Einsatz. ErgebnisseDie Hälfte der Probandinnen erwies sich als psychisch belastet von klinisch relevantem Ausmaß. PÄC-Aspirantinnen MPB verbanden gegenüber solchen OPB mit der Operation häufiger Erwartungen auf Verbesserungen in den Bereichen Gesellschaft, Sexualität und Partnerschaft. PÄC-Patientinnen MPB zeichneten sich durch ein anderes Persönlichkeitsprofil, ein negatives Körpererleben sowie mehr generalisierte Ängste aus. Sie nannten häufiger ein schlechtes Aggressionsmanagement und Hänseleien in der Kindheit, ihre Eltern hatten besonders viel Wert auf die eigene Erscheinung gelegt. DiskussionDie Differenzierung einer PÄC-Gesamtstichprobe in Patientinnen MPB vs. OPB erwies sich als sinnvoll. Psychische Belastungssymptome bei PÄC-Patientinnen standen in Verbindung mit an die Operation geknüpften unrealistischen Hoffnungen auf Verbesserungen in interpersonellen Beziehungen. Diese Patientinnen würden vermutlich auch von einer Psychotherapie profitieren. Methodische Einschränkungen der Studie, insbesondere die geringe Rücklaufquote, werden diskutiert.
... First, research seeks to understand the underlying causal mechanism of biology or psychology that would impel someone to alter their body (Iannaccone et al., 2013;Liu & Lester, 2012). These studies often link the presence of a modification to some form of deviance (Dukes, 2016;Dukes & Stein, 2011;Koch, Roberts, Armstrong, & Owen, 2005;Rivardo & Keelan, 2010;Silver E., Silver, Siennick, & Farkas, 2011) or psychological pathology (Claes, Vandereycken, & Vertommen, 2005;Iannaccone et al., 2013;Stirn, 2003;Stirn & Hinz, 2008), typically presumed to be the result of underlying trauma (Liu & Lester, 2012;Stirn et al., 2011), by employing advanced statistical models. ...
This manuscript evaluates existing literature on body modification. Prior research has focused on the modification itself, either the motivation for attaining it or the meanings behind it from the perspective of the wearer. Considering these prior findings, scholars have neglected to examine how body modifications are the outcome of a complex social process. This manuscript rectifies these weaknesses by addressing the field of body modification through the framework of cultural production. This shifts the focus from the outcome of a social process, the modification, to an analysis of the processes by which modifications are produced. By examining these processes, a more coherent theoretical understanding can be developed.
... Auch wenn im Prozess der Kör permodifikation die Überzeugung der subjektiven Kontrolle über den Körper wächst und er damit wieder in Besitz genommen wird, stellt sich die Frage, ob diese "Heilung" ein dauerhafter Effekt ist. Dagegen spricht, dass die Be troffenen häufiger eine suchtartige Entwicklung für das Bedürfnis nach wei teren Körpermodifikationen beschreiben (Stirn u. Hinz 2008;Stirn et al. 2011). (Swanger 2006). ...
Введение. В последние десятилетия отмечается рост популярности телесных модификаций (татуировок, пирсинга, пластических операций). Несмотря на то, что разработанность этой темы в науке крайне мала, есть ряд исследований, указывающих, что у лиц с телесными модификациями больше трудностей в социальной адаптации, выше уровень психологического неблагополучия и, как следствие, выше риски отклоняющегося поведения. Эти факты указывают на необходимость более глубокого изучения феномена телесных модификаций и их психологического механизма. В статье предпринята попытка установить функциональный смысл такого явления, как телесные модификации, дать определение понятию и обозначить место феномена в структуре аутоагрессивного поведения. Материалы и методы. В статье рассматривается история происхождения и развития практики нанесения татуировок в человеческой культуре, феномен модификаций тела сопоставляется с феноменом несуицидального самоповреждающего поведения, приводятся данные о распространенности и классификациях модификаций тела и самоповреждений. Результаты. Телесные модификации рассматриваются как форма самоповреждающего поведения. Делается вывод о том, что современная практика модификаций тела является сложной социализированной и окультуренной формой самоповреждающего поведения, которая возникла в результате эволюционного развития общества. В контексте культурно-исторического подхода установлен функциональный смысл телесных модификаций, который трактуется как опосредствование аффекта, являющегося натуральной психической функцией, через внешний знак — модификацию тела. Татуировка рассматривается как орудие овладения и управления негативными переживаниями, которые не достигли стадии высшей психической функции — зрелой эмоции. Заключение. Рассмотрение феномена телесных модификаций в контексте культурно-исторического подхода позволяет дать научное обоснование взаимосвязи этого феномена с особенностями психической деятельности субъекта. Дальнейшее научное изучение этой взаимосвязи важно для формирования правовой основы регулирования индустрии пластических операций, которая получает широкое распространение в ответ на запросы общества, но это вовсе не означает, что она отвечает интересам потребителя в части охраны и поддержания его здоровья. Кроме того, доступность татуировок и пирсинга для объективного наблюдения позволяет широко использовать этот поведенческий индикатор в целях первичного выявления лиц с повышенным риском дезадаптации как в сфере образования, так и при профессиональном психологическом отборе.
Body modification is a blanket term for tattooing, piercing, scarring, cutting, and other forms of bodily alteration generally associated with fashion, identity, or cultural markings. Body modifications like tattooing and piercing have become so common in industrialised regions of the world that what were once viewed as marks of abnormality are now considered normal. However, the psychological motivations for body modification practices are still being investigated regarding deviance or risky behaviours, contributing to a sense in the academic literature that body modifications are both normal and deviant. We explored this inconsistency by conducting a scoping review of the psychological literature on body modifications under the assumption that the psychological and psychiatric disciplines set the standard for related research. We searched for articles in available online databases and retained those published in psychology journals or interdisciplinary journals where at least one author is affiliated with a Psychology or Psychiatry programme (N = 94). We coded and tabulated the articles thematically, identifying five categories and ten subcategories. The most common category frames body modifications in general terms of risk, but other categories include health, identity, credibility/employability, and fashion/attractiveness. Trends in psychology studies seem to follow the shifting emphasis in the discipline from a clinical orientation regarding normality and abnormality to more complex social psychological approaches.
This study aimed at identifying motivations, risk behavior and social practices, comparing tattooed and non-tattooed women. 316 women (50% tattooed) were surveyed online, answering questions on sociodemographic data, social practices, motivations, and risk behavior. Data collection strategies included snow-balling, social networks, personal contact, and visits to tattoo parlors. The main results indicate that the majority of women express satisfaction with their physical appearance after getting tattooed, and wouldn’t get the tattoo removed. Being tattooed correlated with risk behaviors such as casual sex with unknown people, alcohol and drug use, and psychopathology. The sample presented more similarities than differences between tattooed and non-tattooed groups, suggesting that growing popularization and social acceptance of tattooing has led to a decrease of the differences between the groups. Such results may inform future research and the production of informative materials aimed at demystifying negative stereotypes associated to tattoos.
Non-suicidal self-injury (NSSI) has been shown as a characteristic feature in many clinical populations in recent years and schizophrenia is one of the most common psychiatric disorders which is associated with NSSI. In this study, we aimed to investigate predictors of NSSI in patients with schizophrenia spectrum disorders (SSD) and the role of lifetime substance use disorder (SUD). A sample of 165 patients with a diagnosis of SSD who were in remission participated in the study. Lifetime NSSI was assessed using the Inventory of Statements About Self-injury (ISAS). Lifetime SUD were evaluated. Logistic regression analysis was conducted to predict NSSI. SUD was found to be related to NSSI in patients with SSD, and it was associated with an approximately fourfold increase in the risk of NSSI. The rates of lifetime SUD in our sample and in the NSSI (+) group were 38.2% and 55.6%, respectively. The most commonly abused substances among patients with NSSI were cannabis and synthetic cannabinoids. The prevalence of NSSI was 43.6% in our sample. ‘Self-cutting’ was the most common type and ‘affect regulation’ was the most common function of NSSI. One of the most significant risk factors for NSSI was a previous history of suicide attempts. SUD appears to be a significant predictor of NSSI in patients with SSD. Further investigation of treatable risk factors such as SUD which are related to NSSI is needed. It is also essential to screen SSD patients for NSSI due to the probable relation to high risk of suicide.
To investigate the mental health and associated psychopathology among tattooed and non-tattooed individuals of both sexes. Participated in the study 614 individuals, divided between 306 with tattoo and 308 without tattoo. A self-administered online questionnaire was developed, with open and closed answers. The questionnaire presented two blocks of information: a) socio-demographic issues: age, marital status, religion, educational level and number of tattoos; b) risk behavior: psychological disorders and suicidal ideation. For data analysis, a descriptive and relational statistical analysis was performed, using the statistical program SPSS - version 17.0. The results indicated statistically significant associations connected with psychiatric diagnosis among tattooed women. Although with statistically significant results, it is emphasized that the values presented between tattooed and not tattooed were very similar, indicating caution in associating psychiatric diagnosis with individuals with tattoos.
https://madridge.org/journal-of-nursing/mjn-1000117.php
This work is based on data from a qualitative research study of multiply body modified individuals in the greater San Francisco Bay Area. Participant narratives produced emergent findings of significant life stress, and traumatic events, in the lives of multiply body modified individual. The following publication provides original data regarding the domains of post-traumatic growth as expressed by multiply body modified individuals in their life narrative. Of the five domains (new paths, personal strength, appreciation, increased spirituality, and closer relationships) the most frequent that was reflected in their body modification was an increased sense of personal strength.
Little is known about the connection between body modification and borderline personality disorder (BPD). This study investigated the relation between a wide range of body modification practices (piercing, tattooing, scarification, pubic hair removal, and cosmetic surgery) and BPD features, with a special focus on identity and identity dysfunction, in an adult community sample ( N = 330). Results indicated BPD features were positively correlated with total number of body modifications and breadth of body modification practices endorsed, as well as, specifically, increased piercings, tattoos, and scarifications. Furthermore, identity problems (i.e., identity diffusion and low self-concept clarity) were associated with body modifications. Implications of these findings are discussed, including their heuristic value in understanding body modification in light of its connection to BPD (and particularly identity/self-concept functions).
Tattooing the skin as a means of personal expression is a ritualized practice that has been around for centuries across many different cultures. Accordingly, the symbolic meaning of tattoos has evolved over time and is highly individualized, from both the internal perspective of the wearer and the external perspective of an observer. Within modern Western societies through the 1970s, tattoos represented a cultural taboo, typically associated with those outside of the mainstream such as soldiers, incarcerated criminals, gang members, and others belonging to marginalized and counter-cultural groups. This paper aims to review the more recent epidemiology of tattoos in Western culture in order to establish that tattooing has become a mainstream phenomenon. We then review psychological and psychiatric aspects of tattoos, with a goal of revising outmoded stigmas about tattooing and helping clinicians working with tattooed patients to facilitate an exploration of the personal meaning of skin art and self-identity. We suggest that as a kind of augmentation of the physical exam, looking at and talking to patients about their tattoos can provide a valuable window into the psyche, informing clinical practice.
Von ärztlicher Seite aus wird vorwiegend auf medizinische Risiken von Tätowierungen, Piercings und anderen Formen der Body-Modification hingewiesen. Abgesehen von medizinisch sinnvollen Tattoos, etwa einer auftätowierten Brustwarze nach Mammakarzinom, können gerade junge Menschen in ihrer Persönlichkeitsentwicklung von Körperschmuck profitieren. Beispiele sind das subjektive Gefühl gestiegener Attraktivität, Stolz auf die „Mutprobe“ durch das Ertragen der Schmerzen und bessere Integration in die Gruppe der Gleichaltrigen. Bei Borderline-Patienten kann es sogar zum Rückgang selbstverletzender Verhaltensweisen kommen. Nicht selten verarbeiten Menschen traumatische Lebensereignisse, z. B. den Tod einer nahestehenden Person, durch ein Tattoo. Obwohl heute in Deutschland rund 8 Mio. Menschen tätowiert sind, zeigen aktuelle Studien, dass es weiterhin Vorurteile gibt. Die Entscheidung für ein tätowiertes Bild ist nicht zufällig, sondern spiegelt den Charakter des Trägers wider. Ein Mensch, der sich mit Tattoos wie z. B. Blumengirlanden schmückt, ist tatsächlich meist friedfertiger. Jemand, dessen Oberarm ein „Skull“ ziert, muss aber nicht aggressiver sein; der Totenschädel kann ihn auch an die Begrenztheit des Lebens mahnen.
Body-Modifications (z.B. Tätowierungen und Piercings) sind nicht nur Körperschmuck, sie sind auch Ausdruck der Persönlichkeit. Abhängig von der persönlichen Motivation lässt sich aus der nahezu unendlichen Vielfalt von Möglichkeiten ein Körperschmuck auswählen, der die eigene Lebensanschauung symbolisiert. Auf der einen Seite werden die Träger gesellschaftlich auch heute noch stigmatisiert, auf der anderen Seite zeigen umfangreiche Forschungsergebnisse, dass Menschen von Body-Modifications profitieren können. Das subjektive Gefühl der Attraktivität erhöht sich, und Stolz für das Bestehen einer Mutprobe erhöht das Selbstbewusstsein. Selbstverletzendes Verhalten verringert sich häufig, und ein Tattoo kann sogar Trauer beim Tod einer nahestehenden Person vermindern.
Body-modifications as therapy
Body-modifications (e.g. tattoos and piercings) are not only body jewellery they are also an expression of personality. Dependenting on personal motivation one can select from an almost infinite variety of body jewellery to symbolize one´s own view of life. Even today , on the one hand, wearers of tattoos are still socially stigmatized. On the other handHowever, extensive scientific research shows that people can benefit from body-modifications. The subjective feeling of attractiveness increases and the pride of being for the existence of courageous increases self-confidence. Self-injurious behaviour decreases and a tattoo can even reduce grief after the death of a close person.
This study investigated the differences in mental health history and social, health, alcohol and substance, and sexual behaviors of individuals with and without body modification in a community sample. Previous research primarily focused on negative behavioral and psychological correlates of body modification practices in college student, juvenile delinquent, inpatient, and incarcerated populations. This tendency does not take into account changes in the demographics and motivations of individuals who obtain body modifications in the last two decades. The Community Body Modification Checklist was developed based on previous studies; reliability and validity for the measure were established using Cronbach’s alpha and factor analysis. The results indicated that individuals with body modifications were not more likely to engage in risky behaviors or report a history of mental health problems when compared to non-modified persons; however, they were more likely to engage in social and health behaviors. These findings may be best explained by the body modification community becoming diversified by the middle class whose meanings, motivations, and usage of tattoos and piercings are unique.
• Objective: To review the health risks associated with tattoos and body piercing. • Methods: Review of the literature. • Results:Tattooing and piercing have become increasingly popular practices in the United States. There are important physical and behavioral risks associated with these forms of body modification. The most common complications from tattooing include skin infections and allergic reactions. Minor complications such as infection and bleeding occur frequently with piercings, but major complications have also been reported. Tattoos and piercings appear to be a marker for risk-taking behavior. • Conclusion: Clinicians should understand the potential complications of these procedures and be able to counsel patients on how to reduce their health risks.
Tattoos and piercings can represent auto aggression, thus the body is intentionally alienated, destroyed or hurt, similar to self-injuring behaviour (SIB). These self-chosen, painful interventions on the body are, however, also attempts to cope with crisis, loss and traumatic experiences, which are shifted into the body, suppressed and shall be overcome by body modification (BM). Positive effects of BM comprise active configuration of the self and thus aspects of control and acquirement of the body, as well as partly the cessation of SIB and hence apparently a successful "self-therapy". Decorating and beautifying oneself with tattoos and piercings can also represent self-caring tendencies.
At least 1 in 600 adults wound themselves sufficiently to need hospital treatment. More men than women do it, although more women receive psychological treatment. Many have a history of sexual or physical abuse. Self-wounding differs from other self-harm in being aimed neither at mutilation nor at death. Self-wounding coerces others and relieves personal distress. Repeated self-wounding is one criterion of borderline personality disorder but we prefer to consider it an 'addictive' behaviour rather than an expression of a wider disorder. Psychological management may need to be augmented by drug or social treatment. Carers, including professional carers, usually need help to contain the turbulence that self-wounding produces.
Professional and amateur tattooing on women is flourishing. Understanding the tattooing procedure, the rationale for obtaining a tattoo, and the associated risks are important to better understand clients' needs and to develop health education. Nursing care for women requesting removal of their tattoos with laser therapy is presented.
The goal was to examine tattooing in suicides, as tattoos have been associated with several risk factors for suicide.
A chart review of a three-year sample of 134 consecutive suicides in Mobile County, Alabama, was conducted. The prevalence of tattoos was compared between young (<30) white suicides and accidental deaths matched for age, gender and race, in a case-control study.
Tattoos were found in 21% of suicides. Fifty-seven percent of young white suicides were tattooed compared to 29% of matched accidental deaths.
Findings are preliminary due to the small sample size. The study methodology precluded obtaining information of psychiatric diagnoses prior to death.
Tattoos may be possible markers for lethality from both suicide and accidental death in young people, presumably because of shared risk factors such as substance abuse and personality disorder. Affective disorders should receive further, more specific studies. The clinical value of inquiring about tattoos in young people at risk of suicide needs further study.
Tattooing and body piercing are increasing, especially among college students. A study of 766 tattooed and/or body-pierced college students in 18 universities across the United States and one in Australia was conducted to discover the demographic characteristics, motivational factors, and health concerns. The traditional college time of 18 to 22 years of age (69%) was when they obtained their tattoo (73%) and/or body piercing (63%). More frequent health problems and impulsive decision making were noted for those with body piercing when compared to those tattooed. Three cases of hepatitis were reported. Health professionals should openly discuss body art with students, convey a nonjudgmental attitude, and assist with informed decision-making information to either reduce risks or dissuade. Open communication and applicable health education will be very important.
The purpose of this preliminary study was to document self-reported tattooing and body piercing behavior among a sample of 860 adolescent detainees. Additionally, the study examined the relationship of alcohol and drug use to tattooing and body piercing--an often overlooked HIV risk behavior.
Adolescents (N = 860) participating in a substance use and HIV risk reduction intervention were surveyed upon entrance to a Youth Development Campus (YDC).
Twenty-nine percent of the sample (N = 245) had at least one tattoo, and more than half (69%) had at least one body piercing. Fifteen percent had two or more tattoos, while 28% had three or more piercings. Although a small percentage of the youth reported knowingly sharing needles for tattoos or piercings (2% and 1.5%, respectively), 21% had tattoos that had been administered unprofessionally and 20% had unprofessionally administered piercings. Marijuana and alcohol were the highest reported substances used in this sample, 62% and 54%, respectively. Alcohol, marijuana, antidepressants, and sedatives were significant correlates of having tattoos. Alcohol was found to be a marginally significant (P = .052) correlate of body piercing.
The popularity of tattooing and piercing and the risk involved with these activities make them an HIV risk behavior worthy of address. Risk reduction messages to youth should consistently address these behaviors and focus on them as they relate to substance use.
To describe the characteristics of body modification among adolescents and to determine whether adolescents who engage in body modification are more likely to screen positive for alcohol and other drug problems than those who do not.
Adolescents aged 14 to 18 years presenting to an urban adolescent clinic for routine health care completed a questionnaire about body modification and a substance use assessment battery that included the 17-item Problem Oriented Screening Instrument for Teenagers Alcohol/Drug Use and Abuse Scale (POSIT-ADS). Body modification was defined as piercings (other than one pair of bilateral earlobe piercings in females), tattoos, scarification, and branding. Problem substance use was defined as a POSIT-ADS score > or =1. Data were analyzed using logistic regression to determine whether the presence of body modification was an independent predictor of problem substance use.
The 210 participants had a mean (+/- SD) age of 16.0 (+/- 1.4) years and 63% were female. One hundred adolescents (48%) reported at least one body modification; girls were more likely than boys to have body modification (59% vs. 28%, p < or = .0005). Ninety (42%) reported piercings, 22 (10%) tattoos, 9 (4%) scarification, and 1 (< 1%) branding; 21 (10%) had more than one type of body modification. These were in a variety of locations, most commonly the ear and the nose (piercings) or the extremities (tattoos). One-third of the sample (33%) screened positive for problem substance use on the POSIT-ADS questionnaire. Controlling for age, adolescents with body modification had 3.1 times greater odds of problem substance use than those without body modification (95% CI 1.7, 5.8).
Body modification was associated with self-reported problem alcohol and other drug use among middle adolescents presenting for primary care. More research is needed to determine the clinical and sociocultural significance of body modification and its relationship to substance use in this population.
Tattoos are an increasingly prevalent form of self-expression, especially for adolescents. This study was conducted to determine health-risk behaviors associated with tattoos in young men and women entering military service.
We surveyed a cohort of 550 military recruits using a modification of the Youth Risk Behavioral Survey (YRBS), a validated instrument used to assess health risk behaviors in adolescents. All individuals entering basic training in the US Marine Corps or the US Air Force from June through September 1999 were eligible to participate. The primary outcome variables of interest were tobacco use, alcohol use, seatbelt use, suicidal behaviors, depression, and physical violence.
The survey response rate was 91% (n = 499 of 550). Overall, 27% of respondents had tattoos (n = 125) when entering military service. Women entering military service were more likely to have a tattoo than men. Controlling for age and gender, individuals with tattoos were more likely to smoke, drink heavily, use smokeless tobacco, and ride in a vehicle with someone who had been drinking than non-tattooed individuals.
In a population of military recruits, tattoos were associated with predictable adverse health-risk behaviors. This represents an important opportunity for targeted preventive counseling.
Research question: In German society body modification practices have increased considerably. At the same time no valid data is available and the historic research appears rather prejudiced. Thus, a first explorative collection of data relevant to the group of tattooees and piercees was undertaken. What motivations do tattooed and pierced individuals of today themselves express for getting their bodies modified? Method: 104 tattooed and/or pierced individuals from a general population answered a questionaire of 36 items + social data which was correlated with the Gießen-test. Results: Expression of individuality and denotation of personal identity, alternate perceptions of the body and art were the most numerous motivations for getting tattooed and/or pierced. Discussion: The relations between psychological patterns possibly causing people to modify their bodies and the quasi-therapeutic aspects that are associated with these practices are discussed as well as the relation between the strive for identity and being addicted to collecting tattoos and piercings.
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Since the 1980s, tattooing has emerged anew in the United States as a widely appealing cultural, artistic, and social form. In Bodies of Inscription Margo DeMello explains how elite tattooists, magazine editors, and leaders of tattoo organizations have downplayed the working-class roots of tattooing in order to make it more palatable for middle-class consumption. She shows how a completely new set of meanings derived primarily from non-Western cultures has been created to give tattoos an exotic, primitive flavor. Community publications, tattoo conventions, articles in popular magazines, and DeMello's numerous interviews illustrate the interplay between class, culture, and history that orchestrated a shift from traditional Americana and biker tattoos to new forms using Celtic, tribal, and Japanese images. DeMello's extensive interviews reveal the divergent yet overlapping communities formed by this class-based, American-style repackaging of the tattoo. After describing how the tattoo has moved from a mark of patriotism or rebellion to a symbol of exploration and status, the author returns to the predominantly middle-class movement that celebrates its skin art as spiritual, poetic, and self-empowering. Recognizing that the term “community” cannot capture the variations and class conflict that continue to thrive within the larger tattoo culture, DeMello finds in the discourse of tattooed people and their artists a new and particular sense of community and explores the unexpected relationship between this discourse and that of other social movements. This ethnography of tattooing in America makes a substantive contribution to the history of tattooing in addition to relating how communities form around particular traditions and how the traditions themselves change with the introduction of new participants. Bodies of Inscription will have broad appeal and will be enjoyed by readers interested in cultural studies, American studies, sociology, popular culture, and body art.
Viewing the body as both an evocative social text and a vehicle of social resistance, this article explores recent developments within the Neo Primitive (NP) movement. As a segmented branch of the larger body modification cultural scene, Neo Primitives have created individuals have created a renaissance of deeply flamboyant and often radical body marking practices. Members stress the spiritual, emotional, and practical rewards of body modification for those entrenched within (and ultimately oppressed by) hegemonic boundaries of physical expression in the modern metropolis, especially as those boundaries relate to codes of beauty, gender, sexuality, spirituality, and personal creativity. Building on qualitative data gathered in two Canadian cities, and viewing members of this subculture as active agents of counter-expression and dissent, this article explores the ideologies, practices, and lived experiences of NPs attempting to recreate, reclaim, and revolutionize the flesh.
The following article examines the processes tattoo collectors undergo to become collectors.I examine howtattoo collectors learn that they want to become collectors, are recruited into the social world of tattoo collectors by other collectors and artists, and learn howto interpret their collecting as appropriate for themselves. This ethnographic study is framed in Matza's (1969) theory of the etiology of deviance and Schutz's (1962, 1967) phenomenology.
This article examines how tattoos may function as a way to deal with personal trauma. First, I examine a recent theory of how personal trauma cannot be fully experienced; thus, it calls for a return to the event in order to incorporate it into the psyche. Second, I look at how that return, often achieved symbolically, might include the process of acquiring a tattoo. Finally, I turn to various examples, taken from memoirs, film, and an interview, of trauma that has been expressed through tattooed images that turn bodies into memory-laden texts.
Patients with factitious disorder consciously induce or feign illness in order to obtain a psychological benefit from being in the sick role. Due to the nature of the disorder, the literature on factitious disorder is largely confined to case reports and case series, limiting the information available. Patients with factitious disorder present with a broad spectrum of signs and symptoms, and effective diagnosis often requires a high index of suspicion. The differential diagnosis of factitious disorder includes physical illness, somatoform disorders, malingering, psychiatric illness, and substance abuse. While factitious disorder is extremely difficult to cure, effective techniques exist to minimize morbidity, and some patients are able to benefit greatly from psychiatric intervention.
A sample of 281 (females=160) college students with body modifications completed a demographics questionnaire, questions about body modification practices, the Sensation Seeking Scale (SSS-V; Zuckerman, 1994), the Impulsivity subscale of the Zuckerman–Kuhlman Personality Questionnaire (ZKPQ; Zuckerman, Kuhlman, Joireman, Teta, & Kraft, 1993), and a selected portion of the History of Psychosocial Stressors (HPS; Scotti, 1992, 1999). Gender differences were found on the number of body modifications and when they were first obtained. In general, males with tattoos and piercings had higher scores than females on subscales of the SSS-V. Females with piercings and tattoos had higher scores on the Impulsive Sensation Seeking subscale of the ZKPQ. No gender differences were found when participants were asked if he/she would obtain another body modification or if his/her friends had a body modification. Gender and sensation seeking preference were predictive of number of tattoos but not number of piercings. Exposure with psychosocial stressors was predictive of number of piercings but not number of tattoos. These results suggest that sensation seeking preferences and exposure to a psychosocial stressor may be associated with obtaining a body modification in some college students.
Kim Hewitt explores self-mutilation through history and across cultural divisions, finding these acts âpositive expressions of social custom, individualism and resourcefulness . . . symptomatic of crises of identity, religious faith, or modern social structures.â In modern contexts, such ancient rituals continue to function as an avenue of symbolic death and rebirth. In her analysis of the origins and motivations of body modification, the author draws upon psychological, medical, and cultural theories on self-inflicted pain—tattooing and scarification as well as fasting, bulimia, and some performance art. She finds such contemporary acts of self-mutilation may âexpress a change in how society perceives marginalization.â
A cross-sectional, convenient sample of adolescents (N = 2101) from 8 states were queried regarding interest in tattooing. Permanent markings and blood-borne diseases were reasons respondents refrain from tattooing, yet 55% (n = 1159) expressed an interest in tattooing. Tattooed adolescents in the sample (10%, n = 213) responded with their experiences. Tattooing was frequently done around the 9th grade and as early as 8 years of age; over half (56%, n = 120) report academic grades of As and Bs. Potential health risks and definite psychosocial findings of purchase and possession risks were evident, building on data from a similar 1994 study by Armstrong and McConnell. Health providers and educators should initiate applicable health education and become community adolescent advocates regarding this risk-taking behavior. Findings indicate that adolescents who want a tattoo will obtain one, regardless of money, regulations, or risks. Adolescents view the tattoos as objects of self-identity and body art, whereas adults perceive the markings as deviant behavior. Informed decision-making could be promoted in health education by incorporating information about the possibility of blood-borne diseases, permanent markings, and themselves as growing and changing people.
Since teens are engaging in a variety of body modifications at increasingly early ages, health care providers should be aware of the extent and the possible harm of these activities. This article reviews the historical context, medical uses, and risks of tattooing and other forms of body modification. There is little historical precedent for the extent of body piercing as carried out by the youth today. Body building is also practiced in excess. There is little legislative control of body modification other than for tattooing. The need for even young adolescents to improve their appearance and self-esteem with such extreme and even risky measures is evidence of a regressive trend in our culture.
To survey the prevalence of body art (body piercing and tattooing) in university undergraduate students and to determine the incidence of medical complications from these procedures.
Between February and May 2001, students were offered the opportunity to complete an anonymous, voluntary survey at the beginning of class or organizational meetings. The survey instrument requested information concerning body piercing and tattooing (current or removed) by body site, age, sex, height, weight, body mass index, undergraduate class, athletic status, and the occurrence of medical complications.
Four hundred fifty-four (94.4%) of 481 students completed the survey (14.7% of total campus enrollment). The prevalence of body piercing was 51%, and that of tattooing was 23%. The chi2 analysis showed female students were more likely to be pierced than males (P=.002); there was no significant difference in the prevalence of tattooing by sex. Male athletes were more likely to be tattooed than male nonathletes (P=.02). No relationships were shown between piercing/tattooing and age or measures of body somatotype. The incidence of medical complications of piercing was 17%, and these complications included bleeding, tissue trauma, and bacterial infections. Pierced navels were particularly prone to infection. There were no reported medical complications from tattooing. Eighteen percent of piercings (58/315) and 4% of tattoos (6/149) had been removed.
Body art is prevalent among undergraduate university students, and there is a significant incidence of medical complications among students with piercing. Male athletes were significantly more likely to be tattooed than male nonathletes.
Postmodern perspectives of body piercing and tattooing interpret these as signifiers of the self and attempts to attain mastery and control over the body in an age of increasing alienation. In this exploratory study, 79 adolescent females, ages 15 to 18 (M = 16.08, SD = 1.36), completed the Coopersmith Self-Esteem Inventory (SEI; Coopersmith, 1981), the Beck Depression Inventory (BDI; Beck, 1978), the Body Investment Scale (BIS; Orbach & Mikulincer, 1998), and the State-Trait Anger Expression Inventory (STAXI-2; Spielberger, 1996). Analyses revealed that body piercings and tattoos were significantly correlated with trait anger (Angry Reaction subscale scores). A multiple regression analysis indicated that three of the dependent variables (Trait Anger-Reaction, BDI, and Feeling subscale of the BIS) were predictors of the total number of body piercings and tattoos.
Body piercing is increasing in popularity around the world. In this review, I describe the history, origins, and peculiarities of various forms of body piercing, and procedures involved, variations in healing time, legal aspects and regulations, and complications and side-effects. I have also included a discussion of the motivation for and psychological background behind body piercing. In presenting research results, I aim to raise awareness of the many risks associated with body piercing. In presenting psychological data, I intend to create an understanding of the multifaceted and often intense motivations associated with body piercing, and, thus, to diminish any prejudices held by health professionals against people with piercings.
The phenomenon 'autodestructive behaviour' is becoming an increasingly serious disease and cost factor in a wide range of medical fields. The present paper presents a survey of the literature on autodestructive behaviour, excluding psychotic, substance-induced or organic brain disorders. Starting out with a conceptual overview, the paper goes on to look into the epidemiology of autodestructive behaviour and the forms in which it manifests itself.
A literature search was conducted in Medline, Psycinfo and Psyndex using the search terms 'artifact', 'artificially induced', 'autodestructive', 'self-mutilation', 'factitious', 'self-harm', 'self-induced', 'self-inflicted', 'self-injuring' and 'self-mutilation' for the period from 1977 to 2003.
Five of a total of 18 empirical studies describe the simultaneous occurrence of direct and indirect forms of autodestructive behaviour. Reported prevalence rates range from 0.032% to 9.36%. The ratio of females to males was found to be 2:1 (average age: 31.5 years; SD: 9.3 years); in contrast, the gender ratio was reversed for Munchausen's syndrome. The case history data presented are patchy and differ in terms of their priorities. We found a large number of codiagnoses, which seems to indicate that personality and dependence disorders, or substance misuse, are characteristic of both direct and indirect forms of autodestructive behaviour.
The task at hand is to use a yet-to-be-developed nomenclature and adequately operational diagnostic criteria to work out standardised survey instruments that do justice to the heterogeneity of this disorder complex.
The objective of this study was to obtain data on the incidence and relationship of psychological factors to tattooing and body piercing from a large and representative sample of German citizens (N=2043).
Representative data (sample age range=14-93 years) were evaluated with respect to health-related quality of life (SF-36), mental health (General Health Questionnaire), mental disorders (Patient Health Questionnaire), and sensation seeking (Arnett Inventory of Sensation Seeking).
The prevalence of tattooing and that of body piercing in the general German population are 8.5% and 6.5%, respectively. Individuals aged between 14 and 24 years display the highest rate of body piercings or tattoos (females, 41%; males, 27%). Within the group of individuals aged between 14 and 44 years, unemployment and nonaffiliation to a church are positively correlated, tattooing is significantly correlated with the perception of reduced mental health, and both tattooing and body piercing are correlated with significantly increased sensation-seeking behavior.
Next to being motivated by fashion and the urge to fit in with one's peers, the major reasons for body modification practices in the German population appear to be negatively perceived conditions of life, reduced social integration, and increased sensation-seeking behavior.
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