Body piercing, tattooing, self-esteem, and body investment in adolescent girls.

From: Adolescence | Date: 9/22/2002 | Author: Anderson, Roxanne

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.

Tattooing and body piercing have become increasingly prevalent in popular culture over the last 30 years
(Featherstone, 1999; Sweetman, 1999). Such practices are considered forms of body modification along
with branding, cutting, binding, inserting implants to alter the appearance and form of the body
(Featherstone, 1999), plastic surgery, and gender reassignment (Benson, 2000). Martin (1997) perceived
adolescence as a time when body modification becomes particularly appealing as adolescents struggle for
identity and control over their changing bodies. Particularly noteworthy is the rise in body piercing and
tattooing among adolescents (Armstrong & McConnell, 1994; Houghton, Durkin, Parry, & Turbett,
1996), with current estimates among adolescents ranging from 10% (Armstrong & Pace Murphy, 1997) to
25% (Grief, Hewitt, & Armstrong, 1999).

Debate persists about the motivation of persons who engage in such body modifications as tatooing and
piercing. Some (e.g., Craik, 1994) assume that body piercings and tattoos are nothing more than fashion
accessories. For example, Sweetman (1999) noted in his interviews with tattooed and pierced adults that
most referred to their body art as decorative accessories. According to Sweetman, these components fit
into the postmodern world of fashion where "anything goes." Among tattooed adults, Houghton et al.
(1995) noted that most participants in their study had obtained their tattoos in late adolescence and were
motivated to do so by the desire to improve appearance and because they perceived tattooing as a viable
art form. Alternative explanations for body modifications, particularly for piercing and tattooing, abound;
predominate among these interpretations are that: (a) body art constitutes a statement of control or
ownership over the body in a cultural context characterized by accelerating commodification and
alienation and is, therefore, an expression of individuality and uniqueness; (b) body art is a means of
identifying and affiliating with a group; and (c) body art is a manifestation of self-destructive impulses
and can, therefore, be seen as a form of self-mutilatory behavior (Jeffreys, 2000; Martin, 1997).

Body Art as a Search for the Self

Giddens (1991) emphasized the increasingly close connection between the body and self-identity as
evidenced by the growing trend toward relating to the body as a "project." Featherstone (1999) argued
that in postmodernity, identity is fluid and thus "the body is mobilized as a plastic resource." Armstrong
and McConnell (1994) found that among their sample of 642 high school students, tattooing was
motivated by the desire to project a certain image to others and to enhance (realzar) self-concept.
Armstrong et al.'s (1996) study of persons attending a dermatology clinic for tattoo removal found that
the majority of participants reported that they had obtained their tattoos impulsively, and that they related
this decision to a search for self-identity. In their sample of over 19 universities in the United States and
824 respondents, Grief, Hewitt, and Armstrong (1999) reported that 73% of their sample were tattooed
and 51% had body piercings. The predominate motivation for piercing and tattooing among their sample
was sel fexpression. Sweetman (1999) observed, in his intensive interviews with light, moderate, and
heavy body modifiers, that many stressed the sense of commitment required to make the decision to
pierce the body and/or tattoo, the relative permanence of such a decision, the experience of pain and
discomfort involved, and the necessity for aftercare. Many moderately and heavily tattooed and pierced
persons described these markings as "acts of self-creation" (p. 68) and noted an increased sense of self-
confidence after having pierced or tattooed their bodies. According to Sweetman, it was as though the
desire to mark the body supposedly emanated from some inner (interior) sense of self, rather than the
opposite desire to create a particular image in order to be liked. Similarly, Featherstone (1999) indicated
that many in his sample described their tattoos and piercings as a means of carrying visible signs of
identity.

According to Sweetman (1999) and Soyland (1997), tattoos and piercings also permit one to record one's
history on the body. Soyland (1997) conducted a series of in-depth (a fondo) interviews with pierced and
tattooed adults, and reported that at important developmental milestones (hito), participants experienced
the desire to mark their bodies in a relatively permanent way. Grumet (1983) observed that tattoos, like
dreams, "condense, symbolize, and displace psychic energy to a meaningful image" (p. 491). This view is
somewhat like the postmodern theorists' views of the body as text (Butler, 1993; Grosz, 1994). Grosz
writes: "In many recent texts, the body has figured as a writing surface on which messages, a text, are
inscribed ... the blank page on which engraving (grabados), graffiti, tattooing, or inscription can take
place" (p. 117).

Interestingly, some disagree with the interpretation that body piercings and tattoos serve to increase
feelings of positive self-worth and body image. For example, in one of a number of limited qualitative
studies, Kuniansky (1997) explored self-esteem among high school students who had pierced and tattooed
themselves and those who had not. Her analysis concluded that such forms of body modification are not
associated with positive self-esteem.

Body Art as a Search for Peer Acceptance

Others (Armstrong, Ekmark, & Brooks, 1995; Armstrong & McConnell, 1994; Armstrong, Stuppy,
Gabriel, & Anderson, 1996) have viewed body art as motivated by the desire for peer acceptance. For
example, in a series of focus groups conducted by Houghton, Durkin, and Turbett (1995), it was found
that the predominate motive for tattooing among 80 Australian youth, ages 6 to 17, was the desire for peer
acceptance.

Body Art as a Form of Self Mutilation

Jeffreys (2000) and Martin (1997) have viewed such forms of body art as tattooing and piercing as forms
of self-destructive or self-mutilatory behavior. In her feminist analysis, Jeffreys (2000) argued that body
art was a consequence of having lower social status in a male dominated society. She argued that certain
social groups such as women and girls, who are less powerful in our culture and who "are reared (son
criadas) to hate their bodies or mold them to the requirements of male sexual culture" (p. 410), have a
tendency to "self-mutilate." Research on body tattooing among adolescents has demonstrated an
association with gang affiliation, delinquent behavior (Angis, 1977; Kuniansky, 1997), substance abuse
(Loimer & Werner, 1992), and self-destructive behaviors (Ceniceros, 1998). Concerning the latter,
Ceniceros (1998) found a strong correlation between involvement in Russian roulette and the types and
numbers of tattoos and piercings in psychiatric patients. In their comparative study of body modifiers
versus nonbody m odifiers, Frederick and Bradley (2000) reported that the younger the age when body
piercing began, the higher the self-reported antisocial attitudes.

Present Study

The question of whether body art among adolescents is associated with identity and feelings about the self
and the body requires further study. Given the relatively conflicting findings about the possible
motivators for, and correlates of, body tattooing and piercing among adolescents, the present investigation
was intended to be exploratory in nature. The major focus was to explore the relationship between body
piercing and tattooing, self-esteem, and body investment. A secondary purpose was to assess the
relationship between these forms of body modification and depressive symptoms, internalized anger, and
externalized anger.

METHOD

Participants and Procedure

Participants were 79 adolescent girls who ranged in age from 15 to 18 (M = 16.08, SD = 1.36) attending a
nonresidential educational program for "at-risk" high school age girls. The girls who are eligible for this
program are defined as "at-risk" by county public high schools because of number of days of school
absenteeism and truancy. The goals of the program are the prevention of high school noncompletion, teen
pregnancy, substance abuse, and juvenile delinquency. Parental consent was acquired prior to
respondents' participation. Letters were sent to parents informing them that the purpose of this research
was to explore their daughters' thoughts and feelings about a variety of topics, including themselves, their
families, friends, and school, as well as their use of body art. Participants were diverse in their self-
reported ethnic identity: 35 (44.3%) were European American, 30 (38%) African American, 4 (5.1%)
multiracial, 2 (2.5%) Asian American, 1 (1.3%) was Native American, and 1 (1.3%) self-classified a s
"other" (6 did not report their ethnicity). Participants completed the following self-report measures in
counterbalanced order: Demographic Face Sheet, School Short Form of the Coopersmith Self-Esteem
Inventory (Coopersmith, 1981), Body Investment Scale (Orbach & Mikulincer, 1998), Beck Depression
Inventory (Beck, 1978), and State-Trait Anger Expression Inventory (Spielberger, 1996).

Instruments

Demographics. Participants answered a series of questions (designed by the authors) regarding their age,
ethnicity, and number and location of body piercings and tattoos. Further, respondents were asked to
specify the reasons for acquiring each body piercing and/or tattoo.

Self-esteem. The School Short Form of the Coopersmith Self-Esteem Inventory (SEI; Coopersmith, 1981)
was used in the present study. The SEI is designed to measure evaluation of the self The School Short
Form was developed as an alternative to the regular School Form and contains 25 items from the original.
The correlation of the School Form with the School Short Form is .86 (Coopersmith, 1967).

Body image. The Body Investment Scale (BIS; Orbach & Mikulincer, 1998) taps a person's emotional
investment in his or her body and includes subscales relating to feelings and attitudes about the body,
body care, body protection, and comfort in physical touch. The self-administered BIS contains four
subscales with 6 items each: BIS-F includes items tapping images, feelings, and attitudes about one's
body; BIS-T consists of statements about one's comfort with physical touch; BIS-C includes items
concerning body care; and BIS-P consists of items about one's desire for protection of one's body.
Responses range from 1 ("1 do not agree at all") to 5 ("strongly agree"), with high scores indicating more
positive responses about the body. In the present sample, the reliability of the BIS using Cronbach's alpha
was .65 (n = 79).

Depression. The Beck Depression Inventory (BDI; Beck, 1978) was used to measure depression. The
self-administered BDI measures 21 symptoms and attitudes that are clinically derived and appear to be
specific for depression. Beck provided the following scores for determining levels of depression: not
depressed, 0-9; mild depression, 10-15; mild-moderate depression, 16-19; moderate-severe depression,
20-29; severe depression, 30-63. Reliability and validity of the BDI have been extensively documented
(Beck, Steer, & Garbin, 1988; Tanaka-Matsumi & Kaineoka, 1986). In the present sample, the reliability
of the BDI using Cronbach's alpha was .85 (n = 79).

Anger. Several scales from the State-Trait Anger Expression Inventory (STAXE-2; Spielberger, 1996)
were incorporated in the present study. The STAXI-2 assesses state anger (the psychobiological
emotional state), trait anger (disposition to perceive a wide range of situations as annoying or frustrating),
the expression of anger, and anger control. For purposes of this investigation, the three subscales
pertaming to state anger, Feeling Angry (S-Ang/F), Feel Like Expressing Anger Verbally (S-Ang/V), and
Feel Like Expressing Anger Physically (S-Ang/P), and the two subscales assessing trait anger, Angry
Temperament (T-Ang/T), and Angry Reaction (T-Ang/R), were administered. Lastly, two subscales
assessing the degree to which angry feelings are expressed outwardly (AX-O) and the degree to which
angry feelings are suppressed inwardly (AX-I) were administered. Respondents were asked to rate the
frequency with which they engaged in certain behaviors when feeling anger across a 4-point Likert-type
scale ranging from 1 ("almost never") to 4 ("almost always").

RESULTS

Thirty-four (43%) participants indicated that they had tattooed or pierced at least one part of their bodies
other than their ear lobes. A greater number reported piercings (n = 29) than tattoos (n = 16). Nine had
pierced their tongues, 9 had their navels pierced, 6 pierced their noses, 3 pierced above their eyebrows,
and 2 indicated that their piercings were on another part of the body. Tattoo locations included legs (n =
5), stomach (n = 4), arms (n = 3), breasts (n = 2), shoulder (n = 1), and hand (n = 1).

Participants were asked to indicate their reasons for piercing and! or tattooing. Thirteen stated they
"wanted it," 6 stated it was "in style," 4 respondents stated that "it was cute," and 1 indicated that "it was
fun." When asked to specify reasons for their decisions to tattoo one or more parts of their bodies, their
responses included "wanting it" (n = 6), "beauty" (n = 2), "because it's my body" (n = 1), and "liking it" (n
= 1).

Next, a series of Pearson product-moment correlations were computed among the variables, including
total number of body piercings and tattoos, self-esteem, the subscales of body investment, depression, and
anger (see Table 1). This analysis indicated that the total number of body piercings and tattoos was
significantly correlated with only 3 of the 13 dependent measures: T-Ang/R, r(34) = .30, p < .01; BIS-F,
r(34) = -.20, p <.05; and S-Ang/V, r(34) = .19, p < .05. Significant and moderately high correlations were
noted between the BDI and the self-esteem and trait anger variables: SEI, r(34) = - .65, p <.01, and T-
Ang/R, r(34) = .50, p < .01.

In order to examine the relative importance of the variables for body art, a stepwise multiple regression
analysis was performed. First, three of the variables (or scales) were identified as predictors of the total
number of body piercings and tattoos. The strongest predictor, entered first in the stepwise regression
procedure, was T-Ang/R. This variable accounted for 9% of the total variance in body art. Each
subsequent step contributed additional predictive value to the model. Together, the three variables
explained 21% of the variance. The analysis of variance was significant for the prediction of body art
frequency, F(3, 74) = 6.38, p < .001 (see Table 2). Three of the variables were found to be significant
contributors (p = .05) to the prediction of body art frequency. Table 3 presents the stepwise model
parameter estimates for these three.

DISCUSSION

Regardless of the particular motivations, it appeared that close to half of the adolescent girls surveyed had
engaged in at least one form of body modification. When compared to prior research in samples of
adolescents (i.e., Drews et al., 2000; Houghton et al., 1996; Shepperd & Kwavnick, 1999), the percentage
of participants in our sample with tattoos and piercings was considerably higher. It appeared that despite
such serious health risks as infection, viral transmission, tissue damage, and allergic reactions associated
with such forms of body art, many in our sample were willing (dispuestos) to assume such risks. The
connection between propensity for risk-taking behaviors and body art is supported by previous research,
primarily with college age subjects. For example, Grief et al. (1999) found a significant correlation
between body art and such risk-taking behaviors as smoking cigarettes, taking drugs, drinking alcohol,
and greater sexual activity. In their survey of 235 college students, Drews, Allison, and Probst (20 00)
indicated that 15.7% reported obtaining tattoos and that these students engaged in more "risky behaviors"
(i.e., physical fights, shoplifting, using drugs) than did their nontattooed counterparts.

In the present study, there were significant associations between the number of tattoos and body piercings
and scores on the STAXI-2 subscalew of State Anger-Verbal and Trait Anger-Reaction. In other words,
the greater the number of tattoos and piercings, the higher the scores on scales measuring the
predisposition to react with anger and the higher the incidence of anger being expressed verbally. A
significant negative association was also found between the number of body piercings and tattoos and the
Feeling subscale of the BIS. Hence, the greater the number of body modifications, the more negative
feelings toward the body. In contrast to previous research, the results of the current study did not support
the notion of an increase in self-esteem following the incorporation of body art.

The most significant predictors of body piercing and tattooing in our sample were anger, depression, and
feelings toward the body. These results seemed consistent with those of previous studies of adolescent
self-esteem that have demonstrated significant connections between self-esteem deficits, depression,
anger and aggressive impulses (i.e., Lehnert, Overholser, & Spirito. 1994; Clay, Hagglund, Kashani, &
Frank, 1996). The strongest predictors of body piercing and tattooing in our sample were anger and
negative feelings toward the body. Given the possible connection between anger, negative feelings toward
the body, and increased piercings and tattoos, one might speculate, as others have (Jeffreys, 2000; Martin,
1997), that these forms of body modification constitute forms of self-mutilation.

Caution must be exercised in terms of generalizing from the results of this study, given the nature and size
of the sample. The extent to which our "at-risk" adolescent females typify the "average" adolescent
female is certainly open to speculation. Yet, this exploratory research constitutes one of the few studies
that have examined the relationship between body art, self-esteem, and body investment in high school
aged girls. Obviously, future research is needed to examine this complex and multidetermined
phenomenon.

Table 1

Correlations Between Total Body Piercings and Tattoos, SEI, BDI, BIS,
and STAXI-2

Variables 1 2 3 4 5 6

1 Body Art --
2 SEI-S .04 --
3 BDI -.08 -.65 ** --
4 BIS-C .10 -.11 -.12 --
5 BIS-T .03 -.05 .01 .08 --
6 BIS-P .03 .22 -.47 ** .45 ** -.17 --
7 BIS-F -.20 * .35 ** -.34 ** .25 * -.19 .32 **
8 S-Ang/F .09 -.44 ** .47 ** -.07 .06 -.39 **
9 S-Ang/V .19 * -.36 ** .30 ** -.05 .05 -.32 **
10 S-Ang/P .06 -.39 ** .42 ** -.01 .14 -.42 **
11 T-Ang/T .19 -.41 ** .38 ** -.08 -.16 -.23 **
12 T-Ang/R .30 ** -.33 ** .50 ** .04 .05 -.22 *
13 AX-O .07 -.31 ** .40 ** .04 .03 -.26 **
14 AX-I .08 -.53 ** .47 ** .02 .10 -.33 **

Variables 7 8 9 10 11 12 13

1 Body Art
2 SEI-S
 3 BDI
4 BIS-C
5 BIS-T
6 BIS-P
7 BIS-F --
8 S-Ang/F -.21 --
9 S-Ang/V -.16 .77 ** --
10 S-Ang/P -.19 .88 ** .78 * --
11 T-Ang/T -.09 .47 ** .30 ** .45 ** --
12 T-Ang/R -.20 .38 ** .22 * .34 ** .40 * --
13 AX-O -.07 .31 ** .18 .38 ** .54 ** .42 ** --
14 AX-I -.33 ** .33 ** .29 ** .32 ** .23 * .33 ** .36 *

Variables 14

1 Body Art
2 SEI-S
3 BDI
4 BIS-C
5 BIS-T
6 BIS-P
7 BIS-F
8 S-Ang/F
9 S-Ang/V
10 S-Ang/P
11 T-Ang/T
12 T-Ang/R
13 AX-O
14 AX-I --

Note. SEI-S = Coopersmith Self-Esteem Inventory-Short Form.

BDI = Beck Depression Inventory. Body Investment Scale:

BIS-C = Care subscale

BIS-T = Touch subscale

BIS-P = Protection subscale

BIS-F = Feeling subscale.

STAXI-2: S-Ang/F = Feeling Angry subscale

S-Ang/V = Feel Like Expressing Anger Verbally subscale

S-Ang/P = Feel Like Expressing Anger Physically subscale

T-Ang/T = Angry Temperament

T-Ang/R = Angry Reaction

AX-O = Anger Expressed Outwardly

AX-I = Anger Expressed Inwardly.

* p < .05

** p < .01.

Table 2

Analysis of Variance for Total Body Piercings and Tattoos

Source SS df MS F p

Regression 59.17 3 19.72 6.38 .001

Residual 228.78 74 3.09
Total 287.95 77

Table 3

Parameter Estimates for Prediction of Total Body Piercings and Tattoos

Parameter
Variable Estimate (B) SE B t Sig t

Constant 9.39 1.18

T-Ang/R 6.63 .02 3.58 .001
BDI -7.45 .03 -3.02 .003
BIS-F -7.57 .03 -2.43 .03

Note. T-Ang/R = Angry Reaction

BDI = Beck Depression Inventory

BIS-F = Feeling subscale.

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Roxanne Anderson, PACE Center for Girls, Jacksonville, Florida.

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