علائم خال کوبی، سوراخ کردن بدن و اختلال تغذیه ای در نوجوانان: بدن از شواهد

Objective Tattoos and body piercing have been linked to risk-taking behaviors, including disordered eating, but the findings have come from selected samples that were at greater risk for bias due to comorbidity. This study set out to explore concurrently the prevalence of tattoos and body piercing, and eating disorder symptoms in a representative adolescent sample of a community in Sardinia, a major island in Italy. Methods A community sample of 828 students (female, 535; male, 282; mean age=17.5±1.4 years) among those attending high school in the district of Cagliari, Italy, were invited to take the Eating Attitudes Test, the Bulimic Investigatory Test of Edinburgh, and the Body Attitudes Test, alongside a short questionnaire aimed at evaluating their resorting to body modification practices, including tattooing and body piercing. Results Females scored higher than males at all eating disorder inventories. More males than females admitted the use of tattoos (14.5% vs. 5.4%), whereas the reverse was found for body piercing (18.4% vs. 21.3%). Tattoos among females and body piercing in both genders were statistically associated with eating disorder measures related to bulimia symptoms. On the whole, the degree of association was modest. Conclusions Tattoos and body piecing should be seen as desires to show a subject's identity rather than as a marker of psychopathology. Greater health education, however, is needed in the wake of the growing popularity of these body modification practices.

Tattoos and body piercings have gained ground in the Western culture, particularly among adolescents, after having been confined for a long time to marginal sectors of modern societies [1] and [2]. Population studies indicate that 10–16% of adolescents have permanent tattoos [3], [4] and [5]. Less data are available on body piercing. One study found that up to 51% of college students in the United States reported to have undergone body piercing [6]. Conversely, in a German sample, individuals aged 14–24 years reported a similarly high rate of endorsement of tattoos and body piercing (41% and 27% among females and males, respectively); in both genders, tattoos and body piercings were related to lower perceived mental health and reduced social integration [7]. In another study carried out in 1999 among 550 military recruits entering basic training at the US Marine Corps, 27% were found to have tattoos, and those with a tattoo were more likely to display health-risk behaviors [8]. Among Australian people aged 14 years and over, too, the prevalence of tattoos and body piercing has been found to be considerably higher among those displaying high-risk behaviors, including injecting drug users [9]. Other past studies reported a link between the use of tattoos and/or piercing and risk-taking behaviors, particularly behaviors imposing harm to one's health, such as the use of psychotropic substances, unhealthy diet habits, and self-harm [4] and [5]. Unhealthy diet habits and a propensity for self-harm are also two features of eating disorders [10], [11] and [12]. Subjects with eating disorders, indeed, engage in a wide range of self-harming behaviors in both clinical and community samples and expose themselves to health-risk behaviors, including psychotropic substances abuse [11], [12], [13] and [14]. Adolescent people are most at risk: prevalence studies report rates between 0.5% and 0.8% for anorexia nervosa and around 1% for bulimia nervosa, with subthreshold and atypical variants involving another 3–5% of the population at risk, with the age group including 12- to 19-year-olds [10]. So far, no study has investigated the frequency and distribution of body modification practices, such as tattoos and body piercing, among adolescent students in Italy. Furthermore, no study has investigated the links between body modification practices and eating disorder symptoms with a sound methodology for the identification of eating disorder symptoms. In the past, symptoms of eating disorders have been interpreted as a kind of symbolic language used by people who do not know how to, or are afraid to, express powerful emotions directly with words (so-called alexithymia) and who lack a strong sense of identity [15] and [16]. Tattoos and piercings, in some way, would express both the intent to mark one's own identity and the intention to introduce a change in one's own habitual look [17] and [18]. Among people with eating disorders, resorting to body modification practices such as tattoos and body piecing could be seen as a strategy to emphasize the self by acting on the body. This study set out to explore concurrently the prevalence of tattoos and body piercing, and eating disorder symptoms in a representative adolescent sample of a community in Sardinia, a major island in Italy. We expect people who score higher on validated scr

Past studies in selected adolescent samples found a link between the use of tattoos and/or body piercing and risk-taking behaviors, including disordered eating [4] and [5]. On the other hand, samples drawn from treatment settings, as were most of the samples of previous studies, tend to be exposed to a higher risk of comorbidity—the so-called Berkson's fallacy, thus inflating links between psychopathology and risk-taking behaviors [32]. Our study supports past findings by showing that these links are evident even when using validated measures of symptoms and when investigating community-based samples. The association between tattoos or body piercing and eating disorder symptoms is, however, modest. Nevertheless, resorting to tattoos or body piercing is not a hazard-free practice. Most health professionals' concerns are with regard to infectious complications, whose hazards were reported to increase in both tattooing and body piercing procedures [33] and [34], including a potentially higher risk of transmitting blood-borne diseases [35], [36] and [37]. More serious health hazards are linked to emergency situations after severe accidental injury or motor vehicle accidents. Here, speed of treatment is crucial, and the inability to remove an impeding tongue or mouth piece of jewelry inserted during body piercing causes interference with emergency procedures [38]. Greater health education is needed in the wake of the growing popularity of these body modification practices.