Body art education: the earlier, the better.

Using the major format identified for successful prevention and intervention work, five "W" questions: what, why, whom, where, and who, plus one: how, this article first summarizes the current body art literature. Then, educational strategies specifically regarding the topic of tattoos and body piercing are presented for school nurses. These strategies can be used to create applicable, realistic information for young students before they are faced with decisions related to body art. The school nurse might be the first and only credible source of information the students receive related to body art in an education/health environment. Curriculum emphasis is on the decision making leading up to the action, and the major purposes, rather than on the markings or jewelry associated with procurement. Reducing decisional conflict while promoting positive development in the areas of empowerment, self-esteem, and maturing can help achieve stronger informed decision making.

College students with body art: well-being or high-risk behavior?

Body art is mainstream, with wearers readily admitting to being risk takers. Yet, are high-risk behaviors (e.g., cigarette, alcohol, and illegal drug use, sexual activity) and emotional distress (e.g., depression, suicide, eating disorders, abuse/forced sexual activity) present in all individuals with body art? Of the 595 college students who were queried, 127 (21%) had tattoos and 195 (33%) had lifetime piercings, with 17 (3%) having intimate (nipple, genital, or both) piercings; they also reported their self-views regarding religion, self-esteem, and Need for Uniqueness. Three consistent self-identity outcomes for their body art were: it helped me (a) express myself, (b) feel unique, and (c) be myself. When quantifying their body art amounts, well-being similar to that of individuals with no body art was present in those with one tattoo and less than four piercings. Individuals with four or more tattoos, seven or more piercings, and/or intimate piercings described higher risk behaviors and emotional distress. Education, monitoring, and non-profiling should continue as body art is only "skin deep."

Need for uniqueness in older women: an exploratory look.

Problem. Information about older women dwells on age-related illness and disabilities yet, other empowering traits could be promoting positive forces. Aim. While everyone desires some distinctiveness, this study explores higher levels of the motivational construct need for uniqueness (NU) in older women. NU concepts are: 1) perceived feelings of being or thinking different, 2) outspoken social behaviour, and 3) creative consumer consumption. Design. An exploratory, descriptive cross-sectional study provided quantitative data and focus groups generated qualitative data. Major results. Significant differences in all three NU concepts were evident between 87 (42%) with no/weak NU and 122 (58%) who 'preferred to be different from other people'. Focus groups provided examples over their lifetime within the context of their societal expectations. Relevance to clinical practice. The nurse's strategy to partner with older women to individualize their care and teaching will be important in maintaining their well-being. Examining their decision-making with how they respond to perceived feelings of being or thinking different (such as taking risks), how outspoken are they, and their patterns of consumer consumption are a few questions that could be asked to examine an older woman's NU. Further research examining specific health care decisions in those with NU will also be needed to note their responses toward future self-care activities.

Motivation for contemporary tattoo removal: a shift in identity.

OBJECTIVE: To compare the results of a 1996 study of tattoo possession and motivation for tattoo removal with those of a 2006 study, in light of today's current strong mainstream tattoo procurement and societal support within the young adult population. DESIGN: Descriptive, exploratory study. SETTING: Four dermatology clinics in Arizona, Colorado, Massachusetts, and Texas. PARTICIPANTS: The 2006 study included 196 tattooed patients (66 men and 130 women). MAIN OUTCOME MEASURES: Incidence of purchase and possession risk, as measured by a 127-item survey and factor analysis. RESULTS: In contrast to the 1996 study, more women (69%) than men (31%) presented for tattoo removal in 2006. Women in the 2006 study were white, single, college educated, and between the ages of 24 and 39 years; they reported being risk takers, having stable family relationships, and moderate to strong religious beliefs (prayer and closeness to God). Commonly, tattoos were obtained at approximately 20 years of age, providing internal expectations of uniqueness and self-identity. Tattoo possession risks were significant, cited when the quest for uniqueness turned into stigmata (P < .001), negative comments (P < .003), and clothes problems (P < .004). CONCLUSIONS: In both the 1996 and the 2006 studies, a shift in identity occurred, and removal centered around dissociating from the past. However, in the 2006 study, more women than men were notably affected by possession risks. Societal support for women with tattoos may not be as strong as for men. Rather than having visible tattoos, women may still want to choose self-controlled body site placement, even in our contemporary society.

Requencies and relations of body piercing and sexual experience in college students.

This research examined the relation between having a body piercing and having engaged in premarital sexual intercourse. Data were gathered from a convenience sample of 450 college students. 72% were women; 85% were ages 18 to 22 years (M=20.9, SD=4.5), 80% were Euro-American. Women with piercings reported substantively and significantly greater frequency of sexual activity than college students without piercings. There were no significant differences in sexual experience between men with piercings and those without. These findings differ from previous research comparing the sexual activity of college students with and without tattoos.

The hole picture: risks, decision making, purpose, regulations, and the future of body piercing.

Can it be said that body piercing is ubiquitous, found across all socioeconomic groups? The major concentration is among adolescents and young adults 15 to 30 years old, in some studies, 50% of the population. Commonly identified physical risks are bleeding, tissue trauma, and bacterial infections; psychosocial risks are unhappiness, low self-esteem, and disappointment. The Health Belief Model is used to explain decision making; purposes for body piercing consistently center on personal expression (self-identity) and uniqueness. The international and US body piercing regulations are discussed, leading to the need for tracking complications globally and standardization of regulations. Proactive health education for clients and health providers remains a priority.

Investigating the removal of body piercings.

Although body piercing procurement continues to increase, 13% to 18% of them are removed. Reasons for piercing removal in college students were examined with three groups: (a) those who kept all their piercings, (b) those who removed some, or (c) those who removed all of their body piercings. Of the sample, 41% were still pierced; 50% in their lifetime. Their major purpose for the body piercing was "helped them feel unique." Females obtained more (in high school) and then removed more, usually as upperclassmen. Males and females reported themselves as risk takers at procedure time and currently; however, only 10% cited deviancy as a reason for the body piercing(s). Only removal elements of "I just got tired of it" and "I just decided to remove it" were present, especially with the Some Removed Group. Further examination of body piercing building personal distinctiveness and self-identity to promote their need of uniqueness is suggested.

Correlates of tattoos and reference groups.

520 college students from a public university in the southwest were questioned to examine correlations between having a tattoo and the presence of tattoos among their family and friends. Tattoos among both friends and family were positively correlated with respondents' having a tattoo. The magnitude of friends' influence was about double the influence of family.

College students, tattoos, and sexual activity.

This research examined the association of having a tattoo and engaging in premarital sexual intercourse. Data gathered from a convenience sample of 450 college students indicated that tattooed respondents were substantively and significantly more likely to be sexually active than nontattooed college students. Tattooed men became sexually active at a significantly earlier age than nontattooed men but no such difference was found between tattooed and nontattooed college women.

Religious belief and practice in attitudes toward individuals with body piercing.

Some research suggests adorning the body with tattoos or piercing jewelry is normative. Survey data were gathered from 450 undergraduates (72% female; 80% Euro-American; 63% freshmen and sophomores). Correlations between an index of respondents' religious belief and practice and their attitudes toward individuals who had more body piercings were weak if piercings were 7 or more, including piercings of the nipples and genitals. As religiosity is a carrier of normative behavior, individuals who have body piercings may be viewed as behaving within cultural norms.

Contemporary college students and body piercing.

Student (N = 450) demographic characteristics (parental composition and relationships, and religious participation) were documented in those with body piercings (32%) and those without body piercings (55%), yet many risky behaviors were present, including tattooing (22%). Major piercing purposes were self-expression and identity, rather than deviancy or rebellion.

Correlations of religious belief and practice with college students' tattoo-related behavior.

This research builds on a large body of literature which suggests that religious belief and practice suppress deviant behavior. Survey data from 520 undergraduates (64% freshmen and sophomores; 70% female; 80% Euro-American) at a large public university in the southwest were examined for whether students' strength of religious faith, church attendance, or frequency of prayer correlated with their having a tattoo, being interested in tattoos, or being likely to get a (or another) tattoo. Analysis showed strength of religious faith had a weak, negative correlation with having a tattoo, being interested in tattoos, and being likely to get a (or another) tattoo. Church attendance also weakly correlated with a reduced interest in tattooing. Since the strength of the numerous correlations was very low and barely reached statistical significance, religious belief and behavior do not appear to be associated substantively with attitudes and behavior regarding tattoos. This suggests increasing cultural acceptance of tattooing.

Toward building a composite of college student influences with body art.

Body piercing and tattooing flourish on American campuses. The theoretical framework of symbolic interaction and subculture identity were used to examine two similar studies (methods, sample, and tools) for building a composite of influences associated with body art and further understand the psychosocial dimensions. In data from Armstrong, Owen, Roberts, and Koch (2002a, 2002b), and the described study within, four groups of college students (N=908) were formed; those without tattooing (n=419, 81%), and with tattooing (n=97, 19%), and those without body piercing (n=247, 55%) and with body piercing (N=145, 32%). Influences (purpose, image, identity, cues, barriers, family, friends) were examined. All four student groups reported a positive image for the body art. Friends provided major support, whereas family were not as influential. Uniqueness was important, with the major purposes "I just wanted one, express myself, feel unique, be myself, I don't need to impress anyone anymore, and it helps me feel independent."

College tattoos: more than skin deep.

Nontattooed (n = 423, 81%) and tattooed (n = 97, 19%) college students report their cues, purpose, reason, risks, barriers, and customer criteria for tattooing; some psychosocial risks were documented. Challenges are posed and suggestions made for developing applicable health education.

College students and tattoos. Influence of image, identity, family, and friends.

Tattoos are popular among many groups of people. College students from a large university in the southwestern United States were queried using the 134-item Armstrong Team Tattoo Attitude Survey. Findings documents a progressive increase in tattooing and reflect significant support for tattoos, even from non-tattooed students. Similar and positive demographic characteristics were present in individuals who were both non-tattooed and tattooed. In addition, tattooed people were viewed positively, even among non-tattooed respondents. Friends significantly affected procurement and possession of tattoos, whereas of all family members, the sister was the only significant influence. Overall, friends, identity, and image seem to be the major influences for obtaining tattoos.