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Body modification and substance use in adolescents: is there a link?

Presented in part at the annual meeting of the Ambulatory Pediatrics Association, May 16, 2000, Boston, Massachusetts.
https://doi.org/10.1016/S1054-139X(02)00446-9Get rights and content

Abstract

Purpose

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.

Methods

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 ≥1. Data were analyzed using logistic regression to determine whether the presence of body modification was an independent predictor of problem substance use.

Results

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 ≤ .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).

Conclusions

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.

Section snippets

Participants

The sample was composed of 210 patients aged 14 to 18 years receiving routine health care at an adolescent clinic of an urban children’s hospital and participating in a larger ongoing study of substance use among adolescents [30]. After providing informed assent (age < 18 years) or consent (age = 18 years), participants completed a structured interview about substance use and self-administered the Problem Oriented Screening Instrument for Teenagers/Alcohol and Drug Abuse Scale (POSIT-ADS) 31, 32

Results

Descriptive data are shown in Table 1. The mean age of the sample was 16.0 (± 1.4) years; 63% were female and 48% were black. One hundred adolescents (47%) reported some type of body modification. More than twice as many teens with any body modification reported problem substance use, compared with those without body modification (47% vs. 21%, p < .0005). Older adolescents were more likely than younger adolescents to have obtained any body modification (p = .004) and were somewhat more likely

Discussion

In this adolescent clinic sample, body modification and self-reported problem substance use were common, associated risk behaviors. Not surprisingly, older age was associated with the presence of both body modification and problem substance use. The relationship between age and other risk behaviors has been previously reported [28], and is likely owing to longer time for exposure to risk behaviors and opportunity to engage in risk. In addition, both liquor stores and venues offering body

Acknowledgements

We thank Erin Gates for collection of the data, Stacy Taylor for verification of data entry, and S. Jean Emans, M.D. for her helpful comments and reading of the manuscript. This work was supported by #R01 AA-12165-01A1 from the National Institute on Alcohol Abuse and Alcoholism, #036126 from the Robert Wood Johnson Foundation, and LEAH 5 T71 MC 00009-08 from the Maternal and Child Health Bureau Health Resources and Services Administration.

References (39)

  • R. Jessor

    Risk behavior in adolescenceA psychosocial framework for understanding and action

    J Adolesc Health

    (1991)
  • J. Knight et al.

    Reliability of the Problem Oriented Screening Instrument for Teenagers(POSIT) in an adolescent medical clinic populations

    J Adolesc Health

    (2001)
  • M. Hayes et al.

    Body piercing as a risk factor for viral hepatitisAn integrative research review

    Am J Infect Control

    (2001)
  • M.H. Christensen et al.

    To the pointThe contemporary body piercing and tattooing renaissance

    Nurs Spectr

    (1999)
  • D. Marcoux

    Cosmetics, skin care, and appearance in teenagers

    Semin Cutan Med Surg

    (1999)
  • S.S. Tweeten et al.

    Infectious complications of body piercing

    Clin Infect Dis

    (1998)
  • S. Slawik et al.

    Body piercingAn unusual cause of priapism

    BJU Int

    (1999)
  • American Dental Association (ADA). ADA statement on intraoral/perioral piercing, 1999. Revised edition, October 2000...
  • H. Ferguson

    Body piercing

    BMJ

    (1999)
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