Tattoos may be a coping mechanism for some college-age women

According to his new study, some interesting emotional correlations emerge among college-age respondents with four or more tattoos. Women with multiple tattoos report higher levels of self-esteem than anyone else in the study. Moreover, escalating acquisition of body art does not correlate with increased depression or suicide ideation among men or women. However, the same multi-tattooed women also report a much higher frequency of past suicide attempts.

So how does Koch explain this paradox?

"I think women, especially, are more aware of their bodies through, among other things, fat shaming, the cosmetics and plastic surgery industry and hyper-sexualized imagery in media," Koch said. "What we may be seeing is women translating that awareness into empowerment. We know women sometimes replace a surgically removed breast, for example, with elegant body art. We wonder if more tattoos might be a way of reclaiming a sense of self in the wake of an emotional loss -- evidenced by a suicide attempt."

The study, titled "Tattoos, gender and well-being among American college students," will be published in The Social Science Journal in 2016. It is the companion piece to Koch's 2010 study, "Body art, deviance and American college students," which found respondents with four or more tattoos, seven or more body piercings or piercings in the nipples or genitals were significantly more likely to report regular marijuana use, occasional use of other illegal drugs and a history of being arrested for a crime.

"This latest piece takes the same question inside out," Koch said. "Instead of talking about deviance, it's about wellness. We wanted to find out, to what extent does the acquisition of body art correlate to a sense of well-being or a greater sense of self? It's pretty paradoxical."

In a 2008 study, "Motivation for Contemporary Tattoo Removal," Koch's team found women were more than twice as likely as men to want tattoos removed, most often as a way of dissociating from the past. But this new study appears to show the addition of a tattoo can serve the same purpose as a removal.

"That's what we think is going on," Koch said. "Women with four or more tattoos were the group that showed us the only two interesting connections: they had a much higher suicide attempt history, and paradoxically, it was this same group -- and the only group -- that showed an increased level of self-esteem. Our interpretation is maybe it's a parallel, emotionally, of what we see with breast cancer survivors. We can only speculate what these findings might mean, and more research needs to be done. But I think the logic holds when linking suicide survivors and breast cancer survivors who might use tattoos when reclaiming an emotional or physical loss."