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Volume 32, Issue 1, Pages 44-49 (January 2003)


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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.

Traci L Brooks, M.D.a, Elizabeth R Woods, M.D., M.P.H.a, John R Knight, M.D.abc, Lydia A Shrier, M.D., M.P.H.acCorresponding Author Informationemail address

Accepted 15 July 2002.

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.

a Division of Adolescent/Young Adult Medicine, Children’s Hospital Boston, Harvard Medical School, Boston, Massachusetts, USA (T.L.B., E.R.W., J.R.K., L.A.S.)

b Division of General Pediatrics, Children’s Hospital Boston, Harvard Medical School, Boston, Massachusetts, USA (J.R.K)

c Center for Adolescent Substance Abuse Research, Children’s Hospital Boston, Harvard Medical School, Boston, Massachusetts, USA (J.R.K., L.A.S.)

Corresponding Author InformationAddress correspondence to: Lydia A. Shrier, M.D., M.P.H., Division of Adolescent/Young Adult Medicine, Children’s Hospital Boston, 300 Longwood Avenue, Boston MA 02115, USA.

PII: S1054-139X(02)00446-9


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