Body Image 8 (2011) 237–244

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Body Image
journal homepage: www.elsevier.com/locate/bodyimage

Marked for life? A prospective study of tattoos on appearance anxiety and

dissatisfaction, perceptions of uniqueness, and self-esteem
Viren Swami a,b,∗
a
Department of Psychology, University of Westminster, London, UK
b
Department of Psychology, HELP University College, Kuala Lumpur, Malaysia

a r t i c l e i n f o a b s t r a c t

Article history: Previous studies on psychosocial aspects of tattooing have not examined prospective changes in self- and
Received 10 March 2011 body-related attitudes as a result of obtaining a tattoo. In the present study, 82 British residents obtain-
Received in revised form 16 April 2011 ing their first tattoo completed measures of state appearance anxiety and dissatisfaction prior to, and
Accepted 21 April 2011
immediately after, obtaining a tattoo. They also completed measures of trait body appreciation, distinc-
tive appearance investment, self-ascribed uniqueness, social physique anxiety, and self-esteem before
Keywords:
obtaining a tattoo and three weeks later. Results showed that both women and men had significantly
Tattoo
lower appearance anxiety and dissatisfaction immediately after obtaining their tattoo, and significantly
Body art
Uniqueness
higher body appreciation, distinctive appearance investment, self-ascribed uniqueness, and self-esteem
Body image after three weeks. Women reported greater social physique anxiety after three weeks, whereas men
Appearance anxiety reported lower anxiety. These results are discussed in relation to the positive impacts of obtaining body
Self-esteem art and the mainstreaming of tattooing in Western societies.
© 2011 Elsevier Ltd. All rights reserved.

Introduction psychosocial aspects of tattooing had, for a time at least, remained

The art of tattooing may have an incredibly long history among
many cultural groups, but the growth of its popularity and accep-
tance in Western, industrialised societies since the early 1990s has
been particularly dramatic (Caplan, 2000; DeMello, 1995, 2000;
Rubin, 1988; Swami & Harris, 2011). For instance, the incidence
of tattooing among respondents in North America and Europe is
approximately 25% (Armstrong, Roberts, Owen, & Koch, 2004; Greif,
Hewitt, & Armstrong, 1999; Laumann & Derick, 2006; Makkai &
McAllister, 2001; Mayers & Chiffriller, 2008; Stieger, Pietschnig,
Kastner, Voracek, & Swami, 2010) and at least one commentator
believes it will reach 40% in the next decade (Anderson, 2006).
Moreover, the historic trend of higher prevalence among men
appears to have been overturned, with women now being just as
likely to have tattoos (Laumann & Derick, 2006; Mayers & Chiffriller,
2008; Stieger et al., 2010).
Where tattoos were once more common among out-groups that
were stigmatised as being deviant or aggressive (e.g., bikers, prison-
ers, organized crime syndicates), they now appear to have achieved
an unprecedented degree of mainstreaming across socioeconomic
and other demographic boundaries (DeMello, 2000; Forbes, 2001).
Yet, despite this apparent mainstreaming, scholarly interest in the
∗ Correspondence address: Department of Psychology, University of Westminster,
309 Regent Street, London W1B 2UW, UK. Tel.: +44 2079115000.
E-mail address: v.swami@wmin.ac.uk
relatively piecemeal (Fisher, 2002; Tate & Shelton, 2008). More
recently, it has been possible to discern at least three broad areas
of interest (Swami & Harris, 2011), relating to sociocultural and
individual motivations for obtaining tattoos, interpersonal percep-
tions of individuals with tattoos, and psychological and behavioural
correlates of tattooing.
In terms of the former, some sociologists have attempted to
understand the contemporary popularity of tattooing as a means
of reclaiming some agency over corporeal experiences in post-
industrialised societies where the body is violently commodified
(e.g., Benson, 2000). Others have highlighted the appropriation
of counter-cultures by twentieth-century capitalism alongside the
editing out of discourse on traditional body art populations, such
that tattoos are now packaged as a bourgeois means of self-styling
within cultures that require constant work on the body (Blanchard,
1994; Kosut, 2006; Sanders, 1989). In addition to these macro-
level factors, the contemporary popularity of tattooing may also
have benefited from advances in procedures (e.g., in terms of safety
and faster recovery), the influx of new artists into the industry,
and higher disposable incomes and the lower cost of tattooing
(DeMello, 2000).
Concurrently, a raft of recent studies has focused on individual
motivations for obtaining a tattoo (for a review, see Wohlrab, Stahl,
& Kappeler, 2007). Broadly speaking, these studies have centred on
fashion-related motivations versus meaning-related motivations,
while also downplaying the role of tattoos in signalling simple out-
group affiliation. In the first instance, the rapid mainstreaming of

1740-1445/$ – see front matter © 2011 Elsevier Ltd. All rights reserved.
doi:10.1016/j.bodyim.2011.04.005
238 V. Swami / Body Image 8 (2011) 237–244
tattooing has led some scholars to dismiss tattoos as passé or as
an example of the incorporation of the ‘exotic’ into the fashion
system (Falk, 1995; Steele, 1996). In this perspective, tattoos are
viewed as meaningless cultural ephemera or ‘fashion accessories’
that serve purely aesthetic functions and thus signal an individual’s
participation in the fashion system (Steele, 1996).
Certainly, qualitative research by Sweetman (1999, p. 55) sug-
gests that lightly tattooed respondents view their tattoos as little
more than fashion accessories, similar to “more standard forms
of jewellery or other items intended to enhance a particular
‘look”’. Other work has similarly suggested that common motiva-
tions for obtaining tattoos include “just wanting one” (Greif et al.,
1999) or because “they look good” (Forbes, 2001; Tiggemann &
Hopkins, 2011). However, Sweetman (1999) also problematises
the argument that tattoos are fashionable per se by highlight-
ing the permanence, planning, and pain involved in tattooing. His
research showed how both heavily and lightly tattooed respon-
dents viewed tattooing as a form of ‘anti-fashion’, employed as a
means of preserving individual or social identities, while advertis-
ing the permanence of their experiences, values, or beliefs.
Indeed, it appears to be the case that many tattooed individuals
emphasise their tattoos as an individual means of self-expression
or as a means of constructing self-identity by drawing attention
to the body (Armstrong et al., 2004a; Millner & Eichold, 2001).
For instance, recent studies have discussed tattooing as a means
through which individuals are able to accentuate their self-identity
or achieve uniqueness in the appearance domain (Tiggemann &
Golder, 2006; Tiggemann & Hopkins, 2011). In this view, individuals
with a need for uniqueness and distinctive appearance investment
may be more likely to obtain tattoos, and the resulting perception
of uniqueness may help improve an individual’s self-esteem, par-
ticularly in contemporary industrialised societies where the ‘body
project’ remains ubiquitous.
However, any positive impact of tattoos on the psychological
well-being of respondents may be tempered by negative inter-
personal attributions they experience (Swami & Furnham, 2007).
For example, several studies have reported that children are more
likely to attribute negative acts (e.g., drug use) to tattooed figures
(Durkin & Houghton, 2000) and that non-tattooed adults perceive
tattooed individuals as more neurotic, less agreeable, less con-
scientious, and less open to experience than themselves (Forbes,
2001; Wohlrab, Fink, Kappeler, & Brewer, 2009). Within occupa-
tional settings, employers are more likely to hold negative attitudes
toward tattooed employees compared with non-tattooed employ-
ees (Bekhor, Bekhor, & Gandrabur, 1995; Stuppy, Armstrong, &
Casals-Ariet, 1998).
Such negative attributions may be more readily elicited for
women with visible tattoos compared to tattooed men (Armstrong,
1991; Degelman & Price, 2002; Hawkes, Senn, & Thorn, 2004).
In one study, line-drawn figures of women with visible tattoos
were rated as less physically attractive, more sexually promiscu-
ous, and heavier consumers of alcohol than the same figure without
tattoos (Swami & Furnham, 2007). Another study using computer-
generated images showed that tattooed women were rated as more
sexually uninhibited and less motivated, honest, and healthy than
non-tattooed women (Wohlrab, Stahl, Rammsayer, & Kappeler,
2007). This gendered pattern of findings has been discussed in rela-
tion to norms of behaviour ascribed to men and women, such that
women bearing tattoos are viewed as transgressing conservative
gender attitudes, which in turn results in greater stigmatisation
(Armstrong, 1991; Hawkes et al., 2004).
A third avenue that has received sustained attention from
researchers interested in body art concerns behavioural and per-
sonality differences between body-modified and non-modified
individuals. This body of work is based on the premise that the
agency involved in obtaining body art reflects, or results in, dif-
ferences between those who have tattoos and those who do not
(Tate & Shelton, 2008). Thus, several studies have suggested that
tattoo possession is associated with being sexually active (Carroll,
Riffenburgh, Roberts, & Myhre, 2002; Roberts & Ryan, 2002). Among
college students, for instance, tattoo possession predicts being sex-
ually active and, among men, becoming sexually active at a younger
age (Koch, Roberts, Armstrong, & Owen, 2005; Koch, Roberts,
Armstrong, & Owen, 2010).
A larger body of research has suggested that tattoo posses-
sion among adults is correlated with greater risk-taking behaviour,
including the use of illegal substances, violent behaviours directed
at others, and illegal activities such as shoplifting (Armstrong et al.,
2004a; Brooks, Woods, Knight, & Shrier, 2003; Burger & Finkel,
2002; Drews, Allison, & Probst, 2000; Forbes, 2001; Nathanson,
Paulhus, & Williams, 2006). Among adolescents, too, tattoo posses-
sion is associated with drug use and sexual activity (Braithwaite,
Robillard, Woodring, Stephens, & Arriola, 2001; Carroll et al., 2002;
Roberts & Ryan, 2002), as well as school truancy, illegal activi-
ties, gang affiliation, and problem gambling (Deschesnes, Fines, &
Demers, 2006).
Finally, some scholars have examined the personality, mood,
or psychopathology of tattooed individuals, although the results
of their work remain equivocal. For example, some studies report
that tattooed individuals score higher than non-tattooed individu-
als on measures of extraversion and related traits, such as sensation
seeking (Copes & Forsyth, 1993; Drews et al., 2000; Stirn, Hinz,
& Brahler, 2006; Wohlrab, Stahl, et al., 2007; see also Roberti,
Storch, & Bravata, 2004), but other studies have returned non-
significant findings (Forbes, 2001; Tate & Shelton, 2008). Similarly,
some studies report that tattooed individuals have lower scores
on measures of depression than non-tattooed individuals (Fredrick
& Bradley, 2000), while others have shown that they have higher
scores (Roberti & Storch, 2005; see also Nathanson et al., 2006). In
summing up this area of research, Tate and Shelton (2008, p. 281)
cautioned that the effect sizes of reported differences have tended
to be very small and “most likely reflect inconsequential real world
differences” between those with and without tattoos.
Although studies on tattoos and their outcomes have bur-
geoned in recent years, Swami and Harris (2011) identified two
specific shortcomings of this literature. Specifically, these authors
noted, firstly, that there have been no in-depth examinations of
the associations between possession of tattoos and measures of
body image. Secondly, they highlight the fact that there have been
no longitudinal studies examining the effects of obtaining tat-
toos, particularly in relation to body-related attitudes in pre- and
post-modification states (especially among individuals who are
obtaining tattoos for the first time). This dearth in the literature is
important because corporeal experiences may not only be motivat-
ing factors in tattoo procurement (Armstrong, 1991), but may also
change markedly once a tattoo has placed on the body (Schildkrout,
2004). In addition, it has been estimated that prevalence rates of
individuals dissatisfied with their tattoos is about 20% (Anderson,
2006; Laumann & Derick, 2006), with 6% seeking removal (Mayers,
Judelson, Moriarty, & Rundell, 2002), and negative corporeal expe-
riences may be an important reason for dissatisfaction (Anderson,
2001; Armstrong, Roberts, Owen, & Koch, 2004; Huxley & Grogan,
2005). The present study, then, was conceived as an attempt to
overcome the afore-mentioned shortcomings in the literature.
Specifically, the current study examined participants’ state body
image and appearance anxiety in their pre-modification state and
immediately after obtaining a tattoo. During the first testing ses-
sion, participants also completed measures of motivations for
obtaining a tattoo, trait body image and appearance anxiety, per-
ceptions of uniqueness, and self-esteem, which were re-examined
three weeks after respondents had obtained their tattoo (by which
time the tattoo would have healed completely). Given the dearth
 V. Swami / Body Image 8 (2011) 237–244
of research on temporal changes in body-related attitudes follow-
ing tattooing, the present study was largely exploratory, although
it was expected that obtaining a tattoo would generally result in
more positive body-related attitudes in the short term.
Method
Design
The present study employed a prospective design in which
respondents completed a questionnaire-based survey immediately
before (Time 1) and after (Time 2) obtaining a tattoo, as well as three
weeks after obtaining their tattoo (Time 3). At Time 1, participants
completed state and trait measures of body image, appearance anx-
iety, motivations for obtaining a tattoo, perceptions of uniqueness,
and self-esteem. At Time 2, participants completed state measures
of body image and appearance anxiety, as well as a measure of
their satisfaction with the new tattoo. Finally, at Time 3, partic-
ipants completed trait measures of body image and appearance
anxiety, perceptions of uniqueness, and self-esteem. Key measures
are described below along with details of testing sessions.
Study Site and Participants
Participants of this study were 82 British residents recruited at
a tattoo parlour in Camden Town, an inner city district in London,
England. In the past several decades, Camden Town has witnessed a
rapid increase in retail, tourist, and entertainment outlets, many of
which are associated with alternative cultures. Part of this change
from its earlier industrial heritage has been the proliferation of tat-
too and body piercing parlours. The present study was conducted at
a licensed tattoo parlour with a complement of five tattoo artists.
The participants of the study were 39 women and 43 men rang-
ing in age from 18 to 50 years (M = 24.89, SD = 6.38) and of whom
a majority were of British White descent (89.0%). In terms of edu-
cational qualifications, 35.4% had completed secondary education,
42.7% had a post-secondary qualification, 19.5% had an undergrad-
uate degree, and 2.4% had a postgraduate degree.
Measures
Demographics. Participants provided their demographic
details at Time 1, consisting of gender, age, ethnicity, and highest
educational qualification.
Visual Analogue Scale (Heinberg & Thompson, 1995). A visual
analogue scale was used to measure state feelings about over-
all appearance at Times 1 and 2. Respondents were asked to rate
their satisfaction with their “overall physical appearance” on a
100-millimetre line, anchored by two extremes, namely No dissat-
isfaction and Extreme dissatisfaction. Responses were measured to
the nearest millimetre, with higher scores indicating greater dis-
satisfaction with overall appearance at a given moment. Visual
analogue scales of this type have been used to determine the effects
of experimental manipulation on body image and have been shown
to have good construct validity (e.g., Cattarin, Thompson, Thomas,
& Williams, 2000; Heinberg & Thompson, 1995).
Physical Appearance State and Trait Anxiety Scale (PASTAS;
Reed, Thompson, Brannick, & Sacco, 1991). The PASTAS, com-
pleted at Times 1 and 2, is an affective measure assessing anxiety
about 16 different body sites. The present study used the state ver-
sion of the PASTAS, in which participants are asked to describe how
anxious, tense, or nervous they feel at that particular moment about
the different body sites. Items are rated on a 5-point Likert-type
scale (0 = Not at all, 4 = Exceptionally so) and an overall PASTAS score
239
is computed as the mean of all 16 items, with higher scored indi-
cating greater state anxiety about appearance. Reed et al. (1991)
reported that PASTAS scores have good internal consistency, high
test-retest reliability over a two-week period, and are sensitive to
situational differences. In the present study, Cronbach’s alpha for
this scale was .88 at Time 1 and .90 at Time 2.
Body Appreciation Scale (BAS; Avalos, Tylka, & Wood-
Barcalow, 2005). The BAS, completed at Times 1 and 3, is a 13-item
measure of trait body image in which items are rated on a 5-point
Likert-type scale (1 = Never, 5 = Always). The scale measures related
aspects of positive body image and, among Western samples, it
has been shown to have a one-dimensional structure (Avalos et al.,
2005; Swami, Stieger, Haubner, & Voracek, 2008). An overall BAS
score is calculated as the mean of all 13 items, with higher scores
indicating more positive body image. Avalos et al. (2005) reported
that the BAS has good internal consistency, good discriminant, con-
struct, and incremental validities, and good test-retest reliability
after three weeks. In the present study, Cronbach’s alpha for the
BAS was .91 at Time 1 and .88 at Time 3.
Self-Attributed Need for Uniqueness Scale (SANU; Lynn &
Harris, 1997). The SANU, which participants completed at Times
1 and 3, is a 4-item measure of self-perceived feelings of being or
thinking differently from others. Items are rated on a 5-point Likert-
type scale (1 = Not at all, 5 = Extremely) and an overall SANU score
is computed as the mean of all four items (higher scores reflect
greater self-attributed uniqueness). Previous work has shown that
the SANU has good internal consistency as well as good construct
validity (Lynn & Harris, 1997; Lynn & Snyder, 2002). In the present
study, Cronbach’s alpha for this scale was .92 at Times 1 and 3.
Social Physique Anxiety Scale (SPAS; Hart, Leary, & Rajeski,
1989). The SPAS, completed at Times 1 and 3, is a 12-item mea-
sure of anxiety associated with perceived evaluation of one’s body
or physical appearance. Items are rated on a 5-point Likert-type
scale (1 = Not at all like me, 5 = Like me a lot) and an overall score
is computed as the mean of all items. For the SPAS, higher scores
indicate greater social physique anxiety. The SPAS has been shown
to have adequate construct validity, internal consistency, and test-
retest reliability (Hart et al., 1989). In the present study, Cronbach’s
alpha for this scale was .90 at Time 1 and .92 at Time 3.
Rosenberg’s Self-Esteem Scale (RSES; Rosenberg, 1965). The
RSES, completed by participants at Times 1 and 3, is the most
widely used measure of an individual’s feeling of self-worth. The
RSES consists of 10 items that are rated on a 4-point Likert-type
scale (1 = Strongly disagree, 4 = Strongly agree). An overall score is
computed as the mean of all items, with higher scores reflecting
greater self-esteem. Scores on the RSES have been shown to have
high internal consistency and good convergent validity (Whiteside-
Mansell & Corwyn, 2003). In the present study, Cronbach’s alpha for
the RSES was .86 at Time 1 and .88 at Time 3.
Distinctive Appearance Investment Scale (DAI; Tiggemann
& Golder, 2006). The DAI is a 6-item measure of an individual’s
desire to look different and stand out specifically in the appear-
ance domain, which participants completed at Times 1 and 3.
Items are rated on a 5-point Likert-type scale (1 = Strongly dis-
agree, 5 = Strongly agree) and an overall score is computed as the
mean of all items (higher scores reflect greater distinctive appear-
ance investment). Tiggemann and Golder (2006) reported that DAI
scores have a one-dimensional structure with high internal con-
sistency and good construct validity, insofar as scores are only
moderately correlated with scores on need for uniqueness and
240 V. Swami / Body Image 8 (2011) 237–244

Table 1
Mean and standard deviations for reasons for obtaining tattoos.

Item Women (n = 39) Men (n = 43) Total (N = 82)

M SD M SD M SD

They celebrate an occasion/person 1.77 0.84 2.26 1.14 2.02 1.09

To feel independent 1.46 0.72 1.63 0.95 1.55 0.84
To look attractive 1.79 0.89 1.81 0.73 1.80 0.81
To express myself 3.97 1.09 4.32 0.92 4.16 1.01
To be an individual 2.74 0.99 2.65 0.92 2.70 0.95
To be unique 3.69 0.83 3.81 1.10 3.76 0.98
To control my body 1.82 1.05 1.58 0.76 1.70 0.91
To be fashionable 1.67 0.87 1.28 0.55 1.46 0.74
To be creative 1.95 0.69 2.16 1.02 2.06 0.88
Because they look good 3.89 1.14 3.67 1.21 3.78 1.18
Because my friend are tattooed 1.23 0.48 1.51 0.82 1.37 0.70
To rebel 1.25 0.64 1.74 1.09 1.51 0.93
To look tough 1.13 0.41 1.30 0.74 1.22 0.61
To feel better about myself 2.07 0.77 1.81 1.01 1.94 0.91
To stand out in a crowd 2.02 1.13 2.21 1.21 2.12 1.17
Because I like to take risks 1.52 0.60 1.60 0.93 1.56 0.79
To feel mature 1.12 0.34 1.27 0.59 1.21 0.49
To have a beauty mark 1.31 0.69 1.44 0.55 1.38 0.62
To show commitment to a group 1.41 0.72 1.44 0.55 1.42 0.63

Note: Means above 3.00 are shown in bold.

appearance investment. In the present study, internal consistency
was .88 at Time 1 and .84 at Time 3.
Reasons for obtaining tattoos (Tiggemann & Golder, 2006).
At Time 1, participants were asked to rate 19 possible reasons for
obtaining their tattoo (see Table 1 for a full list). The list was origi-
nally devised by Tiggemann and Golder (2006) to reflect the range
of motivations for obtaining body art, such as tattoos and pierc-
ings. Items are rated on a 5-point Likert-type scale (1 = Not a reason,
5 = Very strong reason) and are treated individually (Tiggemann &
Golder, 2006; Tiggemann & Hopkins, 2011).
Visibility and extent of tattoos (Tiggemann & Hopkins, 2011).
In order to get an accurate description of participants’ tattoos, par-
ticipants were provided with schematic outlines of the front and
back view of the human figure. At Time 2, participants were asked
to draw a likeness of their tattoo on the figures. The drawings were
then used to ascertain tattoo visibility and percentage of the body
covered by the new tattoo. Tattoo visibility was classified on a 5-
point scale (1 = Rarely visible, 2 = Only visible in underwear, 3 = Visible
in shorts, t-shirt, and open shoes, 4 = Visible in trousers, long sleeves,
and covered shoes, 5 = Always visible). For the present purposes, four
independent judges coded both visibility and percentage of the
body covered by tattoos. In the present study, inter-rater reliability
for both measures was good (visibility, r = .94; percentage of body
covered, r = .96). Following Tiggemann and Hopkins (2011) and for
the purposes of analyses, visibility ratings were collapsed as ‘easily
concealed’ (visibility ratings of 1 or 2) or ‘readily visible’ (visibility
ratings of 3 of more).
Satisfaction with tattoo. At Times 2 and 3, participants were
asked to rate their overall satisfaction with their tattoo using a
single item with a 7-point Likert-type scale (1 = Very dissatisfied,
7 = Very satisfied).
Likelihood of obtaining future tattoos. At Time 3, participants
were asked to indicate how likely they were to obtain tattoos in
the future on a 7-point Likert-type scale (1 = Very unlikely, 7 = Very
likely).
Procedure
Once ethical approval had been obtained from the relevant uni-
versity ethics committee, the tattoo parlour’s management were
approached and agreed to the study taking place on their premises.
Because of the large number of tourists who frequent Camden
Town, participation was limited to British residents of an adult
age and those who were obtaining their first tattoo. A receptionist
working at the tattoo parlour initially screened potential partic-
ipants on the day they made their booking (which was usually
between two and four weeks prior to their appointment) and noti-
fied the author of appointment dates for potential participants.
On the day of the appointment, the author (who has readily vis-
ible tattoos) invited potential participants to take part in a survey
ostensibly on consumer behaviours and attitudes, and informed
participants that they would be retested immediately after their
tattoo had been completed. Of a total of 92 participants who were
invited to take part in the study, 84 agreed, representing a response
rate of 91.3%.
Once participation had been agreed and participants provided
informed consent, they completed a paper-and-pencil question-
naire containing the measures described above, as well as filler
scales related to consumer behaviours and attitudes. The order
of the scales in the questionnaire was semi-randomised for each
participant, with the demographic items always appearing first.
Participants completed the questionnaire in the waiting room of the
tattoo parlour while the tattoo artist prepared for the appointment.
Completed questionnaires were returned to the experimenter in
an envelope. Immediately after obtaining their tattoo, partici-
pants were invited to take part in a second survey, containing
the measures described above as well as filler scales not included
during the first testing session. Two participants declined to take
part at this stage, citing a lack of time, leaving a final sample
of 82 respondents. The order of presentation of scales was fully
randomised and completed questionnaires were returned to the
experimenter.
Three weeks after the appointment, all 82 participants were
invited by email to take part in a third survey, again ostensibly
on consumer behaviour. Where there was no response, invitations
were sent again a week later. All 82 participants from the initial test-
ing agreed to take part in the third survey. Once participation had
been agreed, participants were sent the questionnaire containing
the scales described above as well as filler scales. The question-
naires were sent by email and returned in a sealed envelope to the
experimenter. As required by the ethics committee, nominal codes
were used to link the data from the third testing session with ear-
lier data without breaching the participants’ right to anonymity.
Once testing was complete, all participants who had been sur-
 V. Swami / Body Image 8 (2011) 237–244 241

Table 2
Means and standard deviations for all factors included in the present study at different testing sessions.

Time 1 Time 2 Time 3

Women Men Women Men Women Men

M SD M SD M SD M SD M SD M SD

VAS 60.18 20.32 44.09 17.60 39.21 25.07 29.49 16.69 – – – –

PASTAS 3.27 1.10 2.52 0.97 2.78 1.09 2.12 0.82 – – – –
Satisfaction with tattoo – – – – 6.49 0.68 6.35 0.72 4.62 1.94 5.53 1.39
BAS 2.79 0.90 3.87 0.58 – – – – 3.26 0.90 4.27 0.66
DAI 2.45 1.08 2.42 0.96 – – – – 2.74 0.86 2.67 0.86
SANU 3.70 0.50 3.75 0.53 – – – – 4.00 0.52 4.21 0.62
SPAS 2.45 0.89 2.36 0.83 – – – – 3.04 0.92 1.92 0.49
RSES 3.03 0.53 2.89 0.62 – – – – 3.45 0.60 3.07 0.66

Note: VAS = Visual Analogue Scale, PASTAS = Physical Appearance State and Trait Anxiety Scale, BAS = Body Appreciation Scale, DAI = Distinctive Appearance Investment,
SANU = Self-Ascribed Need for Uniqueness, SPAS = Social Physique Anxiety Scale, RSE = Rosenberg’s Self-Esteem Scale.

veyed were fully debriefed via email and were provided with the
experimenter’s contact details.
Results
Preliminary Analyses
Missing data (<2.0%) were replaced using the mean replace-
ment method. Descriptive statistics for all variables measured
during each testing session are reported in Table 2. Prelimi-
nary analysis showed that there was no significant difference in
age between women (M = 25.46, SD = 6.06) and men (M = 24.37,
SD = 6.69), t(80) = 0.77, p = .443, d = .17. Among men, the most com-
mon position for the tattoo was on the upper arm (n = 16), followed
by the lower arm (n = 11), and chest (n = 7), whereas among women
the most common position was the foot or ankle (n = 11), lower back
(n = 8), or back of the shoulder (n = 8).
Among men, 25.6% had a tattoo that was easily concealed (visi-
bility ratings of 1 or 2) and 74.4% had a tattoo that was readily visibly
(visibility ratings of 3 or more). Among women, 43.6% had a tattoo
that was easily concealed and 56.4% had a tattoo that was readily
visible. A Chi-squared test showed that women were significantly
more likely to have a tattoo that was easily concealed compared
with men, 2 (1) = 8.24, p = .004. Finally, there was no significant
difference between women (4.4%) and men (5.6%) in the average
percentage of the body covered by the new tattoo, t(80) = 1.42,
p = .161, d = 0.32.
Reasons for Obtaining Tattoos
Descriptive statistics for reasons for obtaining tattoos are
reported in Table 1. As can be seen, the most common rea-
sons for obtaining tattoos were ‘To express myself’, ‘Because
they look good’, and ‘To be unique’. To examine whether there
were significant gender differences in responses to the items, a
multivariate analysis of variance (MANOVA) was conducted with
participant gender as the independent variable and responses
to the 19 reasons for obtaining a tattoo as the dependent vari-
ables. The results showed that there was a significant omnibus
effect of participant gender, F(19, 62) = 1.99, p = .022, 2p = .38.
Examination of the analysis of variance (ANOVA) results showed
that men had higher scores than women on obtaining a tat-
too because they celebrate an occasion or person, F(1, 80) = 4.25,
p = .042, 2p = .05, and to rebel, F(1, 80) = 5.93, p = .017, 2p = .07.
Women, on the other hand, had significantly higher scores than
men on obtaining a tattoo to be fashionable, F(1, 80) = 5.95, p = .017,
2p = .07.
Analyses of Scores at Times 1 and 2
To examine possible differences between participants’ appear-
ance anxiety and dissatisfaction at Times 1 and 2, a mixed ANOVA
was conducted with testing session as a within-subjects factor,
participant gender as a between-subjects factor, and the VAS and
PASTAS scores, respectively, as dependent variables. The results
for the VAS scores showed that there was a significant decrease in
dissatisfaction with overall appearance at Time 2, F(1, 80) = 66.58,
p < .001, 2p = .45, and that women were significantly more dissatis-
fied with their appearance across testing sessions, F(1, 80) = 11.18,
p = .001, 2p = .12. There was no significant interaction between
testing session and gender, F(1, 80) = 2.13, p = .148, 2p = .03. The
same pattern of results was observed for PASTAS scores, with a sig-
nificant decrease in appearance anxiety at Time 2, F(1, 80) = 31.57,
p < .001, 2p = .28, and women having significantly higher anxiety at
both testing sessions, F(1, 80) = 11.67, p = .001, 2p = .13. There was
no significant interaction between testing session and gender, F(1,
80) = 0.43, p = .516, 2p < .01.
A series of 2 × 2 ANOVAs (visibility: easily concealed versus
readily visible; gender: women versus men) were conducted to
examine the influence of these variables of state body image and
appearance anxiety at Time 2. Results showed that, for the VAS,
there was no significant main effect of visibility, F(1, 78) = 1.61,
p = .208, 2p = .02, and no significant visibility by gender inter-
action, F(1, 78) = 0.83, p = .365, 2p = .01. There was, however, a
significant main effect of gender, with men having significantly
lower appearance dissatisfaction than women (see Table 2), F(1,
78) = 3.99, p = .049, 2p = .05. The same pattern was repeated for
PASTAS scores at Time 2: there was no significant main effect of
visibility, F(1, 78) = 0.13, p = .722, 2p < .01, and no significant inter-
action, F(1, 78) = 0.05, p = .818, 2p < .01, but there was a significant
main effect of gender (see Table 2), F(1, 78) = 7.28, p = .009, 2p = .09.
Examination of the data for satisfaction with participants’ tat-
toos at Time 2 suggests that there were floor effects. Of the total
sample, 90.2% recorded a score of 6 or 7, 8.5% gave a score of 5,
and 1.2% gave a score of 4. Further analysis showed that, although
the VAS and PASTAS scores were significantly correlated at Time 2
(r = .43, p < .001), neither VAS (r = −.05, p = .632) nor PASTAS scores
(r = .15, p = .178) were significantly correlated with satisfaction with
the new tattoo. The most likely explanation for this lack of sig-
nificant findings is that the floor effects in relation to satisfaction
ratings attenuated any possible association with state appearance
dissatisfaction or appearance anxiety.
Analyses of Scores at Times 1 and 3
The same set of analyses as above was repeated for partici-
pants’ trait body appreciation, distinctive appearance investment,
242 V. Swami / Body Image 8 (2011) 237–244
self-attributed uniqueness, self-esteem, and social physique anx-
iety at Times 1 and 3. Results for body appreciation showed that
there was a significant increase in body appreciation at Time 3,
F(1, 80) = 20.48, p < .001, 2p = .20, and that women had significantly
lower body appreciation than men at both testing sessions, F(1,
80) = 56.48, p < .001, 2p = .41. There was, on the other hand, no
significant interaction between testing session and gender, F(1,
80) = 0.10, p = .759, 2p < .001. For distinctive appearance invest-
ment, there was a significant increase in scores at Time 3, F(1,
80) = 13.46, p < .001, 2p = .14, but no significant main effect of gen-
der, F(1, 80) = 0.07, p = .791, 2p < .01, and no significant interaction,
F(1, 80) = 0.04, p = .843, 2p < .01.
The results for the mixed ANOVA with self-ascribed uniqueness
showed that there was a significant increase in scores at Time 3, F(1,
80) = 28.03, p < .001, 2p = .26. There was, on the other hand, no sig-
nificant main effect of gender, F(1, 80) = 2.00, p = .161, 2p = .02, and
no significant interaction, F(1, 80) = 1.23, p = .270, 2p = .02. Results
for self-esteem showed that there was a significant improvement
in self-esteem at Time 3, F(1, 80) = 25.76, p < .001, 2p = .24, and that
women generally had higher self-esteem than men, F(1, 80) = 4.50,
p = .037, 2p = .05. There was, on the other hand, no significant
interaction between testing session and participant gender, F(1,
80) = 3.91, p = .052, 2p = .05.
Finally, the ANOVA for social physique anxiety scores showed
that there was a significant main effect of gender, F(1, 80) = 18.87,
p < .001, 2p = .19, but importantly also a significant interaction, F(1,
80) = 22.98, p < .001, 2p = .22. A paired samples t-test showed that,
among men, there was a significant decrease in social physique anx-
iety at Time 3, t(42) = 3.86, p < .001, d = 1.19, whereas among women
there was a significant increase at Time 3, t(38) = 3.14, p < .001,
d = 1.02. For SPAS scores, there was no significant main effect of
testing session, F(1, 80) = 0.45, p = .503, 2p = .01.
Further Analyses
As before, a series of 2 × 2 (visibility and gender as indepen-
dent variables) ANOVAs were conducted with the trait measures
above. In all cases, there was no significant main effect of visibility
(all Fs = 0.05–1.34, all ps = .250 to .822, all 2p = .01 to .02) and no
significant interactions (all Fs = 0.16–2.33, all ps = .130 to .689, all
2p = .01 to .03). A mixed ANOVA showed that there was a sig-
nificant decrease in satisfaction with the tattoos between Times
2 and 3, F(1, 80) = 58.17, p < .001, 2p = .42, but no significant main
effect of gender, F(1, 80) = 3.08, p = .083, 2p = .04. Importantly, how-
ever, there was a significant interaction between testing session
and gender, F(1, 80) = 9.03, p = .004, 2p = .10. Paired samples t-tests
showed that the decrease in satisfaction was larger among women,
t(38) = 6.00, p < .001, d = 1.95, than it was among men, t(42) = 4.52,
p < .001, d = 1.39.
In addition, bivariate correlations were carried out between
satisfaction with the tattoo and body appreciation, distinctive
appearance investment, self-attributed uniqueness, self-esteem,
social physique anxiety, and likelihood of getting future tattoos
measured at Time 3. The only significant correlation with satis-
faction scores was with self-esteem (r = .31, p < .001) and likelihood
of getting future tattoos (r = .27, p = .013). An independent samples
t-test showed that there was no significant difference in likelihood
of getting future tattoos between women (M = 4.64, SD = 1.99) and
men (M = 4.67, SD = 1.74), t(80) = 0.08, p = .936, d = 0.02. In terms of
the distribution of responses on the likelihood of getting future tat-
toos, the majority of participants gave scores of 5 or above (56.1%).
Finally, to examine potential correlates of the decrease in tat-
too satisfaction scores between Time 2 and Time 3, a difference
score was first computed by substracting Time 3 satisfaction scores
from Time 2 satisfaction scores (M = 1.32, SD = 1.67). Higher scores
in this instance reflect a greater decrease in satisfaction with the
tattoo between Time 2 and Time 3. Bivariate correlations were
then computed between this difference score and body appreci-
ation, distinctive appearance investment, self-attributed need for
uniqueness, social physique anxiety, and self-esteem scores from
Time 3, as well as visibility and size of the tattoo. The only significant
correlates that emerged in this analyses were self-esteem (r = body
appreciation (r = −.37, p = .001) and body appreciation (r = −.24,
p = .033).
Discussion
Studies on the psychosocial aspects of tattooing have not previ-
ously examined changes in self- and body-related attitudes among
individuals who have obtained their first tattoo. The present study
sought to overcome this dearth in the literature by examining
changes in a range of self- and body-related attitudes immediately
before and after obtaining a tattoo, as well as three weeks later
when the tattoo would have healed completely. Broadly speak-
ing, the results of the present work suggest that obtaining a tattoo
results in positive changes to corporeal attitudes both immediately
after the tattoo is complete as well as three weeks later. Indeed, the
effect sizes of most of the changes were moderate-to-large, sug-
gesting that the positive impact of tattooing is fairly pronounced.
Immediately after the tattoo had been completed, both women
and men reported significant reductions in dissatisfaction with
their appearance and anxiety over their appearance. This signifi-
cant decrease in appearance dissatisfaction and anxiety may be a
result of participants focusing on different aspects of their bodies
at the two time points when contemplating their appearance (e.g.,
a greater relative focus on weight and shape at Time 1 and a greater
focus on their tattoo at Time 2), but importantly, participants also
reported significant improvements to body appreciation after three
weeks. As discussed by Benson (2000), in societies where the body
is commodified and work on the body is expected, tattoos may offer
individuals a means of reclaiming or reappropriating their corpo-
real selves. As she writes, contemporary tattooing is a “statement
of ownership over the flesh. . . the only possession of the self in
a world characterized by accelerating commodification and unpre-
dictability” (Benson, 2000, p. 205). The present results suggest that,
not only do tattoos afford individuals a means of reclaiming some
agency of their bodies, but also that this process results in more
positive body image in the short term.
Interestingly, however, while there was no gender difference
in state anxiety over appearance (with both women and men
reporting a reduction in anxiety), there was a clear gender dif-
ference after three weeks. Specifically, while men experienced a
decrease in social physique anxiety at Time 3 compared to Time
1, women appeared to experience a significant increase in social
physique anxiety. One explanation for this finding is based on work
suggesting that women with tattoos are more likely to elicit nega-
tive attributions than their male counterparts (Armstrong, 1991;
Hawkes et al., 2004; Swami & Furnham, 2007; Wohlrab, Stahl,
et al., 2007). In such a scenario, women may experience greater
appearance anxiety in the slightly longer term precisely because of
their tattoos. Nevertheless, the present results suggest that, while
women may report greater appearance anxiety, they are also more
respectful and appreciative of their bodies. The negotiation of these
different experiences is one aspect of tattooing that will require
further attention.
The present results also showed that, at Time 3, both women
and men reported significant increases in distinctive appearance
investment and self-ascribed uniqueness. This set of results cor-
roborates the work of Tiggemann and colleagues (Tiggemann &
Golder, 2006; Tiggemann & Hopkins, 2011), who suggested that
 V. Swami / Body Image 8 (2011) 237–244
tattoos allow individuals to achieve a sense of distinctiveness,
particularly in the appearance domain. In contrast to their work,
which showed that tattooed individuals have higher scores on
need for uniqueness and distinctive appearance investment than
non-tattooed individuals, the present work showed that the act
of obtaining a tattoo increased an individual’s sense of unique-
ness prospectively. The present results are important because they
highlight self-expression and a sense of identity or uniqueness as
outcomes, rather than just predictors, of obtaining a tattoo.
In the view of Tiggemann and Golder (2006), by achieving a
moderate sense of perceived self-distinctiveness, tattooed indi-
viduals may experience more positive self-regard. That is, tattoos
appear to enhance perceptions that the self is unique in compari-
son to others, which in turn may improve self-esteem. Indeed, the
present study found that obtaining a tattoo resulted in a significant
improvement in self-esteem over a three-week period among both
women and men. This finding is notable because it highlights the
positive impact of obtaining a tattoo on an individual’s overall sense
of self. Because of the nature of the present design, however, it is not
possible to say whether this improvement in self-esteem is a result
of obtaining a tattoo specifically or due to improvements in related
domains, such as greater body appreciation (which is known to be
associated with self-esteem; Swami et al., 2008).
A number of other aspects of the present results are worthy
of comment. First, the current results showed that there were no
significant differences in any of the included variables between
individuals with easily concealed and readily visible tattoos. This
finding is consistent with previous work among tattooed individ-
uals (Tiggemann & Hopkins, 2011) and suggests that the corporeal
meaning of obtaining a first tattoo is more important than its visi-
bility. This is not to say that visibility of a tattoo may not play a more
important role in shaping body attitudes among, say, heavily tat-
tooed individuals (Sweetman, 1999). For Tiggemann and Hopkins
(2011), the lack of differences between individuals with readily
concealed and visible tattoos indicates that the act of obtaining a
tattoo may not necessarily be about appearance per se.
Additionally, the present study showed that two primary moti-
vations for obtaining a first tattoo were to express one’s self
and to be unique. This provides further evidence for Tiggemann
and Golder’s (2006) suggestion that tattoos allow an individual
to achieve distinctiveness in the appearance domain. Another
strongly rated motivation for obtaining a tattoo was because they
look good, which is consistent with previous findings (Forbes, 2001;
Tiggemann & Hopkins, 2011). Although the latter result may be
interpreted as evidence of tattoos being mere ‘fashion accessories’
(Falk, 1995; Steele, 1996), such a view is problematic because of the
permanence, planning, and pain involved in tattooing (Sweetman,
1999), as well as the role of tattoos in self-expression. It is also
worth noting that obtaining a tattoo ‘to be fashionable’ was rated
poorly in the present study, as well as in previous work (Tiggemann
& Hopkins, 2011).
Finally, the present results showed that a majority of partici-
pants self-reported as being likely to obtain further tattoos in the
future. Likelihood of obtaining future tattoos was correlated with
satisfaction with their first tattoo at Time 3, although there was a
significant decrease in satisfaction with tattoos over time. The latter
finding is of note because it highlights the fact that some partici-
pants, at least, were not entirely satisfied with their tattoo. Reasons
for this may include poorer body appreciation and self-esteem at
Time 3, which suggests complex associations between corporeal
experiences, self-perceptions, and tattoo possession. More gener-
ally, reduced satisfaction with the tattoo may be a result of purchase
risks (e.g., pain, expense, problems with the artist, or poor knowl-
edge about the healing process, which requires a good deal of
effort and commitment on the part of the tattooed individual once
they leave the tattoo parlour) or possession risks (e.g., discrepan-
243
cies between expectations and realities, such as that respondents’
selected design may not have been realised in the manner they
expected) (Armstrong, Murphy, Sallee, & Watson, 2000; Armstrong
& Pace-Murphy, 1997; Sanders, 1985). This is an aspect of the cur-
rent study that needs further research.
A number of limitations of the present study need to be
acknowledged. First, although steps were taken to mask the study’s
objectives (e.g., by inviting participants to take part in a study on
consumer behaviours and through the use of filler scales), it is quite
possible that participants discerned the nature of the study and
responded in socially desirable ways. The likelihood of this occur-
ring may have been heightened by the fact that the questionnaire
was initially administered in a tattoo parlour and by an experi-
menter with visible tattoos. Second, the sample size in the present
study was relatively small, although the select nature of the sam-
pling population (i.e., British residents seeking to obtain their first
tattoo at a single tattoo parlour) should be noted. In a similar vein,
the sample in the present work was one of convenience and it is
not clear whether the recruitment technique introduced sampling
biases (e.g., in comparison to individuals who visited the tattoo
parlour but did not make an appointment).
Future work could improve on the present design by including
a wider array of measures that tap an individual’s body attitudes
(e.g., internalisation of societal ideals of appearance) or personal-
ity (e.g., the Big Five personality traits). Additionally, although the
present work relied on a previously used scale to measure motiva-
tions for obtaining a tattoo (Tiggemann & Golder, 2006), this scale
may not tap the full range of potential motivations for obtaining a
first tattoo. For instance, the scale does not contain items relating
to obtaining a tattoo in order to understand traumatic experiences,
to aid healing processes (Jeffreys, 2000), or for religious or spiritual
reasons (Koch, Roberts, Armstrong, & Owen, 2004). Certain items in
this scale may also need to be carefully modified in order to avoid
any negative connotation (e.g., the item ‘To be fashionable’ may
hold negative connotations, particularly for individuals involved in
counter-cultures, despite its intended positive meaning).
Taking into account the above limitations, the present work
suggests that the act of obtaining a tattoo is associated with
improvements in self- and body-related attitudes, at least in the
short term. Although the present work has begun the task of exam-
ining prospective changes as a result of obtaining a tattoo, there
remains scope for future studies in the area. For instance, future
work could examine changes in self- and body-related attitudes
over a much longer period of time. Such work should also examine
changes in satisfaction with the first tattoo as individuals obtain
further body art and also whether tattoo removal results in any
decrease in perceived uniqueness or changes in body-related atti-
tudes more generally (Armstrong, Roberts, Koch, Saunders, Owen, &
Anderson, 2008). The present work suggests that tattooed individ-
uals who obtain a first tattoo experience significant changes in their
self- and body-related attitudes in the short term, but it remains to
be seen whether these positive changes are maintained over the
longer term.
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