Massive use of tattoos and psychopathological clinical evidence

Purpose: This research aims to identify any recurrent psychopathological profi les in individuals who abuse tattoos and that, for this reason, the tattoo itself could be the manifestation of a specifi c symptom. Methods: Clinical interview and administration of the MMPI-II and PICI-1. Results: The research on a population sample of 444 people has shown a strong psychopathological tendency in the MMPI-II that is confi rmed in the PICI-1 (TA version); in fact, the data are even more signifi cant and expressive a precise psychopathological diagnosis of personality. In the male group with a percentage of less than 25%, at least three dysfunctional traits of anxiety, phobic, obsessive, somatic, borderline and antisocial disorder emerged individually. In the male group with a percentage between 26% and 50%, at least four dysfunctional traits of borderline, narcissistic, sadistic and masochistic disorder emerged individually. In the male group with a percentage between 51% and 75%, at least 5 dysfunctional traits of bipolar, borderline, narcissistic, antisocial, sadistic and masochistic disorder emerged individually. In the male group with a percentage between 76% and 100%, at least 6 dysfunctional traits of borderline, narcissistic, antisocial, sadistic and masochistic disorder emerged individually. In the female group with a percentage of less than 25%, at least three dysfunctional traits of anxiety, phobic, obsessive, somatic, borderline and bipolar disorder emerged individually. In the female group with a percentage between 26% and 50%, at least four dysfunctional traits of borderline, borderline, anxiety, phobic, obsessive, somatic, sadistic and masochistic disorder emerged individually. In the female group with a percentage between 51% and 75%, at least fi ve dysfunctional traits of bipolar, borderline, narcissistic, antisocial, sadistic and masochistic disorder emerged individually. In the female group with a percentage between 76% and 100%, at least 6 dysfunctional traits of bipolar, borderline, narcissistic, antisocial, sadistic and masochistic disorder emerged individually. Conclusions: On the basis of these data, it is reasonable to argue that as the percentage of body surface area covered by tattoos increases, so do the dysfunctional traits of a specifi c main disorder. In particular, the recurrent dysfunctional traits are anxious, phobic, obsessive, somatic and bipolar in subjects with less than 25% of the body surface covered by tattoos, while borderline, narcissistic, antisocial, sadistic and masochistic traits are more frequent in subjects with more than 26% of the body surface covered by tattoos. Comparing the data with the control group we reasonably come to the conclusion that the use of tattoos is not directly related to the presence of one or more psychopathologies, but if the use is massive this is a fairly robust indicator of the likely presence of a signifi cant number of psychopathological traits of the same morbid condition. Research Article Massive use of tattoos and psychopathological clinical evidence Giulio Perrotta* Psychologist sp.ing in Strategic Psychotherapy, Forensic Criminologist, Legal Advisor sp.ed SSPL, Researcher, Essayist, Institute for the study of psychotherapies ISP, Via San Martino della Battaglia no. 31, 00185, Rome, Italy Received: 08 April, 2021 Accepted: 05 June, 2021 Published: 07 June, 2021 *Corresponding author: Dr. Giulio Perrotta, Psychologist sp.ing in Strategic Psychotherapy, Forensic Criminologist, Legal Advisor sp.ed SSPL, Researcher, Essayist, Institute for the study of psychotherapies ISP, Via San Martino della Battaglia no. 31, 00185, Rome, Italy, E-mail:


Introduction and background
Tattooing is considered to be a technique of human bodily decoration, while the product of this technique is famously called "tatoo" and consists (in its traditional form) of incising the skin by delaying healing with special substances or of puncturing it by introducing dyes into the wounds. Therapeutic tattoos have been found on the mummy of the 'Pazyryk man' in Central Asia with intricate animal tattoos, or that of the Ukok princess (Altai Mummy) dating from around 500 B.C. depicting an imaginary animal (deer and griffi n) of a high artistic level.
Among the ancient civilisations where tattooing developed was Egypt, but also ancient Rome, where it was banned by Emperor Constantine, following his conversion to Christianity. It should also be noted that, before Christianity became a licit religion and later the state religion, many Christians tattooed religious symbols on their skin to mark their spiritual identity. Tattooing re-emerged from the shadows in the second half of the 19th abnormalities treated with drugs and pregnancy [1][2][3][4][5]. Tattoo removal has been carried out using different tools throughout the history of tattoos. While tattoos were once considered permanent, it is now possible to remove them with treatments in whole or in part. Prior to the development of the laser tattoo removal method, the most common removal techniques included dermabrasion, TCA (trichloroacetic acid, an acid that removes the upper layers of the skin, reaching the layers where the ink resides), salabrasion (rubbing the skin with salt), cryosurgery, and incisions, which are sometimes still used in conjunction with skin grafting for larger tattoos. Some earlier forms of tattoo removal included the injection or application of wine, lemon, vinegar or pigeon droppings. Laser tattoo removal was initially performed with continuous wave lasers, and later with Q-switched lasers, which were commercially available from 1990. Today the words "laser tattoo removal" refer to the non-invasive removal of tattoo pigments using Q-switched lasers and typically black and darker inks are removed more easily [6][7][8][9][10].

Research objectives and Methods
This research aims to identify any recurrent psychopathological profi les in individuals who abuse tattoos and that, for this reason, the tattoo itself could be the manifestation of a specifi c symptom.
The phases of the research were divided as follows: 1) Selection of the population sample.
3) Administration of the MMPI-II and PICI-1 [11], to each population group. 4) Data processing following administration, in relation to data obtained from clinical interviews and the administration of the MMPI-II and PICI-1 [12,13].
All participants were guaranteed anonymity and respects the ethical, moral and clinical content of the 1964 Declaration of Helsinki.

Setting and participants
The requirements decided for the selection of the sample population are: 1) Age between 18 years and 75 years.
2) Residence or domicile on Italian territory for at least 5 year, regardless of nationality and/or citizenship.
3) Male and female gender.

4)
Absence of psychopathological diagnosis before tattooing. The same reasoning was applied to the selected control group, consisting of 444 participants with the following participation requirements:

1) Age between 18 years and 75 years.
2) Residence or domicile on Italian territory for at least 5 years, regardless of nationality and/or citizenship.

Results, limits and possible confl icts of interest
Once the sample of the population that met the requirements had been selected (fi rst stage), the participants were subjected individually to a clinical interview (second stage), aimed at obtaining as complete a personal and family history as possible.
The following relevant data emerged from the clinical interview: The As the frequency of the percentage of tattoos on the body increases, the borderline, narcissistic and antisocial symptoms worsen.
The clinical interview and anamnestic reconstruction reveal very clear and sharp personality profi les .
The male gender of the selected sample of the population (296/444) exhibits mood instability, marked instinctiveness and aggression, obsessive and paranoid thoughts, listlessness, boredom and humour decline, marked narcissistic tendency and a strong inclination towards sadistic/ masochistic traits.
The female gender of the selected sample of the population (148/444) exhibits obsessive and paranoid thoughts about their physical appearance, somatic and body dysmorphic symptoms (in some cases even leading to the need for surgery), listlessness, boredom, bipolar, borderline, narcissistic symptoms and and a strong inclination towards sadistic/ masochistic traits.
4) The population sample selected denies having a previous psychopathological diagnosis and/or need for therapeutic intervention, despite the symptoms found and described in the anamnesis.
The third phase is dedicated to the administration of the MMPI-II and the PICI-1 (TA version). [45][46][47] In the fi rst case, the data emerged confi rm what had already been noted during the clinical interview (presence of at least 65 correct points in the following scales, with at least 50% frequency): The data from the PICI-1 (TA version) [2,3] were administered and analysed, as listed below:The control group, subjected in the last phase to the administration of PICI-1(TA) reported the following values: The main limitations of the research is one: the PICI-1 is not yet standardised psychometric instruments but are proposed, despite the excellent results obtained and already published in international scientifi c journals [11][12][13].
This research has no fi nancial backer, it's indipendent and does not present any confl icts of interest. From PICI-1 (TA version), the data are even more signifi cant and expressive a precise psychopathological diagnosis of personality. In the male group with a percentage of less than 25%, at least three dysfunctional traits of anxiety, phobic, obsessive, somatic, borderline and antisocial disorder emerged individually. In the male group with a percentage between 26% and 50%, at least four dysfunctional traits of borderline, narcissistic, sadistic and masochistic disorder emerged individually. In the male group with a percentage between 51% and 75%, at least 5 dysfunctional traits of bipolar, borderline, narcissistic, antisocial, sadistic and masochistic disorder emerged individually. In the male group with a percentage between 76% and 100%, at least 6 dysfunctional traits of borderline, narcissistic, antisocial, sadistic and masochistic disorder emerged individually. In the female group with a percentage of less than 25%, at least three dysfunctional traits of anxiety, phobic, obsessive, somatic, borderline and bipolar disorder emerged individually. In the female group with a percentage between 26% and 50%, at least four dysfunctional traits of borderline, borderline, anxiety, phobic, obsessive, somatic, sadistic and masochistic disorder emerged individually. In the female group with a percentage between 51% and 75%, at least fi ve dysfunctional traits of bipolar, borderline, narcissistic, antisocial, sadistic and masochistic disorder emerged individually. In the female group with a percentage between 76% and 100%, at least 6 dysfunctional traits of bipolar, borderline, narcissistic, antisocial, sadistic and masochistic disorder emerged individually. On the other hand, the control group scored, with regard to 4 dysfunctional traits, 159/296 for the male group and 100/148 for the female group; with regard to 5 dysfunctional traits, 19/296 for the male group and 11/148 for the female group; with regard to 6 or more dysfunctional traits, 3/296 for the male group and 4/148 for the female group. Overall, in the control group, the following results were obtained: 61.15% of the male group presented at least 4 psychopathological traits, while 77.7% of the female group presented at least 4 psychopathological traits.

The research on a population sample of 444 people demonstrated
Based on these data, recurrent dysfunctional traits are anxious, phobic, obsessive, somatic and bipolar in subjects with less than 25% of body surface covered by tattoos, while borderline, narcissistic, antisocial, sadistic and masochistic traits are more frequent in subjects with more than 26% of body surface covered by tattoos. Comparing the data with the control group we reasonably come to the conclusion that the use of tattoos is not directly related to the presence of one or more psychopathologies, but if the use is massive this is a fairly robust indicator of the likely presence of a signifi cant number of psychopathological traits of the same morbid condition.
In the light of the signifi cant results of this research, it seems consequential to suggest to provide psychological support [48,49] to all subjects presenting at least 3 dysfunctional traits of a specifi c disorder, starting from the meaning of tattoos on the patient's body in order to tap into all those unconscious information about the patient and the deep reasons of his discomfort.