Borderline Personality Symptoms, Body Modification, and Emotional Regulation

Int J Environ Res Public Health. 2025 Jan 10;22(1):89. doi: 10.3390/ijerph22010089.

Abstract

Many people with BPD (borderline personality disorder) experience emotional dysregulation and thus engage in NSSI (non-suicidal self-injury), potentially in the pursuit of emotional regulation. However, research is lacking on whether body modifications (piercings, tattoos, etc.) are linked to BPD in a similar way to NSSI. In the current study, we hypothesized (1) that body modifications are associated with BPD symptoms, (2) that emotional regulation and self-expression motivations for body modifications specifically account for variance in BPD symptoms, and (3) that NSSI craving correlates with body modification craving. Participants (N = 199, ages 18-67, located in the USA) were surveyed on BPD symptomatology, NSSI craving, emotional regulation abilities, and the presence of body modifications. The extent of tattooing (number of tattoos and percentage of body surface covered) was not significantly associated with BPD symptomatology, but the number of piercings was. Individuals with higher BPD symptomatology were not more likely to report emotional regulation and self-expression as motivations for obtaining body modifications. NSSI craving scores were significantly positively correlated with body modification craving scores. Body modification may be an alternative method of emotional regulation to NSSI in individuals with BPD, which clinicians may want to consider when treating those with BPD and NSSI.

Keywords: body modification; borderline personality disorder; emotional regulation; non-suicidal self-injury; tattoos and piercings.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Body Piercing / psychology
  • Borderline Personality Disorder* / physiopathology
  • Borderline Personality Disorder* / psychology
  • Emotional Regulation*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Self-Injurious Behavior* / psychology
  • Tattooing / psychology
  • Young Adult