{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:56:19Z","timestamp":1781769379199,"version":"3.54.5"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100007613","name":"Ankara University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100007613","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"Abstract<\/jats:title>\n \n This study aimed to investigate the relationship between body piercing and risk-taking behaviors among adolescents, while assessing their knowledge and attitudes regarding piercing practices, hygiene, and potential complications. This cross-sectional descriptive study was conducted among 141 adolescents aged 12\u201319\u00a0years attending an adolescent health clinic between February and November 2025. Participants were divided into two groups: adolescents with at least one body piercing (\n n<\/jats:italic>\n \u2009=\u200971) and controls without piercings (\n n<\/jats:italic>\n \u2009=\u200970). Data on sociodemographic characteristics, risk-taking behaviors, and mental health status were collected using a structured questionnaire. Risk behaviors were defined as meeting in person with someone first met online, driving without a seat belt, getting into a stranger\u2019s vehicle, experimenting with cigarettes, alcohol, or substances, and having suicidal thoughts. Suicide risk was evaluated using the \u201cAsk Suicide-Screening Questions.\u201d Knowledge regarding piercing procedures, hygiene, and complications was assessed through an 18-item survey, and scores were calculated on a 100-point scale. Adolescents with piercings demonstrated significantly higher engagement in risk-taking behaviors compared to controls, including smoking (73.2% vs. 11.4%), alcohol use (63.4% vs. 8.6%), substance use (11.3% vs. 0%), and non-suicidal self-injury (42.3% vs. 4.3%) (all\n p<\/jats:italic>\n \u2009<\u20090.001). Positive suicide risk screening was also more frequent in the piercing group (45.1% vs. 7.1%,\n p<\/jats:italic>\n \u2009<\u20090.001). Nearly half of the pierced adolescents reported local complications such as hyperemia, swelling, or pain, and only 49.3% had their procedures performed in licensed studios. The overall knowledge score was moderate (mean\u2009=\u200959.4\u2009\u00b1\u200914.2), with the lowest accuracy in the \u201cSite and Setting of Application\u201d domain. None of the participants answered all questionnaire items correctly.\n <\/jats:p>\n \n Conclusion<\/jats:italic>\n :\u00a0Although body piercing has become a normalized form of self-expression among adolescents, it remains associated with significantly higher rates of risk-taking behaviors and psychological vulnerability. Moreover, adolescents demonstrated insufficient knowledge about safe piercing practices, sterilization, and complications, and most had not received information from health professionals. These findings highlight the need for targeted educational interventions and counseling to promote safer body modification practices and to use piercing as an opportunity for psychosocial assessment in adolescent health care.\n \n \n \n \n \n What is Known:<\/jats:bold>\n \u2022\n Body piercing is a common form of self-expression among adolescents and has been previously linked to certain risk taking behaviors like smoking and substance use.<\/jats:italic>\n \u2022\n Adolescents generally demonstrate insufficient knowledge regarding hygiene, sterilization, and health complications associated with body modifications.<\/jats:italic>\n <\/jats:td>\n <\/jats:tr>\n \n \n What is New:<\/jats:bold>\n \u2022\n This study explicitly details a alarmingly high rate of positive suicide risk screening and non-suicidal self-injury specifically among pierced adolescents.<\/jats:italic>\n \u2022\n It quantifies a distinct gap in knowledge regarding the Site and Setting of Application, revealing that more than half of adolescents utilize unlicensed studios without professional health guidance.<\/jats:italic>\n \u2022\n Body piercing should serve as a practical, visible trigger for pediatricians to initiate comprehensive psychosocial and mental health screenings in clinical settings.<\/jats:italic>\n <\/jats:td>\n <\/jats:tr>\n <\/jats:tbody>\n <\/jats:table>\n <\/jats:table-wrap>\n <\/jats:p>","DOI":"10.1007\/s00431-026-07115-x","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T05:33:19Z","timestamp":1780464799000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Body piercing and adolescent risk-taking: association or expression?"],"prefix":"10.1007","volume":"185","author":[{"given":"Meltem","family":"Ileri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H\u00fcsniye","family":"Y\u00fccel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deniz","family":"Y\u00fccel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rola","family":"Tokan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015feg\u00fcl","family":"\u015eahiner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcls\u00fcm","family":"Ozen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Semra","family":"Cetinkaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ay\u015fe G\u00fcl","family":"G\u00fcven","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zehra","family":"Aycan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"issue":"1","key":"7115_CR1","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1159\/000494350","volume":"235","author":"N Kluger","year":"2018","unstructured":"Kluger N, Misery L, Seit\u00e9 S, Taieb C (2018Dec 1) Body piercing: a national survey in France. Dermatology 235(1):71\u201378","journal-title":"Dermatology"},{"issue":"9","key":"7115_CR2","doi-asserted-by":"publisher","first-page":"2307","DOI":"10.1111\/j.1743-6109.2012.02791.x","volume":"9","author":"K Nowosielski","year":"2012","unstructured":"Nowosielski K, Sipi\u0144ski A, Kuczerawy I, Kozlowska-Rup D, Skrzypulec-Plinta V (2012) Tattoos, piercing, and sexual behaviors in young adults. J Sex Med 9(9):2307\u20132314","journal-title":"J Sex Med"},{"issue":"10","key":"7115_CR3","doi-asserted-by":"publisher","first-page":"2518","DOI":"10.1111\/apa.70206","volume":"114","author":"N Karara","year":"2025","unstructured":"Karara N, Parci\u0144ska K, Fonseca H, Mazur A (2025) Body modifications in adolescents: risks, responsibilities, and the role of paediatricians. Acta Paediatrica, Int J Paediatr 114(10):2518\u20132525","journal-title":"Acta Paediatrica, Int J Paediatr"},{"issue":"7","key":"7115_CR4","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.1111\/j.1530-0277.2011.01711.x","volume":"36","author":"N Gu\u00e9guen","year":"2012","unstructured":"Gu\u00e9guen N (2012) Tattoos, piercings, and alcohol consumption. Alcohol Clin Exp Res 36(7):1253\u20131256","journal-title":"Alcohol Clin Exp Res"},{"issue":"4","key":"7115_CR5","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-1962","volume":"140","author":"CC Breuner","year":"2017","unstructured":"Breuner CC, Levine DA (2017) Adolescent and young adult tattooing, piercing, and scarification from the AmericAn AcAdemy oF PediAtrics guidance for the clinician in rendering pediatric care. Pediatrics 140(4):20171962","journal-title":"Pediatrics"},{"issue":"6","key":"7115_CR6","first-page":"587","volume":"65","author":"S Balci","year":"2015","unstructured":"Balci S, Sari E, Mutlu B (2015) Comparison of risk-taking behaviour and frequency of piercing and tattooing among university students. J Pak Med Assoc 65(6):587\u2013592","journal-title":"J Pak Med Assoc"},{"issue":"6","key":"7115_CR7","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1007\/s10597-012-9509-y","volume":"48","author":"O Ekinci","year":"2012","unstructured":"Ekinci O, Topcuoglu V, Sabuncuoglu O, Berkem M, Akin E, Gumustas FO (2012Dec 22) The Association of Tattooing\/Body Piercing and Psychopathology in Adolescents: a community based study from Istanbul. Community Ment Health J 48(6):798\u2013803","journal-title":"Community Ment Health J"},{"issue":"3","key":"7115_CR8","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1177\/1367493509337443","volume":"13","author":"NC Leather","year":"2009","unstructured":"Leather NC (2009Sep 27) Risk-taking behaviour in adolescence: a literature review. J Child Health Care 13(3):295\u2013304","journal-title":"J Child Health Care"},{"issue":"3","key":"7115_CR9","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1016\/j.adolescence.2005.06.001","volume":"29","author":"M Deschesnes","year":"2006","unstructured":"Deschesnes M, Fin\u00e8s P, Demers S (2006Jun 18) Are tattooing and body piercing indicators of risk-taking behaviours among high school students? J Adolesc 29(3):379\u2013393","journal-title":"J Adolesc"},{"key":"7115_CR10","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-11-774","author":"A Quaranta","year":"2011","unstructured":"Quaranta A, Napoli C, Fasano F, Montagna C, Caggiano G, Montagna M (2011) Body piercing and tattoos: a survey on young adults\u2019 knowledge of the risks and practices in body art. BMC Public Health. https:\/\/doi.org\/10.1186\/1471-2458-11-774","journal-title":"BMC Public Health"},{"key":"7115_CR11","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18179233","author":"C Protano","year":"2021","unstructured":"Protano C, Valeriani F, Marotta D, Bargellini A, Bianco A, Caggiano G et al (2021) Assessing undergraduates\u2019 perception of risks related to body art in Italy: the superba multicenter cross-sectional study. Int J Environ Res Public Health. https:\/\/doi.org\/10.3390\/ijerph18179233","journal-title":"Int J Environ Res Public Health"},{"issue":"11","key":"7115_CR12","doi-asserted-by":"publisher","first-page":"565","DOI":"10.1177\/070674371405901101","volume":"59","author":"ED Klonsky","year":"2014","unstructured":"Klonsky ED, Victor SE, Saffer BY (2014Nov 1) Nonsuicidal self-injury: what we know, and what we need to know. The Canadian Journal of Psychiatry 59(11):565\u2013568","journal-title":"Can J Psychiatry"},{"key":"7115_CR13","unstructured":"Bethesda M (2018) National Institutes of Health National Institutes of Health. Available from: https:\/\/www.nimh.nih.gov\/research\/research-conducted-at-nimh\/asq-toolkit. Accessed 05 Jan 2026"},{"key":"7115_CR14","doi-asserted-by":"crossref","unstructured":"Uygun SD, Uytun M\u00c7, \u00dcnl\u00fc HK, Ay\u0131da\u011fa EA, B\u00fcy\u00fckceran \u00d6\u00c7, Vatansever G, K\u0131l\u0131\u00e7 BG (2022) Turkish adaptation study of the ask suicide-screening questions in adolescents. Archives of Neuropsychiatry 60(2):158","DOI":"10.29399\/npa.28242"},{"key":"7115_CR15","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2022.945775","author":"IN Defoe","year":"2022","unstructured":"Defoe IN, Rap SE, Romer D (2022) Adolescents\u2019 own views on their risk behaviors, and the potential effects of being labeled as risk-takers: a commentary and review. Front Psychol. https:\/\/doi.org\/10.3389\/fpsyg.2022.945775","journal-title":"Front Psychol"},{"issue":"6","key":"7115_CR16","doi-asserted-by":"publisher","first-page":"1021","DOI":"10.1542\/peds.109.6.1021","volume":"109","author":"ST Carroll","year":"2002","unstructured":"Carroll ST, Riffenburgh RH, Roberts TA, Myhre EB (2002) Tattoos and body piercings as indicators of adolescent risk-taking behaviors. Pediatrics 109(6):1021\u20131027","journal-title":"Pediatrics"},{"issue":"3","key":"7115_CR17","doi-asserted-by":"publisher","first-page":"647","DOI":"10.12740\/PP\/131686","volume":"56","author":"M Lammek","year":"2022","unstructured":"Lammek M (2022Jun 30) Modified body \u2013 symbol of risk or resources? Psychiatr Pol 56(3):647\u2013659","journal-title":"Psychiatr Pol"},{"issue":"9","key":"7115_CR18","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1136\/emermed-2017-206887","volume":"35","author":"M Cohen","year":"2018","unstructured":"Cohen M, Jeanmonod D, Stankewicz H, Habeeb K, Berrios M, Jeanmonod R (2018Sep 1) An observational study of patients\u2019 attitudes to tattoos and piercings on their physicians: the ART study. Emerg Med J 35(9):538\u2013543","journal-title":"Emerg Med J"},{"issue":"3","key":"7115_CR19","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1016\/S1054-139X(03)00276-3","volume":"34","author":"TA Roberts","year":"2004","unstructured":"Roberts TA, Auinger P, Ryan SA (2004) Body piercing and high-risk behavior in adolescents. J Adolesc Health 34(3):224\u2013229","journal-title":"J Adolesc Health"},{"issue":"4","key":"7115_CR20","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1080\/07481180600553419","volume":"30","author":"J Hicinbothem","year":"2006","unstructured":"Hicinbothem J, Gonsalves S, Lester D (2006) Body modification and suicidal behavior. Death Stud 30(4):351\u2013363","journal-title":"Death Stud"},{"issue":"1","key":"7115_CR21","doi-asserted-by":"publisher","first-page":"89","DOI":"10.3390\/ijerph22010089","volume":"22","author":"V Avon","year":"2025","unstructured":"Avon V, Gullo N, Walker DC (2025Jan 10) Borderline personality symptoms, body modification, and emotional regulation. Int J Environ Res Public Health 22(1):89","journal-title":"Int J Environ Res Public Health"},{"issue":"23","key":"7115_CR22","doi-asserted-by":"publisher","first-page":"12429","DOI":"10.3390\/ijerph182312429","volume":"18","author":"F Gall\u00e8","year":"2021","unstructured":"Gall\u00e8 F, Valeriani F, Marotta D, De Giorgi A, Bargellini A, Bianco A et al (2021Nov 26) What about your body ornament? Experiences of tattoo and piercing among Italian youths. Int J Environ Res Public Health 18(23):12429","journal-title":"Int J Environ Res Public Health"},{"issue":"5","key":"7115_CR23","first-page":"439","volume":"34","author":"M Scatigna","year":"2022","unstructured":"Scatigna M, Masotta V, Cesarini V, Renzetti P, Petrucci C, Lancia L et al (2022) Sociocultural overview and predisposing factors of body art in a health promotion perspective: survey on a sample of Italian young adults. Ann Ig 34(5):439\u2013452","journal-title":"Ann Ig"},{"key":"7115_CR24","volume":"1","author":"SM Weiler","year":"2021","unstructured":"Weiler SM, Tetzlaff BO, Herzberg PY, Jacobsen T (2021) When personality gets under the skin: need for uniqueness and body modifications. PLoS One 1:16","journal-title":"PLoS One"}],"container-title":["European Journal of Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-026-07115-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00431-026-07115-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00431-026-07115-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T07:34:48Z","timestamp":1781768088000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00431-026-07115-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,3]]},"references-count":24,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["7115"],"URL":"https:\/\/doi.org\/10.1007\/s00431-026-07115-x","relation":{},"ISSN":["1432-1076"],"issn-type":[{"value":"1432-1076","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,3]]},"assertion":[{"value":"25 December 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 May 2026","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 May 2026","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 June 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethics approval was obtained from the Ankara University Health Sciences Scientific Research and Publication Ethics Committee (Meeting date: February 17, 2025; Meeting No: 04; Decision No: 82). This study was planned in accordance with the Helsinki Declaration, Patient Rights Regulation and Good Clinical Practice Rules in Brazil.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"459"}}