The presence of tattoos on forensic psychiatric inpatients should alert clinicians to a possible diagnosis of Antisocial Personality Disorder (ASPD), and also about the potential for histories of suicide attempt, substance abuse, and sexual abuse, according to research recently published in Personality and Mental Health.

ASPD is a mental disorder characterised by several psychological and behavioural phenomena, including a lack of empathy and remorse, a low tolerance for anxiety, and shallowness. People with ASPD prefer action to thought, and pathological lying, cheating, stealing, physical aggression and drug abuse are not uncommon. To be diagnosed with ASPD, the individual must have developed this behaviour before the age of 15, and as such is qualitatively different from the idea of a scheming, dishonest business person or politician, unless the behaviour began earlier in life.

For this research, 36 male inpatients of a maximum-security state forensic psychiatric facility were studied by psychiatrists from the Michigan Center for Forensic Psychiatry (CFP). Around half of the subjects had been admitted because they were found to be unfit to stand trial and the other half had been found not guilty by reason of insanity.

Of the patients studied, 15 had tattoos and 17 were diagnosed as having ASPD. Of those with tattoos, 11 of 15, or 73%, had ASPD, whereas only six of 21, or 29%, of those without tattoos had the same diagnosis. The research also uncovered an increased likelihood for those with tattoos to have previously suffered from sexual abuse, abused substances or to have attempted suicide.

"Our findings suggest that forensic psychiatric inpatients with tattoos are significantly more likely to suffer from ASPD than those without tattoos, and patients with ASPD were also significantly more likely to have higher numbers of tattoos, a larger percentage of their body covered with tattoos, and tended to have tattoos in more visible locations" said lead researcher Dr. William Cardasis, of CFP, Michigan. "I hope that this provides clues for clinicians to look for ASPD in forensic psychiatric patients with tattoos, and also to look for signs of suicide attempt, substance abuse, and sexual abuse."

"One should keep in mind that the population studied was only a small segment of the population, and not indicative of what may or may not be relevant in the general population" added Cardasis. "Other interesting questions which this research raises include whether adolescents with tattoos are more likely to conduct disorder than those without, and what effect the meaning and subject content of the tattoo has."