Some interesting emotional correlations emerged in the study among college-age respondents with four or more tattoos, resaerchers said.
Women with multiple tattoos reported higher levels of self-esteem than anyone else in the study.
Moreover, escalating acquisition of body art does not correlate with increased depression or suicide ideation among men or women, researchers said.
However, the same multi-tattooed women also reported a much higher frequency of past suicide attempts.
"What we may be seeing is women translating that awareness into empowerment. We know women sometimes replace a surgically removed breast, for example, with elegant body art," she said.
"We wonder if more tattoos might be a way of reclaiming a sense of self in the wake of an emotional loss - evidenced by a suicide attempt," she said.
In a 2008 study, Koch's team found women were more than twice as likely as men to want tattoos removed, most often as a way of dissociating from the past.
"Women with four or more tattoos were the group that showed us the only two interesting connections - they had a much higher suicide attempt history, and paradoxically, it was this same group - and the only group - that showed an increased level of self-esteem," Koch said.
"Our interpretation is maybe it's a parallel, emotionally, of what we see with breast cancer survivors. We can only speculate what these findings might mean, and more research needs to be done," Koch said.
The study appears in The Social Science Journal.
