Risk of depression and self-harm in teenagers identifying with goth subculture : a longitudinal cohort study.

Abstract

Background Previous research has suggested that deliberate self-harm is associated with contemporary goth subculture in young people; however, whether this association is confounded by characteristics of young people, their families, and their circumstances is unclear. We aimed to test whether self-identifi cation as a goth is prospectively associated with emergence of clinical depression and self-harm in early adulthood. Methods We used data from the Avon Longitudinal Study of Parents and Children, a UK community-based birth cohort of 14 541 pregnant women with expected delivery between April 1, 1991, and Dec 31, 1992. All children in the study were invited to attend yearly follow-up visits at the research clinic from age 7 years. At 15 years of age, participants reported the extent to which they self-identifi ed as a goth. We assessed depressive mood and self-harm at 15 years with the Development and Wellbeing Assessment (DAWBA) questionnaire, and depression and self-harm at 18 years using the Clinical Interview Schedule-Revised. We calculated the prospective association between goth identifi cation at 15 years and depression and self-harm at 18 years using logistic regression analyses. Findings Of 5357 participants who had data available for goth self-identifi cation, 3694 individuals also had data for depression and self-harm outcomes at 18 years. 105 (6%) of 1841 adolescents who did not self-identify as goths met criteria for depression compared with 28 (18%) of 154 who identifi ed as goths very much; for self-harm, the fi gures were 189 (10%) of 1841 versus 57 (37%) of 154. We noted a dose–response association with goth self-identifi cation both for depression and for self-harm. Compared with young people who did not identify as a goth, those who somewhat identifi ed as being a goth were 1·6 times more likely (unadjusted odds ratio [OR] 1·63, 95% CI 1·14–2·34, p<0·001), and those who very much identifi ed as being a goth were more than three times more likely (unadjusted OR 3·67, 2·33–4·79, p<0·001) to have scores in the clinical range for depression at 18 years; fi ndings were similar for self-harm. Associations were not attenuated after adjustment for a range of individual, family, and social confounders. Interpretation Our fi ndings suggest that young people identifying with goth subculture might be at an increased risk for depression and self-harm. Although our results suggest that some peer contagion operates within the goth community, our observational fi ndings cannot be used to claim that becoming a goth increases risk of self-harm or depression. Working with young people in the goth community to identify those at increased risk of depression and self-harm and provide support might be eff ective. Funding Wellcome Trust, Medical Research Council Programme.