Abstract

SummaryBackgroundPrevious 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-identification as a goth is prospectively associated with emergence of clinical depression and self-harm in early adulthood.MethodsWe 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-identified 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 identification at 15 years and depression and self-harm at 18 years using logistic regression analyses.FindingsOf 5357 participants who had data available for goth self-identification, 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 identified as goths very much; for self-harm, the figures were 189 (10%) of 1841 versus 57 (37%) of 154. We noted a dose–response association with goth self-identification both for depression and for self-harm. Compared with young people who did not identify as a goth, those who somewhat identified 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 identified 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; findings were similar for self-harm. Associations were not attenuated after adjustment for a range of individual, family, and social confounders.InterpretationOur findings 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 findings 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 effective.FundingWellcome Trust, Medical Research Council Programme.

Highlights

  • Depression is the leading contributor to the worldwide burden of disease in young people aged 10–24 years.[1]

  • Compared with young people who did not identify as a goth, those who somewhat identified as being a goth were 1·6 times more likely, and those who very much identified as being a goth were more than three times more likely to have scores in the clinical range for depression at 18 years; findings were similar for self-harm

  • Interpretation Our findings suggest that young people identifying with goth subculture might be at an increased risk for depression and self-harm

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Summary

Introduction

Depression is the leading contributor to the worldwide burden of disease in young people aged 10–24 years.[1]. Understanding of specific risk factors during this important transition is needed to inform prevention strategies During this period, peers are the main sources for social comparison and appraisal, and self-consciousness is heightened.[4] Studies have shown that peers report similar levels of depressive symptoms to each other,[5] evidence for peer contagion effects on depression and related phenotypes (eg, self-harm) is mixed.[6,7,8,9,10] Identification of young people at heightened risk of depression and related phenotypes is a key area for future research.[10] A strong and robust increased risk of self-harm and attempted suicide has been reported in young people identifying with contemporary goth subculture and related subcultures generally described as alternative youth.[11] A goth is defined in the Oxford Dictionary as “a member of a subculture favouring black clothing, white and black make-up, and goth music”. The goth subculture has been suggested to provide an important source of validation and community to individuals who do not conform with societal norms.[12]

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