Teens identifying with goth subculture at higher risk of depression and self-harm

1. In this longitudinal cohort study, teenagers who identify with goth subculture were found to be at increased risk for depression and self-harm.

Evidence Rating Level: 2 (Good)

Study Rundown: Goth subculture, which is typified by “favoring black clothing, white and black make-up, and goth music”, has been associated with depression and self-harm. Depression causes significant morbidity and mortality in the adolescent demographic. For this reason it is crucial to identify young people who are at risk for depression. In this longitudinal cohort study by Bowes et al., the investigators set out to test hypothesized association between self-identification with goth subculture and increased risk for depression and self-harm. To date, this is the largest prospective cohort study of the association between goth subculture and depression. The investigators were careful to control for the potential confounding effects of peer victimization, maltreatment, and behavioral problems in the subjects. The investigators found a significant positive association between identification with goth subculture and clinical depression as well as self-harm. These findings suggest that young people identifying as goths may represent a vulnerable population, susceptible to developing depression. The study was strengthened by the large sample size, involving more than 5000 adolescents self-identifying with goth subculture.

The study was funded by Wellcome Trust, Medical Research Council Programme.

Click to read the study, published today in The Lancet

Relevant Reading: Vulnerable goth teens: the role of schools in this psychosocial high-risk culture

In-Depth [ prospective cohort]: This study investigated the association between goth subculture and clinical depression. The study collected data about goth self-identification from 5357 adolescents. Depression and self-harm data was collected in 3694 participants. In order to find which subgroups the adolescents identified most with, the investigators used modified Peer Crowd Questionnaire. To measure depressed mood, the Development and Wellbeing Assessment and the Clinical Interview Schedule-Revised were used. Self-harm was assessed using the same tools.

The results showed a significant positive association between depression and goth self-identification. When compared to young people who did not identify as goth, those who identified “somewhat” with goth subculture were 1.6 times more likely to score in the clinical range on depression batteries (OR = 1.63, 95% CI, 1.14-2.34, p<0.001). Those who identified “very much” with goth subculture had an even stronger risk of depression (OR=3.67, 95% CI 2.33-4.79, p<0.001). With regard to self-harm, those who “somewhat” identified as goth were 2.33 times more likely to report self-harm. In those who “very much” identified as goth, rates of reported self-harm were more than 5 times more likely. For each unit increase in affiliation with goth subculture, the OR of self-harm increased by 1.52 (95% CI 1.42-1.63).

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