title: 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-identification 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-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.
  
  
  RESULTS
  Of 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.
  
  
  CONCLUSIONS
  Our 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.
  
  
  BACKGROUND
  Wellcome Trust, Medical Research Council Programme.
authors: Department of Experimental Psychology, University of Oxford, Oxford, UK. Electronic address: lucy.bowes@psy.ox.ac.uk.
authors: Lucy
authors: L
authors: Bowes
authors: Centre for Academic Mental Health, Addiction and Suicide Research, School of Social & Community Medicine, University of Bristol, Bristol, UK.
authors: Rebecca
authors: R
authors: Carnegie
authors: Centre for Academic Mental Health, Addiction and Suicide Research, School of Social & Community Medicine, University of Bristol, Bristol, UK.
authors: Rebecca
authors: R
authors: Pearson
authors: Centre for Academic Mental Health, Addiction and Suicide Research, School of Social & Community Medicine, University of Bristol, Bristol, UK.
authors: Becky
authors: B
authors: Mars
authors: Centre for Academic Mental Health, Addiction and Suicide Research, School of Social & Community Medicine, University of Bristol, Bristol, UK.
authors: Lucy
authors: L
authors: Biddle
authors: MRC Social, Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors: Barbara
authors: B
authors: Maughan
authors: Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK.
authors: Glyn
authors: G
authors: Lewis
authors: Developmental Psychology, Durham University, Durham, UK.
authors: Charles
authors: C
authors: Fernyhough
authors: Centre for Academic Mental Health, Addiction and Suicide Research, School of Social & Community Medicine, University of Bristol, Bristol, UK.
authors: Jon
authors: J
authors: Heron
mesh_terms: D000293:Adolescent; D002648:Child; D003469:Culture; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010290:Parents; D011247:Pregnancy; D015995:Prevalence; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D013406:Suicide, Attempted / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology