Goth Teens at Risk for Depression, Self-harm

Megan Brooks

August 31, 2015

UPDATED September 1, 2015 // Adolescents who identify with the goth subculture may be at increased risk for depression and self-harm, and the more they identify as goth, the greater the risk, a new study finds.

Teenagers who identified very strongly with being a goth at age 15 years were three times more likely to be clinically depressed and five times more likely to commit self-harm at age 18 years than young people who did not, the researchers report.

"One potential clinical implication of our study is that the subcultures that young people identify with may be an important factor to consider when assessing vulnerability to depression or self-harm," Lucy Bowes, PhD, from the Department of Experimental Psychology, University of Oxford, United Kingdom, told Medscape Medical News.

"Raising awareness to reduce social stigma targeted at alternative subcultures may also be important," she said.

Dr Lucy Bowes

The study was published online August 27 in the Lancet Psychiatry.

Dose-Response Association

A "goth" is defined in the Oxford English Dictionary as "a member of a subculture favouring black clothing, white and black make-up, and goth music," the authors explain. "Much diversity exists within the goth subculture, making definition of the average adolescent goth difficult; however, many social norms are associated with being a goth, including alternative clothing and music, and a dark, morbid mood and aesthetic."

It has been suggested that the goth subculture provides an important source of validation and community to individuals who do not conform with societal norms, they point out. "Why affiliation with goth subculture is associated with an increased risk of self-harm and whether it is also associated with increased depression is unclear."

In the current study, participants included 3694 teenagers from the UK Avon Longitudinal Study of Parents and Children (ALSPAC), who provided information on depressive mood and self-harm and the extent to which they identified as a goth at age 15 and self-reported depression and self-harm at age 18.

The researchers say 105 (6%) of 1841 adolescents who did not self-identify as goth met criteria for depression, compared with 28 (18%) of 154 who identified "very much" as goth; for self-harm, the figures were 189 (10%) of 1841 vs 57 (37%) of 154.

According to the researchers, the more that young people identified with the goth subculture at age 15, the greater their likelihood of having scores in the clinical range for depression and self-harm 3 years later.

Table. Risk for Depression, Self-Harm by Level of Identification with Goth Subculture

Level of Identification Depression OR (95% CI) Self-harm OR (95% CI)
Not very much 1.16 (0.83 - 1.62) 1.52 (1.20 - 1.93)
Somewhat 1.63 (1.14 - 2.34) 2.33 (1.80 - 3.02)
More than somewhat 2.33 (1.56 - 3.47) 3.65 (2.72 - 4.89)
Very much 3.67 (2.33 - 4.79) 5.14 (3.58 - 7.36)

OR, odds ratio; 95% CI, 95% confidence interval.


Goth identification remained a strong predictor of future depression and self-harm after accounting for a range of individual, family, and social factors known to increase the risk for depression and self-harm, including previous depression and self-harm, early emotional and behavioral difficulties, psychiatric disorder, history of bullying, and the mental health of mothers.

The researchers say the goth subculture might provide an important source of validation and a community within which young people who do not conform with societal norms can be understood.

"Teenagers who are susceptible to depression or with a tendency to self-harm might be attracted to the goth subculture, which is known to embrace marginalized individuals from all backgrounds, including those with mental health problems," coinvestigator Rebecca Pearson, PhD, from the University of Bristol, United Kingdom, said in a statement.

"Alternatively, the extent to which young people self-identify with the goth subculture may represent the extent to which at-risk young people feel isolated, ostracized, or stigmatized by society. These young people may be attracted to like-minded goths who face similar stressors," Dr Pearson said.

Writing in a linked commentary, Prof. Rory O'Connor, of University of Glasgow, United Kingdom, and Gwendolyn Portzky, PhD, of Ghent University, Belgium say, "Clinicians working with adolescents showing an interest in goth subculture and displaying signs of goth identification should be aware of the increased risk of depression and self-harm in later adolescence. Further monitoring and assessment of self-harm risk is recommended for these young people."

They add, "It is, however, important to determine whether adolescents identifying with goth subculture seek professional help for emotional problems and whether they have different help-seeking attitudes compared to adolescents who identify with other cultures. If adolescents identifying as goth seek less professional help and have different attitudes, this finding will have important implications for the management of risk of depression and self-harm in this vulnerable group."

This study was funded by the Wellcome Trust and the Medical Research Council. The authors have disclosed no relevant financial relationships.

Lancet Psychiatry. Published online August 27, 2015. Abstract, Editorial


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