Almost half of "alternative" teenagers - that is, teens identifying as belonging to goth, emo and punk subcultures - self-harm, and nearly 1 in 5 have attempted suicide, according to new research.
In previous research, the lead author behind the new study - Robert Young, senior investigative scientist at the Medical Research Council (MRC) Social and Public Health Sciences Unit at University of Glasgow in the UK - found an association between self-harm and teenagers in Glasgow who identify with the goth subculture.
In that study, Young reported that 53.5% of the goths he studied in Glasgow engaged in non-suicidal self-harm, and 47% claimed that they had attempted suicide.
With the new study - which is published in BMC Psychiatry - Young's team partnered with researchers from the University of Ulm in Germany to investigate the reasons why teenagers in certain subcultures are more likely to self-harm or attempt suicide.
The researchers studied 452 German school pupils aged 14-15. The pupils were asked to describe how strongly they identified with specific youth cultures, such as alternative, "nerd," or "jock."
The study also collected data from the students on their gender, immigration status, their parent's social and economic status and any physical bullying or verbal harassment they experience - all of which are risk factors strongly linked to self-harm.
Young and his team found that teenagers identifying as alternative (defined here as being goth, emo or punk) were 3-4 times more likely to self-injure and 6-7 times more likely to attempt suicide than other teenagers.
The study reports that identifying with the alternative subculture is a stronger predictor for teenage self-injury or attempted suicide than being repeatedly bullied.
'Jocks' and 'nerds' are much less likely to self-injure than 'alternative' teens
Athletic teenagers who identified as "jocks" were the group least likely to self-injure, according to the study. The researchers wonder if this may be influenced by the effect of regular physical activity, which is known to improve depression symptoms in adults.
Despite being stereotyped as socially excluded, academic or "nerd" teenagers were found to be no more likely to self-injure or attempt suicide than any other teenage group.
Academic or "nerd" teenagers, meanwhile, were found to be no more likely to self-injure or attempt suicide than any other teenage group. The authors consider this surprising, as the nerd stereotype is often associated with bullying and peer exclusion.
"Our research supports the notion that social mechanisms influence self-harm," says Young. "This is a crucial finding when thinking of ways to address and prevent self-harm in adolescence."
Although previous research has suggested that there may be a "socially contagious" element to self-injury - as the majority of adolescents in these studies were found to have friends who also self-injure - the new study found that only a minority of teenagers self-injure in an attempt to "feel more part of a group."
"It may well be that building on the strong identification with a certain kind of music or youth group, therapeutic approaches such as music therapy, in combination with strategies to decrease distress, are a feasible option for addressing self-harm," considers Young.
Commenting on the study, Prof. David Lomas, chair of the MRC Population and Systems Medicine Board, says:
"Global estimates suggest 30% of all teenagers have suicidal thoughts, 18% have self-injured and 4% actually attempt suicide, and the overall rates in this study were typical for this age group (26%, 21% and 4%, respectively). Understanding the reason why different groups of teenagers self-injure will hopefully lead to early detection and help develop effective interventions for those at risk from self-injury or suicide."