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Pediatrics. 2019 Feb;143(2). pii: e20173963. doi: 10.1542/peds.2017-3963.

Adolescent Mental Health and the Choking Game.

Author information

1
Inserm U1219, Team Healthy, Bordeaux Population Health Center, University of Bordeaux, Bordeaux, France; gregory.michel@u-bordeaux.fr.
2
Inserm U1219, Team Healthy, Bordeaux Population Health Center, University of Bordeaux, Bordeaux, France.
3
Department of Psychology, University of Tours, Tours, France.
4
Bordeaux Hospital University Center, Bordeaux, France; and.
5
Centre Hospitalier Universitaire de Montpellier, Montpellier, France.

Abstract

OBJECTIVES:

To examine the demographic and health risk factors associated with participation in the choking game (CG), a dangerous and potentially fatal strangulation activity in which pressure is applied to the carotid artery to temporarily limit blood flow and oxygen.

METHODS:

We obtained data from 2 cross-sectional studies realized respectively in 2009 and 2013 among French middle school students. The 2009 (n = 746) and 2013 (n = 1025) data sets were merged (N = 1771), and multivariate modeling was conducted to examine demographic and clinical characteristics of youth reporting a lifetime participation in the CG. The 2 studies included questions about risk-taking behaviors and substance use, and standardized assessments were used to collect conduct disorder symptoms and depressive symptoms.

RESULTS:

In the merged 2009 and 2013 data set, the lifetime prevalence of CG participation was 9.7%, with no statistically significant differences between boys and girls. A multivariate logistic regression revealed that higher levels of conduct disorder symptoms (odds ratio: 2.33; P < .001) and greater rates of depressive symptoms (odds ratio: 2.18; P < .001) were both significantly associated with an increased likelihood of reporting CG participation.

CONCLUSIONS:

The significant relationship between elevated levels of depressive symptoms and participation in the CG sheds new light on the function of self-asphyxial activities. However, with the finding that higher rates of conduct disorder symptoms were the most important predictor of CG participation, it is suggested that the profile and the underlying motivations of youth who engage in this activity should be reexamined.

PMID:
30835246
DOI:
10.1542/peds.2017-3963

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

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