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Conduct Disorders and Depression Can Help Predict Which Teens are Likely to Engage in the Choking Game


Teens who experience symptoms of depression, especially when combined with conduct disorders, are more likely to engage in the choking game, according to a study in the February 2019 issue of Pediatrics. The choking game is an activity that involves strangulation to temporarily limit blood flow and oxygen to the brain, often producing a euphoric feeling. The study, “Adolescent Mental Health and the Choking Game,” published online Jan. 28, surveyed 1,771 French middle-school students who reported participating in the choking game, asking them if they have ever experienced depression symptoms or symptoms of a conduct disorder, such as anti-social behaviors or rule-breaking. Researchers found that the overall rate of participation in the game was 9.7 percent, for both male and female students. Having a conduct disorder was a strong indicator for participation in the choking game. Symptoms of depression also indicated a risk factor for participation, but not as strongly as conduct disorder symptoms. According to the authors, this study supports the idea that participating in the game serves as a coping mechanism for teens in distress. They suggest prevention programs emphasize the importance of emotion-regulating skills and emotion management to regulate the negative effects of depression and conduct disorders.


The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit and follow us on Twitter @AmerAcadPeds