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Teens Who Participate in Choking Game Alone At High Risk of Suicidal Thoughts

​Youths who engage in the "choking game," intentionally blocking blood to the brain in search of a rush when the strangulation stops, put themselves at serious risk of injury or death.  Those who participate in the game alone also face significantly higher rates of suicidal thoughts, according to new research in the December 2016 Pediatrics. For the study, "Solitary Participation in the `Choking Game' in Oregon" (published online Nov. 21), researchers examined data from the 2011 and 2013 Oregon Healthy Teens Survey. The survey is conducted every other year in Oregon, the only U.S. state that conducts statewide formal surveillance on this topic. The researchers compared responses from teens who reported engaging in the choking game in group settings with those who participated alone, pressing on their carotid artery by hand or with objects such as belts to achieve a brief euphoria when the pressure is released and blood flow returns.  They found that among nearly 21,000 8th-grade students in the study, 3.7 percent had participated in the choking game, and 18 percent of those participated alone. Adjusting for gender and geography, respondents who participated in the choking game alone had nearly five times the odds of having contemplated suicide compared to those who reported participating in a group. They also were more likely to report poor mental health. Authors of the study say solitary participation may signal underlying distress and be similar to non-suicidal self-injury, a gateway behavior for suicide.  They cite previous research showing nearly one-third of pediatricians and family physicians are unaware of the choking game and say this study underscores a need for increased provider awareness education, prevention messaging and patient referrals for mental health services when warranted.
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