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Study: Conduct problems, depression linked to ‘choking game’ participation :

January 28, 2019

Children with conduct problems or depressive symptoms have higher odds of participating in the “choking game,” a new study found. Participants in this deadly activity strangle themselves or each other to get a brief high as they lose consciousness and again when blood rushes back to the brain.

This dangerous practice can result in chronic headaches, memory loss, seizures, neurological damage and death. A 2008 Centers for Disease Control and Prevention report found 82 children and teens died while participating from 1995-2007.

Researchers set out to look at which children were most likely to play the game. They studied surveys from 1,771 French middle school students taken in 2009 and 2013 and found 9.7% had participated in the choking game with no significant difference between males and females.

Multivariate models showed both conduct disorder and depressive symptoms were associated with participation. Those with conduct disorder had an odds ratio of 2.33 while depression had an odds ratio of 2.18, “supporting the idea that this behavior serves as a specific coping mechanism for distressed adolescents,” authors wrote in “Adolescent Mental Health and the Choking Game” (Michel G, et al. Pediatrics. Jan. 28, 2019,

They also questioned whether antisocial behaviors “constitute a façade of a masked depression” since both are tied to participation. They called for more in-depth research into these motivations.

Alcohol, tobacco and marijuana use did not predict participation in the choking game, according to the study.

Authors recommended health care providers educate children about the dangers of the choking game, especially those with conduct problems or depression. These children also should be encouraged to seek mental health services.

“Interventions that are focused on emotion management might help these youths to cultivate the ability to regulate their negative affects rather than CG (choking game) participation,” they wrote.

Parents also should talk to their children about the choking game, according to the Academy. Signs their child is participating include bruising or red marks around the neck; belts, rope, ties or clothes lying around the child’s bedroom; confused behavior; behavior changes and bloodshot eyes.

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