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Young risk-takers drawn to dangerous "game"

In a recent study, about six percent of eighth grade students admitted they had participated in the "choking game," in which blood and oxygen to the brain are cut off to produce a euphoric "high." The results are attained by strangulation, either by oneself or one's friend, or by using a belt, rope, scarf or other similar item - oftentimes to the point of unconciousness.

Researchers found that two-thirds of those kids had played the dangerous game multiple times and many engage in other risky behaviors.

"If kids do participate, they are likely to do it more than once," said lead researcher Robert Nystrom, adolescent health manager at the Oregon Public Health Division in Portland. About two-thirds of the 6.1 percent who admitted to trying the game had done so more than once, and nearly 27 percent had done it more than five times.

Nystrom's team did not gather data on deaths, but the U.S. Centers for Disease Control and Prevention (CDC) has reported that 82 children died from the activity in the years 1995 through 2007. That number is possibly even higher as some of the deaths are ruled suicides.

Those who play the game, also called Knock Out, Space Monkey, Flatlining, or the Fainting Game, can lose consciousness within seconds. Within three minutes of continued strangulation, basic body functions such as memory, balance and the central nervous system can fail. Death can occur shortly after, according to the CDC.

For the survey, Nystrom and his colleagues obtained data from the 2009 Oregon Healthy Teens survey. It included nearly 5,400 eighth graders, ages 12 to 15, who answered questions about the choking game as well as questions about their physical health, sexual activity, exercise, nutrition, body image, substance abuse and exposure to violence.

Males and females seem to participate equally in the choking game, and those who did participate tended to engage in other risky behaviors, Nystrom's team found. They were more likely to be sexually active and to be substance abusers.

Dr. Dennis Woo, a staff pediatrician at the UCLA Medical Center in Santa Monica, said he was surprised that the number of kids participating was that high. "Six percent is quite a few kids," he noted.

Parents can help their children avoid problems by being aware that age 13 is a time when youth are transforming to adulthood and trying to find themselves. Be aware of your children's friends and their activities. Be alert to behavior changes, such as suddenly not doing well in school, because that might indicate they are getting involved in risky behaviors.

Parents can strike a balance between giving their pre-teen "alone time" in his room but also having access, and remind him that he is still subject to random searches.

Some parents are casual about risk-taking behavior in their pre-teens and teens, reasoning that "kids will be kids." Woo would tell those parents that "you really do want to be vigilant because some of the behaviors can have tragic consequences."

Nystrom agreed that parents need to talk to their children and stay aware of any warning signs of the game activity. That could include marks on the neck, red dots around the eyelid (reflecting hemorrhage) or unexplained headaches. Contact your child's healthcare provider right away if you suspect something.

Sources: Robert Nystrom, M.A., adolescent health manager, Oregon Public Health Division, Portland; Dennis Woo M.D., staff pediatrician, UCLA Medical Center, Santa Monica, and associate professor, pediatrics, UCLA David Geffen School of Medicine of Los Angeles; April 16, 2012, "Pediatrics" online

Written by: U.S. National Library and Medicine, National Institutes of Health
Posted: Sep 11, 2013 by Lisa Callaham

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