ResultsĬG Participation ( n = 171 9.7%), % ( n)
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All statistical analyses were conducted with R software (R Core Team, Vienna, Austria), and statistical significance levels were fixed at P <. Odds ratios and 95% confidence intervals (CIs) are presented to reflect association strength. Demographic and health risk-factor variables revealing a significant bivariate association with CG participation were then used for the multivariate logistic regression, controlling for key and potentially confounding demographic variables (sex, age, grade repetition, and geographic location ) to better predict CG participation. The logistic regression models were fitted to each of the variables independently. Then, bivariate logistic regressions were conducted to examine the possible association between CG participation and (1) certain demographic characteristics, (2) conduct disorder symptoms, (3) depressive symptoms, (4) risk-taking behaviors (high-risk sports activities and 2-wheeled vehicle risk), and (5) substance use (experimentation and current consumption of tobacco, alcohol, or marijuana). Statistical Analysisįirst, we categorized the sample into 2 groups: (1) youth who had reported participating in the CG versus (2) those who had never participated in it. In the current study, Cronbach’s α coefficient for this self-administered questionnaire was 0.72. The total score, ranging from 0 to 12, represented the number of conduct problem symptoms that were present. 27 The timescale for all violent and antisocial behavior questions referred to the past 12 months, and respondents were asked to report responses limited to yes or no. The measurement of these 2 distinct but correlated dimensions made it possible to consider heterogeneity within antisocial behaviors. Three deleted criteria were the following: “has forced someone into sexual activity,” “has deliberately engaged in setting fire with the intention of causing serious damage,” and “has broken into someone else’s house, building, or car.” Finally, our measure of conduct disorder symptoms consisted of a 12-item self-reported scale that included 7 questions referring to aggressive symptoms and 5 questions used to assess the nonaggressive but rule-breaking form of antisocial behavior.
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In the current study, not all the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision ( N = 15) were held, according to the wishes of the school inspectorate. To measure the conduct problem symptoms of the teenagers, we constructed a self-report questionnaire on the basis of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria for conduct disorder 25 (unchanged in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition 26). In fact, various negative short- and long-term health outcomes from engagement in the CG have been reported, including chronic headaches, changes in behavior, confusion, short-term memory loss, recurrent episodes of syncope, seizures, retinal hemorrhage, visual impairments, neurologic damages, and death. 7, 9 This extensive propagation of videos of asphyxial games may potentially render this type of activity normal despite its dangerousness. 5, – 8 An abundance of CG information is now available on video-sharing Web sites, such as YouTube. 3, 4 A variety of techniques are deployed to achieve the state of unconsciousness, including self-induced hyperventilation, strangulation, chest and neck constriction, or ligatures. 1, – 3 Youth who engage in this risky behavior often relate experiencing a pleasurable “high” before they lose consciousness as well as a “rush” when the blood flow to the brain is restored and consciousness is regained. The “Choking Game” (CG) is a thrill-seeking activity in which self-strangulation or strangulation by another person is used to restrict oxygen flow to the brain and induce a temporary and brief euphoric state caused by cerebral hypoxia.
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