Online Program

Alone and At Risk: Profile of Solitary Choking Game Participants Among Oregon Youth

Monday, November 2, 2015

Alexandra Ibrahim, MPHc, School of Public Health (Maternal and Child Health-Epidemiology), University of Illinois,Chicago, Chicago, IL
Sarah Knipper, MSW, Adolescent and School Health Program, Oregon Public Health Division, Portland, OR
Elizabeth Thorne, MPH, Oregon Public Health Division, Portland, OR
Background: The choking game (CG) is a strangulation activity that carries high risks for morbidity and mortality. Previous research has linked participation to substance use and other health risks. Our study of Oregon eighth-grade students is the first to focus on youth at highest risk of injury or death-those who participate alone- and examine the relationship between risk characteristics and solo choking game participation. 

Methods: This study analyzed data (N=20,832) from the 2011 and 2013 Oregon Healthy Teens survey (OHT).  This is a cross sectional survey of 8thgrade students that asked about a variety of risk behaviors, including lifetime CG participation and most recent mode of participation (alone/group). Bivariate and multivariate logistic regression analyses were run on unweighted data that accounted for the survey design.

Results: Lifetime prevalence of CG participation in the combined 2011/2013 dataset was 3.7%, a small decline from 5.7% in 2008. Among CG participants, 17.6% reported that they were alone during their most recent CG participation.  Multivariate logistic regression revealed that individuals who participated alone had significantly increased odds of contemplating suicide (OR: 4.08 [95%CI: 1.92-8.69]) and poorer mental health (OR: 2.21 [95% CI: 1.14-4.3]) compared to those who participated in groups.

Discussion:  Results from this study demonstrate adolescents who participate in the CG alone are at substantially elevated risk for suicidal ideation and other mental health problems.  Healthcare providers should be aware of this risk profile and assess whether prevention messaging in the context of a health care visit is appropriate.

Learning Areas:

Public health or related research

Learning Objectives:
Identify salient risk characteristics of youth who participate in the choking game alone

Keyword(s): Adolescents, Mental Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a student pursuing my MPH with a focus on MCH-Epidemiology. I have been working as an intern at the Oregon Health Authority through the Graduate Student Epidemiology Program and have become familiar with choking game literature and the Oregon Healthy Teens data set used to analyze the data. I have spent the last several weeks working with the data and am working with my preceptors to draft a manuscript on our findings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.