Category Archives: Games
Tales of the unexpected: 10 bad habits that sometimes do us good (Part 1)
All of us have bad habits, and all of us from time to time feel guilty about these habits. But there are some bad habits – at least when carried out in moderation – that might actually have benefits for psychological and/or physical wellbeing. Most bad habits help change our mood state and reduce stress (at least in the very short-term) but tend to become less helpful the more they are engaged in. Some of these bad habits turn into addictions where the short-term benefits are outweighed by the long-term costs. However, there are many activities that can sometimes have unexpected benefits and five of these are outlined in this blog. The next five bad habits will be in my next blog.
(1) Fidgeting helps burn calories
While fidgeting might be annoying for individuals and those around them, it is an activity that expends energy and burns calories. Fidgeting is one of a number of activities (along with walking, gardening, typing, tidying up, etc.) that are known as non-exercise activity thermogenesis (NEAT). In basic terms, NEAT is any activity that is not eating, sleeping, or sporting exercise. A number of studies carried out by obesity expert Dr. James Levine at the US Mayo Clinic (Arizona, US) have shown that individuals who fidget burn up about 350kcal a day. This is because fidgeting speeds up an individual’s metabolism by stimulating neurochemicals in the body thus increasing the ability to convert body fat into energy. So, if you are a compulsive foot tapper, an excessive thumb twiddler, or a restless doodler, just remember that all of these activities burn calories.
(2) Chewing gum helps boost thinking and alertness
Watching people chew gum is not a pretty site but if English football managers are anything to go by, chewing gum appears to be a stress relieving activity. In fact, there appear to appear to be many cognitive benefits of chewing gum. Dr. Kin-ya Kubo and colleagues in the book Senescence and Senescence-Related Disorders noted that chewing gum immediately before performing a cognitive task increases blood oxygen levels in the prefrontal cortex and hippocampus (important brain structures involved in learning and memory), thereby improving task performance. Dr. Kubo argues that chewing gum may therefore be a drug-free and simple method of helping those with senile dementia and stress-related disorders that are often associated with cognitive dysfunction. Another study by Dr. Yoshiyuki Hirano and colleagues showed that chewing gum boosts thinking and alertness, and that reaction times among chewers were 10% faster than non-chewers. The research team also reported that up to eight areas of the brain are affected by chewing (most notably the areas concerning attention and movement). As Professor Andy Smith (Cardiff University, UK) neatly summed up: “The effects of chewing on reaction time are profound. Perhaps football managers arrived at the idea of chewing gum by accident, but they seem to be on the right track”.
(3) Playing video games helps relieve pain
Many individuals that do not play video games view the activity as a complete waste of time and potentially addictive. While excessive video game playing may cause problems in a minority of individuals, there is lots of scientific evidence that playing video games can have many beneficial effects. For instance, a number of studies have shown that children with cancer who play video games after chemotherapy take less pain killing medication. Video games have also been used as pain relieving therapy for other medical conditions such as burns victims and those with back pain. This is because playing video games is an engaging and engrossing activity that means the player cannot think about anything else but playing the game (and is what psychologists refer to as a ‘cognitive distractor task’). Pain has a large psychological component and individuals experience less pain if the person is engaged in an activity that takes up all their cognitive mind space. As well as being a pain reliever, there are also many studies showing that playing video games increase hand-eye co-ordination, increase reaction times, and have educational learning benefits.
(4) Eating snot helps strengthen the immune system (maybe)
How does it make you feel when you see someone picking their nose and then eating what they have found? Disgust? Contempt? Amused? In 2008, Dr Friedrich Bischinger, an Austrian lung specialist, claimed that picking your nose and eating it was good for you. He claimed that people who pick their noses with their fingers were healthy, happier and probably better in tune with their bodies than those who didn’t. Dr. Bischinger believes that eating the dry remains of what you pull out of your nose is a great way of strengthening the body’s immune system. He explained that in terms of the immune system, the nose is a filter in which a great deal of bacteria are collected, and when this mixture arrives in the intestines it works just like a medicine. He said that “people who pick their nose and eat it get a natural boost to their immune system for free. I would recommend a new approach where children are encouraged to pick their nose. It is a completely natural response and medically a good idea as well”. He went on to suggest that if anyone was worried about what other people think, they should pick their noses privately if they want to get the benefits. This view is also shared by Dr. Scott Napper, a biochemist at the University of Saskatchewan. He theorises that hygiene improvement has led to the increase in allergies and auto-immune disorders and that eating snot may boost the immune system by ingesting small and harmless amounts of germs into the body. The same theory has also been applied to another bad habit – biting fingernails – because again, the act of biting nails introduces germs directly into a person’s orifices.
(5) Daydreaming helps problem solving
Daydreaming is something that can occupy up to one-third of our waking lives and is often viewed as a sign of laziness, inattentiveness and/or procrastination. However, scientific research has shown that the ‘executive network’ in our brain is highly active when we daydream. A study carried out by Professor Kalina Christoff and colleagues and published in the Proceedings of the National Academy of Sciences found activity in numerous brain regions while daydreaming including areas associated with complex problem solving. These brain regions were more active while daydreaming compared to routine tasks. It is believed that when an individual uses conscious thought they can become too rigid and limited in their thinking. The findings suggest that daydreaming is an important cognitive state where individuals turn their attention from immediate tasks to unconsciously think about problems in their lives. Christoff says that “when you daydream, you may not be achieving your immediate goal – say reading a book or paying attention in class – but your mind may be taking that time to address more important questions in your life, such as advancing your career or personal relationships”. In addition to this, Dr. Eric Klinger of the University of Minnesota has argued that daydreaming also serves an evolutionary purpose. When individuals are engaged on one task, daydreaming can trigger reminders of other, concurrent goals so that they do not lose sight of them.
Part 2 of this article will be in the next blog.
Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Christoff, K., Gordon, A.M., Smallwood, J., Smith, R., & Schooler, J.W. (2009). Experience sampling during fMRI reveals default network and executive system contributions to mind wandering. Proceedings of the National Academy of Sciences, 106, 8719-872
Fox, K.C., Nijeboer, S., Solomonova, E., Domhoff, G.W., & Christoff, K. (2013). Dreaming as mind wandering: evidence from functional neuroimaging and first-person content reports. Frontiers in Human Neuroscience, 7, 42. doi: 10.3389/fnhum.2013.00412.
Griffiths, M.D. (2005). The therapeutic value of videogames. In J. Goldstein & J. Raessens (Eds.), Handbook of Computer Game Studies (pp. 161-171). Boston: MIT Press.
Griffiths, M.D., Kuss, D.J., & Ortiz de Gortari, A. (2013). Videogames as therapy: A review of the medical and psychological literature. In I. M. Miranda & M. M. Cruz-Cunha (Eds.), Handbook of research on ICTs for healthcare and social services: Developments and applications (pp.43-68). Pennsylvania: IGI Global.
Hirano, Y., Obata, T., Takahashi, H., Tachibana, A., Kuroiwa, D., Takahashi, T., … & Onozuka, M. (2013). Effects of chewing on cognitive processing speed. Brain and Cognition, 81, 376-381.
Kato, P. M., Cole, S. W., Bradlyn, A. S., & Pollock, B. H. (2008). A video game improves behavioral outcomes in adolescents and young adults with cancer: A randomized trial. Pediatrics, 122, E305-E317.
Klinger, E. (2009). Daydreaming and fantasizing: Thought flow and motivation. In Markman, K. D., Klein, W.P., & Suhr, J.A. (Eds.), Handbook of Imagination and Mental Simulation (pp. 225-239). New York: Psychology Press.
Klinger, E., Henning, V. R., & Janssen, J. M. (2009). Fantasy-proneness dimensionalized: Dissociative component is related to psychopathology, daydreaming as such is not. Journal of Research in Personality, 43, 506-510.
Kubo, K. Y., Chen, H., & Onozuka, M. (2013). The relationship between mastication and cognition. In Wang, Z. & Inuzuka (Eds.), Senescence and Senescence-Related Disorders. InTech. Located at: http://www.intechopen.com/books/senescence-and-senescence-related-disorders
Levine, J.A. (2004). Nonexercise activity thermogenesis (NEAT): environment and biology. American Journal of Physiology-Endocrinology And Metabolism, 286, E675-E685.
Levine, J.A., Melanson, E. L., Westerterp, K. R., & Hill, J.O. (2001). Measurement of the components of nonexercise activity thermogenesis. American Journal of Physiology-Endocrinology and Metabolism, 281, E670-E675.
Levine, J.A., Schleusner, S. J., & Jensen, M.D. (2000). Energy expenditure of nonexercise activity. American Journal of Clinical Nutrition, 72, 1451-1454.
Redd, W.H., Jacobsen, P.B., DieTrill, M., Dermatis, H., McEvoy, M., & Holland, J.C. (1987). Cognitive-attentional distraction in the control of conditioned nausea in pediatric cancer patients receiving chemotherapy. Journal of Consulting and Clinical Psychology, 55, 391-395.
Reichlin, L., Mani, N., McArthur, K., Harris, A.M., Rajan, N., & Dacso, C.C. (2011). Assessing the acceptability and usability of an interactive serious game in aiding treatment decisions for patients with localized prostate cancer. Journal of Medical Internet Research, 13, 188-201.
Vasterling, J., Jenkins, R.A., Tope, D.M., & Burish, T.G. (1993). Cognitive distraction and relaxation training for the control of side effects due to cancer chemotherapy. Journal of Behavioral Medicine, 16, 65-80.
Wighton, K. (2013). From biting your nails to burping and even eating in bed: The bad habits that can be GOOD for you! Daily Mail, April 8. Located at: http://www.dailymail.co.uk/health/article-2305953/Bad-habits-From-biting-nails-burping-eating-bed-The-bad-habits-GOOD-you.html
The punch bunch: Aggressive behaviour in adult slot machine gamblers
I was idly looking through some of the academic papers I have published over the last 25 years and I was surprised by how a fair number of them examined aggressive behaviour in some way. Many of these concern the effect of video game violence on aggressive behaviour but I have also published papers examining sexual orientation and aggression, mindfulness and aggression, and gambling and aggression (see ‘Further Reading’ below for a selection of these).
Back when I was doing my PhD on slot machine addiction (1987-1990) I spent a lot of my time in amusement arcades watching fruit machine players. One thing that I noticed during my observational studies is how physically aggressive players could be when they lost (such as kicking or punching the machine if they lost a lot of money or being verbally aggressive towards staff and other players when things weren’t going the way they wanted). A number of studies have reported a link between gambling and aggressive behaviour although most of the research has concentrated on domestic violence between gamblers and their partners (i.e., problem gamblers taking out the frustration of losing lots of money on their partners).
In a paper in a 2005 issue of the Journal of Community and Applied Social Psychology, Dr. Adrian Parke and I speculated that there are two main types of aggressive act which are prevalent in slot machine gambling based on environmental and structural design factors – instrumental aggression and emotional aggression. Instrumental aggression differs from emotional aggression because there is an ulterior motive behind the act whereas emotional aggression is a result of being unpleasantly aroused. The Frustration-Aggression theory states that a barrier to expected goal attainment generates emotional aggression. Furthermore, the level of aggression is directly proportional to the (i) level of satisfaction they had expected, (ii) more they are prevented from achieving any of their goals and (iii) more often their attempts are resisted. Psychologists such as Dr. Leonard Berkowitz maintains that it is not the frustration that causes the aggressive urges, but the negative affect elicited by the frustration.
Dr. Parke and I also published some other papers on slot machine aggression during 2004 and 2005 in the International Journal of Mental Health and Addiction and Psychological Reports. We carried out a non-participant observation study and monitored the incidence of aggressive behaviour in 303 slot machine players over four 6-hour observation periods in a UK amusement arcade. We concluded that aggression was prevalent in the UK gambling arcade environment with an average of seven aggressive incidents per hour.
We also reported that the majority of aggressive incidents were verbal. Verbal aggression was directed towards members of staff, other gamblers and also the slot machines themselves. Verbal aggression towards members of staff, from an objective point of view, appeared to be caused by a misinterpretation of staff reactions towards incurred losses. With cues available to determine which slot machine will be profitable to play, selecting a machine with which the gambler incurs a loss can be interpreted as poor slot machine gambling skill. The psychologists Dr. Brad Bushman and Dr. Roy Baumeister argue that threatened egotism (an explicit dispute against one’s self value) is a strong risk factor for aggression reprisal. It is probable that in this situation the gamblers were motivated to rebuke such evaluations through an affrontive reprimand. For example:
“After losing all of the money he entered the premises with, participant 6 becomes verbally aggressive to an arcade staff member: ‘I should bring a bat into this place and break the fucking machine…What would you do? You wouldn’t have the balls to call the police.” (Parke & Griffiths, 2005; p. 53)
Given the apparent disproportionate aggressive reaction to minor provocation from staff members, there is scope to propose that rather than being a primary source of frustration and aggression, the phenomenon is evidence of Triggered Displaced Aggression. Displaced Aggression theory contends that individuals who are provoked but who are constrained against retaliating directly to the primary source may displace such anger onto unaccountable individuals. Triggered Displaced Aggression theory extends this position, by stating that after a preclusion of direct retaliation against the provocateur, minor triggers will produce an incommensurate level of aggression. Applying this theory to the phenomenon of verbal aggression towards staff members, it is probable that the gambler while frustrated and negatively aroused may be motivated to displace disproportionately high aggressive reactions onto staff members based on minor triggers such as amusement at incurred losses.
We also reported that verbal aggression directed towards other slot machine gamblers was probably a response to predatory play from opposing slot machine gamblers. With structural design factors enabling identification of slot machines that are profitable to play, naturally the environment becomes competitive. Gamblers become callous in their machine selection because the most effective way to make profits is to target machines that other gamblers have lost considerably on. Again, for the individual, self-esteem is likely to be diminished by permitting opponents to profit from experiencing loss. As a result it is probable that attempts are made to deflect such predatory behaviour with aggressive reprimands. For example:
“Participant 3 had gambled a considerable amount of money on one machine, and had no funds to continue playing. Participant 4 immediately began to play the same machine and win. Participant 3 retorted in an aggressive tone: ‘You watching me lose my money before. Wait till I lose everything and then play mate?’” (Parke & Griffiths, 2005; p.54)
Verbal aggression towards other slot machine gamblers could be understood from perspective of the Cognitive Neo-associationistic Model. (Fundamentally, this model suggests that aversive events produce negative affect, which transforms all associated stimuli into potential triggers of aggression). Applying this theory to the verbal aggression phenomenon, it is reasonable to propose that the experience of losing transforms environmental factors, such as opposing gamblers, into sources of aggression. Berkowitz has advocated two tiers of aggression activation. The first stage is simultaneous emotions of rudimentary fear and anger. The second stage is a second order evaluative phase where the individual considers the actual liability of environmental factors in anger creation. Naturally, as Berkowitz states, the individual’s attributional processes dictate whether they will actualise aggressive emotions. Put simply, an acknowledgement of the ability to isolate slot machines that are profitable to play based on identifying losing gamblers, is potentially a risk factor for acting aggressively towards other gamblers.
Finally, verbal aggression towards the slot machine is considered to be an emotionally aggressive act as a means to vent frustration rather than instrumentally preserve status as suggested above. Invariably, verbal emotional aggression was expressed through vilification and attribution of negative human characteristics to the machine such as sadism. Interestingly, such vilification was primarily sexually aggressive and constituted a feminisation of the slot machine. For example:
“This bitch is fucking me around…Are you going to fuck me around again this week?” (Parke & Griffiths, 2005; p.54)
We argued that the physical aggression towards the slot machine was believed to be an extension of tension release that was previously observed with verbal aggression towards the slot machine. For example:
“After considerable losses, Participant 8 began to slam the glass of the machine. After experiencing a near miss Participant 8 subsequently kicked the base of the machine.” (Parke & Griffiths, 2005; p.55)
Physical aggression was not directed towards opposing gamblers – perhaps identifying a boundary of conduct in order to remain within the gambling environment, as it was probable that such behaviour would result in getting thrown out of the premises. Essentially this does not equate to gamblers not be motivated to act physically aggressive to other slot machine gamblers, rather it only represents a reluctance to actualise such behaviour in the gambling environment.
It is probable that aggressive behaviour observed in the slot machine gambling environment is not solely based on structural and environmental factors. Individual differences of the gamblers are likely to affect the prevalence of aggressive behaviour, based on propositions of the General Aggression Model that suggests that trait hostility can develop through life experiences. It is possible that the participants in our observational study held aggression-related biases. For example, Dr. Karen Dill and her colleagues argue that trait hostility precipitates a hostile expectation bias (the expectation that aggressive behaviour will be used by others instrumentally) and a hostile perception bias (the propensity of interpreting interpersonal interactions as aggressive). For gamblers, it is probable that trait hostility is exacerbating aggressive reactions towards provocation from environmental and structural game design factors. Overall, our research concluded that gambling-induced aggression is a manifestation of the underlying conflict of engaging in dysfunctional behaviour while consciously acknowledging its detrimental effects.
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Additional input: Dr. Adrian Parke (University of Lincoln, UK)
Further reading
Anderson, C.A. & Bushman, B.J. (2002). Human Aggression. Annual Review of Psychology, 53, 27-51.
Berkowitz, L. (1993). Aggression: Its causes, consequences, and control. Philadelphia: Temple University Press.
Berkowitz, L. (1989). The frustration-aggression hypothesis: Examination and reformulation. Psychological Bulletin, 106, 59-73.
Berkowitz, L. (1990). On the formation and regulation of anger and aggression: A cognitive-neoassociationistic analysis. American Psychologist, 45, 494-505.
Bushman, B. J. & Baumeister, R. F. (1998). Threatened egotism, narcissism, self-esteem, and direct and displaced aggression: Does self-love or self-hate lead to violence. Journal of Personality and Social Psychology, 75, 219-229.
Dill, K.E., Anderson, C.A., Anderson, K.B. & Deuser, W.E. (1997). Effects of personality on social expectations and social perceptions. Journal of Research in Personality, 31, 272-292.
Dollard, J., Doob, L.W., Miller, N.E., Mowrer, O.H. & Sears, R.R. (1939). Frustration and Aggression. New Haven, Connecticut: Yale University Press.
Griffiths, M.D. (1997). Video games and aggression. The Psychologist: Bulletin of the British Psychological Society, 10, 397-401.
Griffiths, M.D. (1998). Video games and aggression: A review of the literature. Aggression and Violent Behavior, 4, 203-212.
Griffiths, M.D., Parke, A. & Parke, J. (2003). Violence in gambling environments: A cause for concern? Justice of the Peace, 167, 424-426.
Griffiths, M.D., Parke, A. & Parke, J. (2005). Gambling-related violence: An issue for the police? Police Journal, 78, 223-227.
Grüsser, S.M., Thalemann, R. & Griffiths, M.D. (2007). Excessive computer game playing: Evidence for addiction and aggression? CyberPsychology and Behavior, 10, 290-292.
Mehroof, M. & Griffiths, M.D. (2010). Online gaming addiction: The role of sensation seeking, self-control, neuroticism, aggression, state anxiety and trait anxiety. Cyberpsychology, Behavior, and Social Networking, 13, 313-316.
Miller, N. Pederson, W.C., Earleywine, M. & Pollock, V.E. (2003). A theoretical model of triggered displaced aggression, Personality and Social Psychology Review, 7, 75-97.
Miller, N.E. (1941). The frustration-aggression hypothesis. Psychological Review, 48, 337-342.
Parke, A. & Griffiths, M.D. (2004). Aggressive behavior in slot machine gamblers : A preliminary observational study. Psychological Reports, 95, 109-114.
Parke, A. & Griffiths, M.D. (2005). Aggressive behaviour in adult slot machine gamblers: A qualitative observational study. International Journal of Mental Health and Addiction, 2, 50-58.
Parke, A. & Griffiths, M.D. (2005). Aggressive behaviour in adult slot machine gamblers: An interpretative phenomenological analysis. Journal of Community and Applied Social Psychology, 15, 255-272.
Sergeant, M.J.T., Dickins, T.E., Davies, M.N.O., & Griffiths, M.D. (2006). Aggression, empathy and sexual orientation in males. Personality and Individual Differences, 40, 475-486.
Shonin, E.S., van Gordon, W., Slade, K. & Griffiths, M.D. (2013). Mindfulness and other Buddhist-derived interventions in correctional settings: A systematic review. Aggression and Violent Behavior, 18, 365-372.
Choking aside: Another look at self-asphyxial risk-taking behaviour in adolescence
In a previous blog I examined the ‘choking game’ (also known by dozens of names including the ‘fainting game’ and ‘suffocation roulette’). This was a game that I played a couple of times as an adolescent (although we called it ‘Headrush’). This was a game where I would have my breathing temporarily stopped by someone holding onto my chest after a deep expiration and hyperventilation (so that I could not breathe). It induced feelings of light-headedness and dizziness followed by temporary unconsciousness (usually lasting 10 to 15 seconds).
This activity that I engaged in as a teenager is an example of self-asphyxial risk-taking behaviour (SARTB). It also appears that what I did when I was an adolescent was a form of ‘self-induced hypocapnia’ (i.e., a state of reduced carbon dioxide in the blood). It has also been reported that these ‘games’ can be played alone and typically involve self-strangulation, or sometimes with others, and where like my own experiences, the cutting off of the oxygen supply was carried out by somebody else.
Reports of SARTB date back to the early 1950s in the medical literature (for instance, Dr. P. Howard and his colleagues reported a case in a 1951 issue of the British Medical Journal). SARTB has been defined by R.L. Toblin and colleagues in a 2008 issue of the Journal of Safety Research as self-strangulation or strangulation by another person with the hands or a noose to achieve a brief euphoric state caused by cerebral hypoxia. As with autoerotic asphyxiation (i.e., suffocation as a way of enhancing sexual arousal), the aim of SARTB is to intentionally cut off the oxygen supply to the brain to experience a feeling of euphoria (the only difference being that in children’s games, it is not done for a sexual reason).
How prevalent the activity is debatable as most of the academically published studies are case reports (usually when a problem – and in some cases, death – has occurred). However, a comprehensive systematic review of SARTB was recently published by Busse et al (2015). They attempted to assess the prevalence of engagement in SARTB and associated morbidity and mortality in children and adolescents (and up to early adulthood). Busse and colleagues examined every survey and case study that had been published on SARTB, and more specifically examining the behaviour among those aged 0–20 years (excluding any study where the motive was autoerotic, suicidal or self-harm). They reported that 36 studies had examined child and adolescent SARTB in 10 different countries (North America and France being the most common, but also reports in the UK).
Risk factors for SARTB were hard to assess because most of the studies examining such risks did not control for other confounding variables. However, five of the studies reported an association between SARTB and a number of other risky behaviours including substance misuse, risky sexual behaviours, poor mental health, poor dietary behaviours, and engagement in risky sports. The review also reported that there did not seem to be any association between SARTB and engagement in physical activity, and experiencing accidents, and/or hospital admissions. It was also noted that a number of other behaviours increased the likelihood of engaging in SARTB including experiences of violence, being more impulsive, having a thrill-seeking personality, and having lower school achievement. However, only six of the 36 studies they reviewed reported the potential for SARTB to be associated with other risky behaviours. No consistent findings were found between SARTB and gender, age and other demographic factors (such as socio-economic status).
Examining the studies as a whole, Busse and colleagues reported that awareness of SARTB ranged from 36% to 91%, and that the median lifetime prevalence of engagement in SARTB was 7.4% (however, these were studies that used convenience sampling, therefore none of the studies were necessarily representative). In the SARTB literature, a total of 99 fatal cases were reported (and of the 24 detailed case reports, most of the deaths occurred when individuals were engaged in SARTB alone and used some type of ligature).
In a different analysis in the Journal of Safety Research, Dr. R.L. Toblin and colleagues used US news media reports to estimate the incidence of deaths from SARTB. Their report identified 82 probable SARTB deaths among youths aged 6-19 years during 1995 and 2007. Of these 82 cases, 71 (86.6%) were male, and the mean age of death was just over 13 years of age. The study also noted that deaths were recorded in 31 US states and were not clustered by location, season or day of week. Busse and colleagues assert the importance of education and prevention and more specifically note:
“As it has been suggested that knowledge and identification of symptoms and signs of engagement in [SARTB] could have possibly enabled early identification and possible prevention of fatal cases, we believe that clinicians, paediatricians, health professionals and teachers should receive education on the symptoms and signs of [SARTB]. The need to educate health professionals has been highlighted as awareness of [SARTB] will enable these individuals to identify symptoms and signs and to act as educators to young people and their parents…We further recommend that more research is carried out together with young people to develop appropriate education material. In line with recommendations from others, we further recommend removing existing videos about [SARTB] from the internet and ensuring that preventative website rather than promotional websites appear first on internet searches” (p.8).
This brief examination of the literature suggests that a significant minority of adolescents have engaged in SARTB and that in extreme cases it may lead to death. Despite being known about for over 60 years, the data concerning SARTB are still limited and relatively little is known about the associated risk factors. However, SARTB certainly appears to be an activity that parents and teachers should be made more aware of even if the prevalence of such activity among children and adolescents is low.
Dr. Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
Further reading
Aggrawal A. (2009). Forensic and Medico-legal Aspects of Sexual Crimes and Unusual Sexual Practices. Boca Raton: CRC Press.
Busse, H., Harrop, T., Gunnell, D. & Kipping, R. (2015). Prevalence and associated harm of engagement in self-asphyxial behaviours (‘choking game’) in young people: A systematic review. Archives of Disease in Childhood, doi:10.1136/archdischild-2015-308187.
Drake, J.A., Price, J.H., Kolm-Valdivia, N. & Wielinski, M. (2010). Association of adolescent choking game activity with selected risk behaviors. Academic Pediatrics, 10, 410-416.
Egge, M.K., Berkowitz, C.D., Toms, C. & Sathyavagiswaran, L. (2010). The choking game: A cause of unintentional strangulation. Pediatric Emergency Care, 26, 206-208.
Griffiths, M.D. (2015). A brief review of self-asphyxial risk-taking behaviour in adolescents. Education and Health, 33, 59-61.
Howard, P., Leathart, G. L., Dornhorst, A.C., & Sharpey-Schafer, E.P. (1951). The mess trick and the fainting lark. British Medical Journal, 2, 382-384.
MacNab, A.J., Deevska, M., Gagnon, F., Cannon, W.G. & Andrew, T (2009). Asphyxial games or “the choking game”: A potentially fatal risk behavior. Injury Prevention, 14, 45-49.
Shlamovitz, G.Z., Assia, A., Ben-Sira, L. & Rachmel, A. (2003). “Suffocation roulette”: A case of recurrent syncope in an adolescent boy. Annals of Emergency Medicine, 41, 223-226.
Toblin, R.L., Paulozzi, L.J., Gilchrist, J. & Russell, P.J. (2008). Unintentional strangulation deaths from the “choking game” among youths aged 6-19 years -United States, 1995-2007. Journal of Safety Research, 39, 445-448.
Urkin, J. & Merrick, J. (2006). The choking game or suffocation roulette in adolescence (editorial). International Journal of Adolescent Medicine and Health, 18, 207-208.
