*The following is excerpted from an online article posted on HealthDay.
About 4 percent of U.S. teens surveyed admit to trying the "choking game" -- a potentially deadly game of temporary strangulation.
And new research suggests that kids who "play" the game alone are much more likely to harbor thoughts of suicide.
The so-called choking game is the practice of using hands, fingers or external wrapping materials -- such as a belt, tie or noose -- to apply strong pressure against the carotid arteries lining either side of the neck.
Located on the right and left side of the windpipe, these arteries are critical conveyors of blood and oxygen to the brain. By interrupting the usual blood flow, and then suddenly removing pressure to restore flow, individuals reportedly trigger a short-lived feeling of euphoria.
But, the practice carries a high risk for asphyxiation, loss of consciousness, and even death. And the risks grow when "players" act alone without anyone around to intervene and stop an out-of-control strangulation process, the study authors said.
"We know from earlier research that youth who engage in the choking game also report higher levels of suicidal thoughts than those who don't participate in the choking game at all," said study co-author Sarah Knipper.
"This new study tells us that within that group of kids, those who participate alone are even more likely to have suicidal thoughts," added Knipper. "[They're] five times more likely than those who participate in a group."
Knipper is a school health epidemiologist with the adolescent and school health program in the Oregon Public Health Division of the Oregon Health Authority in Portland.
The study authors pointed to prior estimates suggesting that somewhere between 5 percent and 11 percent of American children have tried the choking game at least once. Fatality figures remain unclear, however, as related deaths are often lumped in as undefined suicides or accidents.
The new study looked at mental health data on roughly 21,000 students in grades 8 and 11 in Oregon. The information was collected in 2011 and 2013 by the Oregon Healthy Teens Survey. Oregon is the only state that routinely monitors choking game behavior in its surveys, the study authors said.
The researchers found that nearly 4 percent of both boys and girls said they had participated in a choking game at some point in their lives. Of these, about 18 percent said they had done so by themselves.
What's more, teens who had tried the practice alone were almost five times more likely to have thoughts of suicide than those who had done it in groups, and more than twice as likely to say they were in poor mental health overall.