Prevalence and characteristics of choking/strangulation during sex: Findings from a probability survey of undergraduate students

Herbenick, Debby; Fu, Tsu‐Tan; Patterson, Callie; Gonzalez, Yael R Rosenstock; Luetke, Maya; Svetina, Dubravka; Eastman-Mueller, Heather; Guerra‐Reyes, Lucia; Rosenberg, Molly

doi:10.1080/07448481.2021.1920599

Cited by 25 publications

(11 citation statements)

References 49 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Acute and chronic effects of stress have been linked to widespread changes in activation and connectivity in the brain (van Oort et al, 2017 ; Kunimatsu et al, 2020 ). That said, the majority of sexual choking events have been described as consensual, wanted, and often initiated by women (Herbenick et al, 2021b , d , e ). Fifth, we did not assess tendencies to participate in risky sex or sensation-seeking behaviors, which may be contributing factors to engaging in sexual choking.…”

Section: Discussionmentioning

confidence: 99%

“…Strangulation/choking as a partnered sex behavior is disproportionately experienced by women. For instance, in a recent undergraduate probability survey study, nearly one-third of undergraduate women reported being choked by a partner during their most recent sexual event that included oral, vaginal, or anal sex, compared to only 8% of men (Herbenick et al, 2021b ). Further, 58% of undergraduate women reported a lifetime history of at least one instance of being choked during partnered sexual activities, with 34% reporting more than five lifetime choking experiences (Herbenick et al, 2021a ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Frequent and Recent Non-fatal Strangulation/Choking During Sex and Its Association With fMRI Activation During Working Memory Tasks

Huibregtse

Alexander

Klemsz

et al. 2022

Front. Behav. Neurosci.

Self Cite

View full text Add to dashboard Cite

Being strangled, or “choked,” by a sexual partner has emerged as a prevalent, often wanted and consensual sexual behavior among adolescent and young adult women, yet the neurological consequences of repeated exposure to this behavior are unknown. The objective of the study was to examine the association between a history of repeated, recent choking/strangling episodes during sex and fMRI activation during working memory tasks in young adult women. This case-control study involved young adult women (18–30 years old) at a large, public university, and consisted of two study groups: a choking group consisting of participants who were recently and frequently choked/strangled during sex by a partner (≥4 times in the past 30 days) and a choking-naïve (control) group who had never been choked/strangled during sex. Participants completed two variations of the N-back (0-back, 1-back, and 2-back) working memory task during functional magnetic resonance imaging (fMRI): verbal and visual N-back tasks. Data from 20 participants per group were available for analysis. Between-group differences for accuracy and reaction time were not significant for either variation of the N-back task. Significant differences in fMRI activation patterns were detected between the choking and the choking-naïve groups for the three contrasts of interest (1-back > 0-back, 2-back > 0-back, and 2-back > 1-back). The choking group exhibited increased activation in multiple clusters relative to the choking-naïve group for the contrasts between the 1-back and 2-back conditions compared to the 0-back conditions (e.g., superior frontal gyrus, corpus callosum). However, the choking-naïve group exhibited increased activation relative to the choking group in several clusters for the 2-back > 1 back contrast (e.g., splenium, middle frontal gyrus). These data indicate that recent, frequent exposure to partnered sexual strangulation is associated with different neural activation patterns during verbal and visual working memory tasks compared to controls, suggesting that being choked/strangled during sex may modify the allocation of neural resources at increasing levels of cognitive load. Further investigation into the neurologic effects of this sexual behavior is warranted, given the prevalence of sexual choking among adolescent and young adult women.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Frequent and Recent Non-fatal Strangulation/Choking During Sex and Its Association With fMRI Activation During Working Memory Tasks

Huibregtse

Alexander

Klemsz

et al. 2022

Front. Behav. Neurosci.

Self Cite

View full text Add to dashboard Cite

show abstract

“…One small audit of 48 patients referred for imaging after forensic examination due to non-fatal strangulation noted internal injury in five patients (including three patients with neck artery dissections). 19 Beyond the intimate partner violence context, we note that non-fatal strangulation is also used in consensual sexual practices, 20 including chemsex and group sex subcultures, and has been used in autoerotic contexts, violent pornography and dangerous adolescent 'choking games', 21 leading to accidental death. 22 Further discussion of non-fatal strangulation in these contexts, as well as injuries seen in near-hangings and hangings in a mental health or homicidal context (addressed in the forensic medical literature), 23 is beyond the scope of this article.…”

Section: Epidemiology and Significancementioning

confidence: 99%

‘I thought I was about to die’: Management of non-fatal strangulation in general practice

2022

View full text Add to dashboard Cite

BackgroundAwareness of the significance of non-fatal strangulation is increasing in health and justice settings. While approximately half of patients strangled will sustain no immediate physical injury, strangulation has potential significant sequelae such as carotid dissection, hypoxic brain injury and laryngeal injury. Non-fatal strangulation by an intimate partner increases homicide risk by 7.48 times. General practitioners have a key role in identification, education and appropriate treatment.'I thought I was about to die'

show abstract

“…Among young U.S. adults, sexual choking is now a frequent, normative part of consensual sex, with 1 in 3 college women having been choked the most recent time they had sex (Herbenick et al, 2021a). Given its prevalence and frequency, sexual choking may be the most common form of choking/strangulation in the U.S., and it disproportionately impacts women.…”

Section: Physical Responses Of Choking/strangulationmentioning

confidence: 99%

“…Most people will have insufficient training to attend to someone should they lose consciousness, experience a seizure or cardiac arrest, or become unresponsive while being choked. Apart from occurrences in public sex locations, sexual choking likely occurs in private and not uncommonly by people who have just met and/or are using alcohol or other substances (Herbenick et al, 2021a). Some people may also point out that various forms of choking/ strangulation routinely occur in sports such as mixed martial arts (MMA); indeed, there is an emerging and controversial literature examining potential neurocognitive effects of having been choked/strangled as part of MMA (e.g., Lim et al, 2019;Stacey et al, 2021;Stellpflug, 2019).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students

Herbenick

Eastman-Mueller

et al. 2022

Arch Sex Behav

Self Cite

View full text Add to dashboard Cite

Although sexual choking is now prevalent, little is known about how people engage in choking in terms of frequency, intensity, method, or potential health sequelae. In a campus-representative survey of undergraduate and graduate students, we aimed to: (1) describe the prevalence of ever having choked/been choked as part of sex; (2) examine the characteristics of choking one's sexual partners (e.g., age at first experience, number of partners, frequency, intensity, method); (3) examine the characteristics of having been choked during sex; and (4) assess immediate responses of having been choked including the extent to which frequency and method (e.g., hand, ligature, limb) of having been choked predicts the range of responses endorsed by participants. A total of 4254 randomly sampled students (2668 undergraduate, 1576 graduate) completed a confidential online survey during Spring 2021. The mean age of first choking/being choked was about 19, with more undergraduates than graduate students reporting first choking/ being choked in adolescence. Women and transgender/gender non-binary participants were significantly more likely to have been choked than men. Participants more often reported the use of hands compared to limbs or ligature. Common responses to being choked were pleasurable sensations/euphoria (81.7%), a head rush (43.8%), feeling like they could not breathe (43.0%), difficulty swallowing (38.9%), unable to speak (37.6%), and watery eyes (37.2%). About 15% had noticed neck bruising and 3% had lost consciousness from being choked. Greater frequency and intensity of being choked was associated with reports of more physical responses as was use of limb (arm, leg) or ligature.

show abstract

Prevalence and characteristics of choking/strangulation during sex: Findings from a probability survey of undergraduate students

Cited by 25 publications

References 49 publications

Frequent and Recent Non-fatal Strangulation/Choking During Sex and Its Association With fMRI Activation During Working Memory Tasks

Frequent and Recent Non-fatal Strangulation/Choking During Sex and Its Association With fMRI Activation During Working Memory Tasks

‘I thought I was about to die’: Management of non-fatal strangulation in general practice

Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students

Contact Info

Product

Resources

About