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I remember when I was in primary school, there was a popular game where you press the chest of another person, cause suffocation and the other person will faint and fall. It was before internet was common and no smart phones. I heard story that kid has died, but I could never verify. My opinion is that tragedy happens with or without internet, internet spreads news faster and further.

«Youth who participate alone in the choking game are a particularly high risk group, exhibiting substantially higher rates of suicidal ideation and poorer mental health compared with youth who participate in the choking game in a group.»

I would guess her risk was elevated.

https://pediatrics.aappublications.org/content/138/6/e201607...

That doesn't mean much without knowing why they did it while alone. What does "participation" in that context even mean? And it doesn't change the possibility that a "challenge" on social media had an influence.

Any guesses about the risk she was in a priori are not relevant, and cannot be determined from that paper.

No, they are wondering if this type of activity has been going on all along but now the internet just informs us of the case by case.