Limited research has been conducted regarding motivations for practicing the fainting game, although thrill seeking has been identified as a risk factor,[3] as has the perception that it is a low-risk activity.
Steve Field, chairman of the Royal College of General Practitioners in London,[6] claims that the fainting game is pursued primarily by children and teens "to get a high without taking drugs."
Apart from the direct restriction of blood to the brain there are two other significant responses produced by pressing on the neck: The second mechanism requires hyperventilation (forced overbreathing) until symptoms of hypocapnia such as tingling, light-headedness or dizziness are felt, followed by a breath-hold.
The symptoms of alkalosis are neuromuscular irritability, muscular spasms, tingling and numbness of the extremities and around the mouth, and a dizziness, or giddiness, often interpreted as a sense of euphoria.
This vasoconstriction appears to be made even worse by a sudden increase in blood pressure caused by squeezing or holding the breath "hard".
[citation needed] In both strangulation and self-induced hypocapnia blackouts the victim may experience dreaming or hallucinations, though fleetingly, and regains consciousness with short-term memory loss and involuntary movement of their hands or feet.
[15] Statistics on fatalities and neurological damage are controversial; no definitive, empirical study exists although the indications are that the practice is a significant contributor to death and disability, particularly among male juveniles in most developed countries.
[13] These include discussion of the game, bloodshot eyes, marks on the neck, severe headaches, disorientation after spending time alone, ropes, scarves, and belts tied to bedroom furniture or doorknobs or found knotted on the floor, and unexplained presence of things like dog leashes, choke collars and bungee cords.
In the season 5 episode of Criminal Minds called "Risky Business," a serial killer uses an online version of the choking game to get teenagers to accidentally commit suicide.