Psycho-Social Correlates of Altered Consciousness from Intentional Choking in Youth and Young Adults Experiencing Homelessness

Research Objectives: In this study, we aimed to determine the psycho-social differences between youth who experienced intentional choking with or without altered consciousness.

Design: A total of 53 eligible youth participated in this study by completing a one-time survey.

Setting: The setting for this study was a drop-in services center for youth experiencing homelessness.

Participants: Participants were drawn from a sample of youth and young adults ages 14-24 experiencing homelessness who smoke combustible tobacco. Youth were included in the current study if they experienced an incident of intentional choking at least once, measured by the question “How many times in your life have you ever been choked, strangled or made to feel like you couldn’t breathe by another person trying to scare, harm, or control you? “.

Interventions: Not Applicable

Main Outcome Measures: Participants were administered the Brain Injury Severity Assessment, where participants who endorsed any of these symptoms were defined as having altered consciousness (n=42) and participants who had none of these symptoms were defined as no altered consciousness (n=11). Participants also completed the Behavioral Risk Factor Surveillance System (BRFSS) Adverse Childhood Experiences (ACEs) Scale, Perceived Stress Scale, Sciences of Behavior Change (SOBC) Brief COPE, SOBC Structured Interview for Disorders of Extreme Stress (SIDES) Affect Dysregulation Scale, and SOBC Emotion Regulation Strategies Scale.

Results: Participant groups differed significantly by race (0.0070) and, while gender was nonsignificant, all 3 transgender/nonbinary participants experienced altered consciousness. Participants who experienced altered consciousness experienced more ACEs (p-value = 0.0022) and had greater perceived stress continuously (0.0004) and categorically (0.0265) than those who did not experience altered consciousness. They had higher self-distraction (0.0460), self-blame (0.0050), difficulty with self-regulation (0.0217) and anger management (0.0156), and greater dysregulated expression (0.0492).

Conclusions: Experiencing altered consciousness related to intentional choking is associated with long-term sequalae and functional impairments compared to those without altered consciousness.

Author(s) Disclosures: The authors have no conflicts of interest to disclose.