1
|
Hou J, Huibregtse ME, Alexander IL, Klemsz LM, Fu T, Rosenberg M, Fortenberry JD, Herbenick D, Kawata K. Structural brain morphology in young adult women who have been choked/strangled during sex: A whole-brain surface morphometry study. Brain Behav 2023; 13:e3160. [PMID: 37459254 PMCID: PMC10454256 DOI: 10.1002/brb3.3160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 07/01/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023] Open
Abstract
INTRODUCTION Being choked/strangled during partnered sex is an emerging sexual behavior, particularly prevalent among young adult women. Using a multiparameter morphometric imaging approach, we aimed to characterize neuroanatomical differences between young adult women (18-30 years old) who were exposed to frequent sexual choking and their choking naïve controls. METHODS This cross-sectional study consisted of two groups (choking [≥4 times in the past 30 days] vs. choking-naïve group). Participants who reported being choked four or more times during sex in the past 30 days were enrolled in the choking group, whereas those without were assigned to the choking naïve group. High-resolution anatomical magnetic resonance imaging (MRI) data were analyzed using both volumetric features (cortical thickness) and geometric features (fractal dimensionality, gyrification, sulcal depth). RESULTS Forty-one participants (choking n = 20; choking-naïve n = 21) contributed to the final analysis. The choking group showed significantly increased cortical thickness across multiple regions (e.g., fusiform, lateral occipital, lingual gyri) compared to the choking-naïve group. Widespread reductions of the gyrification were observed in the choking group as opposed to the choking-naïve group. However, there was no group difference in sulcal depth. The fractal dimensionality showed bi-directional results, where the choking group exhibited increased dimensionality in areas including the postcentral gyrus, insula, and fusiform, whereas decreased dimensionality was observed in the bilateral superior frontal gyrus and pericalcarine cortex. CONCLUSION These data in cortical morphology suggest that sexual choking events may be associated with neuroanatomical alteration. A longitudinal study with multimodal assessment is needed to better understand the temporal ordering of sexual choking and neurological outcomes.
Collapse
Affiliation(s)
- Jiancheng Hou
- Research Center for Cross‐Straits Cultural DevelopmentFujian Normal UniversityFuzhouChina
- Department of KinesiologyIndiana University School of Public Health‐BloomingtonBloomingtonIndianaUSA
| | - Megan E. Huibregtse
- Department of KinesiologyIndiana University School of Public Health‐BloomingtonBloomingtonIndianaUSA
- Department of Psychiatry and Behavioral SciencesEmory University School of MedicineAtlantaGeorgiaUSA
| | - Isabella L. Alexander
- Department of KinesiologyIndiana University School of Public Health‐BloomingtonBloomingtonIndianaUSA
| | - Lillian M. Klemsz
- Department of KinesiologyIndiana University School of Public Health‐BloomingtonBloomingtonIndianaUSA
| | - Tsung‐Chieh Fu
- Department of Applied Health Science, Indiana University School of Public HealthIndiana UniversityBloomingtonIndianaUSA
- The Center for Sexual Health Promotion, Indiana University School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - Molly Rosenberg
- Department of Epidemiology and Biostatistics, Indiana University School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - James Dennis Fortenberry
- Department of Pediatrics, Indiana University School of MedicineIndiana UniversityIndianapolisIndianaUSA
| | - Debby Herbenick
- Department of Applied Health Science, Indiana University School of Public HealthIndiana UniversityBloomingtonIndianaUSA
- The Center for Sexual Health Promotion, Indiana University School of Public HealthIndiana UniversityBloomingtonIndianaUSA
| | - Keisuke Kawata
- Department of KinesiologyIndiana University School of Public Health‐BloomingtonBloomingtonIndianaUSA
- Program in NeuroscienceThe College of Arts and SciencesIndiana UniversityBloomingtonIndianaUSA
| |
Collapse
|
2
|
Herbenick D, Guerra-Reyes L, Patterson C, Wilson J, Rosenstock Gonzalez YR, Voorheis E, Whitcomb M, Kump R, Theis E, Rothman EF, Nelson KM, Maas MK. #ChokeMeDaddy: A Content Analysis of Memes Related to Choking/Strangulation During Sex. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1299-1315. [PMID: 36526942 PMCID: PMC9757635 DOI: 10.1007/s10508-022-02502-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 11/04/2022] [Accepted: 11/30/2022] [Indexed: 05/11/2023]
Abstract
Recent research indicates that some young people initially learn about sexual choking through Internet memes. Thus, a qualitative content analysis was performed on 316 visual and textual memes collected from various social media websites and online searches to assess salient categories related to choking during sex. We identified nine main categories: communication, gendered dynamics, choking as dangerous, choking as sexy, sexualization of the nonsexual, shame and worry, romance/rough sex juxtaposition, choking and religious references, instructional/informational. Given that memes, through their humor, can make difficult topics more palatable and minimize potential harm in the phenomenon they depict, more concerted, synergistic effort that integrates media literacy into sexuality education programming on the potential risks that may ensue for those engaging in sexual choking is warranted.
Collapse
Affiliation(s)
- Debby Herbenick
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA.
- The Center for Sexual Health Promotion, Indiana University School of Public Health, SPH 116, Indiana University, Bloomington, IN, 47405, USA.
| | - Lucia Guerra-Reyes
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, SPH 116, Indiana University, Bloomington, IN, 47405, USA
| | - Callie Patterson
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, SPH 116, Indiana University, Bloomington, IN, 47405, USA
| | - Jodi Wilson
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, SPH 116, Indiana University, Bloomington, IN, 47405, USA
| | - Yael R Rosenstock Gonzalez
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, SPH 116, Indiana University, Bloomington, IN, 47405, USA
| | - Eva Voorheis
- The Center for Sexual Health Promotion, Indiana University School of Public Health, SPH 116, Indiana University, Bloomington, IN, 47405, USA
| | - Maddy Whitcomb
- The Center for Sexual Health Promotion, Indiana University School of Public Health, SPH 116, Indiana University, Bloomington, IN, 47405, USA
| | - Rachel Kump
- The Center for Sexual Health Promotion, Indiana University School of Public Health, SPH 116, Indiana University, Bloomington, IN, 47405, USA
| | - Evan Theis
- The Center for Sexual Health Promotion, Indiana University School of Public Health, SPH 116, Indiana University, Bloomington, IN, 47405, USA
| | - Emily F Rothman
- Department of Occupational Therapy, Boston University, Boston, MA, USA
| | - Kimberly M Nelson
- Department of Community Health Sciences and Department of Psychiatry, Boston University, Boston, MA, USA
| | - Megan K Maas
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| |
Collapse
|
3
|
Herbenick D, Fu TC, Patterson C. Sexual Repertoire, Duration of Partnered Sex, Sexual Pleasure, and Orgasm: Findings from a US Nationally Representative Survey of Adults. JOURNAL OF SEX & MARITAL THERAPY 2023; 49:369-390. [PMID: 36151751 DOI: 10.1080/0092623x.2022.2126417] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
In a confidential U.S. nationally representative survey of 2,525 adults (1300 women, 1225 men), we examined participants' event-level sexual behaviors, predictors of pleasure and orgasm, and perceived actual and ideal duration of sex, by gender and age. Event-level kissing, cuddling, vaginal intercourse, and oral sex were prevalent. Sexual choking was more prevalent among adults under 40. While women and men reported a similar actual duration of sex, men reported a longer ideal duration. Participants with same-sex partners reported a longer ideal duration than those with other-sex partners. Finally, findings show that gendered sexual inequities related to pleasure and orgasm persist.
Collapse
Affiliation(s)
- Debby Herbenick
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
| | - Tsung-Chieh Fu
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
| | - Callie Patterson
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
| |
Collapse
|
4
|
Herbenick D, Fu TC, Eastman-Mueller H, Thomas S, Svetina Valdivia D, Rosenberg M, Guerra-Reyes L, Wright PJ, Kawata K, Feiner JR. Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3121-3139. [PMID: 35902430 PMCID: PMC9333342 DOI: 10.1007/s10508-022-02347-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 04/22/2022] [Accepted: 04/23/2022] [Indexed: 05/25/2023]
Abstract
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.
Collapse
Affiliation(s)
- Debby Herbenick
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA.
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, 47405, USA.
| | - Tsung-Chieh Fu
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, 47405, USA
| | - Heather Eastman-Mueller
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, 47405, USA
| | - Sally Thomas
- Office of Sexual Violence Prevention and Victim Advocacy, Indiana University, Bloomington, IN, USA
| | - Dubravka Svetina Valdivia
- Department of Counseling and Educational Psychology, School of Education, Indiana University, Bloomington, IN, USA
| | - Molly Rosenberg
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, 47405, USA
- Department of Epidemiology and Biostatistics, Indiana University School of Public, Health, Indiana University, Bloomington, IN, USA
| | - Lucia Guerra-Reyes
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, 47405, USA
| | - Paul J Wright
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, 47405, USA
- The Media School, Indiana University, Bloomington, IN, USA
| | - Keisuke Kawata
- Department of Kinesiology, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- Program in Neuroscience, Division of Clinical and Translational Neuroscience, College of Arts and Sciences, Indiana University, Bloomington, IN, USA
| | - John R Feiner
- Department of Anesthesia and Perioperative Care, University of California at San Francisco School of Medicine, San Francisco, CA, USA
| |
Collapse
|
5
|
Huibregtse ME, Alexander IL, Klemsz LM, Fu TC, Fortenberry JD, Herbenick D, Kawata K. Frequent and Recent Non-fatal Strangulation/Choking During Sex and Its Association With fMRI Activation During Working Memory Tasks. Front Behav Neurosci 2022; 16:881678. [PMID: 35722189 PMCID: PMC9201570 DOI: 10.3389/fnbeh.2022.881678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Megan E. Huibregtse
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN, United States
| | - Isabella L. Alexander
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN, United States
| | - Lillian M. Klemsz
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN, United States
| | - Tsung-chieh Fu
- Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, United States
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States
| | - J. Dennis Fortenberry
- Department of Pediatrics, School of Medicine, Indiana University, Indianapolis, IN, United States
| | - Debby Herbenick
- Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, United States
- Department of Applied Health Science, School of Public Health, Indiana University, Bloomington, IN, United States
| | - Keisuke Kawata
- Department of Kinesiology, School of Public Health, Indiana University, Bloomington, IN, United States
- Program in Neuroscience, College of Arts and Sciences, Indiana University, Bloomington, IN, United States
- *Correspondence: Keisuke Kawata
| |
Collapse
|
6
|
Herbenick D, Patterson C, Khan S, Voorheis E, Sullivan A, Wright P, Keene S. "Don't Just Randomly Grab Someone's Neck during Intercourse!" An Analysis of Internet Articles about Choking/Strangulation during Sex. JOURNAL OF SEX & MARITAL THERAPY 2022; 49:41-55. [PMID: 35570586 DOI: 10.1080/0092623x.2022.2065392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Sexual choking/strangulation has become prevalent among young U.S. adults, yet little is known about media articles that teach readers about choking. We conducted a content analysis of 27 Internet articles, examining how choking is described, information related to health risks and healthcare, and article accuracy. Most articles described choking in positive terms and indicated choking can be done safely or properly, even while acknowledging potential dangers. Only two articles indicated having undergone expert/medical review. Few gave information about signs that would warrant seeking healthcare. Sexuality professionals need to be aware of choking-related information and misinformation in online media articles.
Collapse
Affiliation(s)
- Debby Herbenick
- The Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Callie Patterson
- The Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Shahzarin Khan
- The Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Eva Voorheis
- The Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Anne Sullivan
- The Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Paul Wright
- The Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, USA
- The Media School, Indiana University, Bloomington, IN, USA
| | - Samantha Keene
- School of Social and Cultural Studies, The Institute of Criminology, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
| |
Collapse
|
7
|
Herbenick D, Guerra-Reyes L, Patterson C, Rosenstock Gonzalez YR, Wagner C, Zounlome NOO. "If Their Face Starts Turning Purple, You Are Probably Doing Something Wrong": Young Men's Experiences with Choking During Sex. JOURNAL OF SEX & MARITAL THERAPY 2022; 48:502-519. [PMID: 34873995 DOI: 10.1080/0092623x.2021.2009607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Choking/strangulation during sex has become prevalent in the United States. Yet, no qualitative research has addressed men's choking experiences. Through interviews with 21 young adult men, we examined the language men use to refer to choking, how they first learned about it, their experiences with choking, and consent and safety practices. Men learned about choking during adolescence from pornography, partners, friends, and mainstream media. They engaged in choking to be kinky, adventurous, and to please partners. While many enjoyed or felt neutral about choking, others were reluctant to choke or be choked. Safety and verbal/non-verbal consent practices varied widely.
Collapse
Affiliation(s)
- Debby Herbenick
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
| | - Lucia Guerra-Reyes
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
| | - Callie Patterson
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
| | - Yael R Rosenstock Gonzalez
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
| | - Caroline Wagner
- Department of Applied Health Science, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN, USA
| | - Nelson O O Zounlome
- Department of Educational, School, and Counseling Psychology, College of Education, University of Kentucky, Lexington, KY, USA
| |
Collapse
|