The role of primary care physicians in preventing and managing dangerous games among adolescents: A qualitative study - 16/12/25

Doi : 10.1016/j.arcped.2025.10.009

Chantal Stheneur ^a,^b,^c,^g,^⁎ , Sirine Sandli ^d,^e, Solène Sirieys ^f, Alexandra Loisel ^b,^d,^f,^g, Marie Rose Moro ^b,^d,^f,^g, Rahmethnissah Radjack ^b,^d,^f,^g, Anne Li ^b,^d,^f,^g
^a University Center for Adolescent and Young Adult Health, Fondation Santé des Etudiants de France, Paris, 75014, France
^b CESP, UVSQ Inserm U1018 Team DevPsy, Villejuif, France
^c UVSQ, UFR Simone Veil, University Paris-Saclay, France
^d Maison de Solenn, Maison des Adolescents, AP-HP, Cochin Hospital, 97 Boulevard de Port-Royal, 75014 Paris, France
^e Sorbonne Paris Nord University, 93430 Villetaneuse, France
^f PCPP, Paris Cité University, 92100 Boulogne-Billancourt, France
^g French Clinical Research Group in Adolescent Medicine and Health, Paris, France

^⁎Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Tuesday 16 December 2025

Highlights

•	There is a lack of knowledge among physicians regarding dangerous games.
•	This study shows that players’ profiles are characterized by psychological vulnerability, peer pressure, and social media, with no clear suicidal intent.
•	Although schools are the primary setting for prevention and management, physicians also play a pivotal role in these efforts.

Le texte complet de cet article est disponible en PDF.

Abstract

Background

Dangerous games are playful activities engaged in by children and adolescents, posing significant risks to their health. Various types exist, aggressive games, challenge games, and asphyxiation games, with the ‘Choking game’ (where individuals attempt strangulation) being the most well-known. The prevalence of dangerous games among adolescents is increasing, yet it remains a little-known and studied societal issue among healthcare professionals.

Objective

To assess physicians’ role in the prevention and management of dangerous games.

Methods and Settings

Qualitative semi-structured interviews with general practitioners, pediatricians, and psychiatrists were performed. All data were transcribed verbatim and analyzed using a content analysis approach.

Results

We interviewed 6 general practitioners, 6 psychiatrists, and 5 pediatricians practicing in the Paris region. Three main themes emerged from the data: 1) physicians' lack of knowledge about the topic due to insufficient training, 2) players’ profiles characterized by psychological vulnerability, influence of peer pressure and social media, with no clear suicidal intent, and 3) the need to primarily focus on screening, prevention, and management at the school level.

Conclusion

This study highlights a critical public health issue. Physicians' roles are essential for identifying psychological vulnerabilities and raising awareness among youth of the associated risks. However, prevention requires close collaboration between the educational sector and healthcare professionals, who could benefit from targeted training and regular interventions within educational institutions.

Le texte complet de cet article est disponible en PDF.

Keywords : Dangerous behaviors, Choking, Primary care, Adolescents, Prevention

Abbreviations : APEAS, COREQ