University of North Dakota UND Scholarly Commons Theses and Dissertations Theses, Dissertations, and Senior Projects January 2018 Characteristics Of Individuals Who Participate In Autoerotic Asphyxiation Practices: An Exploratory Study Lauren Chapple Follow this and additional works at: https://commons.und.edu/theses Recommended Citation Chapple, Lauren, "Characteristics Of Individuals Who Participate In Autoerotic Asphyxiation Practices: An Exploratory Study" (2018). Theses and Dissertations. 2185. https://commons.und.edu/theses/2185 This Dissertation is brought to you for free and open access by the Theses, Dissertations, and Senior Projects at UND Scholarly Commons. It has been accepted for inclusion in Theses and Dissertations by an authorized administrator of UND Scholarly Commons. For more information, please contact [email protected]. CHARACTERISTICS OF INDIVIDUALS WHO PARTICIPATE IN AUTOEROTIC ASPHYXIATION PRACTICES: AN EXPLORATORY STUDY by Lauren Elise Chapple, M.A. Bachelor of Arts, Bay Path University, 2007 Master of Arts, The Chicago School of Professional Psychology, 2010 A Dissertation Submitted to the Graduate Faculty of the University of North Dakota in partial fulfillment of the requirements for the degree of Doctor of Philosophy Grand Forks, North Dakota August 2018 Copyright 2018 Lauren Elise Chapple ii PERMISSION Title Characteristics of Individuals Who Participate in Autoerotic Asphyxiation Practices: An Exploratory Study Department Counseling Psychology and Community Services Degree Doctor of Philosophy In presenting this dissertation in partial fulfillment of the requirements for a graduate degree from the University of North Dakota, I agree that the library of this University shall make it freely available for inspection. I further agree that permission for extensive copying for scholarly purposes may be granted by the professor who supervised my dissertation work or, in her absence, by the Chairperson of the department or the dean of the School of Graduate Studies. It is understood that any copying or publication or other use of this dissertation or part thereof for financial gain shall not be allowed without my written permission. It is also understood that due recognition shall be given to me and to the University of North Dakota in any scholarly use which may be made of any material in my dissertation. Lauren Elise Chapple August 2018 iv TABLE OF CONTENTS LIST OF TABLES ......................................................................................................... ix ACKNOWLEDGMENTS ............................................................................................. x ABSTRACT ................................................................................................................... xi CHAPTER I. INTRODUCTION .................................................................................... 1 Background of the Problem ............................................................. 2 Assumptions of the Present Study ................................................... 4 Definitions of Relevance to this Study ............................................ 7 II. LITERATURE REVIEW ......................................................................... 8 Autoerotic Asphyxiation (AeA): Defining the Construct ............... 8 Differentiating AeA from Other Similar Asphyxiation-Related or Suicide Deaths ............................................................................ 9 Traumatic Asphyxia ....................................................................... 12 Asphyxia Solo and Partnered Sexual Activities ..................... 13 Airplay, BDSM, Kink, and AeA: Definitions and Intersectionality .............................................................................. 13 Methodology: Typical AeA Method Prevalence Definitions, Descriptions, and Rates .................................................................. 15 Suffocation, Smothering, Hanging, and Strangulation Practices .................................................................................. 16 v Water, Liquid, and Drowning Practices ................................. 17 Chemically Induced Asphyxiation Practices .......................... 17 Other Significant AeA Methods: Prevalence, Definitions, and Descriptions............................................................................... 18 Extant Prevalence Rates of AeA ..................................................... 20 Asphyxiation Practices, Behaviors, and Crimes Excluded from the Present Study ............................................................................. 22 The Use of Sexual Positivity in Research ........................................ 23 The Use of Sex Positivity in Research ............................................. 24 Sex and Sexuality as Dynamic Paradigms ............................ 26 Summary ......................................................................................... 28 Purpose ............................................................................................ 29 III. METHODS ................................................................................................ 32 Participants ....................................................................................... 32 Sampling Procedures ....................................................................... 35 Research Instruments ...................................................................... 36 Demographic and AeA Engagement Information .................. 36 Patient Health Questionnaire .................................................. 37 Open-Ended Qualitative Data ................................................ 37 Statistical Analyses, Goals, and Domains Addressed ..................... 38 IV. RESULTS ................................................................................................ 40 Engagement in the Target Behaviors ............................................. 40 Main Analyses and Hypothesis Testing ......................................... 42 vi Frequencies and Prevalence Findings ..................................... 42 Between-Group Differences on Mental Health Symptom Endorsement ........................................................................... 45 The Absence of Largescale Suicidal Ideation ......................... 48 Chi-Square Tests of Independence ......................................... 49 Gender of Participants............................................................. 49 Age of participants .................................................................. 50 Sexual Orientation of Participants .......................................... 50 Ethnicity of Participants .......................................................... 50 Marital Status of Participants .................................................. 51 Methods of Breathplay Participants Tried .............................. 51 Methods of Breathplay Participants Preferred ........................ 51 Motivations to Engage in AeA ............................................... 52 Why Participants Will Not Engage in AeA ............................ 56 Why Participants Chose to Engage in AeA ............................ 57 Motivations to Not Engage in AeA ........................................ 57 Support Sought for Oxygen Restriction Practices .................. 59 Safety Measures Used During Autoerotic Asphyxiation Practices ................................................................................. 60 Preferences in Pornography across Breathplay Participants .............................................................................. 63 Preferred Method of Oxygen Restriction Practices ................ 64 V. DISCUSSION ........................................................................................... 65 Interpretation of Findings ................................................................ 65 vii Research Questions and Hypotheses ............................................... 66 Autoerotic Asphyxiation Practitioner Characteristics ............ 69 Motivations to Engage in AeA .............................................. 70 Motivations to Not Engage in AeA ....................................... 71 Support Sought for Oxygen Restriction Practices ................. 72 The Absence of Largescale Suicidal Ideation ....................... 73 Safety Measures Used During Autoerotic Asphyxiation Practices ................................................................................. 74 Preferred Method of Oxygen Restriction Practices ............... 75 Limitations ....................................................................................... 75 Clinical Implications ....................................................................... 77 Recommendations for Future Research .......................................... 79 Conclusion ....................................................................................... 81 APPENDICES ..................................................................................................... 83 Appendix A: Letter to Participants ............................................................... 84 Appendix B: Study Questionnaire ................................................................ 88 Appendix C: Demographics Questionnaire .................................................. 95 REFERENCES .................................................................................................... 97 viii LIST OF TABLES Table Page 1. 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