An Online Wellness Magazine produced by The University of Texas Health Science Center at Houston (UTHealth)

Truth or Dare

Serious injuries — or worse — make dares and challenges no laughing matter

Truth or Dare

“Everybody’s doing it!” is a rallying cry of adolescents everywhere, with the parental retort being, "Well, if everyone jumped off a cliff, would you, too?” 

It turns out the likely answer is yes.

An increasing number of youths take copycat risks, egged on by YouTube and social media. And, alas, kids have come a long way from the 50s and 60s, when they crammed themselves into phone booths or VW “Bugs” (both of which are in short supply these days).

Today, daredevils try everything from ingesting cinnamon powder or AA batteries to chugging gallons of water or immersing themselves in ice and salt.

“Challenges run as far as someone could possibly imagine, and new ones come up so fast, I can’t keep up with them all,” says Richard N. Bradley, MD, associate professor of emergency medicine at The University of Texas Health Science Center at Houston (UTHealth) Medical School.

At first glance, it’s hard to imagine why scarfing cinnamon or gulping gallons of water could harm you. But many trendy challenges can lead to permanent internal injuries — even death. Cinnamon particles damage lungs; too much ingested water dilutes internal salt levels needed to function; choking cuts blood and air flow; and toxins from huffing or binge drinking slow body actions, causing unconsciousness. (See below for more information on common dares and challenges.)

You’d never know it from the videos. “It’s like the cliché, ‘Cool guys don’t look at explosions,’ ” Bradley says. “Most of what you see is artificial or manipulated and does not reflect reality. Fires on TV and in movies don’t have smoke, which can kill you.”

The omnipresent images of extreme sports and special effects — even faux explosions on phone apps — glamorize risk-taking and numb us to repercussions. They plant the seed in teens’ minds: Hey that looks fun. Why don’t I try it?

Kids do the darndest (dangerous) things

By their early teens, half of kids confess to taking dares, according to a Pediatrics Journal survey, and 53.5 percent of boys — versus 42.8 percent of girls — succumbed to the impulse. Lead author of the survey, Susan G. Millstein, MD, reported that greater attention should be paid to this younger group and their health-risk behaviors.

That such actions occur mostly between the ages of 11 to 22 is no surprise to researchers — or parents. That’s when young people are most likely to chafe against parental and societal restraints. And their not-fully-matured brains heighten the emotion-inducing amygdale, but not the more sensible results-focused cortex.

Media alert

Fanning the flames are more than 50,000 YouTube videos that depict others — even Illinois governor Pat Quinn — attempting the cinnamon challenge, reports a recent study also in Pediatrics.

One video alone was viewed 19 million times.

Further proof that interest in this decade-old dare has sky-rocketed: Google recorded 2.4 million hits for the topic in 2012, up from 200,000 in 2009.

Injuries and hospitalizations keep pace. Calls made to the American Association of Poison Control Centers for the cinnamon challenge rose from 51 in 2011 to 222 in 2012.

The Internet wasn’t first to fuel such dangers. “Children will learn from and imitate aggressive models seen on film,” reported Joel Daven, MD, who authored the 1976 study, “The Consequences of Imitative Behavior in Children: The Evel Knievel Syndrome.” “While there is little question that thrill-seeking daredevils have been a part of our society since the earliest times, never in the history of man have the activities of these ‘heroes’ been so promptly and realistically reported for viewing by the children of the nation.

“Had Evel Knievel not been glorified by the news media, the bicycle accidents reported … might have been prevented,” Daven added.

As with YouTube, repercussions, punishment and injuries were not shown, but the kids (ages 11 to 15) who attempted to recreate Knievel’s feats of jumping over lines of cars on a bike broke bones, lost teeth and ended up in emergency rooms.

Ways to squelch temptation

Given that controlling kids 24 hours a day is an unattainable challenge of its own, what’s a concerned adult to do? Here are some suggestions:

  • Give room to chat. “Parents need to have an open conversation with their children to help them think through activities and their consequences,” says Bradley. “Point out that videos cut off as soon as the stunt ends — and they don’t show broken bones and disfiguring injuries. Remind kids that helmets and safety gear can be the difference between walking away with minimal injuries or a permanently disabling head injury.” Also, brainstorm with your kids on how to handle peer pressure when they’re pressed to do stupid things.
  • Don't coddle. "Risk-taking behavior is a normal component of cognitive development," says Ronald J. Peters Jr., DrPH, associate professor of health promotion and behavioral sciences at UTHealth School of Public Health. "Allowing children to explore independent decision making is an essential step in the development of innovative thinking. Parents should keep in mind that the fear of punishments does not always outweigh the perceived peer approval gained by engaging in risk-taking behavior."
  • Curb exposure. The American Academy of Pediatrics recommends limiting total screen time in front of a TV or computer to no more than one to two hours a day for children older than 2 years. Place computers in rooms where you can monitor your children, and install software to track websites and block offensive sites and material. “But be aware many kids know how to circumvent such filters,” says Michelle S. Barratt, MD, MPH, professor of pediatrics at UTHealth Medical School. “And avoid blanket statements like, ‘You’re not allowed,’ because there’ll be a push-back.”
  • Educate yourself. Surf the Internet with your children — and, on your own, search for such terms as “Teen Dare” on YouTube so you know what’s out there, Barratt says.
  • Divert the spotlight. “Kids want to have something that gives them excitement, energy and risk,” Barratt says. “Suggest healthy ways: debate club, school plays and sports.  Encourage them to do something that’s more long-term — and fun — than swallowing cinnamon.”

And who knows? Relying on another adage just might make them think twice: Curiosity killed the cat.

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