Are psychological distress, substance misuse, and sexual sensation seeking associated with autoerotic asphyxiation-related distress?

Autoerotic asphyxiation (AEA) involves enhancing sexual arousal by deliberately self-inducing a reduction of oxygen to the brain. Most studies of AEA have focused on those who have expressed distress or who have died from the practice. The present study explores correlates of AEA-related distress in a community sample, focusing on self-reported measures of psychological distress, substance misuse, and sexual sensation seeking. Individuals who expressed an interest in AEA (n = 165) participated in an online anonymous survey. Findings revealed a significant positive association between AEA-related distress and symptoms of depression, and a significant negative association between AEA-related distress and sexual sensation seeking. Both depression and sexual sensation seeking remained associated with AEA-related distress at the multivariate level. The findings are consistent with prior literature on AEA that suggests comorbidity with depression and highlights the importance of psychological screening when people present to clinicians due to AEA, particularly for depression. Contrary to our hypothesis, those with higher sexual sensation seeking reported lower levels of AEA-related distress. Future research on AEA-related distress may benefit from using a sexual sensation seeking measure that better assesses sexual dysregulation.