Strangulation is the Highest Predictor of Murder

The case captivated and terrified the country in 2021: Abuser Brian Laundrie murdered his 22-year-old girlfriend Gabby Petito in Wyoming during a cross-country camping trip. Her death came two weeks after Moab, Utah police were called when a witness saw Laundrie strike Petito. Even though police determined there had been an assault, Laundrie was not arrested and the couple was allowed to go on their way. A medical examiner later determined that Laundrie strangled Petito to death. Laundrie wrote his confession of the murder in a notebook before dying by suicide. 

There’s no doubt that Petito’s death could have been prevented had Moab police been more proactive, but there’s another glaring red flag that only few knew about. Petito’s mom, Nichole Schmidt, tells DomesticShelters.org that a friend of her daughter’s told her the murder wasn’t the first time Laundrie strangled Schmidt’s daughter. He’d done it before. 

“This was a close friend Gabby had confided in, but not someone I had spoken to before [Gabby’s murder]. The way her friend worded it, it sounded like something he liked to do,” Schmidt says. 

Unfortunately, there’s an all-too-common myth that “consensual” strangulation, or choking, during intimacy, somehow isn’t as dangerous or as much of a red flag as when strangulation occurs during an assault. It’s simply not true. It takes very little pressure to obstruct blood flow or airflow, says Gael Strack, CEO of the Alliance for HOPE International. Unconsciousness can occur in a matter of seconds, death within minutes and delayed death may occur days, weeks or months later. 

Strangulation in any context is also known to be the biggest predictor of homicide later on by that partner. It’s a fact Schmidt learned only after her daughter’s death when she decided to take a course on strangulation from The Training Institute on Strangulation Prevention, a program of the Alliance. 

“When I took the course on strangulation, I couldn’t believe the things I didn’t know,” says Schmidt. “It’s not only dangerous, but typically someone willing to [strangle]  another person is hundreds of times more likely  to kill that person…whether [the strangulation] is enjoyable or not,  I don’t think it makes a difference. There’s something wrong with that person.”

The Stats Show Homicide Risk Jumps After Strangulation 

In a study of homicide victims killed by an intimate partner, it was found that 43 percent had experienced a non-fatal strangulation by their partner prior to their murder. In attempted homicides by an intimate partner, 45 percent of victims had been strangled before the attempted murder. Researchers in the study, including acclaimed domestic violence expert Jacquelyn Campbell, who developed the Danger Assessment in 1987, determined that being strangled by a partner even one time increases a victim’s risk of homicide by that perpetrator over 600 percent.

“The majority of women murdered in domestic violence homicides are shot, so everyone thinks [prevention] is about getting the guns. But strangulation is the high predictor of a homicide with a gun,” says Casey Gwinn, JD, president of the Alliance for HOPE International. In fact, because of the connection between strangulation and a later homicide with a gun, the hashtag for the  Alliance’s Training Institute on Strangulation Prevention is #lastwarningshot. 

One of the most difficult aspects of identifying strangulation as an abusive tactic is that it often doesn’t cause  visible injuries at the time of the assault. Based on the published research of Strack, in at least half of all cases, there are no marks on the victim right after the assault. While bruises may show up days later, abusers have an easier time denying the assault when the police are called, and survivors are more likely to minimize what happened to them. 

“They often think, there’s nothing serious about this because I look and feel fine. The more normative strangulation becomes, the more survivors get it in their mind that nothing bad is going to happen,” Gwinn says.

Strack agrees that strangulation is often minimized. “Serious consequences can happen in only mere seconds after being strangled. Preventing air and blood flow by compressing one’s throat can cause swelling and closure of the airway, or delayed  stroke or cardiac arrest.” 

Many times, these deaths are not attributed to a prior strangulation assault, and an abuser is able to escape accountability for his victim’s murder.  Victims can have signs of strangulation (things you can see) or they may have symptoms (things you can describe but may not be visible).

Besides bruises or scratches  on the neck, other signs and symptoms of strangulation can include:

• Changes in one’s voice
• Neck pain
• Difficulty swallowing or breathing
• Ear pain
• Vomiting blood
• Vision change
• Tongue swelling
• Bloodshot eyes
• Lightheadedness 
• Petechial hemorrhages (small little red spots on the neck, face, or head)
• In the case of pregnant victims, miscarriage
• And long-term physical, emotional, and mental health consequences.

What to Do If You’ve Been Strangled

Gwinn doesn’t mince words when it comes to stranglers. 

“When a woman is trying to get away from a strangler she’s in the most danger of her life,” he says. “If the system fails in holding him accountable, she could die.”

That system includes law enforcement, the courts and child welfare systems, all of which have varying degrees of strangulation training and some, none at all. While we hate to give this advice, it is often on the victim of strangulation to ensure she gets proper care after being strangled. If a survivor presents with no visible injuries, a police officer or paramedic on scene may not recommend medical care or follow up, but this is not best practice. Strack says all victims should be evaluated by a medical professional. One survivor, Tyesha Wayne, was in just that situation in 2023 in Arizona. Paramedics not only didn’t recommend treatment after she was strangled and even went unconscious, but police also didn’t arrest the perpetrator. When law enforcement and medical professionals fail a strangulation victim, it may make it less likely that she will come forward for help the next time it happens.

If you’ve been strangled—either violently or consensually, once or multiple times, even if you don’t believe you’ve suffered any injuries or feel any of the symptoms above—experts agree that it’s always safest to get checked out by a medical professional as soon as possible. Record any signs or symptoms you have in the days following. Note if they increase in severity and let your physician know. 

Reach out to a trained domestic violence advocate to talk. Strack and Gwinn both agree that Family Justice Centers have more trained professionals who know about strangulation assaults and how to investigate and document them than many other domestic violence agencies. Even if you’re not ready to leave your partner, it may still be helpful to hear your situation validated and to plan for future incidents. If you’re ready to do so, file for an order of protection before separating from your partner in order to prevent them from coming near you, contacting you or threatening you as you figure out next steps. Remember that stranglers are more likely to kill their victims than other types of abusers and stranglers become stalkers after victims leave.

The Institute has excellent resources for victims and for advocates working with victims.  They are all accessible on the survivor resources pages of the Institute’s website.

Saving Yourself During Strangulation

There are a few things you can do in the moment during a violent strangulation that may save your life. 

• Try not to panic. Stay calm and try to think clearly about what you can do to escape.
• Protect your airway. If possible, try something called the “turtle shell technique.” Tuck your chin down toward your chest as much as possible and raise your shoulders up to help support your neck. 
• Fight back as much as possible. Kick, pinch, bite or gouge any part of the attacker’s body that you can. If you are able to reach something with a free hand, use it as a weapon to strike the attacker and possibly release his hold. Here are some additional self-defense moves you can learn at home.
• Run. As soon as you’re free, escape quickly or find something with which to defend yourself. Remember that the presence of a gun in the home increases a domestic violence survivor’s homicide rate by nearly 750 percent. 

Do Police Believe Strangulation Victims?

When it comes to prosecuting strangulation, attorney Gwinn says a victim’s chances all depend on the jurisdiction. Some prosecutors,  judges and law enforcement professionals have been specially trained, but not enough, says Gwinn.

“We train more than 100 days a year and we’ve graduated over 4,000 people from a four-day advance course on strangulation prevention, but it’s still just a drop in the bucket. You’ve got a million police officers, tens of thousands of medical workers. We’ve probably trained 10 percent.”

When strangulation often occurs with no visible injuries afterward, the other difficult part of prosecuting strangulation is that the prosecutor must  prove the victim was strangled even with minimal signs or symptoms. And if a survivor fights back during a strangulation, she can sometimes wind up being the one arrested for assault. 

The hope is that the more information that emerges about strangulation and its dangers, the more people will take it as seriously the first time. It’s something Schmidt, Petito’s mom, wishes she knew much, much earlier.

“If people would only know, if people would hear … then maybe they would understand how dangerous strangulation is. Maybe victims of domestic violence would leave sooner if they knew how dangerous it was. We have to push to put this [education] out there more in the mainstream media.”

If you are an advocate, healthcare professional, police officer or anyone else who may come in contact with a survivor of strangulation, make sure to check out the Advocacy Toolkit for Survivors of Strangulation/Suffocation from the Family Justice Center Alliance.