ENTERTAINMENT
Children's Group Says Video Games Are Too Violent

Technology: Study also finds few female and racially diverse role models. Industry representatives question methodology.

By ALEX PHAM, TIMES STAFF WRITER

A children's advocacy group on Monday leveled broad criticism at the video game industry, saying games are too violent and send messages that reinforce racial and gender stereotypes.

Oakland-based Children Now said a survey of popular titles showed that females and non-whites are underrepresented in games. When they are present, women are scantily clothed and more likely to be victims of violence, according to the survey. It also found that nearly 80% of games rated appropriate for all ages contain some violence.

"The preponderance of violence and the lack of representations of females and characters of color suggests that parents should not simply take the ratings as substitutes for their own judgment about what is best for their children," said Lois Salisbury, president of Children Now. Those in the game industry objected to the study's methodology, which deems violent such games as "Ms. Pac Man," "The Sims" and "Frogger." Many, however, acknowledged that developers can do a better job of making games that appeal to a broad audience, not just young males.

"There are plenty of games that appeal to women, many of them enormously successful," said Doug Lowenstein, president of the Interactive Digital Software Assn. "Can there be more? Absolutely."

Lowenstein said varying definitions of violence make such studies subjective. Violence in games has not proven to encourage violent behavior in real life, he said.

Game developer American McGee, who designed "Alice" for Electronic Arts Inc., said conflict is one of a game maker's most important tools.

"It's hard to tell a story without conflict as a vehicle," McGee said. "Games are cathartic, and people can act out their fantasies in a nondestructive way."

Advocates at Children Now, however, said the ability of players to assume the role of characters makes games an especially powerful influence on behavior, attitudes and beliefs.

"These images can have unhealthy effects on children's self esteem, behavior and relationships with others," the study said.

The study found that more than 40% of players of video games are female, but just 13% of characters in games are. The survey of 70 games included the top 10 best-selling titles for seven popular hardware platforms.

But industry representatives said the list contains professional sports games such as "Madden NFL 2001," which has only male players. In addition, a game such as "Michelle Kwan Figure Skating" was not counted.

"This list shows what people buy, not necessarily what we make," McGee said.

Group decries violence, sex in games
'Grand Theft Auto: San Andreas' called worst of the lot

The Associated Press
Updated: 10:27 p.m. ET Nov. 23, 2004

WASHINGTON -- Video games that have players shoot rival gang members, watch bare-breasted women and recreate the assassination of President Kennedy were criticized Tuesday by a watchdog group that said, at the least, they should be kept away from children.

In issuing its annual report card on video games, the National Institute on Media and the Family urged the industry to educate parents better about ratings and asked retailers not to sell such games to younger teenagers.

"This segment of games keeps getting more realistic, and they keep pushing the envelope," David Walsh, the institute's president, said at a news conference. "The problem is that these games are the ones that are particularly popular with kids, particularly teenagers."

The video game trade association said its games carry appropriate ratings and recommended that parents police the activities of their children.

Among those listed as the worst games of the year was "Grand Theft Auto: San Andreas," a game in which the hero vows to avenge his mother's murder and restore glory to his neighborhood gang. Players rack up points by gunning down police, committing carjackings, burglarizing homes and dealing in other underworld activities.

The game debuted in October and instantly became the year's best seller, part of a series of "Grand Theft Auto" games that has sold more than $32 million over the past few years. The institute's list also includes "The Guy Game," which features video of women exposing their breasts.

Like others on the group's list, the games are rated "M" for mature, which means retailers are not supposed to sell them to people under 17. Walsh said some of the games should be rated "AO" or "adults only," which would limit purchase to those 18 and over. Many stores will not carry games with that rating.

Lax enforcement cited

The institute blamed game retailers for lax enforcement, citing a survey it conducted this year. The survey found that half of underage boys and 8 percent of girls who tried were allowed to buy M-rated games, the group said.

A trade group that represents game retailers said it is premature to criticize stores because they already are putting a new enforcement policy into place. The Interactive Entertainment Merchants Association has pledged to create tougher standards by December to forbid the sale of mature games to children.

Doug Lowenstein, president of Entertainment Software Association, said all the games on the institute's objectionable list are rated M, which he said shows the industry is doing its job.

"The reality is that most of the time when kids get these games, they get them from an adult or a parent, and that is a failure of parenting," Lowenstein said. He also cited a survey that showed that most parents agree with the rating system.

Sen. Joe Lieberman, D-Conn., credited the industry for creating many good games but said the small percentage of games with extremely violent or pornographic content is "worse than ever."

"The fact that the assassination of President Kennedy, which broke our hearts and altered our history, could become the subject of a video game from which people are making money is just outrageous, it is despicable, it's unbelievable," Lieberman said.

The "JFK Reloaded" game, released Monday to near universal condemnation, is available only by downloading from the Internet. Lowenstein said the game does not come from a mainstream company and agreed that its subject matter was inappropriate.

Copyright 2004 The Associated Press.

Did Va. Tech Murderer Learn From Video Games?

Jim Meyers
Wednesday, April 18, 2007

The shootings at Virginia Tech have once again brought the issue of violent video games to the fore, with critics citing a link between murderous rampages like Monday's and games that often involve simulated mass murder.

Appearing on Larry King's CNN show on Monday night, psychologist Phil McGraw — TV's "Dr. Phil" — stated: "Common sense tells you that if these kids are playing video games, where they're on a mass killing spree in a video game, it's glamorized on the big screen, it's become part of the fiber of our society."

Murders Echo Game Scenarios

The grisly murders of 31 people at Virginia tech eerily seem to match the stalking of targets in video programs some times called "first person shooter" (FPS) games. In the FPS video game genre is characterized by an on-screen view that simulates the in-game character's point of view and by the use of handheld weapons.

Typically, the game player participant stalks through rooms, mazes or buildings seeking out victims, firing multiple shots into targets to ensure death. The player is frequently required to change ammunition.

"You take that and mix it with a psychopath, a sociopath or someone suffering from mental illness and add in a dose of rage, the suggestibility is too high," Dr Phil added.

"We're going to have to start addressing those issues and recognizing that the mass murders of tomorrow are the children of today that are being programmed with this massive violence overdose." Video games with names like "Quake," "Grand Theft Auto," or "Doom" are among the most popular killer programs.

Such games allows a player to vicariously experience a shooting rampage like the one gunman Cho Seung-Hui perpetrated at Virginia Tech. Reportedly, Cho killed some of his real-life targets with multiple shots to assure their demise.

The modern FPS games emerged when home computers became powerful enough to utilize basic 3-D graphics in real time. Other popular FPS games include "Duke Nukem 3D," "Blood," "System Shock," "Counter-Strike," "GoldenEye 007" and "Quake."

First released in June 1996, "Quake" was the first FPS game to gain widespread popularity as a multiplayer Internet game. "Quake" and its three sequels have sold more than 4 million copies, and in 2005 a version of the game was even produced for mobile phones.

FPS games have been called "murder simulators" by Lt. Col. David Grossman, a former West Point psychology professor who has written several books on violence in the media, including "Stop Teaching Our Kids to Kill."

He argues that the games inure young people to the act of murder by simulating the killing of hundreds or even thousands of opponents in a single game.

It was widely reported that the two shooters in the 1999 Columbine High School massacre were fans of first-person shooter games. Last year the Alabama Supreme Court kept alive a $600 million lawsuit blaming the violent video game "Grand Theft Auto" for the murders of two police officers and a police dispatcher in Fayette in 2003.

Attorneys for the relatives of the three men slain claimed the killer, 18-year-old Devin Moore, played the game obsessively, and Moore reportedly told investigators after his arrest: "Life is a video game. Everybody has to die sometime."

Sens. Hillary Clinton and Joe Lieberman have been highly critical of violent video games and their manufacturers. Clinton has attacked violent games as "a silent epidemic" among children, and in July 2005 she called for a federal investigation into "Grand Theft Auto: San Andreas."

In 1993, Lieberman headed Senate hearings about violent games that led to the establishment of the Entertainment Software Ratings Board. And late last year he co-sponsored legislation that would make it a crime to sell violent video games to minors.

Banned: Violent Games in Germany

Germany has taken steps to go even further and ban violent video games outright, the trade publication Variety reported. A bill placed before parliament would outlaw the depiction of violent acts committed against human characters, and would effectively ban most first-person shooter games.

The bill was introduced late last year after 18-year-old Sebastian Bosse shot up a high school in Emsdetten, injuring 37 before killing himself. An investigation revealed that Bosse spent most of his waking hours playing the game "Counter-Strike."

© NewsMax 2007. All rights reserved.

Don't Shoot
Why video games really are linked to violence.

By Amanda Schaffer
Posted Friday, April 27, 2007, at 4:10 PM ET

On The Daily Show on Thursday, April 26, Jon Stewart made short work of the suggestion that the Virginia Tech shooter, Cho Seung-Hui, might have been influenced by violent video games. (Cho may or may not have played the popular first-person-shooter game Counter-Strike in high school.) A potential video-game connection has also been dangled after past killings, to the irritation of bloggers. The reports are that shooter Lee Boyd Malvo played the game Halo before his sniper attacks around Washington, D.C., and that Columbine killers Eric Harris and Dylan Klebold loved Doom. Does the link between video games and violence hold up?

Pathological acts of course have multiple, complex causes and are terribly hard to predict. And clearly, millions of people play Counter-Strike, Halo, and Doom and never commit crimes. But the subtler question is whether exposure to video-game violence is one risk factor for increased aggression: Is it associated with shifts in attitudes or responses that may predispose kids to act out? A large body of evidence suggests that this may be so. The studies have their shortcomings, but taken as a whole, they demonstrate that video games have a potent impact on behavior and learning. Sorry, Jon Stewart, but you needn't be a fuddy-duddy to worry about the virtual worlds your child lives in.

Three kinds of research link violent video games to increased aggression. First, there are studies that look for correlations between exposure to these games and real-world aggression. This work suggests that kids who are more immersed in violent video games may be more likely to get into physical fights, argue with teachers, or display anger and hostility. Second, there is longitudinal research (measuring behavior over time) that assesses gaming habits and belligerence in a group of children. One example: A study of 430 third-, fourth-, and fifth-graders, published this year by psychologists Craig Anderson, Douglas Gentile, and Katherine Buckley, found that the kids who played more violent video games "changed over the school year to become more verbally aggressive, more physically aggressive," and less helpful to others.

Finally, experimental studies randomly assign subjects to play a violent or a nonviolent game, and then compare their levels of aggression. In work published in 2000, Anderson and Karen Dill randomly assigned 210 undergraduates to play Wolfenstein 3-D, a first-person-shooter game, or Myst, an adventure game in which players explore mazes and puzzles. Anderson and Dill found that when the students went on to play a second game, the Wolfenstein 3-D players were more likely to behave aggressively toward losing opponents. Given the chance to punish with blasts of noise, they chose to inflict significantly louder and longer blasts than the Myst kids did. Other recent work randomly assigned students to play violent or nonviolent games, and then analyzed differences in brain activation patterns using fMRI scans, but the research is so far difficult to assess.

Each of these approaches has its flaws. The first kind of correlational study can never prove that video-game playing causes physical aggression. Maybe aggressive people are simply more apt to play violent games in the first place. Meanwhile, the randomized trials, like Anderson and Dill's, which do imply causation, necessarily depend on lab-based measures of aggression, such as whether subjects blast each other with noise. This is a respected measure, but obviously not the same as seeing whether real people hit or shoot each other. The longitudinal work, like this year's elementary-school study, is a useful middle ground: It shows that across the board, playing more-violent video games predicts higher levels of verbal and physical aggression later on. It doesn't matter why the kids started playing violent games or whether they were already more aggressive than their peers; the point is that a year of game-playing likely contributes to making them more aggressive than they were when they started. If we had only one of the three kinds of studies, the findings wouldn't mean much. But taken together, the body of research suggests a real connection.

The connection between violent games and real violence is also fairly intuitive. In playing the games, kids are likely to become desensitized to gory images, which could make them less disturbing and perhaps easier to deal with in real life. The games may also encourage kids (and adults) to rehearse aggressive solutions to conflict, meaning that these thought processes may become more available to them when real-life conflicts arise, Anderson says. Video games also offer immediate feedback and constant small rewards—in the form of points, or access to new levels or weapons. And they tend to tailor tasks to a player's skill level, starting easy and getting harder. That makes them "phenomenal teachers," says Anderson, though "what they teach very much depends on content."

Critics counter that some kids may "use games to vent anger or distract themselves from problems," as psychiatry professor Cheryl Olson writes. This can be "functional" rather than unhealthy, depending on the kid's mental state and the extent of his game playing. But other studies suggest that venting anger doesn't reduce later aggressive behavior, so this thesis doesn't have the most solid support.

When video games aren't about violence, their capacity to teach can be a good thing. For patients suffering from arachnophobia, fear of flying, or post-traumatic stress disorder, therapists are beginning to use virtual realities as a desensitization tool. And despite the rap that they're a waste of time, video games may also teach visual attention and spatial skills. (Recently, a study showed that having played three or more hours of video games a week was a better predictor of a laparoscopic surgeon's skills than his or her level of surgical training.) The games also work for conveying information to kids that they will remember. Video games that teach diabetic kids how to take better care of themselves, for instance, were shown to decrease their diabetes-related urgent and emergency visits by 77 percent after six months.

Given all of this, it makes sense to be specific about which games may be linked to harmful effects and which to neutral or good ones. Better research is also needed to understand whether some kids are more vulnerable to video-game violence, and how exposure interacts with other risk factors for aggression like poverty, psychological disorders, and a history of abuse. Meanwhile, how about a game in which kids, shrinks, and late-night comics size up all these factors and help save the world?

Amanda Schaffer is a science and medical columnist for Slate.

How violent video games may violate children's health

By Elisa Hae-Jung Song, MD, and Jane E. Anderson, MD

Evidence is mounting that playing violent video games contributes to aggressive behavior. Pediatricians can protect their patients by knowing the potential risks of these games and advising parents.

Before 1950, books, comics, motion pictures, phonograph records, and radio programs, which included dramas and game shows, were the only media entertainment available to children. Since the offerings were relatively slim, it was rather easy for parents to control what their children listened to and watched.

In the past 50 years, however, children's access to media has exploded, beginning with the introduction of television, which rapidly became a fixture in more than 98% of American homes. The emergence of video games, designed initially as large consoles and then modified for use on home television sets, dramatically changed children's media environment. This new form of entertainment raised concern because the negative effects of violent television on children's behavior had been extensively documented, and video games added an interactive component to the entertainment.

The second most popular form of entertainment after television, video games have rapidly become the largest segment of the entertainment industry, taking in $6.3 to $8.8 billion in 1998, compared with $5.2 billion in Hollywood box office receipts.1 Video games, which now can be played at home on a computer or a television set, account for 30% of the toy market in America. With 181 million computer games sold in 1998, each home has, on average, two video games.2

The time is right to ask the inevitable question: "Are violent video games having a negative effect on children's health?" Although the answer to this question remains equivocal, data now exist to suggest that the answer may, indeed, be "Yes."

Everybody plays

Consider these statistics: About 90% of United States households with children have rented or own a video or computer game,3 49% of children have a video game player or computer on which to play the games in their own bedroom, and 46% of children would choose, in preference to any other form of media, to take a video game player or computer to a desert island.4 Clearly, many homes in America are affected by the explosion of video games.

According to a 1993 survey of 357 seventh- and eighth-grade students, boys spent more time playing video games than girls. While 60% of girls clocked an average of two hours a week playing video games, 90% of boys played for more than four hours a week. Boys and girls also differed in where they liked to play: 50% of boys spent time in arcades, compared with 20% of girls. Only 2% of preferred games had educational themes, while about half had violent themes.5

A 1996 survey of 1,000 fourth- to eighth-grade students confirmed that boys spent more hours each week than girls playing video games, with game playing decreasing as grade level increased.6 Children of all ages preferred games with violent content; boys preferred human violence, girls, fantasy violence.

A study of 227 college students showed that 97% of students played games.7 Again, girls spent less time than boys in this activity. The survey also investigated respondents' earlier use of games: Students reported that the time they spent playing games gradually decreased from the junior high years (five and one half hours a week) to college (about two hours a week). Figures on earlier use of games may not be reliable, however, because they were based on long-term recall.

Parents are usually not aware of the nature of the video games their children are playing. In a 1999 study, most parents were not able to name their child's favorite game, or named an incorrect game. In 70% of these incorrect matches, the child described their favorite game as violent.8 Even when a parent watches her child playing a video game, she is unlikely to still be looking as her child attains higher levels with increased violent content. On average, according to another study, parents recognized only nine of the 49 most popular video games.9

In a study from British Columbia, only 22% of teens said that their parents had set rules for playing video games. This compares with 39% of teens who had rules for television viewing. The rules for video games, when they existed, related to when and for how long the child was allowed to play but did not usually address the content of the game. About 40% of teens had to finish their homework and chores before playing. Only 15% were subject to restrictions on the type of game they played.10

These findings are especially of concern because the graphic violence depicted by video games has increased greatly in recent years. According to the National Coalition on Television Violence, a nonprofit organization dedicated to reducing gratuitous violence on television, sales of games rated extremely violent (see "What the ratings mean" below) have jumped from 53% of all sales in 1985 to 82% in 1988.11 Analysis of a sample of the 33 Sega and Nintendo games that were most popular in 1995 showed that nearly 80% featured aggressiveness or violence; in 21% of the games, the aggression or violence was directed toward women. In nearly 50% of the games examined, violence or aggression was directed against other characters, and the violence generally was very graphic.12 Another survey found that violence was a theme in 40 of the 47 top-rated Nintendo video games.11 This means that, on a typical day, one of four boys in the United States plays an action or combat game like "Doom" or "Duke Nukem."

The many faces of video violence

Violence in video games can be categorized as fantasy violence or human violence. Each of these categories can be further divided into games where the player controls a character on screen who performs the violence (third-person shooters) or those where the player views the game as if he or she were the character performing the violence (first-person shooters). First-person violence allows the player to actually look along the barrel of the gun on the screen and feel as though he were pulling the trigger and killing someone.

"Super Smash Brothers" is an example of a game that uses fantasy animated violence. The game is rated E (meaning it is for everyone). Descriptions of the game appearing on the package include "Duke it out as your favorite Nintendo characters," "It's a bumpin', bruisin', brawlin' bash!," and "Smash your opponent silly." This game was placed on the "Dirty Dozen" list by the Lion and Lamb Project.

Human violence is the main component of many video games. "Carmageddon" is rated M for mature audiences and is described on the package as "The racing game for the chemically imbalanced." The object of the game is to run over people or crash into other cars. "Waste contestants, pedestrians, and farmyard animals for points and credit," the game instructs players. Points are scored for artistic gore, based on how blood is smeared on the tires after each crash. A player who completes all levels may have killed as many as 33,000 people.

The most popular third-person shooter game is "Mortal Kombat," which is rated M. The package states: "3D fatalities: Watch as brand new and classic fatalities take on a completely different meaning in three dimensions." In 1993, Sega sold a version of the game in which a warrior rips off his opponent's head and spine while spectators shout, "Finish him! Finish him!" Nintendo's version, also rated M, did not include that scene, but it was outsold three to two by Sega's product.

Games that use first-person shooters are increasingly popular. "Doom" (rated M) is the best known because Eric Harris and Dylan Klebold, the Columbine killers, were avid players. The manufacturer introduces "Doom" this way: "A single Demon Entity escaped detection. Systematically it altered decaying, dead carnage back into grotesque living tissue. The Demons have returned- stronger and more vicious than ever before. Your mission is clear, there are no options: Kill or be killed." "Doom" allows players to use more powerful and more gory weapons as the level of play progresses, so players can trade in shotguns for automatic weapons and then chain saws.

Another M-rated game, "Quake," has the following descriptions on the package, "Nail them to the wall," "Incorporates the ferocity of the-single-player game with the supreme bloodlust of the two-player death match," and "Realistic explosions echo and reverberate, transporting the player to a hellish, dungeon-like environment." "Quake" sold more than 1.7 million copies the first year it was introduced. "Duke Nukem," rated M, advertises "32 levels of non-stop carnage" so the player can "Bag some aliens with over a dozen hi-tech weapons."

New video games with improved graphics and more realistic violence are constantly being developed. Video games also can be downloaded from the Internet and customized, adding a new dimension to the violence in keeping with individual preferences. Columbine killers Harris and Klebold customized "Doom" to graphically portray their neighborhood and school, allowing them to practice the shooting they would later enact in real life.

Does exposure to violence harm children?

What effect does exposure to this type of violence have on children? Studies of the effects of violent video games are limited, but investigations of the effects of violent television programming, which have been thoroughly evaluated during the past 50 years, offer insight.

In more than 1,000 studies, researchers have used laboratory-based exposure, population-based observations, and longitudinal analysis, among other methods, to document that children exposed to violent programming are more likely to behave in an aggressive or violent manner and are more likely to become involved with the justice system than children who have not had such exposure. Defenders of violent video games use the same argument as defenders of violent television do, however. They claim that the catharsis these games offer allows players to release aggressive tendencies.

To evaluate how violent video games affect children, one must consider the techniques these games rely on and what the literature shows about the games' impact. Unfortunately, most of the existing research was performed before 1993, the time after which violent content and realistic images began to increase greatly.

Video games and principles of learning. Exposure to violent video games is of even more concern than exposure to violence on television because the games take advantage of many of the principles of learning-identification (or participant modeling), practice and repetition, and reward and reinforcement.

Identification with the aggressor increases the likelihood that the participant will imitate behavior; in most violent video games, the player must identify with one violent character and perform violent acts through his eyes. The interactive nature of video games may also increase the likelihood that the participant will learn aggressive behavior. Adding to the increase in learning, the player of a video game is required to repeat behaviors. Last, video games reinforce violent choices with rewards of additional points, longer playing time, or special effects for certain acts of aggression or violence.

A recent study shows that physiologic changes associated with learning take place while playing video games.13 It demonstrated that striatal dopamine release increases during video game playing and that the correlation between dopamine release and performance level was significant. Dopaminergic neurotransmission is probably related to learning, reinforcement behavior, attention, and sensorimotor integration.

The profound effects of video games on learning were summed up by researchers J. B. Funk and D. D. Buchman, who wrote: "If, as many believe, violence is primarily a learned behavior, then the powerful combinations of demonstration, reward, and practice inherent in electronic game playing creates an ideal instructional environment.... the lessons being taught are that violence is fun, obligatory, easily justified, and essentially without negative consequences."6 The Columbine shooters are chilling examples of this principle. They were "Doom" fanatics who reconfigured a version of "Doom" to be in the "God mode" (the format in which the player becomes indestructible). The pair graphically reenacted the behavior they learned from the video game-they said the planned shooting was "going to be like f — ing 'Doom,'" "Tick, tick, tick, tick ... Haa! That f — ing shotgun is straight out of 'Doom.'"14

The type of learning that takes place may be influenced by the type of violent video game that is being played. Video games played on computers rely on the "mouse" to do the shootings, and players therefore learn strategies and warfare tactics. Video games played in arcades are much more likely to use "joy sticks" or hand-operated devices that simulate pulling the trigger on the gun. Players of these games learn not only strategies but improve their hand-eye coordination and their aim. By joining "clans," online players can cooperate making battle plans and specialize in various aspects of warfare.

The most disconcerting and convincing argument for the hypothesis that violent video games teach violent behavior comes from Lieutenant Colonel David Grossman, a psychologist and adjunct professor at Arkansas State University, who specialized as a "killologist" for the United States military. After more than 25 years researching the psychology of killing for the Army, Grossman is convinced that the willingness to kill another person does not come naturally but is a learned behavior. It requires desensitization by repeated exposure to violence and classical conditioning by associating aggressive acts with a pleasant experience. Willingness to kill also relies on stimulus-response training so that the conditioned response (shooting a gun) becomes automatic with the right stimulus (alien or person in view).

According to Grossman, the United States Army and Marines use the same techniques that violent video games depend on to train recruits to kill. The Army also turns to an actual video game-"Doom"-to train soldiers to kill. This game, as well as "Quake" and similar games, teaches players to "clear the room" by moving quickly from target to target; to aim for the head; and to avoid repeatedly shooting the same target, as novices do. Grossman goes so far as to call violent video games "murder simulators."15

People who have never fired a gun but have practiced shooting on video games are excellent marksmen when they fire a gun for the first time. A lawsuit filed against Michael Carneal, the 14-year-old Paducah, Ky. boy who killed three students, alleges that Carneal "clipped off nine shots in about a 20-second period. Eight of those shots were hits. Three were head and neck shots and were kills. That is way beyond the military standard for expert marksmanship. This was a kid who had never fired a pistol in his life, but because of his obsession with computer games had turned himself into an expert marksman."16 According to Grossman, "Michael Carneal ... fired eight shots ... at a bunch of milling, scrambling, screaming children.... Even more astounding was the kill ratio. Each kid was hit once. Three were killed; one was paralyzed for life. Never, to my knowledge, in the annals of law enforcement or military or even criminal history can we find an equivalent achievement.... It turned out that while the kid had never fired a pistol before ... he held the gun in two hands. He had a blank look on his face. He never moved his feet. He never fired too far to the right or the left or up or down. He simply fired one shot at everything that popped up on his screen."17

What studies show. In 1997, the Canadian Journal of Psychiatry published a meta-analysis of 13 studies on the relationship between video games and aggression.18 Among the reviewed studies were some performed in the laboratory, where children played video games and were then observed during free play. One of those studies showed that 7- and 8-year-old boys who played video games with violent content were more likely to exhibit interpersonal aggression during free play than boys who had not played such games. In another study in the meta-analysis, researchers observed 5- to 7-year-old children after they played video games with aggressive or nonaggressive content and found that children who played a karate game were more likely to imitate the behavior seen in the game and were more aggressive than children who played a jungle game.

These studies have obvious limitations, including short duration of observation. The authors of the meta-analysis concluded, however, that "the majority of the studies show that children do become more aggressive after either playing or watching a violent video game."18

Studies conducted in the 1980s that relied on questionnaires to correlate time spent playing video games and aggressive behavior provide conflicting results. Some studies demonstrated that playing video games increases aggressive behavior; others did not. In a study published last year, investigators surveyed college students about exposure to video game violence and self-reported aggressive behavior and delinquency. College students played a violent or nonviolent video game and then engaged in a competitive game in which they could punish their opponent by delivering a blast of noise, the length of which they could determine. Those who played violent games delivered significantly longer blasts after losing than nonviolent game players did.29 In a separate study outside the laboratory by the same investigators, violent video game play was positively related to aggressive behavior and delinquency.7

A slightly earlier investigation found that third- and fourth-grade children who played a violent video game later provided more hostile interpretations of a story with an ambiguous ending (provocation story) than children who played a nonviolent game.19 Undergraduates who played a violent virtual reality game had more aggressive thoughts than students who simply observed the game.7

According to a 1992 survey of sixth through 12th graders, playing violent video games contributed to an increase in aggressive behavior. Investigators also found that the longer a child played video games, the more likely she was to be considered aggressive by her teacher. 20

Correlational studies have also supported the relationship between violent video games and aggressive behavior. Interpol reported that, between 1977 and 1993, the assault rate in Australia and New Zealand increased almost 400%, tripled in Sweden, and doubled in Belgium, Denmark, England, France, and Scotland.16 Although these cultures differ in many ways, they have had a similar increase in violent video game exposure.

Some studies show no relationship between video game playing and aggression or violence. A 1987 study of eighth-grade students found that game play did not affect subsequent aggressive behavior.21 In another investigation, frequent users of video games seemed to play more when they were tense and felt more relaxed after playing.22

Findings in two studies performed in 1985 and in 1987 in 6- to 11-year-old children were conflicting. In the first study, children had more assertive fantasies after playing violent video games-a finding that the second study failed to confirm. Because these studies were conducted before the more violent and realistic video games were introduced, their results may not be applicable to today's environment.23

More research into the long-term effects of video game playing is needed, especially in light of the recent improvements in the graphic display of games and the increase in their violent content.

Academic and educational concerns

Like watching television, playing video games displaces other activities of childhood, such as reading, playing outside, exercising or participating in sports, working on hobbies such as music or art activities, doing homework, or simply talking with friends and family. One study of 234 fourth- through sixth-grade students evaluated ratings of academic performance and various behaviors. A small but significant negative relationship was seen between arcade game use and teachers' ratings of math ability and general academic ability in boys. No such relationship was found when games were played at home.24 Another study that examined only "new game" use found that children were more likely to avoid homework when a new game was introduced, but over time played less frequently and for a shorter time.

Homework and chores were the activities most likely to be displaced by game playing, according to 21% of teens surveyed in a study from British Columbia. Teenagers who played video games more than seven hours a week were most likely to play games instead of participating in other activities; 37% of these heavy players said they played at the expense of homework and chores, and 18% said they gave up family activities.10 Research in this area is scanty, however, and results are often inconsistent.

The Henry J. Kaiser Family Foundation, which has extensively studied children's use of all forms of media, found that children who earned lower academic grades spent about one hour more a day exposed to media than their counterparts with higher grades did. The study could not evaluate what caused the lower grades, and both groups of students spent about the same amount of time on video games.25

Video games also pose medical risks that stem from the equipment on which they are played or their content. For further discussion of this subject, see "A variety of medical concerns" .

What can pediatricians do?

Pediatricians are in a unique position to influence what computer and video games families and children use, and how they use them. That they make the effort to exert this influence is important if only because playing video games, like watching television, displaces more important activities of childhood. In addition, children, as eager learners, may be especially vulnerable to the impact of violence in video games as they identify with aggressors and practice and repeat the violent actions, delighting in the reward and reinforcement offered by the games' multiple levels of play.

Some data suggest that younger children are more at risk and that if children do not start playing video games until they reach adolescence, they are more likely to choose sport-oriented and strategic planning games (such as "Sim City") instead of first-person shooter games.

Encouraging parents to delay the introduction of video games may be an effective tool for decreasing children's exposure to violent games. Pediatricians also can encourage parents to be actively involved in their children's choice of media entertainment. A useful tool is the accompanying parent guide for choosing video games (below ). When a child has behavioral or academic problems, it is especially important to pay attention to how much time the child spends on interactive media. Parents should be aware that interventions to decrease television, video, and video game exposure have been shown to be effective. Third and fourth grade students in San Jose, Calif. who received a series of classroom lessons encouraging them to monitor and decrease their media use demonstrated less physical and verbal aggression when observed on the playground than students who didn't have the lessons.26

Pediatricians and parents who want to become advocates for wise video game choices in their community have several avenues. Recognizing that video game ratings are merely advisory, they can campaign local video stores, libraries, and arcades to require parental approval before a child can rent, buy, or play a video game with a T, M, or A rating. Another possibility is to conduct workshops and make presentations at schools and churches and in the community. Finally, consider contacting the manufacturers of violent video games and the Federal Communications Commission to urge them to limit violence in video games. Regardless of what intervention is chosen, the most important first step is to recognize that violent video games do indeed harm our children.

References

1. Rich, Michael: Pediatricians Should Educate Parents, Youth about Media's Effects. AAP News September, 1999,16:92.

2. Graf W, Chatrian G, Glass ST, et al: Video game-related seizures: A report on 10 patients and a review of the literature. Pediatrics 1994;93:551

3. Video games and their effects, in Issue Briefs. Studio City, Calif., Mediascope Press, 1999

4. Roberts DF, Foehr UG, Rideout VJ, et al: Kids & media @ the new millennium. Kaiser Family Foundation Report November 1999, p 13

5. Funk J: Reevaluating the impact of video games. Clinical Pediatrics 1993;2:86

6. Funk J, Buchman DD: Video and computer games in the '90s: Children's time commitment and game preference. Children Today 1996;24(1):12

7. Anderson CA, Dill KE: Video games and aggressive thoughts, feelings, and behavior in the laboratory and in life. J Pers Soc Psychol 2000;78:772

8. Funk J, Hagan J, Schimming J: Children and electronic games: A comparison of parents' and children's perceptions of children's habits and preferences in a United States sample. Psychol Rep 1999;85:883

9. Funk J, Flores G, Buchman D: Rating electronic games: Violence is in the eye of the beholder. Youth and Society 1999;282

10. Video game culture: Leisure and play preferences of B.C. teens, in Media Analysis Laboratory. Burnaby, British Columia, Simon Fraser University, 1998

11. National Coalition on Television Violence: Nintendo tainted by extreme violence. NCTV News. 1990;11(1-2):1

12. Dietz T: An examination of violence and gender role portrayals in video games: Implications for gender socialization and aggressive behavior. Sex Roles: A Journal of Research. 1998;38:425

13. Koepp M, Gunn R, Lawrence A, et al: Evidence for striatal dopamine release during a videogame. Nature 1998;393:266

14. Gibbs N, Roche T: The Columbine Tapes, in Time Magazine, December 20, 1999

15. Grossman D, DeGaetano G: Stop Teaching Our Kids To Kill. New York, Crown Publishers, 1999, p 110

16. Hanson G: The violent world of video games. Washington Times Insight on the News. June 28,1999, pp v15, n24

17. Grierson B: Head rush. Adbusters 1999;25:22

18. Emes CE: Is Mr. Pac Man eating our children? A review of the effect of video games on children. Can J Psychiatry 1997;42:409

19. Kirsh SJ: Seeing the world through Mortal Kombat-colored glasses: Violent video games and the development of a short-term hostile attribution bias. Childhood 1998;5:177

20. Fling S, Smith L, Rodrigues T, et al: Video games, aggression, and self-esteem: A survey. Social Behavior and Personality 1992;20:39

21. Winkel M: Personality factors, subject gender, and the effects of aggressive video games on aggression in adolescents. J Research Personality 1987;21:211

22. Kestenbaum GI, Weinstein L: Personality, psychopathology, and developmental issues in male adolescent video game use. J Amer Acad Child Adolesc Psychiatry 1986;24:329

23. Graybill D, Kirsch JR, Esselman ED: Effects of playing violent vs. nonviolent video games on the aggressive ideation of aggressive and nonaggressive children. Child Study Journal 1985;15:199

24. Lin S, Lepper MR: Correlates of children's usage of video games and computers. J of Applied Social Psychology 1987;17:72

25. Kids & media @ the new millennium: A comprehensive national analysis of children's media use. A Kaiser Family Foundation Report. Menlo Park, Calif., 1999, p 70

26. Robinson TN, Wilde ML, Navracruz LC, et al: Effects of reducing children's television and video game use on aggressive behavior. Arch Pediatr Adolesc Med 2001;155:17

DR. SONG is Clinical Instructor of Pediatrics, UCSF/Mount Zion Medical Center, San Francisco, Calif.

DR. ANDERSON is Associate Clinical Professor of Pediatrics at the same institution.

Copyright © 2001 and published by Medical Economics Company at Montvale, NJ 07645-1742. All rights reserved.

Anderson, C.A., Bushman, B.J. (2001). Effects of violent video games on aggressive behavior, aggressive cognition, aggressive affect, physiological arousal, and prosocial behavior: A meta-analytic review of the scientific literature. Psychological Science, 12, 353-359.

Abstract

Research on exposure to television and movie violence suggests that playing violent video games will increase aggressive behavior. A meta-analytic review of the video-game research reveals that violent video games increase aggressive behavior in children and young adults. Experimental and non-experimental studies with males and females in laboratory and field settings support this conclusion. Analyses also reveal that exposure to violent video games increases physiological arousal and aggression-related thoughts and feelings. Playing violent video games also decreases prosocial behavior.

With Video Games, Researchers Link Guns to Stereotypes

December 10, 2002
By ERICA GOODE

Asked to make split-second decisions about whether black or white male figures in a video game were holding guns, people were more likely to conclude mistakenly that the black men were armed and to shoot them, a series of new studies reports.

The subjects in the studies, who were instructed to shoot only when the human targets in the game were armed, made more errors when confronted by images of black men carrying objects like cellphones or cameras than when faced with similarly unarmed white men. The participants, who in all but one study were primarily white, were also quicker to fire on black men with guns than on white men with guns.

"The threshold to decide to shoot is set lower for African-Americans than for whites," said Dr. Bernadette Park, a professor of psychology at the University of Colorado at Boulder and an author of a report on the studies to be published today in The Journal of Personality and Social Psychology.

The difference was not large. But the findings mesh with other research indicating that unconscious biases, possibly instilled by the news media, advertising or other cultural influences, can shape behavior, even when people do not consciously endorse such biases. Studies suggest that those hidden stereotypes or attitudes are often activated in situations where people are forced to respond quickly and automatically.

Friends,

A great piece from Dr. Craig Anderson, Head of the Dept of Psychology at Iowa State University. He has done some of the best scholarly research on video games. He has caught some flack lately. Here is his EXCELLENT response, outlining why video games are NOT a form of "catharsis."

Hooah!

Dave [Grossman]

Dear Dave,

I've been getting a lot of questions about video games in which the player can kill Osama bin Laden. In response to those questions, and to a few hate emails that have arrived from people who have seen (and misinterpreted) my statements about these games, I've prepared a "canned" response. Just thought you might be interested. As always, I don't have time to personally respond to all of the inquiries I get, so I'm hoping that this note will be useful.

Craig

Hello,

You are receiving this form letter in response to a request you made for information or in response to an email comment you sent to me concerning the appearance of video game modifications which allow the player to kill Osama bin Laden characters in the game.

The most common question I am asked about this phenomenon is whether playing such "kill bin Laden" video games is likely to be helpful or harmful in some way. Some have suggested that playing such games is therapeutic. More specifically, a common belief among many people in our society is that a person can relieve aggressive inclinations or urges by symbolically aggressing in some way. The ancient Greeks held this belief as well (see Aristotle's "Poetics"). Freudian scholars revived this belief in modern Western societies.

This belief, known among behavioral research scholars as the "catharsis hypothesis," states that aggressive urges can be safely reduced by observing (e.g., in plays, TV shows, movies) or by behaving aggressively is socially approved ways (e.g., playing football, or violent video games).

So, we can boil all this down to one key question: Does catharsis work in the domain of aggressive behavior?

Research psychologists have extensively studied this issue for many years. A clear answer emerged over thirty years ago, and has been confirmed many times since then. The answer is no. Observing violence (e.g., violent television shows) or behaving aggressively in symbolic ways (e.g., playing violent video games) generally increases later aggressive behavior. It does not reduce it.

Obviously, there are many complicating factors at work, factors that increase or decrease the negative impact of entertainment violence on future aggressive behavior. So, my simple "no" answer might seem to require an extensive discussion, one that is certainly too extensive for the time constraints of most TV and radio reports or the space constraints of most newspaper and magazine reports. Similarly, such a discussion is too extensive for me to detail in this e-mail message. Nonetheless, it is important to note that research has failed to find any set of circumstances in which exposure to entertainment violence reliably leads to a decrease in future aggressive behavior.