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Harvard Commentaries
Harvard Commentaries
Reviewed by the Faculty of Harvard Medical School

Minding Your Mind Minding Your Mind

Violent Video Games -- Harmful or Not?

November 25, 2013

By Michael Craig Miller M.D.

Harvard Medical School

Here are just a few of the phrases that the Entertainment Software Rating Board (ESRB) uses to describe the content of several games in the Grand Theft Auto series, one of the most popular video game series among teenagers:

  • Blood and gore
  • Intense violence
  • Strong sexual content
  • Use of drugs

Violence in video games is common. More than half of all video games rated by the ESRB had violence, including more than 90% of those rated as appropriate for children 10 years or older.

The Pew Research Center reported in 2008 that 97% of youths ages 12 to 17 played some type of video game, and that two-thirds of them played action and adventure games that tend to have violent content.

Other research suggests that boys are more likely than girls to use and play violent video games frequently.

It's small wonder that mental health clinicians often find themselves fielding questions from parents who are worried about the impact of violent video games on their children.

Organizations such as the American Academy of Pediatrics (AAP) and the American Academy of Child & Adolescent Psychiatry (AACAP) take the view that exposure to violent media (including video games) can contribute to real-life violent behavior and harm children in other ways.

But other researchers have questioned the research supporting this view. They argue that most youths are not affected by violent video games.

Both sides of this debate agree that it's possible for parents to take steps that limit the possible negative effects of video games.

Let's take a closer look at these opposing views — and what worried parents can do.

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The Evidence for Harm

The AAP bases its position on studies that link exposure to violence in the media (video games, television, movies and music) with aggression and violent behavior in youths.

The AAP policy statement on media violence, published in 2009, describes violent video games as one of many influences on behavior, noting that many children's television shows and movies also contain violent scenes. But the authors believe that video games are particularly harmful because they are interactive and encourage role-playing. The authors fear that these games may act as virtual rehearsals for actual violence.

Both the AAP and AACAP reason that children learn by watching, imitating and adopting behaviors — a basic principle of social learning theory. These organizations are concerned that aggressive behavior or violence in video games and other media may, over time:

  • Desensitize youths by numbing them emotionally
  • Cause nightmares and sleep problems
  • Impair school performance
  • Lead to aggressive behavior and bullying.

A 2001 report from the U.S. Surgeon General on youth violence made a similar judgment. Some reviews of psychological research studies and large observational studies have found a link between violent video games and more aggressive thinking and behavior in youths. And some people go further, assuming that tragic school shootings prove a link between such games and real-world aggression.

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Challenging the Popular View

Other researchers have challenged the popular view that violent video games are harmful.

In an article appearing in the Review of General Psychology in 2010, Dr. Christopher Ferguson of Texas A&M International University argued that many studies on media violence measure aggression in ways that don't correspond with real-world violence.

Even more important, these associations don't prove cause and effect. He also cited data from federal criminal justice agencies showing that serious violent crimes among youths have gone down since 1996, even as video game sales have soared.

Other researchers have challenged the connection between violent video game use and school shootings. They note that most of the young shooters had signs of anger, mental illness and aggression before the shootings, and that these factors made them more likely to commit violence. So it's harder to accept that playing violent games is a direct cause of violent behavior. When the U.S. Secret Service and Department of Education looked at targeted school violence, they cautioned that no particular behavior, including interest in violence, could be used to produce a “profile” of a likely shooter.

The U.S. Department of Justice has funded research at the Center for Mental Health and Media at Massachusetts General Hospital to better determine what impact video games have on young people. This research and several other studies suggest that only some youths may become more aggressive after playing violent video games. However, in most cases, playing violent video games may be part of normal development, especially in boys — and a legitimate source of fun, too.

Because no two children are alike, experts stress that a youngster's personality, motivations and his or her situation influence behavior rather than the games themselves. For example, psychologists at Villanova and Rutgers Universities have presented evidence that watching and playing violent video games does not affect most children. After reviewing the research, they concluded that certain personality traits might make an individual more likely to act and think aggressively after playing a violent video game: These include a tendency to:

  • Be angry and depressed
  • Be highly emotional and easily upset
  • Be disagreeable, cold or indifferent to other people
  • Act without thinking, fail to keep promises, break rules

Cheryl Olson, cofounder of the Massachusetts General Hospital Center for Mental Health and Media led a study of 1,254 students in public schools (most were ages 12 to 14) in South Carolina and Pennsylvania. The results showed that certain situations increased exposure to violent video games. These included, for example, locating game consoles and computers in children's bedrooms, and allowing older siblings to share games with younger ones. In this study, children who played video games often with older siblings were twice as likely as other children to play mature-rated games (considered suitable for ages 17 and older).

A youth's peer group also influences behavior. In a three-year study done at the University of California, Irvine, researchers interviewed and observed the online behavior of 800 youths. They concluded that video game play and other online activities have become so common among young people that they have changed how young people socialize and learn.

While adults tend to view video games as isolating and antisocial, most youngsters describe the games as fun, exciting, something to counter boredom, and something to do with friends. Thus, for many youths, violent content is not the main draw. Boys, in particular, are motivated to play video games in order to compete and win. In this context, playing violent video games may be similar to the roughhousing play that boys do as part of normal development. Video games are just one more way boys compete for status or to establish a pecking order.

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What Parents Can Do

Parents can protect their children from potential harm from video games. Here are a few commonsense precautions you can take — particularly if you're concerned your child may be vulnerable to the effects of violent content.

  • Check the ESRB rating for video games your child is playing.
  • Play video games with your child to better understand the content, and how your child reacts.
  • Put video consoles and computers in common areas of the home, rather than in your child's bedroom.
  • Set limits on the amount of time your child can play these games. The AAP recommends two hours or less of total screen time per day, including television, computers and video games.
  • Encourage your child to participate in sports or school activities so he or she can interact with peers in person rather than online.

Video games share much in common with other pursuits that are enjoyable and rewarding. They may become hazardous for some children in some situations. Parents can best protect their children by engaging with them, and providing limits and guidance as necessary.

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Michael Craig Miller, M.D. is editor-in-chief of the Harvard Mental Health Letter and an assistant professor of psychiatry at Harvard Medical School. Dr. Miller has an active clinical practice and has been on staff at Beth Israel Deaconess Medical Center for more than 25 years.

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