Violence, Media (Position Paper)

Public outcry followed the 1999 shooting in a Littleton, Colo. school that left 15 students dead and 23 injured. In truth, however, homicides that occur at school, or on the way to and from school, represent only 1 percent of total homicides among youth aged 5-19.1

One can begin to appreciate the true toll of violence in the United States when comparing it with violence in other industrialized nations. In 1998, for instance, the United States experienced 35 times as many gun deaths per capita as England and 285 times as many as Japan.2 Overall, a US child is about 300 times as likely to die from a firearm as a child from a typical industrialized nation.3

Among Americans aged 15-34 years, two of the top three causes of death are homicide and suicide.4 In a given year, more US children will die from gunfire than will die from cancer, pneumonia, influenza, asthma, and HIV/AIDS combined.5 Other forms of violence, such as beating, stabbing, and rape also contribute significantly to US morbidity and mortality.

Media Violence in the United States

Violence is ubiquitous in American mass media. An average American youth will witness 200,000 violent episodes on television alone before age 18.6 Violence is often considerable, even in programs which are not advertised as violent. Overall, weapons appear on prime time television an average of 9 times each hour.7 An estimated 54 percent of American children can watch this programming from the privacy of their own bedrooms.8

Children’s shows are particularly violent. Saturday morning cartoons contain 20-25 violent acts per hour, about 6 times as many as prime time programs.9 Overall, 46 percent of TV violence occurs in cartoons.8 Additionally, these programs are more likely to juxtapose violence with humor (67 percent) and less likely to show the long-term consequences of violence (5 percent).8 Although some claim that cartoon violence is not as “real” and therefore not as damaging, cartoon violence has been shown to increase the likelihood of aggressive, antisocial behavior in youth.10 This makes sense in light of children’s developmental difficulty discerning the real from the fantastic.11

A Skewed Sense of Violence

Media violence presents a picture significantly different from that of true violence. First, the sheer volume of violence is exaggerated; 66 percent of television programs contain violence.8 More significant, however, are the skewed contexts in which media present violence. In media portrayals, 75 percent of violent acts are committed without remorse, criticism, or penalty; 41 percent are associated with humor; 38 percent are committed by attractive perpetrators; and 58 percent involve victims who show no pain.8

This inappropriate presentation of violence leads to inappropriate expectations of youth with regard to true violence. In particular, three major attitudes are learned: aggression, desensitization, and victimization. Statistical analyses show what type of media violence most likely teaches each attribute: violent episodes associated with humor, weapons, and attractive perpetrators increase real-life aggression; humor-associated violence and graphic violence lead to real-life desensitization; and graphic violence and realistic violence tend to generate fear and a sense of victimization in viewers.8

1. Aggression

That media violence leads to increased actual violence has been borne out by amassive body of literature. More than 1000 lab experiments, cross-sectional analyses, longitudinal studies, and epidemiologic studies support this hypothesis, as do meta-analyses.7,12-14

Many of these studies have additionally shown that certain populations are particularly sensitive to media violence. These include males, emotionally labile children, delinquent children, and children with developmental disabilities.10,15

2. Desensitization

Media violence has also been shown to desensitize humans to violence. In one study, portrayals of violence against women in sexual contexts fostered callous attitudes toward victims of sexual and spousal abuse. Subjects viewed “slasher” films and were then asked, in a seemingly unrelated study, to observe and comment on a videotaped rape trial. After repeated viewing of the “slasher” films, subjects showed less sympathy toward victims of rape, perceived less violence in the films, perceived films as less violent toward women, and showed decreases in anxiety and depression due to the rape trial.16

3. Trauma and Victimization

Media violence also leads to fear and a feeling of victimization. In one study, 75 percent of high school students reported media violence at moderate to high levels, and 10 percent sought counseling due to nightmares, anxiety, and fear associated with media violence.17 Another study of 3rd to 8th graders confirmed the relationship between trauma symptoms (such as nightmares) and increased television viewing.18

After the events of September 11, 2001, many Americans developed symptoms of post-traumatic stress disorder (PTSD). One study determined that increased television viewing for the few days after the event was a stronger predictor of PTSD than living in New York City, having had a friend or relative involved in the event, or even having actually been inside the World Trade Center that day.19

The Cost of Media Violence in the United States and Worldwide

In spite of the wealth of data connecting media and actual violence, the extent of damage on our society remains in question. One researcher explored epidemiologically the introduction of television into various societies. He found that the homicide rate consistently doubled in different societies (United States, Canada, and South Africa) during the 10-15 year period after the introduction of television, whenever that happened to be. He extrapolated that, had TV never been introduced, each year the United States would have 10,000 fewer homicides, 70,000 fewer rapes, and 700,000 fewer injurious assaults.20

With American media quickly spreading across the world, the problem has become global. Researchers believe that, as of 1993, media violence was responsible for about 5-15 percent of total actual world violence.21

Other Media

Although most research on media violence has involved television and film, other types of media violence likely contribute to societal violence as well. Violent video games have been shown to increase aggression and delinquency.22 The two youths responsible for the killings in Littleton, CO avidly played Doom, a violent video game used to train soldiers to kill. They created a customized version of the game involving two shooters with unlimited ammunition, extra weapons, and defenseless victims—a fantasy which they later brought to reality in their high school.22 More research needs to be done on the potential of computerized video games, the Internet, and other media to increase violence.

Future Directions

Limiting exposure is one method of lessening the impact of violent media on youth. This can be achieved informally or through the use of technology which “locks out” certain channels or amounts of television. This does not, however, affect the amount of film violence or other types of media violence consumed. Although film ratings and advisory labels can help parents decide on programs to be avoided, there are two major problems with relying on this system. First, certain labels, such as “parental discretion advised” and “R” have been shown to attract children, especially boys.8 Second, as has been noted, violence is present is many programs not considered to be violent, such as children’s cartoons.

In addition to limiting exposure to violent media, educational efforts should be developed to help children understand the divide between real and fictionalized violence. Such media literacy programs have been shown to be effective, both in limiting the negative effects of media as well as in exploring the potential positive and pro-social uses of media.23-26

In summary, the following measures are recommended:

  1. Physicians should become involved in media education by
    1. learning about the potential health risks of media consumption;
    2. questioning patients about excessive exposure to media violence;
    3. incorporating warnings about the health risks of violent media consumption into their preventative services; and
    4. limiting video and television use in waiting rooms and substituting educational materials.
  2. Families should limit and monitor media consumption.
    1. Children under 2 years of age should be discouraged from watching television. Before this age, direct social interaction is critical to brain development, and television has been shown to interfere with such interaction.23
    2. Other children and adults should limit media consumption to less than an average of 1-2 hours a day.
    3. Adults should monitor the various media to which their children are exposed, including TV, films, video games, music videos, and the Internet.
  3. Policy changes should accompany our newfound understanding of the impact of media violence on public health.
    1. Federal, state, and local restrictions on media violence should be increased.
    2. Physicians and community members should partner with media producers to limit the amount and type of violence produced.
  4. Media education and media literacy programs should be encouraged.
    1. Whenever possible, adults should watch with their children and help them process media violence. Taping programs beforehand enables pausing for discussion or processing.
    2. Media education programs that focus on demystifying and processing media violence should be developed and implemented. Emphasis should be placed on the inappropriate, unrealistic nature of violence on television and in films, and the consequences, responsibility, and complexity involved with true violence.


  1. Kachur SP, Stennies GM, Powell KE, Modzeleski W, Stephens R, Murphy R, et al. School-associated violent deaths in the United States, 1992 to 1994. JAMA 1996;275:1729-1733.
  2. Krug EG, Powell KE, Dahlberg LL. Firearm-related deaths in the United States and 35 other high- and upper-middle-income countries. Int J Epidemiol 1998;27:214-221.
  3. Centers for Disease Control and Prevention. Rates of homicide, suicide, and firearm-related death among children -- 26 industrialized countries. MMWR Morb Mortal Wkly Rep 1997;46:101-105.
  4. Hoyert DL, Arias E, Smith BL, Murphy SL, Kochanek KD. Deaths: final data for 1999. Natl Vital Stat Rep 2001 49(8):1-113.
  5. Children’s Defense Fund. Protect children instead of guns, 2004. Accessed 6/10/04 at
  6. American Psychological Association Commission on Violence and Youth. Violence and youth: psychology’s response, Volume 1: Summary report of the American Psychological Association Commission on Violence and Youth, Washington, DC: American Psychological Association, 1993.
  7. Strasburger V, Donnerstein E. Children, adolescents, and the media in the 21st century. Adolesc Med 2000;11:51-68.
  8. Federman J. National television violence study I, II, and III. Thousand Oaks, CA: Sage, 1996-1998.
  9. American Association of Pediatrics Committee on Communications. Media Violence. Pediatrics 1995;95:949-951.
  10. Leung AK, Fagan JE, Cho H, Lim SH, Robson WL. Children and television. Am Fam Physician 1994;50:909-918.
  11. Huesmann LR, Eron LD, Klein R, Brice P, Fischer P. Mitigating the imitation of aggressive behaviors by changing children’s attitudes about media violence. J Pers Soc Psychol 1983;44:899-910.
  12. Eron LD. The impact of televised violence: testimony on behalf of the American Psychological Association before the Senate Committee on Governmental Affairs. Congressional Record, June 18, 1992.
  13. Comstock G, Strasburger VC. Deceptive appearances: television violence and aggressive behavior. J Adolesc Health Care 1990;11:31-44.
  14. Pearl D, Bouthilet L, Lazar JB. Television and behavior: ten years of scientific progress and implications for the eighties. Washington, DC: US Dept of Health and Human Services, Public Health Service, Alcohol, Drug Abuse, and Mental Health Administration, National Institute of Mental Health, 1982.
  15. Strasburger VC. Children, adolescents, and television. Pediatr Rev 1992;13:144-151.
  16. Linz DG, Donnerstein E, Penrod S. The effects of multiple exposures to filmed violence against women. J Commun 1984;34:130-147.
  17. Joshi PT, Kaschak DG. Exposure to violence and trauma: questionnaire for adolescents. Int Rev Psychiatry 1998;10:208-215.
  18. Singer MI, Anglin TM, Song L, Lunghofer L. Adolescents’ exposure to violence and associated symptoms of psychological trauma. JAMA 1995;273:277-282.
  19. Schlenger WE, Caddell JM, Ebert L, Jordan BK, Rourke KM, Wilson D, et al. Psychological reactions to terrorist attacks: findings from the National Study of Americans’ Reactions to September 11. JAMA 2002;288:581-588.
  20. Centerwall Bs. Television and violence: the scale of the problem and where to go from here. JAMA 1992;267:3059-3063.
  21. Comstock G, Strasburger VC. Media violence: Q&A. Adolesc Med 1993;4:495-510.
  22. Anderson CA, Dill KE. Video games and aggressive thoughts, feelings, and behavior in the laboratory and in life. J Pers Soc Psychol 2000;78:772-790.
  23. American Association of Pediatrics Committee on Communications. Media Education. Pediatrics 1999; 104:341-343.
  24. Brown JA. Television “critical viewing skills” education: major media literacy projects in the United States and selected countries. Hillsdale, NJ: L. Erlbaum Associates, 1991.
  25. Voojis MW, van der Voort THA. Learning about television violence: the impact of a critical viewing curriculum on children's attitudinal judgments of crime series. J Res Dev Educ 1993;26(3):133-142.
  26. Huesmann LR, Eron LD, Klein R, Brice P, Fischer P. Mitigating the imitation of aggressive behaviors by changing children's attitudes about media violence. J Pers Soc Psychol 1983 May;44(5):899-910.

(2004) (2010 COD)