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Am Fam Physician. 2002;65(7):1436-1438

Violent video games have been linked to antisocial and aggressive behavior in children and adolescents, although other factors such as family disruption and parental abuse or neglect are more predictive of youth violence and delinquency. Other negative effects, such as reinforcement of racist or sexist stereotypes, have also been associated with use of video games. Conversely, some authors suggest that video games may provide a safe outlet for aggression and frustration. Positive effects on divided-attention performance, developmental issues, and spatial and coordination skills also have been suggested. Bensley and van Eenwyk performed a comprehensive review to see if violent video games are associated with aggression in real life.

The authors note that rates of adolescent violence, homicide, weapon-carrying, and other markers of antisocial behavior fell consistently during the period when violent video games became ubiquitous, more graphic, and more realistic. Furthermore, no consistent theories have emerged to explain a causative relationship between violent video games and antisocial behavior. Theories linking video games to violent behavior include learning and imitating aggressive behavior, arousal by the success or peer status of winning a violent game, and “priming” (changing the threshold at which violence seems acceptable or increasing the likelihood that ambiguous behavior is perceived to be threatening).

An extensive search of literature databases, personal contacts, and other sources identified 29 studies of this topic. The studies varied greatly in design and quality, leading the authors to conclude that a major deficiency in randomized, well-controlled studies prevents firm determinations from being reached. In children of middle-school age and younger, no association was found between video games and aggression in girls. In boys, studies report both increased and decreased aggression. Studies of middle- and high-school students predominately studied boys and often used self-report. Again, both calming and arousal effects were reported, and no consistent relationship was demonstrated between violent games and actual behavior. In college students and young adults, results were again mixed, but studies reporting calming effects were more common, particularly if the prior mood was hostile, angry, or aggressive.

The authors conclude that, contrary to popular impressions, little evidence supports concerns that violent video games are linked to aggressive or antisocial behavior. They caution that this topic is quite complex and not easily studied. The effect may depend on individual characteristics, including age and mood before playing the game, as well as the characteristics and complexity of the game itself. Modern, more realistic games may have very different effects than earlier versions. The authors do not regard violent video games as a significant public health concern.

editor's note: While this article is somewhat reassuring, the pervasive nature of violent video games continues to be disturbing. Besides the direct effects on behavior, what effects do these games have on developing understandings of reality or “normality”? These questions have been raised by every generation about the recreational pastimes of young persons. Novels, films, radio, and television have all been accused of leading young people astray and inducing violent or antisocial behavior. The fuss about video games may be just another case of curmudgeons complaining—but they do differ from earlier pastimes in their reality and scope for direct participation. It will be good news if the link to violent behavior turns out to be a false alarm, but we still have to deal with the consequences of the time diverted to these games. In addition to time lost from studies and other activities, the passive nature of the games plus the link to snacking makes them prime contributors to the epidemic of obesity in young persons.—a.d.w.

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