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CME/CE Information

CME/CE Released: 05/05/2014 ; Valid for credit through 05/05/2015

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The goal of this activity is to provide medical news to primary care clinicians and other healthcare

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Upon completion of this activity, participants will be able to:

1. Describe results of a previous meta-analysis that evaluated the effects of violent video games on

children's

thoughts and actions.

2. Evaluate how violent video games might influence the thoughts and behavior of children and

adolescents.

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From Medscape Education Clinical Briefs

News Author: Laird Harrison

CME Author: Charles P. Vega, MD

Clinical Context

Video games, including violent video games, are increasingly popular among young people. The questionof the

psychological and behavioral effects of these games has existed as long as the games themselves, and a

previous

meta-analysis by Anderson and colleagues, which was published in the March 2010 issue of

Psychological Bulletin,

evaluated the effects of violent games on attitudes and behaviors among children and adolescents. This

research

found a strong positive link between playing violent video games and the development of more

aggressive thoughts,

whereas empathy decreased. Moreover, higher exposure to violent video games was related to a more

aggressive

affect and behaviors. This effect was noted among boys and girls.

There is insufficient research to evaluate how violent video games may result in aggressive behavior,

and the

significant modifiers of this effect. The current study by Gentile and colleagues addresses this issue in a

large cohort

of children.

Study Synopsis and Perspective

Children's thoughts and actions become more aggressive as they play more violent video games, a new

study

suggests.

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During the course of 3 years of observation, 3034 children in Singapore reported that their fantasies and

attitudes

became increasingly aggressive as they played violent games, which led to aggressive behavior.

"This study found that habitual [violent game play] increases long-term [aggressive behavior] by

producing general

changes in [aggressive cognitions], and this occurs regardless of sex, age, initial aggressiveness, and

parental

involvement," Douglas A. Gentile, PhD, from the Department of Psychology, Iowa State University,

Ames, and

colleagues write.

The researchers present their findings in an article published online March 24 in JAMA Pediatrics.

Although previous research has also correlated aggressive behavior with violent gaming, the researchers

wanted to

tease out finer details about the relationship of games, thoughts, and behavior, so they recruited a

larger sample than

in most previous studies and collected data at 3 points at 3 years.

Do Violent Video Games Increase Aggressive Behavior in

Kids? CME/CE

CME/CE Released: 05/05/2014 ; Valid for credit through 05/05/201529/8/2014 Do Violent Video Games

Increase Aggressive Behavior in Kids? (printer-friendly)

http://www.medscape.org/viewarticle/823176_print 5/7

Participants were in grades 3, 4, 7, and 8 at study entry. They started the study with a mean age of 11.2

years.

The participants reported the number of hours they played video games and rated the games according

to how often

they played them and whether the games contained violent themes.

At the second and third follow-up surveys, they also answered questions adapted from the General

Media Habits

Questionnaire about aggressive behavior, such as "When someone has angered or provoked me in some

way, I have

reacted by hitting that person."

In addition, they rated the acceptability of aggressive behaviors on the 4-point Normative Beliefs About

Aggression

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Scale, with questions such as "Suppose a boy says something bad to another boy, John. Do you think it's

wrong for

John to hit him?"

The children also answered similar questions about aggressive fantasies on the Aggressive Fantasy Scale

and

judged instances of provocation, a measure of their hostile attribution bias. Finally, they responded to

questions on

the Children's Empathic Attitudes Questionnaire, such as "When I see a student who is upset, it really

bothers me."

On the basis of statistical modeling, the researchers conclude that violent game playing predicted

aggressive

cognition, which in turn predicted aggressive behavior.

Although boys scored twice as high for violent video game play, the violent games were just as likely to

predict

aggressive behavior in girls as they were in boys, the researchers determined. The authors also found

that violent

games affected younger children more than older ones.

The games seemed to affect children more if they started out less aggressive. Children with "low

aggression"

increased 16% in aggressive behavior, whereas those with "high aggression" increased 10%.

Although more empathetic children were less aggressive, children's capacity for empathy did not seem

to change the

degree to which violent games affected them. Parental involvement in the children's media

consumption also did not

appear to change the effects of the violent games.

"Given that more than 90% of youths play video games, understanding the psychological mechanisms by

which they

can influence behaviors is important for parents and pediatricians and for designing interventions to

enhance or

mitigate the effects," the researchers conclude.

The study was funded by the Ministry of Education and the Media Development Authority of Singapore.

The authors

have disclosed no relevant financial relationships.

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mediators of aggression for these children.

Among children with a previous history of aggressive behavior, aggressive cognitions still promoted

aggressive

behaviors among game players. Secondary analyses suggested that violent video games led to

aggressive

behaviors regardless of the baseline level of aggression.

Parental supervision failed to ameliorate the deleterious effects of violent video games.

One variable that did modify the interaction between violent video games, aggressive cognitions, and

aggressive behaviors was age. Games had a greater impact on aggressive cognitions among younger

children.

Clinical Implications

A previous meta-analysis by Anderson and colleagues found a strong positive link between playingviolent

video games and the development of more aggressive thoughts among children, whereas empathy

decreased.

Moreover, higher exposure to violent video games was related to a more aggressive affect and

behaviors. This

effect was noted among boys and girls.

The current study by Gentile and colleagues finds a significant association between playing violent video

games and aggressive behaviors among children and adolescents. This effect was entirely mediated by

aggressive cognitions. It was similar among boys and girls, and parental supervision failed to ameliorate

this

effect.

CME Test

To receive AMA PRA Category 1 Credit, you must receive a minimum score of 75% on the post-test.

You are seeing an 11-year-old girl whose favorite pastime is playing violent video games. According to

the previous meta-analysis by Anderson and colleagues, what should you consider regarding the

effects of exposure to violent video games among children and adolescents?

Violent video games appeared to promote aggressive thoughts, but not aggressive behaviors

Violent video games had no effect on empathy

Violent video games appeared to promote aggressive thoughts, affect, and behaviors

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Violent video games promoted negative outcomes among boys, but not girls

The parents of this girl are concerned because she has been involved in 2 fights during school during

the past month, and they wonder whether her experience with video games is promoting aggression.

According to the current study by Gentile and colleagues, what can you tell them?29/8/2014 Do Violent

Video Games Increase Aggressive Behavior in Kids? (printer-friendly)

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Violent video games are associated with aggressive cognitions among boys only

An increase in aggressive cognitions among gamers increases the risk for aggressive behavior

Parental supervision reduces aggressive cognitions and aggressive behaviors among gamers

There is no association between violent video games and aggression

Save and Proceed

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