do video games cause behavior problems essay

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• Published: 13 March 2018

Does playing violent video games cause aggression? A longitudinal intervention study

• Simone Kühn 1 , 2 ,
• Dimitrij Tycho Kugler 2 ,
• Katharina Schmalen 1 ,
• Markus Weichenberger 1 ,
• Charlotte Witt 1 &
• Jürgen Gallinat 2  

Molecular Psychiatry volume  24 ,  pages 1220–1234 ( 2019 ) Cite this article

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It is a widespread concern that violent video games promote aggression, reduce pro-social behaviour, increase impulsivity and interfere with cognition as well as mood in its players. Previous experimental studies have focussed on short-term effects of violent video gameplay on aggression, yet there are reasons to believe that these effects are mostly the result of priming. In contrast, the present study is the first to investigate the effects of long-term violent video gameplay using a large battery of tests spanning questionnaires, behavioural measures of aggression, sexist attitudes, empathy and interpersonal competencies, impulsivity-related constructs (such as sensation seeking, boredom proneness, risk taking, delay discounting), mental health (depressivity, anxiety) as well as executive control functions, before and after 2 months of gameplay. Our participants played the violent video game Grand Theft Auto V, the non-violent video game The Sims 3 or no game at all for 2 months on a daily basis. No significant changes were observed, neither when comparing the group playing a violent video game to a group playing a non-violent game, nor to a passive control group. Also, no effects were observed between baseline and posttest directly after the intervention, nor between baseline and a follow-up assessment 2 months after the intervention period had ended. The present results thus provide strong evidence against the frequently debated negative effects of playing violent video games in adults and will therefore help to communicate a more realistic scientific perspective on the effects of violent video gaming.

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The concern that violent video games may promote aggression or reduce empathy in its players is pervasive and given the popularity of these games their psychological impact is an urgent issue for society at large. Contrary to the custom, this topic has also been passionately debated in the scientific literature. One research camp has strongly argued that violent video games increase aggression in its players [ 1 , 2 ], whereas the other camp [ 3 , 4 ] repeatedly concluded that the effects are minimal at best, if not absent. Importantly, it appears that these fundamental inconsistencies cannot be attributed to differences in research methodology since even meta-analyses, with the goal to integrate the results of all prior studies on the topic of aggression caused by video games led to disparate conclusions [ 2 , 3 ]. These meta-analyses had a strong focus on children, and one of them [ 2 ] reported a marginal age effect suggesting that children might be even more susceptible to violent video game effects.

To unravel this topic of research, we designed a randomised controlled trial on adults to draw causal conclusions on the influence of video games on aggression. At present, almost all experimental studies targeting the effects of violent video games on aggression and/or empathy focussed on the effects of short-term video gameplay. In these studies the duration for which participants were instructed to play the games ranged from 4 min to maximally 2 h (mean = 22 min, median = 15 min, when considering all experimental studies reviewed in two of the recent major meta-analyses in the field [ 3 , 5 ]) and most frequently the effects of video gaming have been tested directly after gameplay.

It has been suggested that the effects of studies focussing on consequences of short-term video gameplay (mostly conducted on college student populations) are mainly the result of priming effects, meaning that exposure to violent content increases the accessibility of aggressive thoughts and affect when participants are in the immediate situation [ 6 ]. However, above and beyond this the General Aggression Model (GAM, [ 7 ]) assumes that repeatedly primed thoughts and feelings influence the perception of ongoing events and therewith elicits aggressive behaviour as a long-term effect. We think that priming effects are interesting and worthwhile exploring, but in contrast to the notion of the GAM our reading of the literature is that priming effects are short-lived (suggested to only last for <5 min and may potentially reverse after that time [ 8 ]). Priming effects should therefore only play a role in very close temporal proximity to gameplay. Moreover, there are a multitude of studies on college students that have failed to replicate priming effects [ 9 , 10 , 11 ] and associated predictions of the so-called GAM such as a desensitisation against violent content [ 12 , 13 , 14 ] in adolescents and college students or a decrease of empathy [ 15 ] and pro-social behaviour [ 16 , 17 ] as a result of playing violent video games.

However, in our view the question that society is actually interested in is not: “Are people more aggressive after having played violent video games for a few minutes? And are these people more aggressive minutes after gameplay ended?”, but rather “What are the effects of frequent, habitual violent video game playing? And for how long do these effects persist (not in the range of minutes but rather weeks and months)?” For this reason studies are needed in which participants are trained over longer periods of time, tested after a longer delay after acute playing and tested with broader batteries assessing aggression but also other relevant domains such as empathy as well as mood and cognition. Moreover, long-term follow-up assessments are needed to demonstrate long-term effects of frequent violent video gameplay. To fill this gap, we set out to expose adult participants to two different types of video games for a period of 2 months and investigate changes in measures of various constructs of interest at least one day after the last gaming session and test them once more 2 months after the end of the gameplay intervention. In contrast to the GAM, we hypothesised no increases of aggression or decreases in pro-social behaviour even after long-term exposure to a violent video game due to our reasoning that priming effects of violent video games are short-lived and should therefore not influence measures of aggression if they are not measured directly after acute gaming. In the present study, we assessed potential changes in the following domains: behavioural as well as questionnaire measures of aggression, empathy and interpersonal competencies, impulsivity-related constructs (such as sensation seeking, boredom proneness, risk taking, delay discounting), and depressivity and anxiety as well as executive control functions. As the effects on aggression and pro-social behaviour were the core targets of the present study, we implemented multiple tests for these domains. This broad range of domains with its wide coverage and the longitudinal nature of the study design enabled us to draw more general conclusions regarding the causal effects of violent video games.

Materials and methods

Participants.

Ninety healthy participants (mean age = 28 years, SD = 7.3, range: 18–45, 48 females) were recruited by means of flyers and internet advertisements. The sample consisted of college students as well as of participants from the general community. The advertisement mentioned that we were recruiting for a longitudinal study on video gaming, but did not mention that we would offer an intervention or that we were expecting training effects. Participants were randomly assigned to the three groups ruling out self-selection effects. The sample size was based on estimates from a previous study with a similar design [ 18 ]. After complete description of the study, the participants’ informed written consent was obtained. The local ethics committee of the Charité University Clinic, Germany, approved of the study. We included participants that reported little, preferably no video game usage in the past 6 months (none of the participants ever played the game Grand Theft Auto V (GTA) or Sims 3 in any of its versions before). We excluded participants with psychological or neurological problems. The participants received financial compensation for the testing sessions (200 Euros) and performance-dependent additional payment for two behavioural tasks detailed below, but received no money for the training itself.

Training procedure

The violent video game group (5 participants dropped out between pre- and posttest, resulting in a group of n  = 25, mean age = 26.6 years, SD = 6.0, 14 females) played the game Grand Theft Auto V on a Playstation 3 console over a period of 8 weeks. The active control group played the non-violent video game Sims 3 on the same console (6 participants dropped out, resulting in a group of n  = 24, mean age = 25.8 years, SD = 6.8, 12 females). The passive control group (2 participants dropped out, resulting in a group of n  = 28, mean age = 30.9 years, SD = 8.4, 12 females) was not given a gaming console and had no task but underwent the same testing procedure as the two other groups. The passive control group was not aware of the fact that they were part of a control group to prevent self-training attempts. The experimenters testing the participants were blind to group membership, but we were unable to prevent participants from talking about the game during testing, which in some cases lead to an unblinding of experimental condition. Both training groups were instructed to play the game for at least 30 min a day. Participants were only reimbursed for the sessions in which they came to the lab. Our previous research suggests that the perceived fun in gaming was positively associated with training outcome [ 18 ] and we speculated that enforcing training sessions through payment would impair motivation and thus diminish the potential effect of the intervention. Participants underwent a testing session before (baseline) and after the training period of 2 months (posttest 1) as well as a follow-up testing sessions 2 months after the training period (posttest 2).

Grand Theft Auto V (GTA)

GTA is an action-adventure video game situated in a fictional highly violent game world in which players are rewarded for their use of violence as a means to advance in the game. The single-player story follows three criminals and their efforts to commit heists while under pressure from a government agency. The gameplay focuses on an open world (sandbox game) where the player can choose between different behaviours. The game also allows the player to engage in various side activities, such as action-adventure, driving, third-person shooting, occasional role-playing, stealth and racing elements. The open world design lets players freely roam around the fictional world so that gamers could in principle decide not to commit violent acts.

The Sims 3 (Sims)

Sims is a life simulation game and also classified as a sandbox game because it lacks clearly defined goals. The player creates virtual individuals called “Sims”, and customises their appearance, their personalities and places them in a home, directs their moods, satisfies their desires and accompanies them in their daily activities and by becoming part of a social network. It offers opportunities, which the player may choose to pursue or to refuse, similar as GTA but is generally considered as a pro-social and clearly non-violent game.

Assessment battery

To assess aggression and associated constructs we used the following questionnaires: Buss–Perry Aggression Questionnaire [ 19 ], State Hostility Scale [ 20 ], Updated Illinois Rape Myth Acceptance Scale [ 21 , 22 ], Moral Disengagement Scale [ 23 , 24 ], the Rosenzweig Picture Frustration Test [ 25 , 26 ] and a so-called World View Measure [ 27 ]. All of these measures have previously been used in research investigating the effects of violent video gameplay, however, the first two most prominently. Additionally, behavioural measures of aggression were used: a Word Completion Task, a Lexical Decision Task [ 28 ] and the Delay frustration task [ 29 ] (an inter-correlation matrix is depicted in Supplementary Figure 1 1). From these behavioural measures, the first two were previously used in research on the effects of violent video gameplay. To assess variables that have been related to the construct of impulsivity, we used the Brief Sensation Seeking Scale [ 30 ] and the Boredom Propensity Scale [ 31 ] as well as tasks assessing risk taking and delay discounting behaviourally, namely the Balloon Analogue Risk Task [ 32 ] and a Delay-Discounting Task [ 33 ]. To quantify pro-social behaviour, we employed: Interpersonal Reactivity Index [ 34 ] (frequently used in research on the effects of violent video gameplay), Balanced Emotional Empathy Scale [ 35 ], Reading the Mind in the Eyes test [ 36 ], Interpersonal Competence Questionnaire [ 37 ] and Richardson Conflict Response Questionnaire [ 38 ]. To assess depressivity and anxiety, which has previously been associated with intense video game playing [ 39 ], we used Beck Depression Inventory [ 40 ] and State Trait Anxiety Inventory [ 41 ]. To characterise executive control function, we used a Stop Signal Task [ 42 ], a Multi-Source Interference Task [ 43 ] and a Task Switching Task [ 44 ] which have all been previously used to assess effects of video gameplay. More details on all instruments used can be found in the Supplementary Material.

Data analysis

On the basis of the research question whether violent video game playing enhances aggression and reduces empathy, the focus of the present analysis was on time by group interactions. We conducted these interaction analyses separately, comparing the violent video game group against the active control group (GTA vs. Sims) and separately against the passive control group (GTA vs. Controls) that did not receive any intervention and separately for the potential changes during the intervention period (baseline vs. posttest 1) and to test for potential long-term changes (baseline vs. posttest 2). We employed classical frequentist statistics running a repeated-measures ANOVA controlling for the covariates sex and age.

Since we collected 52 separate outcome variables and conduced four different tests with each (GTA vs. Sims, GTA vs. Controls, crossed with baseline vs. posttest 1, baseline vs. posttest 2), we had to conduct 52 × 4 = 208 frequentist statistical tests. Setting the alpha value to 0.05 means that by pure chance about 10.4 analyses should become significant. To account for this multiple testing problem and the associated alpha inflation, we conducted a Bonferroni correction. According to Bonferroni, the critical value for the entire set of n tests is set to an alpha value of 0.05 by taking alpha/ n  = 0.00024.

Since the Bonferroni correction has sometimes been criticised as overly conservative, we conducted false discovery rate (FDR) correction [ 45 ]. FDR correction also determines adjusted p -values for each test, however, it controls only for the number of false discoveries in those tests that result in a discovery (namely a significant result).

Moreover, we tested for group differences at the baseline assessment using independent t -tests, since those may hamper the interpretation of significant interactions between group and time that we were primarily interested in.

Since the frequentist framework does not enable to evaluate whether the observed null effect of the hypothesised interaction is indicative of the absence of a relation between violent video gaming and our dependent variables, the amount of evidence in favour of the null hypothesis has been tested using a Bayesian framework. Within the Bayesian framework both the evidence in favour of the null and the alternative hypothesis are directly computed based on the observed data, giving rise to the possibility of comparing the two. We conducted Bayesian repeated-measures ANOVAs comparing the model in favour of the null and the model in favour of the alternative hypothesis resulting in a Bayes factor (BF) using Bayesian Information criteria [ 46 ]. The BF 01 suggests how much more likely the data is to occur under the null hypothesis. All analyses were performed using the JASP software package ( https://jasp-stats.org ).

Sex distribution in the present study did not differ across the groups ( χ 2 p -value > 0.414). However, due to the fact that differences between males and females have been observed in terms of aggression and empathy [ 47 ], we present analyses controlling for sex. Since our random assignment to the three groups did result in significant age differences between groups, with the passive control group being significantly older than the GTA ( t (51) = −2.10, p  = 0.041) and the Sims group ( t (50) = −2.38, p  = 0.021), we also controlled for age.

The participants in the violent video game group played on average 35 h and the non-violent video game group 32 h spread out across the 8 weeks interval (with no significant group difference p  = 0.48).

To test whether participants assigned to the violent GTA game show emotional, cognitive and behavioural changes, we present the results of repeated-measure ANOVA time x group interaction analyses separately for GTA vs. Sims and GTA vs. Controls (Tables  1 – 3 ). Moreover, we split the analyses according to the time domain into effects from baseline assessment to posttest 1 (Table  2 ) and effects from baseline assessment to posttest 2 (Table  3 ) to capture more long-lasting or evolving effects. In addition to the statistical test values, we report partial omega squared ( ω 2 ) as an effect size measure. Next to the classical frequentist statistics, we report the results of a Bayesian statistical approach, namely BF 01 , the likelihood with which the data is to occur under the null hypothesis that there is no significant time × group interaction. In Table  2 , we report the presence of significant group differences at baseline in the right most column.

Since we conducted 208 separate frequentist tests we expected 10.4 significant effects simply by chance when setting the alpha value to 0.05. In fact we found only eight significant time × group interactions (these are marked with an asterisk in Tables  2 and 3 ).

When applying a conservative Bonferroni correction, none of those tests survive the corrected threshold of p  < 0.00024. Neither does any test survive the more lenient FDR correction. The arithmetic mean of the frequentist test statistics likewise shows that on average no significant effect was found (bottom rows in Tables  2 and 3 ).

In line with the findings from a frequentist approach, the harmonic mean of the Bayesian factor BF 01 is consistently above one but not very far from one. This likewise suggests that there is very likely no interaction between group × time and therewith no detrimental effects of the violent video game GTA in the domains tested. The evidence in favour of the null hypothesis based on the Bayes factor is not massive, but clearly above 1. Some of the harmonic means are above 1.6 and constitute substantial evidence [ 48 ]. However, the harmonic mean has been criticised as unstable. Owing to the fact that the sum is dominated by occasional small terms in the likelihood, one may underestimate the actual evidence in favour of the null hypothesis [ 49 ].

To test the sensitivity of the present study to detect relevant effects we computed the effect size that we would have been able to detect. The information we used consisted of alpha error probability = 0.05, power = 0.95, our sample size, number of groups and of measurement occasions and correlation between the repeated measures at posttest 1 and posttest 2 (average r  = 0.68). According to G*Power [ 50 ], we could detect small effect sizes of f  = 0.16 (equals η 2  = 0.025 and r  = 0.16) in each separate test. When accounting for the conservative Bonferroni-corrected p -value of 0.00024, still a medium effect size of f  = 0.23 (equals η 2  = 0.05 and r  = 0.22) would have been detectable. A meta-analysis by Anderson [ 2 ] reported an average effects size of r  = 0.18 for experimental studies testing for aggressive behaviour and another by Greitmeyer [ 5 ] reported average effect sizes of r  = 0.19, 0.25 and 0.17 for effects of violent games on aggressive behaviour, cognition and affect, all of which should have been detectable at least before multiple test correction.

Within the scope of the present study we tested the potential effects of playing the violent video game GTA V for 2 months against an active control group that played the non-violent, rather pro-social life simulation game The Sims 3 and a passive control group. Participants were tested before and after the long-term intervention and at a follow-up appointment 2 months later. Although we used a comprehensive test battery consisting of questionnaires and computerised behavioural tests assessing aggression, impulsivity-related constructs, mood, anxiety, empathy, interpersonal competencies and executive control functions, we did not find relevant negative effects in response to violent video game playing. In fact, only three tests of the 208 statistical tests performed showed a significant interaction pattern that would be in line with this hypothesis. Since at least ten significant effects would be expected purely by chance, we conclude that there were no detrimental effects of violent video gameplay.

This finding stands in contrast to some experimental studies, in which short-term effects of violent video game exposure have been investigated and where increases in aggressive thoughts and affect as well as decreases in helping behaviour have been observed [ 1 ]. However, these effects of violent video gaming on aggressiveness—if present at all (see above)—seem to be rather short-lived, potentially lasting <15 min [ 8 , 51 ]. In addition, these short-term effects of video gaming are far from consistent as multiple studies fail to demonstrate or replicate them [ 16 , 17 ]. This may in part be due to problems, that are very prominent in this field of research, namely that the outcome measures of aggression and pro-social behaviour, are poorly standardised, do not easily generalise to real-life behaviour and may have lead to selective reporting of the results [ 3 ]. We tried to address these concerns by including a large set of outcome measures that were mostly inspired by previous studies demonstrating effects of short-term violent video gameplay on aggressive behaviour and thoughts, that we report exhaustively.

Since effects observed only for a few minutes after short sessions of video gaming are not representative of what society at large is actually interested in, namely how habitual violent video gameplay affects behaviour on a more long-term basis, studies employing longer training intervals are highly relevant. Two previous studies have employed longer training intervals. In an online study, participants with a broad age range (14–68 years) have been trained in a violent video game for 4 weeks [ 52 ]. In comparison to a passive control group no changes were observed, neither in aggression-related beliefs, nor in aggressive social interactions assessed by means of two questions. In a more recent study, participants played a previous version of GTA for 12 h spread across 3 weeks [ 53 ]. Participants were compared to a passive control group using the Buss–Perry aggression questionnaire, a questionnaire assessing impulsive or reactive aggression, attitude towards violence, and empathy. The authors only report a limited increase in pro-violent attitude. Unfortunately, this study only assessed posttest measures, which precludes the assessment of actual changes caused by the game intervention.

The present study goes beyond these studies by showing that 2 months of violent video gameplay does neither lead to any significant negative effects in a broad assessment battery administered directly after the intervention nor at a follow-up assessment 2 months after the intervention. The fact that we assessed multiple domains, not finding an effect in any of them, makes the present study the most comprehensive in the field. Our battery included self-report instruments on aggression (Buss–Perry aggression questionnaire, State Hostility scale, Illinois Rape Myth Acceptance scale, Moral Disengagement scale, World View Measure and Rosenzweig Picture Frustration test) as well as computer-based tests measuring aggressive behaviour such as the delay frustration task and measuring the availability of aggressive words using the word completion test and a lexical decision task. Moreover, we assessed impulse-related concepts such as sensation seeking, boredom proneness and associated behavioural measures such as the computerised Balloon analogue risk task, and delay discounting. Four scales assessing empathy and interpersonal competence scales, including the reading the mind in the eyes test revealed no effects of violent video gameplay. Neither did we find any effects on depressivity (Becks depression inventory) nor anxiety measured as a state as well as a trait. This is an important point, since several studies reported higher rates of depressivity and anxiety in populations of habitual video gamers [ 54 , 55 ]. Last but not least, our results revealed also no substantial changes in executive control tasks performance, neither in the Stop signal task, the Multi-source interference task or a Task switching task. Previous studies have shown higher performance of habitual action video gamers in executive tasks such as task switching [ 56 , 57 , 58 ] and another study suggests that training with action video games improves task performance that relates to executive functions [ 59 ], however, these associations were not confirmed by a meta-analysis in the field [ 60 ]. The absence of changes in the stop signal task fits well with previous studies that likewise revealed no difference between in habitual action video gamers and controls in terms of action inhibition [ 61 , 62 ]. Although GTA does not qualify as a classical first-person shooter as most of the previously tested action video games, it is classified as an action-adventure game and shares multiple features with those action video games previously related to increases in executive function, including the need for hand–eye coordination and fast reaction times.

Taken together, the findings of the present study show that an extensive game intervention over the course of 2 months did not reveal any specific changes in aggression, empathy, interpersonal competencies, impulsivity-related constructs, depressivity, anxiety or executive control functions; neither in comparison to an active control group that played a non-violent video game nor to a passive control group. We observed no effects when comparing a baseline and a post-training assessment, nor when focussing on more long-term effects between baseline and a follow-up interval 2 months after the participants stopped training. To our knowledge, the present study employed the most comprehensive test battery spanning a multitude of domains in which changes due to violent video games may have been expected. Therefore the present results provide strong evidence against the frequently debated negative effects of playing violent video games. This debate has mostly been informed by studies showing short-term effects of violent video games when tests were administered immediately after a short playtime of a few minutes; effects that may in large be caused by short-lived priming effects that vanish after minutes. The presented results will therefore help to communicate a more realistic scientific perspective of the real-life effects of violent video gaming. However, future research is needed to demonstrate the absence of effects of violent video gameplay in children.

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SK has been funded by a Heisenberg grant from the German Science Foundation (DFG KU 3322/1-1, SFB 936/C7), the European Union (ERC-2016-StG-Self-Control-677804) and a Fellowship from the Jacobs Foundation (JRF 2016–2018).

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Kühn, S., Kugler, D., Schmalen, K. et al. Does playing violent video games cause aggression? A longitudinal intervention study. Mol Psychiatry 24 , 1220–1234 (2019). https://doi.org/10.1038/s41380-018-0031-7

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October 2, 2018

Do Violent Video Games Trigger Aggression?

A study tries to find whether slaughtering zombies with a virtual assault weapon translates into misbehavior when a teenager returns to reality

By Melinda Wenner Moyer

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Intuitively, it makes sense Splatterhouse and Postal 2 would serve as virtual training sessions for teens, encouraging them to act out in ways that mimic game-related violence. But many studies have failed to find a clear connection between violent game play and belligerent behavior, and the controversy over whether the shoot-‘em-up world transfers to real life has persisted for years. A new study published on October 1 in Proceedings of the National Academy of Sciences tries to resolve the controversy by weighing the findings of two dozen studies on the topic.

The meta-analysis does tie violent video games to a small increase in physical aggression among adolescents and preteens. Yet debate is by no means over. Whereas the analysis was undertaken to help settle the science on the issue, researchers still disagree on the real-world significance of the findings.

This new analysis attempted to navigate through the minefield of conflicting research. Many studies find gaming associated with increases in aggression, but others identify no such link. A small but vocal cadre of researchers have argued much of the work implicating video games has serious flaws in that, among other things, it measures the frequency of aggressive thoughts or language rather than physically aggressive behaviors like hitting or pushing, which have more real-world relevance.

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Jay Hull, a social psychologist at Dartmouth College and a co-author on the new paper, has never been convinced by the critiques that have disparaged purported ties between gaming and aggression. “I just kept reading, over and over again, [these] criticisms of the literature and going, ‘that’s just not true,’” he says. So he and his colleagues designed the new meta-analysis to address these criticisms head-on and determine if they had merit.

Hull and colleagues pooled data from 24 studies that had been selected to avoid some of the criticisms leveled at earlier work. They only included research that measured the relationship between violent video game use and overt physical aggression. They also limited their analysis to studies that statistically controlled for several factors that could influence the relationship between gaming and subsequent behavior, such as age and baseline aggressive behavior.

Even with these constraints, their analysis found kids who played violent video games did become more aggressive over time. But the changes in behavior were not big. “According to traditional ways of looking at these numbers, it’s not a large effect—I would say it’s relatively small,” he says. But it’s “statistically reliable—it’s not by chance and not inconsequential.”

Their findings mesh with a 2015 literature review conducted by the American Psychological Association, which concluded violent video games worsen aggressive behavior in older children, adolescents and young adults. Together, Hull’s meta-analysis and the APA report help give clarity to the existing body of research, says Douglas Gentile, a developmental psychologist at Iowa State University who was not involved in conducting the meta-analysis. “Media violence is one risk factor for aggression,” he says. “It's not the biggest, it’s also not the smallest, but it’s worth paying attention to.”

Yet researchers who have been critical of links between games and violence contend Hull’s meta-analysis does not settle the issue. “They don’t find much. They just try to make it sound like they do,” says Christopher Ferguson, a psychologist at Stetson University in Florida, who has published papers questioning the link between violent video games and aggression.

Ferguson argues the degree to which video game use increases aggression in Hull’s analysis—what is known in psychology as the estimated “effect size”—is so small as to be essentially meaningless. After statistically controlling for several other factors, the meta-analysis reported an effect size of 0.08, which suggests that violent video games account for less than one percent of the variation in aggressive behavior among U.S. teens and pre-teens—if, in fact, there is a cause-and effect relationship between game play and hostile actions. It may instead be that the relationship between gaming and aggression is a statistical artifact caused by lingering flaws in study design, Ferguson says.  

Johannes Breuer, a psychologist at GESIS–Leibniz Institute for the Social Sciences in Germany, agrees, noting that according to “a common rule of thumb in psychological research,” effect sizes below 0.1 are “considered trivial.” He adds meta-analyses are only as valid as the studies included in them, and that work on the issue has been plagued by methodological problems. For one thing, studies vary in terms of the criteria they use to determine if a video game is violent or not. By some measures, the Super Mario Bros. games would be considered violent, but by others not. Studies, too, often rely on subjects self-reporting their own aggressive acts, and they may not do so accurately. “All of this is not to say that the results of this meta-analysis are not valid,” he says. “But things like this need to be kept in mind when interpreting the findings and discussing their meaning.”

Hull says, however, that the effect size his team found still has real-world significance. An analysis of one of his earlier studies, which reported a similar estimated effect size of 0.083, found playing violent video games was linked with almost double the risk that kids would be sent to the school principal’s office for fighting. The study began by taking a group of children who hadn’t been dispatched to the principal in the previous month and then tracked them for a subsequent eight months. It found 4.8 percent of kids who reported only rarely playing violent video games were sent to the principal’s office at least once during that period compared with 9 percent who reported playing violent video games frequently. Hull theorizes violent games help kids become more comfortable with taking risks and engaging in abnormal behavior. “Their sense of right and wrong is being warped,” he notes.

Hull and his colleagues also found evidence ethnicity shapes the relationship between violent video games and aggression. White players seem more susceptible to the games' putative effects on behavior than do Hispanic and Asian players. Hull isn’t sure why, but he suspects the games' varying impact relates to how much kids are influenced by the norms of American culture, which, he says, are rooted in rugged individualism and a warriorlike mentality that may incite video game players to identify with aggressors rather than victims. It might “dampen sympathy toward their virtual victims,” he and his co-authors wrote, “with consequences for their values and behavior outside the game.”

Social scientists will, no doubt, continue to debate the psychological impacts of killing within the confines of interactive games. In a follow-up paper Hull says he plans to tackle the issue of the real-world significance of violent game play, and hopes it adds additional clarity. “It’s a knotty issue,” he notes—and it’s an open question whether research will ever quell the controversy.

Is Playing Violent Video Games Related to Teens' Mental Health?

New research indicates that video games are not as bad as we once feared..

Posted February 25, 2021 | Reviewed by Matt Huston

Key Points:

• Two recent studies provide insight into whether playing violent video games is related to mental health or aggression .
• Teens who had consistently played violent games for years also reported higher aggression compared to those with gaming patterns that changed over time.
• Researchers found no links between violent video game play and anxiety , depression , somatic symptoms, or ADHD after two years.

With so many kids still home this year, and an apparent increase in the number of teens and adults playing video games, it seems appropriate to re-examine the evidence on whether aggression in video games is associated with problems for adolescents or society. A special issue of Cyberpsychology, Behavior, and Social Networking published in January did just that. As a parent of three—aware of how video games can suck kids in—and a psychologist working at a social innovation lab that has been a leader in the games for health movement, I’m eager to look at studies that examine teens’ violent video game play and any effects later on in life. I asked, in the ongoing conversation about whether playing games like Fortnite makes teens more aggressive, depressed, or anxious, what do we now know?

After a few decades of research in this area, the answer is not definitive . There was a slew of studies in the early 2000s showing a link between violent video game play and aggressive behavior, and a subsequent onslaught of studies showing that the aggression was very slight and likely due to competition rather than the violent nature of the games themselves. For example, studies showed that people got just as aggressive when they lost at games like Mario Kart as when they lost a much more violent game such as Fortnite . It was likely the frustration of losing rather than the violence that caused people to act aggressively.

Looking at Mental Health and Gaming Over Time

Two studies in the January special issue add to the evidence showing that violent video games may not be as dangerous as they have been made out to be. These studies are unique because they looked at large samples of youth over long periods of time. This line of research helps us to consider whether extensive play in a real-world environment (i.e., living rooms, not labs) is associated with mental health functioning later on in the teen and young adult years.

The first study revisited the long-standing debate over whether violent video game play is associated with aggression and mental health symptoms in young adulthood. The study reported on 322 American teens, ages 10 to 13 at the outset, who were interviewed every year for 10 years. The study looked at patterns of violent video game play, and found three such patterns over time: high initial violence (those who played violent games when they were young and then reduced their play over time); moderates (those whose exposure to violent games was moderate but consistent throughout adolescence ); and low-increasers (those who started with low exposure to violent games, and then increased slightly over time). Most kids were low-increasers, and kids who started out with high depression scores were more likely to be in the high initial violence group. Only the kids in the moderates group were more likely to show aggressive behavior than the other two groups.

The researchers concluded that it was sustained violent game play over many years that was predictive of aggressive behavior, not the intensity of the violence alone or the degree of exposure for shorter periods. Importantly, none of the three exposure groups predicted either depression or anxiety, nor did any predict differences in prosocial behavior such as helping others.

The second study was even larger, following 3,000 adolescents from Singapore, and looking at whether playing violent video games was associated with mental health problems two years later. Results showed that neither violent video game play, nor video game time overall, predicted anxiety, depression, somatic symptoms, or attention deficit hyperactivity disorder after two years. Consistent with many previous studies, mental health symptoms at the beginning of the study were predictive of symptoms two years later. In short, no connection was found between video games and the mental health functioning of youth.

Taken together, these studies suggest that predispositions to mental health problems like depression and anxiety are more important to pay attention to than video game exposure, violent or not. There is also an implication that any potential effects of violent video games on aggressive behavior would tend to show up when use is prolonged—though the research did not show that gaming itself necessarily causes the aggressive behavior.

So, Should Parents Be Concerned?

These findings are helpful during a year when many kids have no doubt had unprecedented exposure to video games, some of them violent. The most current evidence is telling us that these games are not likely to make our kids more anxious, depressed, aggressive, or violent.

Do parents still need to watch our children’s screen time ? Yes, as too much video game play takes kids away from other valuable activities for their social, emotional, and creative development, such as using their imagination and making things that have not been given to them by programmers (stories, art, structures, fantasy play). Do parents need to be freaking out that our kids trying to find the "imposter" in a game will make them more likely to hit their friends when they are back together in person? Probably not.

We still need to pay attention to mental health symptoms; teens appear to be feeling the effects of the pandemic more than adults, and levels of depression and anxiety have reached unprecedented heights.

So let’s say the quiet part out loud: if they’re using video games to cope right now, it’s not the end of the world, and if they’re struggling psychologically, we should not be blaming the games. Normal elements of daily life have been reduced for teenagers during what should be their most expansive years, for what has become an increasingly large percentage of their lives. It is untenable, and even still, teens are showing us what they always do—that they are adaptive and resilient , and natural harm reduction experts.

As parents, let’s stay plugged in to what they’re going through, and think more about how games can be supportive of well-being. It’s needed now more than ever.

LinkedIn and Facebook image: Monkey Business Images/Shutterstock

Coyne, S. M., & Stockdale, L. (2020). Growing Up with Grand Theft Auto: A 10-Year Study of Longitudinal Growth of Violent Video Game Play in Adolescents. Cyberpsychology, Behavior, and Social Networking, 24(1), 11–16. https://doi.org/10.1089/cyber.2020.0049

Ferguson, C. J., & Wang, C. K. J. (2020). Aggressive Video Games Are Not a Risk Factor for Mental Health Problems in Youth: A Longitudinal Study. Cyberpsychology, Behavior, and Social Networking, 24(1), 70–73. https://doi.org/10.1089/cyber.2020.0027

Kato, P. M., Cole, S. W., Bradlyn, A. S., & Pollock, B. H. (2008). A Video Game Improves Behavioral Outcomes in Adolescents and Young Adults With Cancer: A Randomized Trial. Pediatrics, 122(2), e305–e317. https://doi.org/10.1542/peds.2007-3134

Przybylski, A. K., & Weinstein, N. (n.d.). Violent video game engagement is not associated with adolescents’ aggressive behaviour: Evidence from a registered report. Royal Society Open Science, 6(2), 171474. https://doi.org/10.1098/rsos.171474

Danielle Ramo, Ph.D. , is a clinical psychologist, researcher in digital mental health and substance use, and Chief Clinical Officer at BeMe Health, a mobile mental health platform designed to improve teen wellbeing.

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Do Video Games Influence Violent Behavior?

By:  Roanna Cooper, MA and Marc Zimmerman, PhD, MI-YVPC Director

An op-ed article appeared recently in the The New York Times  discussing the Supreme Court’s decision to strike down California’s law barring the sale or rental of violent video games to people under 18.  The author, Dr. Cheryl Olson,   describes how the proposed law was based on the erroneous assumption that such games influence violent behavior in real life.

Dr. Olson suggests that the deliberately outrageous nature of violent games, though disturbing, makes them easily discernible from real life and suggests that the interactivity could potentially make such games less harmful.

She raises the question of how these two behaviors can be linked if youth violence has declined over the last several years while violent video game playing has increased significantly during the same period.

This analysis ignores the fact that such variation may be explained by factors other than the link between the two. A spurious variable–a third variable that explains the relationship between two other variables—may explain the negative correlation of video game playing and violent behavior. As one example, socioeconomic status may explain both a decline in violent behavior and an increase in video game playing. More affluent youth have the means and time to buy and play video games, which keeps them safely inside while avoiding potentially violent interactions on the street.  Dr. Olsen also cites several studies that have failed to show a connection between violent video game playing and violent behavior among youth.

This conclusion, however, may not be as clear cut as it appears.

Youth violence remains a significant public health issue

The decline of youth violence notwithstanding, it remains a significant public health issue that requires attention.Youth homicide remains the number one cause of death for African-American youth between 14 and 24 years old, and the number two cause for all children in this age group. Furthermore, the proportion of youth admitting to having committed various violent acts within the previous 12 months has remained steady or even increased somewhat in recent years ( http://pediatrics.aappublications.org/content/108/5/1222.full.pdf+html ).  Although the Columbine tragedy and others like it make the headlines, youth are killed everyday by the hands of another.  A more critical analysis of the link between video game playing and violence is necessary for fully understanding a complex problem like youth violent behavior that has many causes and correlates.

Studies support a link between violent video games and aggressive behavior

Researchers have reported experimental evidence linking violent video games to more aggressive behavior, particularly as it relates to children who are at more sensitive stages in their socialization.  These effects have been found to be particularly profound in the case of child-initiated virtual violence.

• In one study, 161 9- to 12-year olds and 354 college students were randomly assigned to play either a violent or nonviolent video game.  The participants subsequently played another computer game in which they set punishment levels to be delivered to another person participating in the study (they were not actually administered).  Information was also gathered on each participant’s recent history of violent behavior; habitual video game, television, and move habits, and several other control variables.  The authors reported three main findings: 1) participants who played one of violent video games would choose to punish their opponents with significantly more high-noise blasts than those who played the nonviolent games; 2) habitual exposure to violent media was associated with higher levels of recent violent behavior; and 3) interactive forms of media violence were more strongly related to violent behavior than exposure to non-interactive media violence.
• The second study was a cross-sectional correlational study of media habits, aggression-related individual difference variables, and aggressive behaviors of an adolescent population.  High school students (N=189) completed surveys about their violent TV, movie, and video game exposure, attitudes towards violence, and perceived norms about violent behavior and personality traits.  After statistically controlling for sex, total screen time and aggressive beliefs and attitudes, the authors found that playing violent video games predicted heightened physically aggressive behavior and violent behavior in the real world in a long-term context.
• In a third study, Anderson et al. conducted a longitudinal study of elementary school students to examine if violent video game exposure resulted in increases in aggressive behavior over time.  Surveys were given to 430 third, fourth, and fifth graders, their peers, and their teachers at two times during a school year.  The survey assessed both media habits and their attitudes about violence.  Results indicated that children who played more violent video games early in a school year changed to see the world in a more aggressive way and also changed to become more verbally and physically aggressive later in the school year.  Changes in attitude were noticed by both peers and teachers.
• Bushman and Huesmann, in a 2006 Pediatrics and Adolescent Medicine article , examined effect size estimates using meta-analysis to look at the short- and long-term effects of violent media on aggression in children and adults.  They reported a positive relationship between exposure to media violence and subsequent aggressive behavior, aggressive ideas, arousal, and anger across the studies they examined.  Consistent with the theory that long-term effects require the learning of beliefs and that young minds can easier encode new scripts via observational learning, they found that the long-term effects were greater for children.
• In a more recent review, Anderson et al. (2010) also analyzed 136 studies representing 130,296 participants from several countries.  These included experimental laboratory work, cross-sectional surveys and longitudinal studies.  Overall, they found consistent associations between playing violent video games and many measures of aggression, including self, teacher and parent reports of aggressive behavior.  Although the correlations were not high (r=0.17-0.20), they are typical for psychological studies in general and comparable with other risk factors for youth violence suggested in the 2001 Surgeon General’s Report on youth violence .

Violent video games may increase precursors to violent behavior, such as bullying

Although playing violent video games may not necessarily determine violent or aggressive behavior, it may increase precursors to violent behavior.  In fact, Dr. Olson points out that violent video games may be related to bullying, which researchers have found to be a risk factor for more serious violent behavior. Therefore, video game playing may have an indirect effect on violent behavior by increasing risk factors for it.  Doug Gentile notes that the only way for violent video games to affect serious criminal violence statistics is if they were the primary predictor of crime, which they may not be.  Rather, they represent one risk factor among many for aggression ( http://www.apa.org/monitor/2010/12/virtual-violence.aspx ).

Should video games be regulated?

L. Rowell Huesmann (2010) points out that violent video game playing may be similar to other public health threats such as exposure to cigarette smoke and led based paint .  Despite not being guaranteed, the probability of lung cancer from smoking or intelligence deficits from lead exposure is increased.  Nevertheless, we have laws controlling cigarette sales to minors and the use of lead-based paint (and other lead-based products such as gasoline) because it is a risk factor for negative health outcomes.  Huesmann argues the same analysis could be applied to video game exposure.  Although exposure to violent video games is not the sole factor contributing to aggression and violence among children and adolescents, it is a contributing risk factor that is modifiable.

Violent behavior is determined by many factors

Finally, most researchers would agree that violent behavior is determined by many factors which may combine in different ways for different youth. These factors involve neighborhoods, families, peers, and individual traits and behaviors. Researchers, for example, have found that living in a violent neighborhood and experiencing violence as a victim or witness is associated with an increased risk for violent behavior among youth. Yet, this factor alone may not cause one to be violent and most people living in such a neighborhood do not become violent perpetrators. Similarly, researchers have found consistently that exposure to family violence (e.g., spousal and child abuse, fighting and conflict) increases the risk for youth violent behavior, but does not necessarily result in violent children. Likewise, researchers have found that first person killing video game playing is associated with increased risk for violent behavior, but not all the time. Yet, constant exposure to violence from multiple sources, including first person violent video games, in the absence of positive factors that help to buffer these negative exposures is likely to increase the probability that youth will engage in violent behavior.

Despite disagreements on the exact nature of the relationship between violent video game playing and violent or aggressive behavior, significant evidence exists linking video game playing with violent behavior and its correlates.  Although we are somewhat agnostic about the role of social controls like laws banning the sale of violent video games to minors, an argument against such social controls based on the conclusion  that the video games have no effect seems to oversimplify the issue. A more in-depth and critical analysis of the issue from multiple perspectives may both help more completely understand the causes and correlates of youth violence, and provide us with some direction for creative solutions to this persistent social problem.

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The Video Games Your Child Plays Has an Effect on Their Behavior

More and more research is emerging with evidence of the negative effects violent video games have on children. The most popular video games are also some of the most violent, and pediatrician Dr. Cindy Gellner speaks about the numerous effects they have on kids. If you notice behavioral problems and other issues with your child, video games with violence and other adult themes may be to blame. Listen to learn about the research and more.

Episode Transcript

With in-person activities for kids on hold a lot during the past year, video games have taken the place of ways for kids to connect while being socially distanced. Is this a good thing? Well, that depends.

Video gaming has become a popular activity for people of all ages since the 1980s. Many kids spend large amounts of time playing them, although the American Academy of Pediatrics recommends kids have more than two hours total of screen time a day. Video gaming is a multi-billion dollar industry, and video games have become very sophisticated and realistic. There are multi-player games, which allow kids to play with their friends across different platforms. However, there's always the possibility that kids can connect with not-so-friendly people out there, too.

While some games have educational content, many of the most popular games emphasize negative themes. They promote the killings in war-like scenarios, sometimes criminal behavior, disrespect for the law and other authority figures, sexual exploitation or violence towards women, racial, sexual and gender stereotypes, and foul language and obscene gestures. Examples of video games not acceptable for children because they have these themes include Grand Theft Auto, Call of Duty, and Mortal Kombat.

There is growing research on the effects of video games on children. Studies of children exposed to violence have shown that they can become immune or numb to violence, imitate the violence they see and show more aggressive behavior with greater exposure to violence. Studies have also shown that the more realistic and repeated the exposure to violence, the greater the impact on children. Kids can become overly involved and even obsessed with video games, which I've been seeing a lot lately, especially in kids who are doing only online learning.

I have parents often asking me how to get their kids off of video games and back onto their classwork. Unfortunately, I don't have any special tricks. But the best thing is to have them do their classwork where you can see them and know what they are doing. Also, check their grades frequently. And if you see a lot of missing assignments, then it's time to limit the video games until school is caught up. Too much video game can lead to poor social skills, time away from family, school work and other hobbies, lower grades, reading less, exercising less, becoming overweight, and having aggressive thoughts and behaviors. I can say that I have definitely seen and heard from parents that decrease grades and increase weight have been directly correlated to kids staying inside and playing video games over the past year.

So how can you, as a parent, protect your child against these types of video games? First, you can check the Entertainment Software Rating Board ratings to learn about the game's content. Every video game will actually have a label on the front to tell you what type of game it is. If it says M for mature, it's not for your child. Our kids have their system set up so they can't purchase a game, even if it's free, without me getting a notification. They're usually pretty good about saying, "Hey Mom, can I get this game so I can play with my friends?" And if it's not one I approve of, they know it's a hard no. We also have it set up in the living room so I know exactly how much time they're playing, what they're playing, and who they're playing with if it's on a group chat.

You can also play the video games with your child to experience the game's content and know exactly what your child is playing. Set clear rules about the game's content for both playing time in and outside of your home. Like if they go to a friend's house. Strongly warn your children about the potential serious dangers of Internet contacts and relationships while playing online. It's sad, but there are a lot of online predators that will look for children specifically playing video games and can lead them into them meeting in real life. Finally, remember that you are a role model for your child. Make sure the video games you play as an adult are ones you would be okay with your child playing.

If you are concerned as a parent that your child is spending too much time playing video games or your child starts becoming obsessed with aggressive or violent video games, make sure you set some limits. Expect some push back because you're going to get it. But kids actually need and want boundaries, and if you set them, eventually they'll surprise you and they'll appreciate that you do monitor them and that you do set limits. I was floored when both of my boys told me that at different times over the past year, that they approved the limits and the monitoring because they know that it's because of what we prioritize in our house and what our family expectations are.

By being aware of what games are out there, who your child is playing with, and what they care playing, and how long they are playing, you can help your child make appropriate decisions about gaming. Video games are a great outlet for some kids, and it helps them connect with their friends when they can't always play in person or when they're older and play dates aren't cool anymore. Most important thing as a parent is to be aware of what your child is doing while gaming and help reinforce positive behaviors and socialization without giving in to excessive gaming time and inappropriate content.

updated: August 9, 2021 originally published: April 6, 2016

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Do Violent Video Games Cause Behavior Problems? Research Paper

Prevalence of video games in the united states, why video games increase aggression and violence, gaam: input variables and internal states, long-term effects of video game violence, unique dangers of violent video games, works cited.

One’s mode of living can be affected by entertainment media. Most behaviors that kids and adults deem suitable come, partially, from the lessons they obtain from movies and television. There exist solid theoretical rationales to suppose that violent video games will include analogous, and perhaps additional, impacts on aggression.

Nevertheless, there exist few writings on the impact of exposure to video game violence since it is a new area of concern in the present U.S. culture. Hence, some people argue that video games do not cause as much aggression as that caused by watching violent TV and movies. This paper proofs that video games have severe, long term and short term behavior effects, which are worse than those of TV and movies.

Media violence is vastly consumed by the U.S. residents. Children and youths with years between 8 and 18 use over 40 hours every week on media excluding time spent on homework and school assignments (Ballard and Jefferson 717). Although television is the most common form of media used, electronic, video games have speedily gained popularity.

A number of children between the ages 2 to 18, approximately 10%, spend over one hour each day playing computer video games (Fling 39). Amongst boys aged between 8 to 13 years, the average number of hours spent on these games is over 7.5 hour each week (Harris and Williams 306). Learners in higher institutions of learning as well play video games frequently. By 1998, 13.3% of men joining universities spent at least 6 hr per week on video games (Irwin 337).

A year later, the number had augmented to 14.8%. Besides, 2% of the men accounted playing video games over 20 hour each week in 1998. A year later, the number enlarged to 2.5%. While the initial video games surfaced in the late 1970s, violent video games became popular in 1990s, with the homicide games Street Fighter, Wolfenstein 3D and Mortal Kombat (Ballard and Jefferson 717). All these three games involve murdering or hurting enemies.

The graphics, for instance, blood and echoes of these games were radical at the phase of their establishment. Before the last part of the 20th century, further graphically violent games grew to be accessible to all players, regardless of age (Gerbner 10). Although a number of enlightening, nonviolent, games subsist, the most profoundly advertised and utilized games are those that are violent.

Girls and boys in the fourth grade, 59% and 73% respectively, report that most of their preferred games are those that contain acts of violence (Dietz 425). A key area of concern is the lack of parental supervision. Most youths in grades 8 up to 12 details that merely 1% of their parents ever disallowed a purchase due to its rating, and 90% of their parents never verified the ratings of the games ahead of their purchase (Kirsh 180).

A number of reasons for predicting exposure to violent video games to augment aggressive conduct in both the long term (constant exposure over a phase of years) and short term (in about 20 minutes of the game) exist.

Founded on some former models of human aggression, the General Aggression Model is a valuable framework for appreciating the impacts of violent media. The act of aggression is mainly founded on the learning, stimulating, and use of aggression-associated knowledge constructions amassed in the memory, such as schemas and scripts.

Conditional input variables, such as latest exposure to violent media games, pressure aggressive behavior via their effect on the individual’s current internal state, symbolized by affective, cognitive and stimulation variables.

Violent media augment aggression through teaching spectators how to be hostile, through priming violent cognitions, counting, formerly, learned aggressive perceptual schemata and aggressive scripts, by mounting arousal, or by forming an aggressive affective condition (Anderson and Deuser 166). Long-term impacts, as well, engross learning procedures. From childhood, humans discover how to perceive, understand, critic, and react to actions in the social and physical surroundings (Geen and Mathew 15).

A variety of knowledge constructions for these actions builds up ultimately. They are normally founded on daily interpretations and relations with other persons. Every violent-media incident becomes a new learning experience. As the cognitions constructions are repeated, they grow to be highly differentiated, composite and hard to modify.

Another model of academic and social impacts of exposure to media violence has been created by Huesmann (Huesmann 37). This model demonstrates that as a child grows to be aggressive regularly, the qualities and social relations that she/he practices also vary. All told the amalgamations of long-term and short-term procedures create the positive relation linking aggressive-violent behavior and exposure to media violence.

Both situational and personal variables can alter an individual’s character through affective, arousal and cognitive variables. For instance, individuals who score high on tests of aggressive traits have highly available information structures for aggression-associated knowledge. They assume aggressive views more regularly than do those persons who attain less on aggressive personality tests, and have social acuity schemas that result to aggressive perception, belief, and provenance prejudices.

The present accessibility of aggression-associated cognitive structures can as well be influenced by situational input variables. Being affronted may lead an individual to consider of how to revenge the insult in a destructive manner.

Playing a violent video game, as well, can augment the availability of violent cognitions by semantic priming procedures. Just seeing an image of a gun or other arm can augment the availability of aggressive feelings. Both input variables control an individual’s existing affective condition, for instance, aggression-associated feelings of aggression or rage.

Several individuals feel irritated nearly at all times. A number of circumstances can make someone irritated. Nevertheless, we do anticipate that playing violent video games will habitually boost thoughts of rage, weighed against playing a peaceful game. Certainly, playing an annoying game is apt to amplify rage (Bandura 91). Nevertheless violent material, in the lack of another aggravation, is liable to have small direct effect on affect.

Impacts of long-term media violence on aggression emerge from over-learning, growth and reinforcement of aggression-linked cognition systems. Every occasion persons play violent video games they practice aggressive scripts that edify and strengthen violent acts against others, positive thinking about the use of violence, caution for opponents, anticipations that others will act in violent ways and viewpoints that aggressive solutions are efficient and suitable.

Moreover, frequent exposure to graphic acts of violence is apt to be desensitizing. The formation of these aggression-linked cognitive structures and the desensitization outcomes transform the individual’s character.

Players involved in video game for long can emerge more aggressive in attitudes, perceptual prejudices, attitudes, values, and actions than they were prior to the frequent exposure or would have befallen with no such exposure. Hypothetically, these long-term transformations in aggressive behavior function in the instant situation via both input variables explained in GAAM; situation and person variables.

The relation to person variables is clear–the individual is now violent in attitude and tendency. However, the way long-term impacts of frequent contact to violent video games can alter situational variables is less apparent. Nevertheless, Huesmann has constructed a lucid model of the academic and social impacts of experience to violence on television (Huesmann 37).

When an individual grows to be aggressive, the social surroundings react. Persons who are ready to interrelate with them, the nature of exchanges that are made, and the circumstances made accessible to the individual all transform. Relations with parents, teachers, and nonviolent peers are apt to deteriorate, whereas exchanges with other aggressive peers might augment. Hence, we anticipate getting a positive relationship between an individual’s height of experience to violent video games and his/her aggressive actions.

Current information indicates that concern regarding the potentially harmful effects of playing violent video games is not mislaid. Additional reflection on some key traits of violent video games denotes that their risks may well be larger than the risks of violent movies or violent television. Three motives can elucidate this. The first is the desire to identify with the aggressive person (Leyens 375). The player presumes the characteristics of the champion, and at times, selects a trait whose qualities the player then adopts.

The player directs the act of this character and frequently visualizes the video game globe via that character’s sight. Hence, the chief character is identical with the game player, latently intensifying the effect of the game. The second cause of concern is the active contribution pertaining video games. Study on the catharsis hypothesis discloses that aggressive behavior typically augments later aggressive mannerisms (Bushman 955).

The dynamic task of the video game player entails opting to aggress and behaving g in an aggressive way. This preference and action constituent of video games might lead to the building of a more whole aggressive script, than would happen in the inert role adopted in watching violent TV shows and movies.

The final reason to suppose video games to include a larger effect than movies or TV engrosses their addictive character. The strengthening distinctiveness of violent video games can also boost the training and presentation of violent scripts.

Video games obsession can stem, partially, from the penalties and rewards, which the game accords the player (Griffiths and Newton 473), similar to the reward construction of slot apparatus. Logically, violent video games present an absolute learning atmosphere for aggression, with concurrent exposure to reinforcement, modeling and practice of behaviors. This amalgamation of learning approach has been revealed to be more potent than any other technique employed (Klein, 395).

In conclusion, video games, which are violent, give a forum for discovering and practicing aggressive resolutions to conflict circumstances. The outcome of violent video games seems to be cognitive in trait. In the short term, playing violent video games influences aggression through priming violent thoughts.

Long term impacts are apt to stay for long, as the player discovers and practices novel aggression-linked scripts that grow to be progressively available for utilization when real-life conflict circumstances occur. If frequent, exposure to violent video games can lead to the formation and heightened availability of a range of aggressive cognitive constructions, hence, varying the individual’s basic persona structure.

The resultant changes in daily social relations might also lead to steady augments in the aggressive change. The lively nature of the learning atmosphere of the video game puts forward that this medium is more risky than the more profoundly explored movie and TV media. With the latest drift toward vast realism and graphic aggression in video games, in addition to, the growing recognition of these games, users of violent video games, as well as parents of users, are supposed to be aware of these latent hazards.

Topical proceedings in the news, for instance, the relation between youth killers in Colorado and violent video game play, have flickered civic debate regarding the impacts of video game violence. While the debate goes on, video games are growing to be increasingly violent, explicit and rampant. Scientists must add new research to the presently small and lacking text on video game violence impacts and elucidate for society what these dangers involve precisely.

The General Affective Aggression Model has been demonstrated as helpful in organizing a broad array of research results on human aggression and in creating testable schemes, including the current exploration on video game violence. Further short-term investigation on the impacts of violent video games is required in order to identify the natures of game players and games that decrease and deepen the aggression-linked impacts.

Anderson, Karl and Deuser Anderson. “The Interactive Relations between Trait Hostility, Pain, and Aggressive Thoughts.” Aggressive Behavior 24 (1998): 161-171.

Ballard, Michael and Jefferson Weist. “Mortal Kombat: The Effects of Violent Video Game Play on Males’ Hostility and Cardiovascular Responding.” Journal of Applied Social Psychology 26 (1996): 717-730.

Bandura, Alois. Aggression: A social Learning Analysis . Englewood Cliffs, NJ: Prentice-Hall, 1973

Bushman, Beckham. “Moderating Role of Trait Aggressiveness in the Effects of Violent Media on Aggression.” Journal of Personality and Social Psychology 69 (1995): 950-960.

Dietz, Tyre. “An Examination of Violence and Gender Role Portrayals in Video Games: Implications for Gender Socialization and Aggressive Behavior.” Sex Roles 38(1998): 425-442.

Fling, Smith. “Videogames, Aggression, and Self-Esteem: A Survey.” Social Behavior and Personality 20 (1992): 39-46.

Geen, Robert and Mathew Quanty. “The Catharsis of Aggression: An Evaluation of a Hypothesis.” Advances in Experimental Social Psychology 10 (1977): 1-37

Gerbner, Gilbert. “The Mainstreaming of America: Violence Profile No. II.” Journal of Communication 30 (1980):10-29.

Griffiths, Michael and Newton Hunt. “Dependence on Computer Games by Adolescents.” Psychological Reports 82(1990): 475-480.

Harris, Morris and Williams, Reagan. “Video Games and School Performance.” Education 105 (1980): 306-309.

Huesmann, Lois. Aggressive Behavior: Current Perspectives . New York: Plenum Press, 1994

Irwin, Gross. “Cognitive Tempo, Violent Video Games, and Aggressive Behavior in Young Boys.” Journal of Family Violence 10 (1995): 337-350.

Kirsh, Smith. “Seeing the World through Mortal Kombat-Colored Glasses: Violent Video Games and the Development of a Short-Term Hostile Attribution Bias.” Childhood 5(1998): 177-184.

Klein, Morris. “The Bite of Pac-Man.” The Journal of Psychohistory 11(1984): 395-401.

Leyens, Picus. “Identification with the Winner of a Fight and Name Mediation: Their Differential Effects upon Subsequent Aggressive Behavior.” British Journal of Social and Clinical Psychology 12(1973): 374-377.

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Internet and Video Games: Causes of Behavioral Disorders in Children and Teenagers

Associated data.

Not applicable.

Even though video games have been present among children for many years, children are using them more continuously and in an abusive and indiscriminate way nowadays because of the “technological boom”. It is affecting the behavior of children and adolescents. This is the reason why we are carrying out this systematic review. The main objective of this article is to investigate literature that directly connects the continuous and undifferentiated use of video games with the emergence of behavioral disorders in children and young people. The PRISMA statement was followed in the process of this article. We used SCOPUS, Web of Science and PubMed as databases, moreover, we searched studies with a scoping review. The results indisputably supported six out of seven of our hypotheses. We find that the excessive use of video games causes addiction to technology, aggressive behaviors, sleep disorders, and poor school performance. In addition, it hinders social relationships and the development of emotional intelligence. To conclude, it is necessary to correctly use video games in particular, and technologies in general, adapting their content to children’s age, as well as the amount of time that they dedicate to use them.

1. Introduction

New technologies are blameworthy for the significant changes that society must face. We are in the digital age and technologies are progressing at an exponential rate, building our current situation [ 1 ]. But what do we consider a new technology? Roca defined new technology as everything that forms the set of information and communication technologies, video game consoles included [ 2 ].

Due to the COVID-19 pandemic, the average time children and adolescents spend playing video games or connected to the Internet has increased [ 3 ], as these devices become a platform to connect with other online users [ 4 ]. The pandemic restricted many of their recreational activities, so tablets, smartphones, computers, and game consoles became their only entertainment. Children and teenagers were using the Internet for many hours per day, without parents being able to control the use of these electronic devices [ 5 ].

1.1. Video Game Users

Children and teenagers are the main groups that play video games [ 6 ]. These groups attend primary education and secondary education.

Regarding primary education, some basic cognitive changes, which technologies could influence, can be highlighted. Students foster their chosen capacity consciously, try to achieve their objectives, their memory and attention capacities improve, and thinking becomes logical and flexible [ 7 ]. Moreover, at this age, they can identify their own emotions and others’ emotions, controlling and communicating them [ 8 ]. Empathy and self-esteem could increase or decrease depending on the social comparison with their peers; friendships play an important role, and technologies influence them [ 9 ].

On the other hand, students in secondary education experience different cognitive changes in comparison to primary school students. This stage represents a period of big changes [ 10 ]. In fact, during this phase, thinking turns abstract [ 11 ], a critical and reflexive attitude is developed which improves the capacity for problem-solving and the adequacy of social behavior, planning capacity is fostered, and adolescents’ thoughts focus on what they want but do not have [ 12 ]. In addition, on a social-affective level, teenagers have changeable emotional states; they need recognition from others such as social acceptance, they cannot express their feelings, and carry self-confidence problems [ 13 ].

1.2. Players’ Personality

Studies have revealed that there is a relationship between the playing style, the intensity of use, and the player’s personality [ 14 ]. Honesty, humility, openness to experience, conscientiousness, extraversion, agreeableness, and emotionality are considered personality dimensions [ 15 ].

In this sense, children and adolescents with low self-esteem, honesty, and/or humility choose to play violent games. They show psychopathic traits, and their gaming behaviors are aggressive [ 16 ]. For its part, adventure games are chosen by children and teenagers with a greater openness to experience [ 17 ]. They are also more successful in video games, which improves their self-efficacy, and stay engaged longer in these games [ 18 ].

Children and adolescents with high conscientiousness scores choose challenging and team-based games [ 14 ]. They achieve accomplishments that increase their self-reliance and keep them playing [ 18 ].

On the other side, users with extroverted personalities participate more in online environments and prefer survivor or daredevil games [ 19 ]. Thus, gamers who are more energetic and able to accept difficult challenges are more successful in video games [ 20 ]. In addition, high levels of friendliness by children and adolescents can lead to greater participation in video games, since in online games children play in teams, forming social bonds [ 21 ]. In fact, kinder people choose games that involve challenges to be solved in a cooperative way.

Finally, children who are more anxious and dependent participate more in working on in-video games and professions because there is a lack of risk and failure [ 22 ]. Moreover, more emotional gamers prefer to replay different levels of the same game, to minimize depressing comments from others. On the other hand, more skilled players tend to be more emotionally calm when playing and choose mostly gambling games [ 18 ].

Video games are also used as an online tool to escape loneliness [ 23 ]. However, previous studies have also shown that a lack of self-control and autonomy may suppose a risk for future video game addiction problems [ 24 ]. In turn, children and adolescents who are unable to adequately manage their gaming time will have a higher risk of gambling addiction [ 25 ]. In addition, personality traits such as aggression or narcissism correlate positively with video game addiction [ 26 ].

1.3. Video Game Influence

In the technological environment, we can find video games. They have an essential role in children’s and adolescents’ life because they modify substantially their way of understanding, interacting, and communicating [ 27 ].

The video game market is the leading audiovisual and interactive leisure industry in our country, in fact, four out of five families have a gadget to play with at home [ 28 ]. These data demonstrate the high popularity of video games among the general population.

Children and adolescents seem to have a great fascination for and attraction to games. The reason could be because videogames are more than entertainment [ 29 ]. Video games which have an important socializing role are a model of behavior for young people [ 30 ], and this model could be negative or positive depending on the game. In addition, video games are involved in identity construction [ 31 ].

1.4. Adverse Effects of Video Games

Before talking about the negative effects of excessive use of video games, we must differentiate between two concepts [ 32 ]: “internet addiction disorder (IAD)” and “internet gaming disorder (IGD)”.

IAD is understood as “the excessive use of the Internet in an uncontrolled and time-consuming manner that leads to timelessness and disruption of people’s lives” [ 33 ] (p. 1). On the other hand, IGD is defined as “persistent and repeated use of the Internet to engage in gaming, usually with other users, that causes clinically significant impairment or distress” [ 34 ] (p. 1). If five or more criteria are met for 12 months, IGD is diagnosed. The criteria are preoccupation, tolerance, drawdown, persistence, escape, problems, disappointment, displacement, and conflict [ 35 ].

IGD is included as a disorder in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5), but IAD is not included. On the contrary, both concepts cause negative impacts and provoke behaviors that could lead to psychological, social, and personal adversities [ 36 ].

Despite the fact that young people are considered digital natives [ 37 ], they are especially vulnerable to video games’ effects because they are growing up and do have not the full potential of their psychosocial resources [ 31 ]. For this reason, compulsive and excessive exposition to video games could modify the levels of healthy use and, consequently, provoke a disorder in the personal development of children and teenagers with effects on a social level or state of mind [ 38 ]. Thereby, supervision is a big defiance for families and responsible adults in our actual society [ 6 ].

Excessive participation in video games is associated with undesired behaviors such as stress, emotional changes, aggressive behaviors, hyperactivity, and impulsivity [ 39 ]. Furthermore, the frequency of use of video games encroaches on social interactions; it is associated with loneliness, retracted manners, and low self-esteem [ 40 ]. In the educational environment, students who spend a lot of time playing video games during schooldays perform worse academically [ 41 ]. In fact, a recent study affirms that academic achievement is influenced by game context [ 42 ].

We can summarize the negative effects of excessive use of video games as the following: reduced attention, emotional and social intelligence deterioration, social isolation, and sleep disorders [ 43 ].

In addition, gaming disorders are associated with deregulation of the dopamine reward system [ 44 ], poor long-term vision from prolonged screen time and dizziness [ 45 ], possible epileptic seizures due to the flashing and contrasting light in the animation [ 46 ], obesity problems from changing physical activity to electronic devices [ 47 ], and brain disorders related to concentration and thinking, so that children become apathetic [ 48 ]. What is more, they can cause headaches due to the electromagnetic radiation emitted by the screen [ 49 ] and physical, muscular and bone stress, as well as back or neck problems from sitting incorrectly in front of these games for long periods of time [ 50 ]. Furthermore, anxiety is one of the major symptoms of psychopathology associated with video games [ 51 ]. People may turn to video games to calm their anxiety, so they learn that video games are a way to avoid negative moods [ 52 ]. Thus, the immediate gratification offered by video games encourages children to use games when they experience negative situations. This action can become a habit and, therefore, video games are prioritized over other important aspects of life [ 53 ].

Even some recent studies show that children may experience cardiac arrhythmia during electronic games due to adrenergic stimulation related to the emotionally charged video game environment [ 54 ].

Regarding the importance of video games for young people, we focus on the adverse consequences in behavior because of violent and inadequate video games.

1.5. Positive Effects of Video Games

However, it is also necessary to consider the benefits of video, with the objective of understanding how video games impact the development of children and adolescents. The nature of video games has changed in recent years, becoming increasingly realistic and diverse [ 55 ]. For this reason, the potential benefits of video games must be contemplated. We focus on four main areas: cognitive, motivational, emotional, and social [ 56 ].

In respect of the cognitive domain, playing video games, especially action games, promotes a wide range of cognitive skills, such as faster and more accurate attention [ 57 ], higher spatial resolution in visual processing [ 58 ], better mental rotation abilities [ 59 ], greater spatial skills [ 60 ], more effective filtering of irrelevant information [ 57 ], more flexible problem solving [ 61 ], and greater development of creativity [ 62 ].

Regarding the motivational domain, video games provide players with immediate feedback that rewards effort and keeps players within what Vygotsky [ 63 ] called the “zone of proximal development”. This motivational point balances levels of challenge and frustration which causes experiences of success [ 64 ]. Thus, players face challenges with motivation and optimism to achieve their goals [ 65 ].

Respecting the emotional domain, previous studies show a causal relationship between playing video games and improving mood or increasing positive emotions. Children describe playing video games as a rewarding experience that provokes a sense of control, thus increasing their self-esteem [ 21 ].

Finally, on the subject of the social domain, the virtual social communities created in video games make children quickly learn social skills and prosocial behavior. In this sense, effective cooperation, support, and helping behaviors are developed [ 66 ]. Subsequently, these behaviors can be generalized to their friendship and family relationships outside the game environment [ 67 ].

1.6. Objectives

The overarching objective of this study is to investigate literature that directly relates the continuous and undifferentiated use of video games with the emergence of behavioral disorders in children and young people.

Specifying this aim, some hypotheses were raised:

Playing video games constantly is a risk factor; it could provoke technology addiction disorders .

Use of technology and video games affect sleep .

Aggressive video games foster aggressive behaviors in real life .

Excessive use of video games makes social relationships more difficult .

Excessive use of video games may provoke a lower academic performance .

Excessive use of technologies and video games hinders emotional intelligence development .

Playing video games provokes attention deficit and hyperactivity disorder (ADHD) .

2. Materials and Methods

In this systematic review, the statement of the preferred reporting items for systematic review and meta-analyses 2020 (PRISMA statement) [ 68 ] was followed. The study, data, and materials included in this article were not preregistered.

2.1. Literature Search

PubMed, Web of Science, and SCOPUS were the databases chosen. The searches were performed from September to November 2022, with the objective of compiling the largest list of studies we could. We looked for relevant articles about the effects of playing video games on behavioral disorders. Additionally, manual searches were carried out on the references of the studies selected and we identified potential studies [ 69 ].

Two Boolean operators were used: AND/OR. The descriptor words were “behavioral disorders”, “behavioral problems”, “video games”; they were used in different ways depending on the database. We did not apply any filters or limitations because we wanted to identify the greatest number of appropriate studies [ 70 ]. It is true that we had applied publication date filters at first; however, several relevant studies had been removed.

In Table 1 , the search strategy can be seen.

Search strategy for each source.

2.2. Selection Process

Firstly, 113 articles were identified in an automatic search. They were imported to a Word file to identify duplicate articles. Out of 113, there were 5 duplicated.

Secondly, we found relevant studies by abstract, keywords, and title. This phase was screened by two independent researchers to eliminate irrelevant articles, which resulted in 70 articles. They used the following exclusion and inclusion criteria:

Articles that included our keywords (behavioral problems, behavioral disorders, video games) were accepted. We refused those articles which did not talk about our topic.

Articles from scientific specialized journals were included. We refused studies in book chapters, doctoral theses and grey literature in general.

Articles with open access were included. We refused articles to which we did not have complete access.

Articles were required to be completed works; we refused in-process articles.

Participants were required to be children or young people; adults’ samples were refused.

A total of 38 articles were selected using these criteria.

Thirdly, the same two independent researchers assessed the articles chosen for eligibility by reading all the text. They applied the same criteria and found 17 relevant articles which were included in our systematic review. In Figure 1 , the selection process can be seen.

Flow diagram of the articles during the selection process.

2.3. Data Extraction

Seventeen studies were analyzed to extract data from them. In a table, two independent researchers compiled the names of authors, publication date, objective(s), the instrument used, sample, age of the sample, country, and outcomes. A third researcher validated the collected information. When some required information was not available, we asked the corresponding author to obtain it; however, sometimes we did not receive any reply.

The instruments used included the variables measured and the age of the sample included the mean.

2.4. Study Quality Assessment

Descriptors were discussed between the authors who reached an agreement. Then, the selection process was carried out by two authors independently. Any disagreement between the two reviewers was solved by consensus. Dividing the number of agreements by the total number of disagreements plus agreements, we calculated the inter-rater reliability. Then we multiplied by 100 to get the percent. The inter-rater reliability was 94%.

3.1. Study Characteristics

A total of seventeen articles were analyzed in detail. They were carried out across several countries around the world. Four were from the United States [ 71 , 72 , 73 , 74 ], two from China [ 75 , 76 ], two from Italy [ 77 , 78 ], and the rest of the countries were studied in one article each. The continent most studied was Asia, in eight out of seventeen articles, closely followed by America (four from North America [ 71 , 72 , 73 , 74 ], and one from South America [ 79 ]).

The age range was very large, from 6 months to 23 years old. However, the majority of the studies had a population aged from 9 to 15 years old. Regarding the instrument, they were varied. Questionnaires and interviews conducted by researchers of the study were the instruments used most (in 52,94% of the articles) [ 73 , 75 , 77 , 79 , 80 , 81 , 82 , 83 , 84 ], followed by the Child Behavior Checklist [ 79 , 80 , 85 ] and demographic data [ 76 , 77 , 84 ]. (See Supplementary Table S1 for characteristics of each article selected).

3.2. Findings

Before starting to analyze the influences on children of playing video games, we want to highlight the importance of considering the different types of games and devices that are included in the articles selected. In this sense, it is also necessary to specify the age-appropriateness, the use frequency, the timetable, or the time they spend gaming. For these reasons, we analyzed each article in detail.

This information is mentioned roughly in sociodemographic data in most of the articles; there are only a few that explain it in an explicit way. Moreover, Yousef et al. specify that the limitation of their work is there is no evaluation of the TV programs and video games. [ 80 ], Accordingly, Chindamo et al. mention that they did not register the time children spent playing [ 77 ].

Nevertheless, data found in some of the studies reveal important findings about the content of games and aggression or delinquent behaviors. For instance, Wei showed that playing violent video games is positively correlated with violence tolerance and aggressivity [ 83 ].

Regarding the age adequacy of each game used, Yilmaz et al. had a sample aged 9–10 years old and most of the games included in their investigation are for teenagers over 13 years old [ 83 ]. In this sense, Salih et al. used a sample aged 4–17 years old. Because of the wide range of children included, it was thought that they used different types of games. However, they used the same games for all participants. These three games are for people over 13 and 16 years old, respectively [ 84 ]. On the contrary, Kirsh and Mounts used adequate games for their sample age [ 77 ].

Similarly, the use frequency and the time children spend gaming are essential to determining a limit between adequate use and excessive use. Accordingly, Cheung et al. affirmed that more frequent use of digital screens provokes less sleep time. In numeric data, each additional hour of tablet use was associated with 15.6 min less total sleep [ 81 ]. Finally, the timetable for playing video games is so relevant. In fact, pre-sleep habits have a big impact on teenagers’ sleep [ 78 ]. Likewise, significant correlations between time spent playing video games just before bed and sleep disorders were demonstrated [ 86 ].

3.2.1. Technology Addiction Disorders (TAD)

We find a positive correlation between the use of video games and technology addiction [ 76 , 84 ]. This has been exacerbated by COVID-19 [ 76 ]. Moreover, we observe close relationships between TAD and ADHD [ 82 , 85 , 87 ], and anxiety [ 76 ]. In addition, the number of hours that young people spend playing video games provokes attention problems [ 80 , 84 , 86 ]. (See Table 2 for more specific information).

Results related to technology addiction disorders.

3.2.2. Sleep Disorders

We observed in Table 3 a negative relationship between playing time and sleep duration [ 77 , 78 , 81 , 86 ]. In addition, we found that gaming frequency significantly increased sleep onset latency [ 77 , 81 ]. In addition, children and adolescents who spend a lot of time playing video games have sleep disorders in general [ 84 ]. However, Cheung et al. did not find a significant correlation between the use of a digital screen and the frequency of nocturnal awakenings. Likewise, we find a close relationship between playing video games and going to bed late [ 78 , 87 ].

Results related to sleep disorders.

3.2.3. Aggressive Behavior

We find a close relationship between the number of hours playing video games per day and the occurrence of aggressive and delinquent behaviors [ 73 , 75 , 80 , 82 ]. In turn, we observe a significant positive correlation between exposure to violent video games and attitudes toward violence [ 75 , 84 ]. Furthermore, reduced happy-face advantage can be found because of violent games [ 72 ]. Finally, self-control correlates negatively and significantly with hours spent playing video games [ 73 , 82 ]. Table 4 details this information.

Results related to aggressive behavior.

3.2.4. Academic Performance

We find a negative correlation between academic performance and hours playing video games [ 73 ]. Likewise, problematic behavior at school is positively and significantly correlated with hours playing video games [ 73 ]. On the other hand, hardcore gamers have to be helped with homework by other classmates [ 82 ]. These gamers use video games during school days and prefer them instead of studying [ 84 ]. On the contrary, Yilmaz et al. [ 82 ] affirmed that some teachers claim that playing video games helps to learn English. In addition, Rodríguez and Sandoval [ 79 ] disagreed; they did not find significant differences between the use of video games and academic performance.

3.2.5. Emotional Intelligence Development

We observe a close relationship between anxiety symptoms in adolescents and abusive use of video games; however, there are no significant differences in children [ 76 ]. On the other hand, depressive symptoms have no significant differences in any age group [ 76 ]. Furthermore, we find that hardcore gamers have affective problems [ 82 ]. Regarding gender, boys enjoy and feel more excitement when playing video games than girls [ 72 ]. Finally, we observe a close relationship between playing violent video games and a reduced expression of happiness [ 72 ].

3.2.6. Attention and Hyperactivity Disorders

We find a negative relationship between playing time and sustained attention [ 86 ]. In addition, it is claimed that hardcore gamers have attention problems in class [ 82 ]. This relationship between video games and sustained attention was measured by sleep duration [ 86 ].

It is observed that video games predispose players to hyperactivity [ 84 ]. Nevertheless, it is true that children with ADHD had higher levels of Internet addiction and spent more hours using video games [ 87 ]. To sum up, we can say that Internet addiction is positively and significantly related to inattention, hyperactivity–impulsivity, and total attention deficit hyperactivity disorder [ 85 ].

3.2.7. Social Relations

Despite the fact that social relationships were not in our minds when we started to investigate video games and technologies, several results emerge from the articles selected ( Table 5 ).

Results related to social relations.

We find a positive correlation between time spent playing video games and social problems [ 80 ]. In addition, hardcore gamers had trouble relating to their classmates, especially girls, because of the topics of conversation. However, communication among hardcore gamers is solid [ 82 ]. Finally, we observe a close relationship between playing violent video games and a lack of empathy (negative relation) [ 75 ] and competitive behaviors (positive relation) [ 71 ].

4. Discussion

This systematic review has given an analysis of the effects of video games in several areas of children’s and teenagers’ lives. Through this epigraph, we analyze the hypothesis we raised before.

In this way, we can observe that H 1 “playing video games constantly is a risk factor, it could provoke technology addiction disorders” is confirmed by Teng et al. [ 76 ] and Salih et al. [ 84 ], whose results show that video games predisposed players to addictive effects. In turn, other studies supported it, they found a significant difference between the time spent playing video games and the addiction. [ 88 ]. Not only in children and adolescents but also in adults Internet addiction is found, with differences depending on age; younger ones have more risk of being addicted [ 89 ]. Moreover, we found that COVID-19 has increased the use of video games and the addiction [ 4 , 76 ]. This statement is supported by the authors of [ 90 , 91 , 92 ]. The reason for this finding is the lockdown. People had more free time and they played video games more frequently [ 93 ]. Considering gender, it was studied that boys have a higher tendency to engage in and become addicted to video games [ 94 ].

The Interaction of Person–Affect–Cognition–Execution (I-PACE) explains the predisposing variables for problematic internet behavior (addiction, gaming, etc.) [ 53 ]. It includes genetic, biological, personality, cognitive and motivation factors, and psychopathology variables (such as depressive and anxiety symptoms) as predisposing variables. Moreover, the WHO recently included Internet Gaming Disorder as a mental health disorder [ 95 ].

COVID-19 has impacted aspects of human life in general, but one of the key research priorities was mental health [ 96 ]. Chronic stress during the lockdown has generated negative emotional distress such as depression or anxiety [ 97 , 98 ] and children are more susceptible to engaging in video game playing to deal with these adverse feelings [ 91 , 99 ]. This engagement could predispose children to experience internet gaming disorder as a stress response [ 100 ] since depressive and anxiety symptoms are predisposing variables affecting gaming [ 101 ].

Regarding H 2 , we found a major number of articles that studied the relationship between the use of technology or video games and sleep disorders [ 76 , 77 , 81 , 83 , 84 , 86 , 87 ]. Sleep time is reduced [ 77 , 78 , 81 , 86 ], and sleep onset latency is increased [ 77 , 81 ] when people use daily technologies. Specifically, for video games, Wolfe et al. [ 86 ] said that there is a significant and negative correlation between gaming time and sleep duration. Other authors agreed with our results, finding that playing games for a long time during the day decreases sleep duration and quality [ 102 , 103 , 104 ]. On the other hand, Cheung et al. [ 81 ] found that there was not a significant correlation between digital screen use and the frequency of night awakenings. Meanwhile, Fobian et al. [ 105 ] disagree. For these reasons, parental limit-setting is so important [ 106 ].

H 3 is related to aggressive behaviors. The American Psychiatric Association affirms that scientific research has demonstrated a close relation between violent video games and increases in aggressive cognitions, behaviors, and affect. [ 107 ]. Our findings support that video games foster undesired behaviors, and violent video games foster aggressive behaviors [ 72 , 73 , 80 , 82 ] and violence [ 75 , 84 ]. Hasan et al [ 108 ] confirm that violent video games are associated with higher aggression levels [ 109 ], and Greitemeyer and Mügge [ 110 ] say that prosocial games are associated with lower aggression levels.

Society frames aggression in negative terms [ 111 ]. It is defined as a behavior that is intended to improve one’s own social dominance at the expense of another [ 112 ]. For its part, violence could not be taken as a synonym for aggression. Violence is not always framed in negative terms since violent acts could be motivated by self-defense or the defense of someone [ 112 ]. While aggression could be innate [ 113 , 114 ], violence is intentional. The World Health Organization defined it as “the intentional use of physical force or power against oneself or another person, or against a group or community, that either results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation” [ 115 ] (p. 3). Moreover, we also found that spending more than 2 hours per day watching TV or playing video games, had higher scores on delinquent behavior [ 80 ]. This delinquent behavior is related to criminality. In this case, it is juvenile delinquency because the sample is under 18 years old, and it is defined as actions against the criminal laws of each country [ 116 ].

Furthermore, significant differences were found between genders. Boys enjoyed playing video games more than girls [ 72 ]. Females felt video games were frustrating. Moreover, boys behave more aggressively than girls after playing violent video games [ 117 ] because males display significantly higher aggressive cognition [ 118 ].

These behaviors provoke difficulties in social relationships. Our hypothesis (H 4 ) is corroborated by our findings [ 71 , 80 , 82 ]. It is also verified by Robertson et al. [ 119 ], who affirm the relationship between screen time and antisocial behavior in early adulthood. On the other hand, Kuss y Griffiths [ 120 ] affirms the effects in social behavior impact just in intensive video gamers.

Low social relationships and aggressive behaviors have a big impact on the educational environment. Teachers and classmates cannot relate well with hardcore gamers [ 80 ] and attention is lost [ 84 ]. The aforementioned issues affect academic performance. Chen et al [ 121 ] and Adelantado-Renau et al. [ 122 ] found a significant and negative relationship between the hours spent playing video games and the general score. In line with them are our results [ 73 , 82 , 84 ]. Thus, we can say that H 5 is corroborated too; excessive use of video games provokes a lower academic performance in the different educative systems of the countries studied.

Emotional intelligence is also important in school performance because it is a predictor of scores of more importance than standardized tests [ 123 ]. Our H 6 says that excessive use of technologies and video games hinders emotional intelligence development, and our results corroborate it [ 72 ]. These results are in line with previous studies that show a negative correlation between time spent playing video games and self-esteem and satisfaction with life [ 124 ]. Likewise, another study shows that exposure to violent video games is negatively related to the accuracy of recognition of negative emotions in others’ faces, [ 125 ]. Our results also show a decrease in empathy when people play violent video games [ 75 ], which is ratified by Díaz et al. [ 126 ].

Finally, H 7 says “playing video games provokes attention deficit and hyperactivity disorders (ADHD). At first, it was rejected because we found that ADHD was the cause of video game addiction [ 87 ]. However, we also found a negative relationship between playing time and sustained attention or attention problems [ 82 , 85 , 86 ]. Moreover, video games predispose players to hyperactivity [ 84 ]. In this sense, numerous authors affirm our results; there is a significant association between playing video games, Internet addiction, and ADHD [ 88 , 127 ]. In fact, pathological Internet use is correlated with social anxiety disorder, anxiety, obsessive–compulsive symptoms, and depression [ 128 ]. All of these are possible characteristics of ADHD. Moreover, it was affirmed that the child group most likely to be addicted is ADHD students, even more than students with other psychiatric symptoms [ 129 ].

Some main ADHD symptoms predict these types of disorders, such as “being easily bored” or “having an aversion for delayed rewards” [ 130 ]. These people have an impulsive need for rapid satisfaction. Core characteristics of ADHD could explain the relationship between this disorder and the Internet and gaming addiction. [ 131 ] In fact, the severity of ADHD symptoms is associated with the severity of IGD [ 132 ]. Using the Internet provides several activities at the same time and instant rewards which could decrease the symptoms mentioned and make ADHD children become addicted to the internet [ 133 ]. Apart from that, abnormal brain activities were found in this population. They produce impaired inhibition, which reduces self-control ability and fosters the incapacity to restrain themselves. Likewise, these people are more vulnerable to internet addiction and video game use [ 133 ].

Relating the two concepts, Weiss et al. [ 134 ] affirm that there is a bidirectional relationship between ADHD and Internet addiction or addiction to playing video games. They say that ADHD makes games more attractive, and games aggravate the symptoms of ADHD (See Figure 2 ). This could be explained by the necessity of ADHD children to escape from their social and emotional problems and stay in a place without obligations [ 135 ].

The cyclical process of ADHD and video games use.

5. Conclusions

Technologies have a strong impact on people’s lives, in general; however, the groups of people who are more affected by them are children and teenagers.

The main objective of this study was to find the effects of using video games in a continuous and undifferentiated way on behavioral disorders in children and young people. As we verified, using video games cause a lot of problems, not only in addition to the Internet or technologies but also in children and young people’s behaviors, social relationships, academic performance, sleep disorders, and so on.

PRISMA methodology is a good method in social science research because it makes studies transparent and open to suggestions and comments. However, our review has one limitation. We refused grey literature, such as other systematic reviews. We selected exclusively articles from specialized journals because we wanted scientific rigor in our article.

Finally, this article would be ideal for families and teachers of primary and secondary education, so they can understand what happens with their children if they do not control the use and type of video games. In this sense, they can use parental controls to avoid excessive use of these devices and inappropriate video games. Parents and guardians can control what children and adolescents are doing without being present. The Entertainment Software Ratings Board website has different manuals explaining how to restrict video game use, depending on the types of devices and software [ 136 ]. Blocking games that include inappropriate content or blocking them by age rating and limiting the time children play would be very recommended. On the other hand, TcosMonitor is an app that teachers can use to control the devices inside their classrooms from their own computers. Not only for control but also for help, teachers can access children’s desktops and manipulate them [ 137 ].

Acknowledgments

We would like to extend our gratitude to the Ministry of University because of the University Teacher Training Program (FPU2021/00004).

Supplementary Materials

The following supporting information can be downloaded at: https://www.mdpi.com/article/10.3390/children10010086/s1 , Table S1: Characteristics of Analyzed Studies [ 138 ].

Author Contributions

J.M.A.-P. and V.L.-A. conceived the idea; M.A.-P. and J.M.F.-C. wrote the introduction; J.M.F.-C. and V.L.-A. did the literature search, A.L.-d.l.R. and R.C.-S. revised the search and wrote the methodology; M.A.-P. and V.L.-A. outlined the results, J.M.A.-P. and A.L.-d.l.R. revised the results and wrote the results; A.L.-d.l.R. and J.M.F.-C. checked the hypothesis (hypothesis validation); M.A.-P. and R.C.-S. wrote the discussion; J.M.A.-P. and R.C.-S. revised the article and approved the article. All authors have read and agreed to the published version of the manuscript.

Institutional Review Board Statement

Informed consent statement, data availability statement, conflicts of interest.

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content.

Home / Essay Samples / Social Issues / Violence in Video Games / Do Violent Video Games Cause Behavior Problems

Do Violent Video Games Cause Behavior Problems

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• Topic: Video Games , Violence in Video Games

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Evidence That Violent Video Games Don't Cause an Increase in Violence

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