Anderson CA, Berkowitz L, Donnerstein E, Huesmann LR, Johnson JD,
Linz D, Malamuth, NM, Wartella E. (2003) The influence of media
violence on youth. Psychological Science in the Public Interest.
2003; 4:81-110.
Summary Research on violent television and films,
video games, and music reveals unequivocal evidence that media violence
increases the likelihood of aggressive and violent behavior in both
immediate and long-term contexts. The effects appear larger for
milder than for more severe forms of aggression, but the effects
on severe forms of violence are also substantial (r .13 to .32)
when compared with effects of other violence risk factors or medical
effects deemed important by the medical community (e.g., effect
of aspirin on heart attacks). The research base is large; diverse
in methods, samples, and media genres; and consistent in overall
findings. The evidence is clearest within the most extensively researched
domain, television and film violence. The growing body of video-game
research yields essentially the same conclusions
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article as PDF file.
Anderson, CA, Carnagy, NL, Flanagan M, Benjamin, AJ Jr., Eubanks,
J., Valentine, JC. (2004).
Violent video games: Specific effects of violent content on aggressive
thoughts and behavior.
Advances in Experimental Social Psychology, Vol. 36, 199-249.
Introduction Three experimental studies, one correlational
study, and a meta-analysis tested key hypotheses concerning the
short-term and long-term impact of exposure to violent video games.
(continued)
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article as PDF file

Bushman, BJ, and Anderson, CA. (2001) Media Violence and the
American Public: Scientific Facts Versus Media Misinformation. American
Psychologist, Vol. 56, No. 6/7, 477-489.
Abstract Fifty years of news coverage on the link
between media violence and aggression have left the U.S. public
confused. Typical news articles pit researchers and child advocates
against entertainment industry representatives, frequently giving
equal weight to the arguments of both sides. A comparison of news
reports and scientific knowledge about media effects reveals a disturbing
discontinuity: Over the past 50 years, the average news report has
changed from claims of a weak link to a moderate link and then back
to a weak link between media violence and aggression. However, since
1975, the scientific confidence and statistical magnitude of this
link have been clearly positive and have consistently increased
over time. Reasons for this discontinuity between news reports and
the actual state of scientific knowledge include the vested interests
of the news, a misapplied fairness doctrine in news reporting, and
the failure of the research community to effectively argue the scientific
case.
View
article as PDF file

Bushman, BJ, and Cantor, J. (2003) Media ratings for violence and
sex: Implications for policymakers and parents. American Psychologist.
Vol 58, No. 2, 130-141.
Abstract This article reviews research on the implementation
of media-rating systems, parents' use and evaluation of them, and
the impact of ratings on children. Although half or more of parents
report using media-rating systems, understanding of various components
of the systems is low, particularly for television ratings. A meta-analysis
of national polls shows that parents overwhelmingly prefer that
ratings specify content, rather than giving age recommendations.
A second meta-analysis, of experiments testing the effects of ratings
on children's interest in programs, shows that ratings indicating
restricted or controversial content have a deterrent effect for
children under age 8 but that, by age 11 and especially for boys,
the ratings show a small enticement effect. This effect occurs for
both age-based and content-based ratings. Implications for policymakers
and parents are discussed.

Committee on Public Education. (2001) Media violence. Pediatrics.
2001;108:1222-1226.
Summary The American Academy of Pediatrics recognizes
exposure to violence in media, including television, movies, music,
and video games, as a significant risk to the health of children
and adolescents. Extensive research evidence indicates that media
violence can contribute to aggressive behavior, desensitization
to violence, nightmares, and fear of being harmed. Pediatricians
should assess their patients' level of media exposure and intervene
on media-related health risks. Pediatricians and other child health
care providers can advocate for a safer media environment for children
by encouraging media literacy, more thoughtful and proactive use
of media by children and their parents, more responsible portrayal
of violence by media producers, and more useful and effective media
ratings.

Dill, K. E., & Thill, K. P. (in press) Video game characters
and the socialization of gender roles: Young peoples perceptions
mirror sexist media depictions. Sex Roles: A Journal of Research
Abstract Video games characters are icons in young
people's popular culture. In Study 1, a visual content analysis
of magazine images of male and female video game characters revealed
the prevalence of exaggerated stereotypes. Male video game characters
are almost always portrayed as violent and that violence is often
glamorized. Female video game characters are almost always portrayed
as stereotypical (e.g., highly sexualized, idealized bodies, scantily
clad, and visions of beauty). Eroticized aggression of females,
a characterization associated with antisocial behavior, is also
common. In Study 2, young people's understanding of video game characters
mirrored the portrayals found in Study 1. Results are discussed
in terms of the role of these particular popular culture representations
of masculinity and femininity in socialization.
View
article online.

Gentile, DA, Humphrey J, Walsh DA. (2005) Media ratings for movies,
music, video games, and television: A review of the research and
recommendations for improvements. Adolescent Medicine Clinics.
2005;16:427-446.
Introduction The "nature-nurture" debate
has intrigued psychologists since the time of Plato. As modern
experimental and behavior genetics techniques have improved, it
has become clear that environmental influences are critical for
the development of most personality traits and behaviors [1].
In the past 60 years, the environment in which children and adolescents
develop has changed in ways that never have been seen before in
human history - it has become media-saturated.
(continued)
View
article online.

Haninger K, Ryan MS, and Thompson KM. (2004) "Violence in
Teen-rated video games." Medscape General Medicine 6(1) March
12, 2004.
Abstract Context: Children's exposure to
violence in the media remains a source of public health concern;
however, violence in video games rated T (for "Teen")
by the Entertainment Software Rating Board (ESRB) has not been
quantified.
Objective: To quantify and characterize the depiction of violence
and blood in T-rated video games. According to the ESRB, T-rated
video games may be suitable for persons aged 13 years and older
and may contain violence, mild or strong language, and/or suggestive
themes.
Design: We created a database of all 396 T-rated video game
titles released on the major video game consoles in the United
States by April 1, 2001 to identify the distribution of games
by genre and to characterize the distribution of content descriptors
for violence and blood assigned to these games. We randomly sampled
80 game titles (which included 81 games because 1 title included
2 separate games), played each game for at least 1 hour, and quantitatively
assessed the content. Given the release of 2 new video game consoles,
Microsoft Xbox and Nintendo GameCube, and a significant number
of T-rated video games released after we drew our random sample,
we played and assessed 9 additional games for these consoles.
Finally, we assessed the content of 2 R-rated films, The Matrix
and The Matrix: Reloaded, associated with the T-rated video game
Enter the Matrix.
Main Outcome Measures: Game genre; percentage of game play
depicting violence; depiction of injury; depiction of blood; number
of human and nonhuman fatalities; types of weapons used; whether
injuring characters, killing characters, or destroying objects
is rewarded or is required to advance in the game; and content
that may raise concerns about marketing T-rated video games to
children.
Results: Based on analysis of the 396 T-rated video game titles,
93 game titles (23%) received content descriptors for both violence
and blood, 280 game titles (71%) received only a content descriptor
for violence, 9 game titles (2%) received only a content descriptor
for blood, and 14 game titles (4%) received no content descriptors
for violence or blood. In the random sample of 81 T-rated video
games we played, 79 games (98%) involved intentional violence
for an average of 36% of game play time, and 34 games (42%) contained
blood. More than half of the games (51%) depicted 5 or more types
of weapons, with players able to select weapons in 48 games (59%).
We observed 37 games (46%) that rewarded or required the player
to destroy objects, 73 games (90%) that rewarded or required the
player to injure characters, and 56 games (69%) that rewarded
or required the player to kill. We observed a total of 11,499
character deaths in the 81 games, occurring at an average rate
of 122 deaths per hour of game play (range 0 to 1310). This included
5689 human deaths, occurring at an average rate of 61 human deaths
per hour of game play (range 0 to 1291). Overall, we identified
44 games (54%) that depicted deaths to nonhuman characters and
51 games (63%) that depicted deaths to human characters, including
the player.
Conclusions: Content analysis suggests a significant amount
of violence, injury, and death in T-rated video games. Given the
large amount of violence involving guns and knives, the relative
lack of blood suggests that many T-rated video games do not realistically
portray the consequences of violence. Physicians and parents should
appreciate that T-rated video games may be a source of exposure
to violence and some unexpected content for children and adolescents,
and that the majority of T-rated video games provide incentives
to the players to commit simulated acts of violence

Haninger, K, and Thompson KM. (2004) Content and ratings of Teen-rated
video games, Journal of the American Medical Association,
2004; 291(7):856-865
Abstract Context Children's exposure to
violence, blood, sexual themes, profanity, substances, and gambling
in the media remains a source of public health concern. However,
content in video games played by older children and adolescents
has not been quantified or compared with the rating information
provided to consumers by the Entertainment Software Rating Board
(ESRB).
Objectives To quantify and characterize the content in video
games rated T (for "Teen") and to measure the agreement
between the content observed in game play and the ESRB-assigned
content descriptors displayed on the game box.
Design and Setting We created a database of all 396 T-rated
video game titles released on the major video game consoles in
the United States by April 1, 2001, to identify the distribution
of games by genre and to characterize the distribution of ESRB-assigned
content descriptors. We randomly sampled 80 video game titles
(which included 81 games because 1 title included 2 separate games),
played each game for at least 1 hour, quantitatively assessed
the content, and compared the content we observed with the content
descriptors assigned by the ESRB.
Main Outcome Measures Depictions of violence, blood, sexual
themes, gambling, and alcohol, tobacco, or other drugs; whether
injuring or killing characters is rewarded or is required to advance
in the game; characterization of gender associated with sexual
themes; and use of profanity in dialogue, lyrics, or gestures.
Results Analysis of all content descriptors assigned to
the 396 T-rated video game titles showed 373 (94%) received content
descriptors for violence, 102 (26%) for blood, 60 (15%) for sexual
themes, 57 (14%) for profanity, 26 (7%) for comic mischief, 6
(2%) for substances, and none for gambling. In the random sample
of 81 games we played, we found that 79 (98%) involved intentional
violence for an average of 36% of game play, 73 (90%) rewarded
or required the player to injure characters, 56 (69%) rewarded
or required the player to kill, 34 (42%) depicted blood, 22 (27%)
depicted sexual themes, 22 (27%) contained profanity, 12 (15%)
depicted substances, and 1 (1%) involved gambling. Our observations
of 81 games match the ESRB content descriptors for violence in
77 games (95%), for blood in 22 (27%), for sexual themes in 16
(20%), for profanity in 14 (17%), and for substances in 1 (1%).
Games were significantly more likely to depict females partially
nude or engaged in sexual behaviors than males. Overall, we identified
51 observations of content that could warrant a content descriptor
in 39 games (48%) in which the ESRB had not assigned a content
descriptor. We found that the ESRB assigned 7 content descriptors
for 7 games (9%) in which we did not observe the content indicated
within 1 hour of game play.
Conclusions Content analysis suggests a significant amount
of content in T-rated video games that might surprise adolescent
players and their parents given the presence of this content in
games without ESRB content descriptors. Physicians and parents
should be aware that popular T-rated video games may be a source
of exposure to a wide range of unexpected content.

Harrison, K. (2003). Television viewers' ideal body proportions:
The case of the curvaceously thin woman, Sex Roles, 48,
255-264.
Abstract Dozens of studies have linked ideal-body
media exposure to the idealization of a slim female figure, but
none have examined the proportions of this figure. College women's
and men's exposure to ideal-body images on television was correlated
with their perceptions of the ideal female bust, waist, and hip
sizes and their approval of surgical body-alteration methods.
For women, exposure to ideal-body images on television predicted
the choice of a smaller waist and hips, and either a larger bust
(for those who perceived themselves to be smaller-busted) or a
smaller bust (for those who perceived themselves to be larger-busted).
For both women and men, exposure to ideal-body images on television
predicted approval of women's use of surgical body-alteration
methods such as liposuction and breast augmentation.

Huesmann, LR, Moise-Titus, J, Podolski, CL, Eron, LD. (2003) Longitudinal
Relations Between Children's Exposure to TV Violence and Their
Aggressive and Violent Behavior in Young Adulthood: 1977-1992,
Developmental Psychology, March 2003 Vol. 39, No. 2, 201-221.
Abstract Although the relation between TV-violence
viewing and aggression in childhood has been clearly demonstrated,
only a few studies have examined this relation from childhood
to adulthood, and these studies of children growing up in the
1960s reported significant relations only for boys. The current
study examines the longitudinal relations between TV-violence
viewing at ages 6 to 10 and adult aggressive behavior about 15
years later for a sample growing up in the 1970s and 1980s. Follow-up
archival data (N = 450) and interview data (N = 329) reveal that
childhood exposure to media violence predicts young adult aggressive
behavior for both males and females. Identification with aggressive
TV characters and perceived realism of TV violence also predict
later aggression. These relations persist even when the effects
of socioeconomic status, intellectual ability, and a variety of
parenting factors are controlled.

Ross, CJ. (2000) Anything Goes: Examining the State's Interest
in Protecting Children from Controversial Speech Commentary
on. Vanderbilt Law Review. 2000;53:427-524.

Thompson KM and Haninger K. (2001) Violence in E-rated video games.
Journal of the American Medical Association, 2001; 286(5):591-598
Abstract Context: Children's exposure to violence,
alcohol, tobacco and other substances, and sexual messages in
the media are a source of public health concern; however, content
in video games commonly played by children has not been quantified.
Objectives: To quantify and characterize the depiction of
violence, alcohol, tobacco and other substances, and sex in video
games rated E (for "Everyone"), analogous to the G rating
of films, which suggests suitability for all audiences. DESIGN:
We created a database of all existing E-rated video games available
for rent or sale in the United States by April 1, 2001, to identify
the distribution of games by genre and to characterize the distribution
of content descriptors associated with these games. We played
and assessed the content of a convenience sample of 55 E-rated
video games released for major home video game consoles between
1985 and 2000.
Main Outcome Measures: Game genre; duration of violence; number
of fatalities; types of weapons used; whether injuring characters
or destroying objects is rewarded or is required to advance in
the game; depiction of alcohol, tobacco and other substances;
and sexual content.
Results: Based on analysis of the 672 current E-rated video
games played on home consoles, 77% were in sports, racing, or
action genres and 57% did not receive any content descriptors.
We found that 35 of the 55 games we played (64%) involved intentional
violence for an average of 30.7% of game play (range, 1.5%-91.2%),
and we noted significant differences in the amount of violence
among game genres. Injuring characters was rewarded or required
for advancement in 33 games (60%). The presence of any content
descriptor for violence (n = 23 games) was significantly correlated
with the presence of intentional violence in the game (at a 5%
significance level based on a 2-sided Wilcoxon rank-sum test,
t(53) = 2.59). Notably, 14 of 32 games (44%) that did not receive
a content descriptor for violence contained acts of violence.
Action and shooting games led to the largest numbers of deaths
from violent acts, and we found a significant correlation between
the proportion of violent game play and the number of deaths per
minute of play. We noted potentially objectionable sexual content
in 2 games and the presence of alcohol in 1 game.
Conclusions: Content analysis suggests a significant amount
of violence in some E-rated video games. The content descriptors
provide some information to parents and should be used along with
the rating, but the game's genre also appears to play a role in
the amount of violent play. Physicians and parents should understand
that popular E-rated video games may be a source of exposure to
violence and other unexpected content for children and that games
may reward the players for violent actions.

Thompson KM, Tepichin K, and Haninger K. (2006)Content and ratings
of Mature-rated video games. Archives of Pediatrics and Adolescent
Medicine 2006; 160:402-410.
Abstract Objectives: To quantify the depiction
of violence, blood, sexual themes, profanity, substances, and
gambling in video games rated M (for "mature") and to
measure agreement between the content observed and the rating
information provided to consumers on the game box by the Entertainment
Software Rating Board.
Design: We created a database of M-rated video game titles,
selected a random sample, recorded at least 1 hour of game play,
quantitatively assessed the content, performed statistical analyses
to describe the content, and compared our observations with the
Entertainment Software Rating Board content descriptors and results
of our prior studies.
Setting: Harvard University, Boston, Mass.
Participants Authors and 1 hired game player.
Main Exposure: M-rated video games.
Main Outcome Measures: Percentages of game play depicting
violence, blood, sexual themes, gambling, alcohol, tobacco, or
other drugs; use of profanity in dialogue, song lyrics, or gestures.
Results: Although the Entertainment Software Rating Board
content descriptors for violence and blood provide a good indication
of such content in the game, we identified 45 observations of
content that could warrant a content descriptor in 29 games (81%)
that lacked these content descriptors. M-rated video games are
significantly more likely to contain blood, profanity, and substances;
depict more severe injuries to human and nonhuman characters;
and have a higher rate of human deaths than video games rated
T (for "teen").
Conclusion: Parents and physicians should recognize that
popular M-rated video games contain a wide range of unlabeled
content and may expose children and adolescents to messages that
may negatively influence their perceptions, attitudes, and behaviors.

Walsh, DA, and Gentile, DG. (2001) A Validity Test of Movie, Television,
and Video-Game Ratings, Pediatrics, 2001;107,6:1302-1308
Abstract Context: Numerous studies have documented
the potential effects on young audiences of violent content in
media products, including movies, television programs, and computer
and video games. Similar studies have evaluated the effects associated
with sexual content and messages. Cumulatively, these effects
represent a significant public health risk for increased aggressive
and violent behavior, spread of sexually transmitted diseases,
and pediatric pregnancy. In partial response to these risks and
to public and legislative pressure, the movie, television, and
gaming industries have implemented ratings systems intended to
provide information about the content and appropriate audiences
for different films, shows, and games.
Objective. To test the validity of the current movie-, television-,
and video game-rating systems.
Design: Panel study.
Measure: Participants used the KidScore media evaluation
tool, which evaluates films, television shows, and video games
on 10 aspects, including the appropriateness
of the media product for children based on age.
Results: When an entertainment industry rates a product as
inappropriate for children, parent raters agree that it is inappropriate
for children. However, parent raters disagree with industry usage
of many of the ratings designating material suitable for children
of different ages. Products rated as appropriate for adolescents
are of the greatest concern. The level of disagreement varies
from industry to industry and even from rating to rating. Analysis
indicates that the amount of violent content and portrayals of
violence are the primary markers for disagreement between parent
raters and industry ratings.
Conclusions: As 1 part of a solution to the complex public
health problems posed by violent and sexually explicit media products,
ratings can have value if used with caution. Parents and caregivers
relying on the ratings systems to guide their children's use of
media products should continue to monitor content independently.
Industry ratings systems should be revised with input from the
medical and scientific communities to improve their reliability
and validity. A single ratings system, applied universally across
industries, would greatly simplify the efforts of parents and
caregivers to use the system as well as the efforts of outside
parties to monitor the use and validity of the system.
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article as PDF file.

Reports
Cantor, J., Stutman, S., & Duran, V. (1996, November). What
parents want in a television rating system: Results from a national
survey.
Report released by the National Parent Teacher Association, the
Institute for Mental Health Initiatives, and the University of
Wisconsin-Madison.

Kaiser Family Foundation (2005) Generation M: Media in the
Lives of 8-18 Year-olds Report, Program for the Study of Entertainment
Media and Health. Publication No.: 7581, Publish Date: 2005-03-09.
The study, Generation M: Media in the Lives of 8-18 Year-olds,
examined media use among a nationally representative sample of
more than 2,000 3rd through 12th graders who completed detailed
questionnaires, including nearly 700 self-selected participants
who also maintained seven-day media diaries.
View
report online.

Kaiser Family Foundation (2004) Parents, Media and Public Policy:
A Kaiser Family Foundation Survey, Program for the Study of
Entertainment Media and Health. Publish Date: 2004-09-23.
A national Kaiser Family Foundation survey of parents found that
a majority says they are "very" concerned about the
amount of sex (60%) and violence (53%) their children are exposed
to on TV.
The survey of 1,001 parents of children ages 2-17 was conducted
in July and August 2004.
View
report online

National Television Violence Study. (1998) The Center for Communication
and Social Policy, University of California, Santa Barbara, Thousand
Oaks, CA, Sage Publications, 1998.
Abstract This third annual report presents comparative
year-to-year data on the nature of violence on television across
program genres and channel types in the United States. It contains
an analysis of how the new television rating system was initially
implemented and tracks trends over three years in the use of program
advisories and content codes. It also evaluates public service
announcements designed to prevent handgun violence among adolescents.
Finally, it provides new analyses of `high risk' presentations
of violence most likely to adversely affect younger audiences.
Books
Anderson, CA, Gentile, DA, Buckley, KE, (2007) Violent Video
Game Effects on Children and Adolescents: Theory, Research and
Public Policy, Oxford University Press, 2007.

Asamen, JK, and Berry, GL. (2003) The Multicultural Worldview
of Children Through the Lens of Television. In Palmer, EL, Young,
BM (Eds.) The Faces of Televisual Media: Teaching, Violence,
Selling To Children, Lawrence Erlbaum Associates, June 2003.

Berry, GL, and Asamen, JK (2001) Television, Children, and Multicultural
Awareness: Comprehending the Medium in a Complex Multimedia Society.
In Singer, DG, and Singer, JL (Eds.) Handbook of children and
the media. Thousand Oaks, CA: Sage Publications, 2001.

Dill, KE. (in press) Do Anti-Social Video Games Corrupt? A study
of pro-rape, anti-women attitudes among gamers. Praeger Publishers.
View
chapter online

Durham, M. G. (2006). Girls, media and the negotiation of sexuality:
A study of race, class, and gender in adolescent peer groups.
In J. O'Brien (Ed.) The Production of Reality: Essays and Readings
on Social Interaction (4th ed.), Thousand Oaks: Sage Publications,
2006.

Gentile, DA, & Anderson, CA (2006).Violent video games: Effects
on youth and public policy implications. In N. Dowd, D.G. Singer,
& R. F. Wilson (Eds.) Handbook of children, culture, and
violence (pp. 225-246). Thousand Oaks, CA: Sage Publications,
2006.

Ross, CJ. (2006) Constitutional obstacles to regulating violence
in the media. In N. Dowd, D.G. Singer, & R. F. Wilson (Eds.)
Handbook of children, culture, and violence (pp. 225-246).
Thousand Oaks, CA: Sage Publications, 2006.
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