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Tenth Annual MediaWise® Video Game Report Card

David Walsh, Ph.D.; Douglas Gentile, Ph.D.; Erin Walsh; Nat Bennett; Brad Robideau; Monica Walsh, MA; Sarah Strickland, David McFadden
National Institute on Media and the Family
November 29, 2005


Click Here for a printable PDF version of the report  Print this report


This MediaWise Video and Computer Game Report Card is the tenth issued by the National Institute on Media and the Family, an independent, non-partisan, non-sectarian, non-profit organization. The MediaWise Video and Computer Game Report Card provides a snapshot of the interactive gaming industry with a focus on issues related to the welfare of children and teens.


Risk to Children Continues to Grow

Every child who plays video games is undergoing a powerful developmental experiment, the results of which we do not yet fully comprehend. This year, we find the video game industry exactly as we have found it every year we've compiled this report: even more powerful than it was the year before. In fact, the video game industry's growing sales numbers and ever-widening influence have become so apparent and so well-known that describing the industry as powerful has become clichéd.

The industry's efforts to be good corporate citizens have not kept pace with its explosive growth. The industry that generated 25 billion dollars in worldwide sales last year (nearly 10 billion in the U.S. alone) seems increasingly focused on the bottom line, at the expense of its customers, especially children and teenagers. Killographic and sexually explicit games are still finding their way into the hands of millions of underage players.

2005 Report Card Highlights

Ratings Accuracy

After years of criticizing the ESRB ratings and calling for improvement and overhaul of the system, we have come to the conclusion that the system itself is beyond repair. The system supposedly put in place to keep killographic games out of the hands of kids seems to often produce the opposite results.

In early July, we discovered that explicit pornography was included in the top selling video game, Grand Theft Auto: San Andreas. We issued a MediaWise Parent Alert, and a firestorm in the news media followed. It took two weeks for the game's manufacturer, Rockstar Games, to cut short its string of denials and finally come clean. The results include lawsuits, a federal investigation, and major retailers cleaning the games off their shelves and sending them back to Rockstar. The so-called "hot coffee" scandal does not simply reveal the bad faith of one of the industry's most prominent companies; it has shown once and for all that the present rating system is broken and can't be fixed.

The ESRB video game rating system, like its cousins in the movie and television industries, is owned and operated by the industry it is supposed to monitor. This obvious conflict of interest is why only eighteen games out of ten thousand have ever been rated Adults Only (AO). It seems that every year M-rated games are on average more violent, contain more sexual content and have more profane language than games released with the same rating the year before. Study after study shows that ratings would be stricter if parents were doing the job. It took explicit porn to get Grand Theft Auto: San Andreas an AO rating, even though the original version, still rated M, rewards players whose onscreen persona had sex with prostitutes and then killed them. We have been calling for AO ratings for the Grand Theft Auto series for years - now it is clear why the ESRB has ignored our request.

Our Response
In response to the ESRB's recent failure, the National Institute on Media and the Family will convene a summit next year on video game ratings with the leading national organizations dedicated to children's health and welfare, including Children Now, the National PTA, and the American Academy of Child and Adolescent Psychiatry. We plan to issue and endorse a set of ratings recommendations.

Retailer Performance

This year the Institute continues another tradition: evaluating video game retailers' efforts to keep M-rated games out of the hands of children. This was the second year the public received promises from the major retailers that they had established and would enforce policies to protect underage customers. Our survey of retailers found that 80 percent of store personnel were able to describe their stores' policies. And yet, in spite of these policies, enforcement falls short. Half of the time, young children are able to walk out of their stores with M-rated games in hand.

This is a significant step back from the previous year's sting operation, which found children able to purchase these games in one out of three attempts. This comparison yields a disturbing conclusion: retailers would much rather appear as if they care about children than actually take basic steps to protect them.

In one case, for example, a clerk at a major retailer asked our Secret Shopper his age when he attempted to buy an M-rated game. He replied with his true birth date. When the cash register would not let her complete the sale because he was under 17 she told him that she would change the birth date so that he could get the game. They both smiled and he walked out with the game.

One retailer, Best Buy, is the exception to this rule. Their performance this year is worth mentioning because it should serve as an example to all other retailers. This year, we found their policy and enforcement flawless in our sting investigation. We know this is not a fluke - Best Buy conducts its own stings to ensure that its policy is enforced, and disciplines employees who fail to follow the rules. Best Buy has set the standard for which all other retailers should strive.


A Widening Gap Between What Kids Do and What Parents Know

The motto at the center of our efforts to create MediaWise communities and organizations is simple: "Watch what your kids watch." Unfortunately, when it comes to video games, parents do not seem to be paying attention. Some of the blame must be laid at the feet of an industry which rubber stamps ultra-violent games and refuses to make the proper effort to enforce responsible retail policies. But parents must bear some of the responsibility too. Especially in the context of a growing body of research showing the link between violent games and real-world aggression, parents need to open their eyes to the reality that their kids' favorite games are not appropriate for children. They are rated M for Mature.

This year, our student survey found that seven out of 10 children report playing M-rated games, and three out of five kids named an M-rated game as one of their favorites. Nearly half of the more than 300 boys who participated in the study named an M-rated title as their most favorite game.

Half of the parents who participated in our survey said they do not allow their children to play M-rated games, but nearly two-thirds of surveyed students said they owned their own M-rated game. What explains this gap? Maybe this statistic: only half of the parents say they were with their children the last time they purchased a game.

In the light of the video game industry's growing power, and its recent lack of concern for its customers, parents have a greater responsibility than ever to be aware of their kids' video game habits.

MediaWise® Video Game Report Card Summary
Ratings Education --------- C+
Retailers' Policies --------- B
Retailers' Enforcement --- D-
Ratings Accuracy --------- F
Arcade Survey ----------- B-

2005 Survey Results

Surveys covered in the 2005 Report Card

  • Student Survey
  • Parent Survey
  • Retailers' Ratings Education
  • Retailers' Policies and Enforcement
  • Game Content and Ratings Accuracy
  • Arcade Survey


    Student Survey

    This year, we surveyed six hundred and fifty-seven 4th-grade through 12th-grade students in their classrooms. These students represented schools both public and private in rural, suburban and urban schools. Students averaging 13.7 years of age completed the surveys anonymously during the fall of 2005. Key findings include:

    • 87% of 8- to 17-year old children play video games at home. More than nine out of ten (92%) boys play video games at home, while 80% of girls say they play at home.
    • Less than half (47%) of children say their parents understand all of the ESRB ratings.
    • Only 26% say that a parent has ever stopped them from getting a video game because of its rating (28% boys, 23% girls).
    • Seven out of 10 children report playing M-rated games.
    • There are vast differences between boys and girls, with 86% of boys admitting that they play M-rated games compared to 49% of girls.
    • Almost two-thirds (61%) of children report owning their own M-rated games, up from 56% in 2003. 78% of boys say they own M-rated games.
    • Almost half of children (45%) say they have bought M-rated games themselves (up from 37% in 2003).
    • Only 55% of children said a parent was present the last time they bought an M-rated game (down from 65% in 2003).
    • Almost two-thirds (60%) of children list at least one M-rated game as their favorite (75% of boys and 35% of girls).

    This survey clearly shows that M-rated games are more popular than ever, more easily accessible and that most children's parents continue to be unaware of the games they play. As technology advances, and the lines between different media begin to blur, it becomes more and more difficult for parents to determine what is and isn't good for their kids. It is more important now, than ever before, that parents not only understand the ratings but understand why it is so important to pay attention.


    Parent Survey

    Obviously, parents play a very important role in supervising the game play of children. From the Student Survey it appears that not enough parents are paying attention. To hear directly from parents, we surveyed by telephone 145 households nationally that were randomly-selected from a list of parents. 71% of these households currently have children living at home. We conducted our surveys in September and October 2005.

    Knowledge and Use of Ratings
    Only 40% of respondents say they understand all of the video game rating symbols. Households with children currently living at home are only slightly more likely to say they understand all of the ratings (47%). In addition, only 53% of parents with kids at home say they have ever stopped their children from getting a video game because of its rating.

    Purchase Behaviors
    Among only households with kids at home, one quarter (27%) of respondents say they allow their children to buy M-rated games, with only half (50%) saying they do not. Just under half (42%) of respondents say their children have bought video games without them present. When asked "the last time your child bought a video game, were you present?" only 50% say yes.


    Retailers' Ratings Education

    There has been a great deal of attention paid to retailers this year as legislation restricting kids' access to Mature-rated games sweeps the country. We contacted the retailers themselves to see what is happening on the ground. We surveyed by telephone 65 video game rental or retail stores in 12 states. We surveyed stores in both large cities and small towns within these states. Of the 65 stores, 34 primarily sell computer and video games, 24 primarily rent, and seven sell and rent about equally. Forty-eight of the stores surveyed are part of a chain of stores. We conducted our surveys in September and October 2005. Key findings include:

    • Seventy-one percent of the stores say they educate the public about the ESRB rating system (72% in 2004).
    • When asked, only 52% could describe how they educate their customers.
    • Only half (52%) of the retail personnel say they have a policy training their employees on the ESRB rating system (same as 2004 and down from 62% in 2003).
    • A majority (97%) of the retail personnel say they personally understand the ESRB rating system (up from 76% in 2004).
    • Only 26% of employees were familiar with ESRB's "OK to Play" Campaign (22% in 2004).

    The video game retailers have a lot of work to do in educating the public about the ESRB ratings. While it is encouraging that more and more retail employees personally understand the ratings, still only half of the stores formally train their employees in the rating system or make a coordinated effort to educate the public.

    Grade for Ratings Education…………………………………..………C+


    Retailers' Policies and Enforcement

    Policies about Ratings
    Over the last three years, we have seen a steady increase in the number of stores that claim to have a policy preventing children younger than 17 from renting or buying M-rated games. This year, the vast majority (94%) of stores say they have a policy. This is an increase from the results of previous years (89% in 2004, 83% in 2003, and 70% in 2002). When the actual policies are examined however, the percentage drops to 80%. When employees were unable to describe the policy we did not count it as such. Last year, we attributed the increase in the number of stores who claimed to have policies in place to the announcement the Interactive Entertainment Merchants Association gave after the report card two years ago stating that they would restrict youth access to M-rated games without parental permission.

    Retailers' Policies……………………………………………………………………………….B

    Policy enforcement
    Last year, it seemed as if the retailers were making a good faith effort to enforce their policies. Between 2003 and 2004, the percentage of successful purchases made by our young Secret Shoppers dropped from 55% to 34%- reflecting progress the retailers made on their promise to restrict youth access to M-rated games.

    However, this year it appears that retailers are actually more negligent in enforcing their policies than last year. As stated earlier in the report, it seems that retailers would rather appear as if they care about children than actually take simple steps to protect them. This fall, children between the ages of 9 and 16 entered retail stores and attempted to purchase M-rated games without adult supervision. Sting Operations took place between August and October 2005 at 46 retail locations throughout the country.

    Of the 46 attempts, 20 resulted in successful purchases. This 44% success rate is significantly higher than 2004 (34%). Even more disturbingly, we saw the success rates for girls skyrocket this year. For the first time in the history of this report card, rates were roughly equivalent for boys and girls (42% boys, 46% girls). This is a large increase for girls from last year when they were able to purchase M-rated games only 8% of the time (last year boys were able to purchase M-rated games 50% of the time).

    We have frequently decried the disparity between genders - last year calling for retailers to enforce their restriction policies with both boys and girls. Needless to say, this is not the kind of equality that we had in mind.

    Policy enforcement ……………………………….……………………………………...……D-


    Game Content and Ratings Accuracy

    The best way to ensure that kids are playing appropriate video games is, of course, to literally watch what they watch, or play what they play. But most parents do not have the time, the interest, or skill to play every video game their kids use. This is why there is a ratings system in place. If the ratings work, all parents should have to do is look at the label on a video game to see if it's okay for their kids. Ratings should be reliable, consistent and informative. Unfortunately, today's ratings don't make it that simple.

    Every year we claim that video games continue to push the envelope on sex, violence and inappropriate language. This year, the 10th Anniversary of the Report Card, we are quantifying these changes. To illustrate the degree to which video games have become more violent, more sexual, and more crude we compared six M-rated games representative of those featured in report cards during the late 1990s to six M-rated games from 2004. The results couldn't paint a more clear picture of what we have said all along; the ratings aren't reflecting the changes in game content.

    Using data generated by PSVratings, a content-based ratings system measuring actual levels of profanity, sex, and violence, we found that games in 2004 were on average more violent, contained more sexual content and had more profane language when compared to games from the late '90s. In the '90s only 16% of the M-rated games contained any profanity at all and only 33% contained sexual content. By 2004 all (100%) of the M-rated games contained some level of profanity and sexual content. The actual figures shot through the roof. The games we analyzed from last year were 30 times more likely to contain profanity than those from the '90s, and the average prevalence of sexual content increased a whopping 800%. Kids are six times more likely to see nude or partially nude figures in M-rated video games today than they were in the late 1990s. Yet the ratings haven't changed.

    It is clear from the data that the games we examined from the late '90s were labeled Mature largely due to their violent content. The games must have been pretty violent to earn an M-rating based on violence alone. However, we see that violence in the video games from 2004 increased 46% from the late '90s. This means that on top of being more sexually explicit and full of obscene language, the games from 2004 were on average even more violent than those games that were given an M-rating based on little more than violent content alone less than ten years ago. The continual increase in adult content, the failure to use the AO rating, and the "hot coffee" scandal of 2005 all point toward the deep flaws in the ESRB rating system.

    Ratings Accuracy………………………………………………………………………………F


    Arcade Survey

    Over five years ago, we called upon the arcade industry to develop, implement, and enforce a rating system. They responded in 2000, with a system of green, yellow, and red stickers. After seeing little improvement by the arcade industry in 2001 in terms of ratings education and enforcement we wanted to see where we stand four years later.

    After visiting 17 arcades in five states, we are encouraged to see that this year all of the arcades have ratings displayed on at least some of the games. However, in arcades where there are ratings, only 78% of the games have ratings displayed (down from 81% in 2001). Only four of the arcades claimed to have a policy regarding the ratings. Two of the respondents said that the ratings were posted, but the monitoring is left up to the parents. This year, 27% of arcades had an attendant watching over the arcade (20% in 2003 and 24% in 2001). Of these, only two attendees were given any training on the ratings and were placed in charge of enforcing the ratings. However, even in arcades without attendants, 20% of arcades had educational materials (posters) describing the ratings system (up from 13% in 2003, 12% in 2001 and 0% in 2000).

    It looks like arcades have taken a few steps forward in the last four years, but we still see a lot of room for improvement.

    Grade for Arcade Industry…………………………………………………………………….B-


    Recommendations:

    1. The National Institute on Media and the Family will convene a National Summit on Video Game Ratings with leading parent, health, and child welfare groups. The purpose will be to review the current ESRB rating system and issue a set of recommendations for improvement.
    2. Retailers need to enforce policies restricting youth access to M-rated games. We challenge the industry to enforce their policies 100% of the time by next year.
    3. Parents need to become MediaWise, "Watch what their kids watch," and only purchase and allow their children to play age-appropriate games.
    4. We call upon the video game industry to join us in educating parents about the need to supervise their children's game play. The industry's efforts so far have educated parents about how to use the ratings but not why the ratings and the new electronic tools built into game consoles are important for children's health.
    Legislative Update

    In state houses across the country, legislation is being introduced to prohibit the sale or rental of Mature-rated video games to children. Such laws were recently enacted in Illinois and California.

    There is a growing nationwide recognition of the harmful effects of violent, or killographic, video games on children, based in large part on the National Institute on Media and the Family's well-known research that shows playing violent video games is linked to aggressive behavior in children. Yet M-rated video games that push the envelope with the depiction of cop killing, the denigration women, and, now, the glorification drug use, unfortunately, get into the hands of children. Through its Annual MediaWise® Video Game Report Card, the National Institute on Media and the Family repeatedly has recommended to the video game industry steps they can take to restrict the sale of M-rated games to those 17 and older.

    The National Institute on Media and the Family appreciates public officials taking steps to ensure children can enjoy good video games, while avoiding those harmful games that are easily accessible to children.

    The National Institute on Media and the Family will actively support legislation that funds and/or promotes the education, communication, and research on issues regarding children and media. The impact of video games on adolescent brain development and the childhood obesity epidemic is a significant public health issue and requires additional analysis. That is why the National Institute on Media and the Family supports the Children and Media Research Advancement Act, which has been introduced in the U.S. Congress. This bipartisan legislation would provide funds to establish a program on children and the media, within the Centers for Disease Control and Prevention, to study the role and impact of electronic media in the development of children.

    The National Institute on Media and the Family will also provide expert testimony on the impact of media on children and youth. The National Institute on Media and the Family will be careful to engage in these activities in order to maintain its position that it does not support legislation involving censorship.

    MediaWise® Report Card Parent Buying Guide
    Game Lists   Rating:
    Parent Alert! Games to avoid for your children and teens
    1. Far Cry M
    2. F.E.A.R. M
    3. The Warriors M
    4. Stubbs the Zombie in Rebel Without a Pulse M
    5. True Crime: New York City M
    6. Blitz: The League M
    7. Grand Theft Auto: Liberty City Stories M
    8. God of War M
    9. Doom 3: Resurrection of Evil M
    10. Urban Reign T
    11. Conker: Live and Reloaded M
    12. Resident Evil 4 M
         
    MediaWise recommended games for children and teens
    1. Harry Potter and the Goblet of Fire E 10+
    2. The Incredibles: Rise of the Underminer E 10+
    3. Peter Jackson's King Kong T
    4. Legend of Zelda: The Minish Cap E
    5. The Chronicles of Narnia: The Lion, The Witch, and The Wardrobe T
    6. Sly 3: Honor Amongst Thieves E 10+
    7. We Love Katamari E
    8. Sid Meier's Pirates! E
    9. Dance Dance Revolution ULTRAMIX3 E 10+
    10. Backyard Baseball 2005 E

    2005 Video Game Research Update

    This year, every new study and all the latest research pointed to the same fact: video games are excellent teachers. Just as activity simulators can help train players for real-world tasks, violent video games coax players into actual aggression and antagonistic attitudes. If there was ever any doubt about the impact of video games on children it has finally been laid to rest. Everyone in the scientific community agrees, whether an ally of the industry or a critic of its practices - whether or not they realize they agree - because every bit of research we have seen has shown, in one way or another, that video games are powerful in potential and effect, for good and for ill. It is this fact that should compel parents, educators, and policy-makers to pay attention to video games.

    In recent years, many more studies have been conducted than in the past, and most of them have been of higher scientific quality than the earlier studies. Bit by bit, the broad picture is becoming clear. This is thanks in part to two new trends in the field: longitudinal studies and meta-analyses. Although some of the studies in these categories were conducted earlier than the last year, their inclusion in the consideration of these trends is essential, hence their mention below.

    In a longitudinal study, researchers study the same people over a period of time. Longitudinal studies allow us to see whether people change over time. To our knowledge, only five longitudinal studies have yet been conducted. Because these are newer, we are reporting on them in some depth.

    In one, 41 adolescents played either a hand-to-hand fighting game (Mortal Kombat), a violent horror game (Resident Evil), or a sports game (NBA Live) once a week for three weeks (Ballard, Panee, Engold, & Hamby, 2001). Physiological arousal (heart rate and blood pressure) and emotions (facial smiling and disgust displays) were measured during play, and self-reported anger, frustration, arousal, and relaxation were measured post-play. Heart rate, blood pressure, and facial displays of disgust decreased significantly over the three play periods, showing desensitization with repeated exposure. Self-reported variables did not change significantly, and there were no reported differences in desensitization by game type. However, this study included a very small sample (only 13-14 playing each game), and only one hour of play each week for three weeks.

    In the second longitudinal study, 807 Japanese 5th and 6th grade students were surveyed twice during a school year (Ihori, Sakamoto, Kobayashi, & Kimura, 2003). The experimenters found that the amount of video game play at Time 1 was significantly related to later physical aggression, but aggression at Time 1 was not related to later video game play. However, the authors only measured the amount of video game play, and did not report whether the children were playing violent games. This distinction between the amount and content of the games is important, and will be discussed in greater detail later in this report.

    In the third study, 2,550 6th and 7th grade students were surveyed four times over two years about their violent media consumption (action movies, video/computer games involving weapons, and Internet sites describing/recommending violence), and their attitudes about and engagement in aggressive behaviors (Slater, Henry, Swaim, & Anderson, 2003). The strength of this approach is that it allows for a strong test of the mutual reinforcement hypothesis (i.e., that aggressive kids seek out violent media, which in turn makes them more aggressive, which makes them seek out more violent media, which further increases their aggressive tendencies, etc.). Indeed, this downward spiral is exactly the pattern that was found. However, this study also has several problems - the most relevant here is that no data were reported for violent video games independently, so it is impossible to determine the effect of violent games by themselves. However, the results are likely to be underestimates of the effects, because the measures used were not sensitive measures of media violence exposure.

    In the fourth longitudinal study, 213 gamers were recruited to play a massively multiplayer online role playing game (MMORPG), 75 of whom were given the game which included violent content (Williams & Skoric, 2005). Most of the gamers were adults (mean age = 28, range 14-68). The experimental group was requested to play the game for at least five hours per week for four weeks, although one third (32%) did not. At the beginning and end of the month, all participants were asked whether they had been involved in a "serious argument" with a friend or a partner during the previous month. There was a correlation between game play and arguments, but not with changes in the number of arguments. Unfortunately, this study suffers from several critical flaws - most importantly the studies did not include a measure of aggression. Arguments with friends and partners are sometimes antisocial behavior, but are rarely aggression. Furthermore, by only asking yes/no, there was no way for this study to measure increases in antisocial behaviors. If you had been involved in an argument at the beginning of the study and also at the end, this study would have only been able to show no change.

    In the fifth longitudinal study, 430 3rd, 4th, and 5th grade students, their teachers, and their peers were surveyed at two points during the school year (Anderson, Gentile, & Buckley, under contract; Study 3). Children who had high exposure to violent video games changed over the school year to become more verbally aggressive, more physically aggressive, and less prosocial (as rated by themselves, their peers, and their teachers). It appears that not only does repeated exposure to violent video games increase aggressive behavior, but it also decreases empathic helpful behavior. This study has several strengths over the preceding longitudinal studies, including more sensitive violence exposure measures and the use of multiple informants. However, the lag time between the two surveys was relatively short, ranging between two and six months.

    All but one of these studies document increases in aggressive cognitions and behaviors in connection with violence exposure. Because these are longitudinal studies, we can make some claims about a likely causal direction, as later behaviors cannot cause prior behaviors. However, unless the studies are experimental in design, strong causal claims cannot be made.

    Several meta-analyses have been conducted on violent video games (e.g., Anderson, 2004; Anderson & Bushman, 2001; Anderson, Carnagey, Flanagan, Benjamin, Eubanks, & Valentine, 2004; Gentile & Anderson, 2003; Sherry, 2001). All of them have concluded that there is a significant relation between violent video game play and aggression. Anderson and his colleagues have conducted detailed analyses on five specific effects (e.g., Anderson & Bushman, 2001; Anderson et al., 2004). Across studies, violent video games have significant effects on aggressive affect, physiological arousal, aggressive cognitions, and aggressive behaviors. They are also significantly negatively related to prosocial behaviors. These conclusions hold for both experimental and cross-sectional studies, so both causality and applicability to real-world aggression can be inferred (Anderson et al., 2004). These conclusions also hold for studies with children and adults (Gentile & Anderson, 2003). It would be expected that we might find larger effects with newer studies since violent video games have become more violent over time. Indeed, this is the pattern found, with earlier studies showing smaller effect sizes than more recent studies (Gentile & Anderson, 2003). Finally, it could be argued that the pattern of effects is driven by methodologically flawed studies - that is, poorer quality studies show a large effect, but high-quality studies show small or no effects. Anderson et al. (2004) coded each of the studies included in the meta-analysis on nine different quality dimensions, and the opposite pattern was found. Methodologically weaker studies actually show significantly smaller effects of violent video games than do studies using "best practices."

    References

    • Anderson, C.A. (2004). An update on the effects of playing violent video games. Journal of Adolescence, 27, 113-122.
    • Anderson, C. A., & Bushman, B. J. (2001). Effects of violent video games on aggressive behavior, aggressive cognition, aggressive affect, physiological arousal, and prosocial behavior: A meta-analytic review of the scientific literature. Psychological Science, 12, 353-359.
    • Anderson, C.A., Carnagey, N.L., Flanagan, M., Benjamin, A.J., Eubanks, J., & Valentine, J.C. (2004). Violent video games: specific effects of violent content on aggressive thoughts and behavior. Advances in Experimental Social Psychology, 36, 199-249.
    • Anderson, C. A., Gentile, D. A., & Buckley, K. E. (under contract). Violent video game effects on children and adolescents. New York: Oxford University Press.
    • Ballard, M. E., Panee, C. D., & Engold, E. D., & Hamby, R. H. (2001). Society for Research in Child Development Conference.
    • Gentile, D. A. (2005). Examining the effects of video games from a psychological perspective: Focus on violent games and a new synthesis. Minneapolis, MN: National Institute on Media and the Family. Available online: www.mediafamily.org/research/Gentile_NIMF_Review_2005.pdf
    • Gentile, D. A., Lynch, P. J., Linder, J. R., & Walsh, D. A. (2004). The effects of violent video game habits on adolescent hostility, aggressive behaviors, and school performance. Journal of Adolescence, 27, 5-22.
    • Gentile, D. A., & Stone, W. (in press). Violent video game effects on children and adolescents: A review of the literature. Minerva Pediatrica.
    • Gentile, D. A. & Anderson, C. A. (2003). Violent video games: The newest media violence hazard. In D. A. Gentile (Ed.), Media violence and children. (pp. 131-152). Westport, CT: Praeger Publishing.
    • Green, C. S., & Bavelier, D. (2003). Video games modify visual attention. Nature, 423, 534-537.
    • Greenfield, P. M., DeWinstanley, P., Kilpatrick, H., & Kaye, D. (1994). Action video games and informal education: Effects on strategies for dividing visual attention. Journal of Applied Developmental Psychology, 15, 105-123.
    • Ihori, N., Sakamoto, A., Kobayashi, K., & Kimura, F. (2003). Does video game use grow children's aggressiveness?: Results from a panel study. Proceedings of the International Simulation and Gaming Association, Tokyo, Japan, 34, 221-230.
    • O'Keefe, B.J., & Zehnder, S. (2004). Understanding media development: A framework and case study. Journal of Applied Developmental Psychology, 25, 729-740.
    • Rosser, J.C. Jr., Lynch, P.J., Haskamp, L.A., Yalif, A., Gentile, D.A., & Giammaria, L. (2004, January). Are Video Game Players Better at Laparoscopic Surgery? Paper presented at the Medicine Meets Virtual Reality Conference, Newport Beach, CA.
    • Sherry, J. L. (2001). The effects of violent video games on aggression: A meta-analysis. Human Communication Research, 27, 409-431.
    • Slater, M.D., Henry, K.L., Swaim, R.C., & Anderson, L.L. (2003). Violent media content and aggressiveness in adolescents. Communication Research, 30(6), 713-736.
    • Williams, D., & Skoric, M. (2005). Internet fantasy violence: A test of aggression in an online game. Communication Monographs, 72, 217-233.
  • ©2005 National Institute on Media and the Family.