Violence in Teen-Rated Video Games

Kevin Haninger; M. Seamus Ryan; Kimberly M. Thompson, MS, ScD

Disclosures
In This Article

Abstract and Introduction

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.

The marketing of violent entertainment to children and adolescents continues to represent a significant area of public concern,[1,2,3,4] despite the uncertainties that remain about the impacts of playing video games.[5,6,7,8,9,10] Recent meta-analyses of experimental and non-experimental studies suggested children and young adults may show increased aggression with exposure to playing violent video games.[8,9] In addition, a small study of adults who played a large, diverse set of games (ie, 46 games rated E for "Everyone," T for "Teen," and M for "Mature" that represented a mixture of genres [C.S. Green, personal communication, 2003]) showed that visual attentional skills improve with video game playing.[10] These results provide more evidence that people learn from playing video games, although the impact of this type of learning for children remains insufficiently studied to date.

Studies of media use by children and adolescents document the popularity of video games, reporting that 8-13 year olds play video games an average of 32 minutes per day, while 14-18 year olds play video games an average of 20 minutes per day.[11] On any given day, children in either age group who play video games spend more than an hour playing them.[11]

Since 1994, the ESRB has rated video games with age-based rating symbols and content descriptors, which game manufacturers display on the game box to inform consumer choices. According to the ESRB, the T-rating means that game content "may be suitable for persons ages 13 and older [and] may contain violent content, mild or strong language, and/or suggestive themes."[12] We previously characterized violence in E-rated video games[13] and compared the content we observed in a random sample of T-rated video games to ESRB content descriptors.[14] In this study, we characterize and quantify the depiction of violence and blood in the random sample of T-rated video games, and we assess the content of 9 additional games released on the 2 newest platforms to provide perspective on more recent games and to further explore issues related to cross-media marketing.

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