Video games and real-life aggression: review of the literature.

Concern about violent video games has been widely expressed [1–3]. A professor of military science has asserted that some games are “very definitely enabling violence” in a way analogous to training programs used by the military and police agencies [4, p. 315]. Also, violent video games have been suggested as a contributing factor in recent school shootings by adolescent males who played violent games [5]. However, population-level evidence suggests that between 1991 and 1997, there was a linear decrease in adolescent weapon-carrying and physical fighting [6], and this downward trend continued in 1999 [7]. Also, between 1993 and 1998 (the most recent year available), national homicide rates dropped from 2.5 to 1.5 per 100,000 for 10to 14-year-olds and from 20.5 to 11.7 per 100,000 for 15to 19-year-olds. During this period, video games were ubiquitous, and most games contained violence [8,9], calling into question the notion that video games have a largescale harmful effect on youth violence. We reviewed the scientific literature to determine whether the evidence supports a public health concern that violent video games contribute to real-life aggression. Youth violence and delinquency have been consistently associated with family factors such as child abuse and neglect, parental rejection of the child, and parental criminality and alcoholism [10]. Individual factors such as poor performance in school and on standardized tests, truancy, gang membership, and attention–deficit-hyperactivity and conduct disorders are also consistent predictors of youth violence and delinquency, although these factors may be early manifestations or “markers” rather than causes of later problem behavior. Violent video games may be considered in the context of war play and other forms of aggressive play by youth. Societal attitudes toward aggressive play differ among adults [11]. Aggressive play differs from real aggression by the fact that it does not include an attempt to injure someone. Although opponents of aggressive play argue that such play fosters real-life violence, proponents argue that it is a natural, even inevitable, aspect of boys’ play and provides an opportunity to try to come to terms with war, violence, and death [11]. Several psychological theories are relevant to the possible role of video game violence in youth aggression. J. L. Sherry [personal communication, October 25, 1999] identified six theories used to predict either increased or decreased aggression after violent video game play. First, social learning theory [12,13] suggests that at least some aggression is learned by observing, and then by imitating, a model who acts aggressively. Aggressive video game characters might serve as models for aggressive behavior. Further, rewards such as higher points and longer playing times within the game and increased status From the Office of Epidemiology, Washington State Department of Health, Olympia, Washington. Address correspondence and reprint requests to: Lillian Bensley, Ph.D., Non-Infectious Conditions Epidemiology, Washington State Department of Health, P.O. Box 47812, Olympia, Washington 98504-7812. E-mail: Lillian.Bensley@doh.wa.gov. Manuscript accepted March 1, 2001. JOURNAL OF ADOLESCENT HEALTH 2001;29:244–257