Gun Violence in Video Games and Subsequent Firearm Play
Authors: Cheryl A. King, Cynthia Ewell Foster
Journal: JAMA Network Open (2019)

The study by Chang and Bushman 1 reports findings from a randomized clinical trial designed to determine whether children who played a video game with gun violence would hold a handgun for a longer period and pull the handgun's trigger more times during subsequent play compared with children who played the same video game with sword violence or no violence.The children, aged 8 to 12 years, had access to a variety of toys during the play period, including 2 real, disabled 9-mm handguns.Among the study's sample of 242 children, 220 (90.9%) found the handguns.Among the children who found a handgun, 38.6% touched a handgun and did not tell an adult and 17.7% pulled the trigger at least 1 time.Relative to the other 2 conditions, playing the video game with gun violence was associated with more firearm touching, firearm trigger pulls, and shooting at oneself and one's playmate.Other variables, including trait aggressiveness, attitude toward guns, parental estimate of the child's interest in guns, and previous exposure to violent media, were also predictors of children's greater handgun use.We cannot extrapolate from these study results to suggest that playing shooter video games for a short time has a long-term effect on violent behavior or firearm-related pediatric injuries; however, the children's greater tendency to handle firearms, even in the short term, is cause for concern.Firearm-related injuries are the second leading cause of death among children in the United States, and suicides and homicides account for 35% and 59% of these deaths, respectively. 2A prominent theory of suicide risk, the interpersonal-psychological theory of suicidal behavior, 3 points to capability for self-harm as a contributing factor distinguishing those who experience suicidal thoughts from those who also act on these thoughts.The theory proposes that suicidal behavior and suicides occur when an individual has both the desire for death because of thwarted belongingness and perceived burdensomeness and an acquired capability to enact lethal self-injury.Acquired capability is conceptualized as a fearlessness about self-harm and physical pain, which may be obtained through engaging in risky behaviors, painful experiences, or fear-provoking experiences.The possibility that experience with handling a firearm is associated with a greater acquired capability for using a firearm in a suicide attempt is consistent with the results of a 2018 study 4 of adults that suggested that the experience of shooting a firearm was related to higher self-reported capability for suicide.Experience or comfort with using a firearm combined with access to a firearm during a period of acute suicide risk 5 are likely to substantially increase the risk of death because of the high lethality associated with firearm suicide attempts.The short-term precipitating effects identified by Chang and Bushman 1 also have implications for our understanding of intentional violence toward others.A child or adolescent who actively engages with a video game with firearm violence may have a lower threshold for using a firearm against another person when experiencing strong negative emotions and a precipitating event.This may occur through 1 or more of the mechanisms that have been proposed to account for the relationship of exposure to violence with aggressive behavior (eg, desensitization, activation of a schema or script for aggression). 6One framework for understanding the likelihood of subsequent aggression, the general aggression model, 7 emphasizes the importance of personal variables (eg, personality traits) and situational or external variables (eg, presence of weapons, exposure to media violence, availability of alcohol, provocation of others).Based on this framework, the risk profiles of children and adolescents are highly heterogeneous, ever changing, and not entirely controllable.