October 30, 2020

Violent Video Games

Testimony of Michael Rich, MD, MPH, FAAP American Academy of Pediatrics Chicago City Council, Illinois

Good morning. I want to thank Alderman Burke and Alderman Rugei for offering me the opportunity to speak to a subject that is critical to the physical and mental health of children and adolescents. As pediatricians, my colleagues and I are fortunate to be able to work with children. They are our joyful, energetic, hopeful future. At the turn of the 20th Century, the hope for many children was not so bright. Half of them would die before their fifth birthdays, mostly from infectious diseases. We have faced and defeated the scourges of pneumonia, diarrhea, polio and scores of other diseases that were common killers of children. Today, the great majority of a pediatrician's work is with healthy young bodies and minds. Our job is to maintain health by offering guidance about risks to the lives and well being of the children for whom we care.

At the turn of the 21st Century, violence is the most prevalent health risk for children and adolescents. Homicide, suicide and accidents are the top three causes of death for those 15 - 24 years-old. Each year over 150,000 adolescents are arrested for violent crimes, more than 300,000 are seriously assaulted, and 3,500 are murdered. Violence done to and by America's young people is a public health emergency, an emergency that must be addressed by all of us, physicians, parents, children, and policymakers. The good news is that there are factors that contribute to this problem on which we can intervene, and we can do it now.

On April 20, 1999, two heavily-armed adolescent boys walked into Columbine High School in Littleton, Colorado and shot to death 12 of their schoolmates and a teacher before killing themselves. When authorities investigated, they discovered that the boys had played thousands of hours of a "first-person shooter" video game that had been modified to occur in a layout identical to that of their high school with yearbook photographs of their schoolmate selectronically pasted onto the game's imaginary victims. Michael Carneal, a 14-year-old who never held a real gun in his life but who was an expert video gamer, stole a pistol, walked into his Paducah, Kentucky middle school and shot eight of his schoolmates with deadly accuracy. In this excerpt from 60 Minutes, David Grossman, a former West Point professor of the psychology of killing, explains the connection he sees between video games and real-life violence.

Video games clip

Over the past forty years, researchers in the fields of public health, communications, and psychology have examined the effects of entertainment violence on young people. Research has shown that the strongest single factor contributing to violent behavior is previous exposure to violence. More than 3,500 research studies have examined the association between media violence and violent behavior; all but 18 have shown that the more violence you see, the more likely you are to be violent. Virtual violence that is realistic, portrayed without pain and suffering, and experienced in the context of good feelings is most likely to be emulated.

Exposure to media violence has been found to result in increased acceptance of violence as an appropriate means of conflict resolution. Media exaggerate the prevalence of violence in the world, giving rise to fear of being harmed. This is strong motivation to protect oneself by carrying a weapon and being more aggressive. The most insidious and potent effect of media violence, which affects even the majority of young people who do not themselves become violent, is to desensitize young people to "real life" violence and to the harm it causes its victims.

This is not a simple problem. Violence is complex -- many factors contribute. The factors that underlie violent behavior include some of the most vexing and far-reaching social issues of our day, issues with which we have been struggling for generations. They are not easily or quickly solved. Physicians have to be practical people. While the major issues of our society are being wrestled with, we have to intervene on those parts of the problems that can be addressed directly and quickly. Some research that can guide us:

Epidemiologists who studied factors associated with violence, including poverty, racial discrimination, substance abuse, inadequate schools, joblessness and family dissolution, found
that exposure to violent media was a factor in half of the 10,000 homicides committed the previous year.
A study begun in the early 1960s found that boys who watched more television had higher levels of aggression at age 8, a history of aggressive behavior at age 19, and were more violent with their children and had been convicted of more violent crimes by age 30. The effects of media exposure are cumulative and the resulting behaviors are lasting.
The findings of hundreds of studies, analyzed as a whole, showed the strength of the relationship between television exposure and aggressive behavior to be greater than that of calcium intake and bone mass, condom non-use and sexually transmitted HIV, lead poisoning and lower I.Q., or passive tobacco smoke and lung cancer, associations upon which we physicians routinely base public health interventions.

While there is less research to date on the relatively new medium of video games, what we know is concerning. Television and movies are passively received. Video games, by virtue of being immersive, interactive, and enhanced with sensorimotor activity, represent a distinctly different medium, and may have an even more powerful influence on violent attitudes and behaviors.

Think back to those excerpts from what are known as "first-person shooter" video games. You are moving through a virtual world, your weapon extended in front of you, racking up points for wasting as many other beings as you can. You are subjected to all of the most potent elements of media violence -- realistic portrayals of mayhem, the adrenaline rush of fear, the need to "get them before they get me" and positive reinforcement for the killing as quickly and efficiently as possible.

What we do know about interactive media:

Video game revenues are $10 billion a year, larger than that of television and movies, and they are increasing. Fantasy or human violence is the most popular type of video game among children, 50% of 4th graders choose "first-person shooter" video games as their favorites.

The average 7th grader plays these video games for more than 4 hours each week.
Newer generations of video games are using better graphics capabilities to increase the gore, explicitly showing blood and body parts, and to add digital images such as recognizable faces on victims.
Experimental studies have shown that after playing video games, young people exhibit measurable decreases in prosocial and helping behaviors, a 43% increase in aggressive thoughts, and a 17% increase in violent retaliation to provocation.
Research has indicated that playing violent video games accounted for 13-22% of the variance in teenagers' violent behavior. By comparison, smoking tobacco accounts for 14% of the variance in lung cancer.

Children learn by observing, imitating what they observe, and acting on the world around them. They develop what psychologists call "behavioral scripts" interpreting their experiences and responding in terms of those scripts. You can easily see how repeated exposure to violent behavioral scripts can lead to increased feelings of hostility, expectations that others will behave aggressively, desensitization to the pain of others, and increased likelihood of interacting and responding to others with violence. Active participation increases effective learning. Video games are an ideal environment in which to learn violence:

They place the player in the role of the aggressor and reward him or her for success at violent behavior,
Rather than observing part of a violent interaction, video games allow the player to rehearse an entire behavioral script from provocation to choosing to respond violently to resolution of the conflict * this is more effective learning than watching or rehearsing part of the sequence,
Video games are immersive and addictive - kids want to play them for long periods of time to become better. Repetition increases learning.

We have a powerful teaching tool here. The question is: what are our young people learning?

You have a real opportunity to make a difference here in Chicago. While violent video games are clearly not the sole factor contributing to violence, they are clearly a factor. Unlike many of the complex social issues that contribute to violence, they can be easily addressed.

What would we do, as parents, as policymakers, as citizens, if we discovered that the water our children drank contained factors toxic to their physical and mental health? Our young people drink in media, all day, every day - and we know that some of it is toxic. The question for us is simple: how do we want our children to grow up? How can we create an environment that is most conducive to their health and to the health of our society?

I am honored to be here in Illinois, where Attorney General Jim Ryan has shown real leadership on the issue of violent video games. I urge you to join him in protecting our young people and our future.

Thank you.