Using a random sample of 81 video games rated T (for Teen) by the Entertainment Software Rating Board (ESRB), study authors Kevin Haninger, a doctoral student at Harvard University, and Dr. Kimberly Thompson, co-founder and director of research for the Center for Media and Child Health at Children's Hospital Boston, characterized game content related to violence, sexual themes, profanity, substance use, and gambling. They compared the content that they observed in an hour of game play to the ESRB content descriptors provided to consumers. They found that presence of a content descriptor on the game box provided a good indication of that type of content in the game, but the absence of a content descriptor did not mean the absence of content that might concern parents. In 48 percent of games, the researchers observed content involving violence, sexual themes, profanity, substance use, or gambling that was not noted on the game box. This research suggests that T-rated video games expose players to a wide range of unexpected content, and prompts researchers to recommend that parents and physicians play an active role in discussing game content with kids.
"These findings suggest the need for greater clarity and transparency in the use of ESRB content descriptors and in the overall rating process," said the study's lead author Haninger, who also is affiliated with the Center and the Kids Risk Project. "More uniform and complete information about game content will enable parents to make more informed decisions, and greater transparency in the rating process will help maintain confidence in the rating system."
To conduct the study, Haninger and Thompson selected a random sample of 81 video games from the 396 T-rated video game titles released for play on the major video game consoles in the United States by April 1, 2001. An independent game player videotaped at least one hour of game play for each game, which the study authors coded for depictions of violence, blood, sexual themes, gambling, and alcohol, tobacco, or other drug use; whether killing or injuring characters is rewarded or is required to advance in the game; characterization of sex associated with sexual themes; and use of profanity in dialogue, lyrics or gestures.
Haninger and Thompson found that 79 of the 81 games (98 percent) contained violence for an average of 36 percent of game play, with 77 games (95 percent) receiving content descriptors for violence. Notably, the study found that 90 percent of games rewarded or required the player to injure characters, and 69 percent of the games rewarded or required the player to kill. Other findings show content in more games than expected based on the ESRB content descriptors, including the observation of blood in 42 percent of games (with 27 percent receiving content descriptors for blood), the depiction of sexual themes in 27 percent of games (with 20 percent receiving content descriptors for sexual themes), the use of profanity in 27 percent of games (with 17 percent receiving content descriptors for profanity), the depiction or use of substances in 15 percent (with only 1 percent receiving a content descriptor for substances), and the observation of the player character gambling in one game (with no games receiving content descriptors for gambling). The authors found that video games were significantly more likely to depict females partially nude or engaged in sexual behaviors than males.
The researchers note that the current set of content descriptors fails to capture positive messages, and raise this as an issue of the rating system failing to provide incentives to game manufacturers to include positive health messages in games. Based on the wide range of content observed and the absence of some content descriptors, the authors recommended that the ESRB consider using additional age-based categories in its ratings, such as a Youth rating for ages 10 years and up and a T-15 rating for ages 15 years and up. They emphasized that the ESRB should make playing the games an integral part of the rating process to ensure that the process provides the highest quality information to parents.
Haninger and Thompson encourage physicians, particularly pediatricians and specialists in adolescent medicine, to ask patients and their parents about their experiences with video games and to actively mediate any potential health risks. They emphasize that parents remain in the best position to judge the appropriateness of game content for and with their children. With teens consuming large amounts of media containing content that might surprise parents and promote unhealthy behaviors, researchers believe parents should engage their children in discussions about media content.
"The results of this study and the recent glimpse of popular teen culture that parents saw in the Super Bowl half-time show should serve as a wake-up call to parents to pay attention to what's in their children's media diets," says senior author Thompson, who also is associate professor of Risk Analysis and Decision Science at Harvard School of Public Health. "All media educate children, whether intended or not. By using the ESRB rating information and actively engaging in their children's experiences with video games, parents can make the best choices and promote their children's healthy development."
The Center for Media and Child Health at Children's Hospital Boston is committed to improving the understanding of the effects of communications and entertainment media on children and coordinating national and international research on the medical and public health implications of media use. Center researchers study the media as a force that powerfully affects child health. For more information visit: www.childrenshospital.org.
The Kids Risk Project at Harvard School of Public Health strives to empower kids, parents, policy makers, and others to improve children's lives by focusing on the risks that children face and on finding cost-effective strategies to better manage these risks. The project focuses on using an analytical approach to address risks to children. For more information and answers to Frequently Asked Questions about this study visit www.kidsrisk.harvard.edu.
Journal
JAMA