Routledge just published The Video Game Debate: Unravelling the Physical, Social, and Psychological Effects of Digital Games, edited by Rachel Kowert and Thorsten Quandt. (I contributed Chapter 3, “Are Electronic Games Health Hazards or Health Promoters?”) Designed for college students, the book works for any curious person who wants to promote more intelligent and nuanced conversations about electronic games in modern life.
The persistence of “Smurfette Syndrome”
Today, my son and I were watching a taped Colbert Report broadcast, when the issue of including females in animal research came up (cue the fetching girl rodent in lipstick). It reminded me of my first academic publication: a letter to Science (249:612), titled “Shoehorning” Men Into Studies? Published in 1990, when my son was learning to crawl, it ran as follows:
Regarding the controversy about including women in National Institutes of Health-funded studies (News & Comment, 29 June, p. 1601), I can certainly understand the position of a researcher such as Charles H. Hennekens. Since he had chosen physicians as his study population, and there weren’t enough female physicians for his group to draw sound conclusions, it made sense to leave them out.
The real problem seems to lie in the unconscious assumption that the average, typical human being is male. Females are seen as a variation on this norm. How would male researchers react to the statement that “shoehorning men into studies for political rather than scientific reasons would be disastrous”?
You might call this Smurfette Syndrome, after the sole girl member of that blue cartoon tribe. In that world, “male” is the default, and “female” is just a cute trait you assign to tell the characters apart, like a hat or funny hairstyle. Hard to believe that a quarter-century later, we’re still living in that world. 
What can we say about teen suicide?
During the past three years, six students at W.T. Woodson High School in Fairfax County, Virginia died by suicide. Newton, Massachusetts lost three high school students to suicide in recent months. Both communities are heavily populated with high-achieving families, who start plotting their children’s pathways to elite colleges at ever-earlier ages. (My own son, who starts graduate school this fall, is tutoring a ninth-grader taking an AP course in history.)
It’s natural to ask why one school or town would suffer so disproportionately from suicide. Statistically speaking, clusters of rare events are bound to happen now and then. But we still need to check for common threads, just as we would seek to rule out shared exposure to toxins among a cluster of cancer patients.
Most of these students gave no obvious warning signs of problems; they appeared successful and popular. One left a note behind, blaming stress from high expectations. This had led to speculation that relentless pressure to compete and achieve contributed to the deaths. A constant push for near-perfect grades certainly can undermine well-being and self-esteem. But evidence suggests that “the vast majority of youth with suicidal behaviors have pre-existing mental disorders.”
In fact, my doctoral dissertation at the Harvard School of Public Health focused on educating teachers to spot signs of depression or suicidal intent (using educational media I’d produced) and refer teens for assessment and help. Unfortunately, since depression and suicidal thoughts are common, and suicide is rare, it’s a tricky balancing act to help troubled students without stigmatizing them or spreading resources too thin.
With suicide, we also have to worry about the effects of “media contagion.” This was on my mind recently as I updated my chapter on “Psychiatry and the Media” for the new edition of the reference book Massachusetts General Hospital Comprehensive Clinical Psychiatry (Mosby, 2014). This is sometimes called the “Werther effect,” after a series of 18th-century deaths apparently inspired by the suicide of the protagonist of Goethe’s classic novel, The Sorrows of Young Werther.
The World Health Organization and other groups have published guidelines for journalists, that may also be of use to people sharing information on social media. Guidelines include:
- Avoid glamorizing suicide, suggesting that it’s trendy or common, or that it solves problems.
- Don’t share too much detail about the circumstances of a suicide; it may prompt copycat behavior. (One of the Virginia deaths—from a jump off a parking garage—reportedly followed a well-meant school presentation by someone who survived a leap from a building.) Similarly, don’t publish suicide notes.
- Be sensitive to nuances of language; for example, “committing” suicide implies a crime.
- Avoid the temptation of simplistic explanations (e.g., the idea that someone killed himself because he was bullied or he got poor grades).
- Include information about local sources of help.
Why video games are not like cigarettes…
A recent series of opinion pieces in the New York Times resurrected the debate on whether media violence causes actual crime or violence. One article dredged up a discredited claim that the link between media violence and actual violent behavior is “on par with the correlation of exposure to secondhand smoke and the risk of lung cancer” (the original claim involved “first hand” smoking). This confusion arises in part from a misunderstanding of “effect sizes” and how this concept differs in social science research vs. medical research.
Is media violence “linked” (a weasel word for maybe-caused-by-but-possibly-not) to real-life violence? Let’s reframe this issue by looking at how scientists prove cause and effect, using the example of cigarettes and lung cancer.
- Lung cancer was an obscure disease before smoking became common; now it’s the leading cause of cancer deaths. Aggressive behavior was hardly rare before electronic media became popular.
- Lung cancer rates increase as smoking rates go up, and decrease as they go down. For the overall population as well as for subgroups, the more smoking, the more cancer. We see nothing like this relationship when we look at violent media and measures of real-world violence. According to FBI statistics, violent crime has dropped dramatically since the 1990s, as access to violent video games and other media increased.
- There is a well-understood physiological mechanism for how cigarette smoke triggers cancer. How media violence might promote or trigger actual violence is still in the realm of speculation.
- There’s a dose-response relationship between smoking and lung cancer. While genetics and environmental toxins play a role, in general the more one smokes, the higher her risk of lung cancer. We don’t know whether greater exposure to violent media (More hours or years of play? Picking extra-gory games or movies?) is related to greater effects on children.
- Lung cancer is a clearly defined set of diseases; we know it when we see it, and experts pretty much agree on diagnostic methods and results. But experts don’t even agree on the meaning of harmful “aggression,” let alone how to measure it in lab settings or on playgrounds.
- Also, the reliability (consistency) of measurement over time is different. Cancerous cells will still be present three hours later, while aggressive thoughts or behavior may have gone away.
- Finally, smoking causes cancer, not the other way around. But research suggests that children with aggressive personalities may preferentially seek out violent media programs and games.
While linking violent media content with real-world violent behavior is easy for politicians and pundits, the science to support such claims just isn’t there.
New paper: Video game effects on teens with psychological problems
The Journal of Youth and Adolescence just issued a press release for a forthcoming paper that I wrote with Chris Ferguson of Stetson University. Revisiting data collected from my government-funded studies at Harvard Medical School, Chris and I focused on the subset of young teens who reported symptoms of depression and/or attention deficit disorder.
Here is an excerpt from the paper’s conclusions:
…The tragic 2012 shooting of young children in Newtown, Connecticut by a 20-year-old male reportedly fond of playing violent video games put the issue [of effects of video game violence] back on the front burner. The consensus from the government (e.g., Gun Violence Prevention Task Force, 2013) seems to have been that current research does not consistently link exposure to video game violence with aggression or societal violence, but more research is necessary to assess effects on potentially vulnerable subgroups of children.
The current study is an attempt to fill that gap by considering correlational violent video game effects in a sample of youth with clinically elevated mental health symptoms. Our results did not provide support for the hypotheses that exposure to violent video games would be associated with increased delinquency or bullying behaviors in children with elevated mental health symptoms.
Our results indicated that violent video games were associated with neither delinquent criminality nor bullying behaviors in children with either clinically elevated depressive or attention deficit symptoms. Nor did we find support for the belief that trait aggression would interact with video game violence within this sample of youth. That is a particularly interesting finding given that a combination of mental health symptoms and long-term aggressive traits are common elements to attackers who carried out school shootings (U.S. Secret Service and U.S. Department of Education, 2002)….
…Although this is only one piece of evidence, this early result does not support the belief that certain at-risk populations of youth, at least related to clinically elevated depression and attention deficit symptoms and trait aggression, demonstrate negative associations between violent video games and aggression related outcomes.