It’s nearly impossible for U.S. children to escape media violence. They also are being
exposed increasingly to “virtual violence” in first-person shooter games and other
realistic video games and applications. These newer, more interactive immersion games
have intensified the experience far beyond passively watching a violent movie.
Virtual violence games are likely to be expanded and intensified further with new
technology, such as virtual reality headsets. These commercially available devices
will make virtual reality affordable for many families and increase the opportunity
for other less idyllic immersion experiences for children, such as being dropped virtually
into war zones.
A new AAP policy statement titled Virtual Violence summarizes scientific knowledge regarding the effects of virtual violence on children’s
attitudes and behaviors and makes recommendations for pediatricians, parents, industry
and policymakers. The statement, from the AAP Council on Communications and Media,
is available at http://pediatrics.aappublications.org/content/early/2016/07/14/peds.2016-1298 and will be published in the August issue of Pediatrics.
Data on the impact of virtual violence
A small but vocal number of researchers dispute the link between screen violence and
real-world aggression, despite decades of research, hundreds of studies and multiple
peer-reviewed meta-analyses that have found a connection.
How strong is the link?
A meta-analysis of over 400 studies encompassing violent media of all types found
a significant association between exposure to media violence and aggressive behavior,
aggressive thoughts, angry feelings and physiological arousal (Bushman BJ, Huesmann
R. Arch Pediatr Adolesc Med. 2006;160:348-352).
Furthermore, a meta-analysis of 140 studies focusing only on video games (before virtual
reality had arrived on the scene) found slightly stronger associations between exposure
to violence and aggression (Anderson CA, et al. Psychol Bull. 2010;136:151-173).
To put the association between screen violence and real-world aggression in perspective,
it is greater than the association between secondhand smoke exposure and lung cancer
(Anderson CA, Bushman BJ. Am Psychol. 2002;57:448-450) as well as breast self-examination and reduced risk of death from
cancer. Yet many municipalities have banned smoking because of its risks, and most
clinicians advise women to perform regular self-exams.
It is true that a definitive link has not been found between screen violence and real-world
violence (e.g., school shootings). While most school shooters have a heavy diet of
screen violence, so do many non-school shooters. The rarity of shootings makes prospective
The policy makes the following recommendations for pediatricians, parents, policymakers,
the media and the entertainment industry:
Pediatricians need to make children’s media “diets” an essential part of all well
exams. In particular, emphasis must be placed on content and not just quantity.
Parents should be mindful of what shows their children watch and which games they
play. When possible, they should play games with their children to get a better sense
of what the games entail. Children under the age of 6 should be protected from virtual
violence because they do not always distinguish fantasy from reality.
Policymakers should consider promoting legislation that provides caregivers and children
with more specific information about the content of all forms of media and should
enact laws that prohibit easy access to violent media by minors. In addition, a federal
“parent-centric” rating system should be developed.
Pediatricians should take a leadership role in advocating for more child-positive
media and collaborating with the entertainment industry to help develop shows and
The entertainment industry should not glamorize weapons, and violence should not be
portrayed as normal. Violence for laughs and gratuitous violence should be eliminated.
When violence is portrayed, it should include the pain and loss suffered by the victims
Video games should not use human targets or award points for killing.
The news media should acknowledge the association between virtual violence and real-world
aggression in the same way as secondhand smoke is associated with health risks.
Parents repeatedly say they want and rely on their pediatricians for advice about
media. Pediatricians should welcome this opportunity to engage parents in conversations
about what their children watch and play, and share with them the data that link screen violence
Dr. Christakis is lead author of the policy statement and a former member of the AAP
Council on Communications and Media Executive Committee.