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Teen-Rated Video Games Loaded With Violence


Authors call on physicians and parents to engage players in discussions about media violence and its implications

A new study finds that Teen-rated video games contain significant amounts of violence and death. Led by researchers at the Center on Media and Child Health at Children’s Hospital Boston and the Kids Risk Project at the Harvard School of Public Health, the study appears March 12 in Medscape General Medicine (, the first and only online, peer-reviewed primary source general medical journal that is published by Medscape.

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, Seamus Ryan, a research associate, and Dr. Kimberly Thompson, co-founder and director of research for the Center on Media and Child Health at Children’s Hospital Boston, characterized game content related to violence, blood, and weapons. They found violence in 98 percent of games, representing 36 percent of game play time, and blood depicted in 42 percent of games. Deaths from violence occurred in 77 percent of games, at an average rate of 122 deaths per hour of game play, with half of deaths involving human characters.

"This study demonstrates quantitatively that T-rated video games contain significant amounts of violence, injury, and death," said the study’s lead author Haninger, who also is affiliated with the Center and the Kids Risk Project.

Haninger, Ryan, and Thompson found that 90 percent of games in the random sample rewarded or required the player to injure characters, 69 percent rewarded or required the player to kill, and 46 percent rewarded or required the player to destroy objects. Although video games did not always depict blood, 89 percent of games depicted injuries to human characters, including the player, and 54 percent of games depicted injuries to nonhuman characters. Overall, the authors observed 11,499 character deaths in approximately 95 hours of game play from random sample, including 5,689 human deaths.

Overall, 88 percent of games depicted weapons other than the body, 73 percent depicted use of the body as a weapon, and 59 percent allowed players to select weapons. Characters used a wide variety of weapons to commit violent acts, with 51 percent of games depicting five or more types of weapons. A total of 69 percent of games used projectile weapons for violence, 57 percent used guns, 54 percent of games used explosives, 44 percent used knives or swords, 33 percent used fire, 30 percent used magic, 14 percent used toxic substances, and 54 percent used other types of weapons (e.g., automobiles, hammers, police batons).

According to the ESRB, T-rated video games may be suitable for persons aged 13 years and older and may contain violence, mild or strong language, and/or suggestive themes. ESRB content descriptors for violence were assigned to 95% of games in the random sample, providing a good indication that a video game contained violence.

Haninger, Ryan, and Thompson also assessed the content of two R-rated films, The Matrix and The Matrix: Reloaded, associated with the T-rated video game Enter The Matrix. Compared with the video game, the films contained significantly less violence (10 and 16 percent of screen time, respectively) and fewer human deaths per hour (18 and 22, respectively). The video game contained 45 percent violent game play time and 117 human deaths per hour, most of which were police officers, security guards, and postal workers. While the films contained blood and the video game did not, all portrayed graphic violence involving martial arts and guns.

The authors also noted the cross-marketing of R-rated and other mature entertainment to children. The Enter the Matrix game manual contained a $3 rebate toward the purchase of The Matrix DVD. Other T-rated video games contained a character based on an adult film star and music from albums that received Parental Advisory Labels, leading the authors to recommend that the Federal Trade Commission (FTC) consider examining the cross-marketing of both violent and non-violent entertainment to children.

To conduct the study, the authors randomly selected 81 T-rated video games from all 396 T-rated game titles released on the major video game consoles in the United States by April 1, 2001. The authors also played 9 video games released since then on newer consoles. One author videotaped at least one hour of game play for each game, which the study authors coded for different measures of violence and the depiction of blood.

The study authors encourage physicians, particularly pediatricians and specialists in adolescent medicine, to be aware that T-rated video games may be a source of exposure to violence and some unexpected content for children and adolescents, and that these games provide incentives to players to commit simulated acts of violence. They urge parents to judge for themselves the appropriateness of game content, both by using the ESRB rating information and by experiencing the game with their child.

"We see the convergence of media and cross-marketing issues as presenting major challenges to parents and rating boards," said senior author Thompson, who is also associate professor of Risk Analysis and Decision Science at Harvard School of Public Health. "We believe our findings suggest that a significant research effort should be undertaken to explore the development and creation of a universal media rating system. A single system would probably provide the simplest tool for parents, if one can be designed and effectively implemented. The significant amount of violence and death in T-rated video games raises important questions about the age-appropriateness of interactive violence, as well as what criteria the ESRB uses to distinguish T-rated and M-rated (for Mature) video games. We stress the need for greater clarity in the ESRB rating process."

The Center on 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 about the hospital visit:

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:

Mary-Ellen Shay | Children’s Hospital Boston
Further information:

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