Factors correlated with violent video game use by adolescent boys and girls

Types of On-Screen Content and Mental Health in Kindergarten Children

Importance

Excessive screen time has been associated with a higher risk for mental health problems, but whether the associations differ by screen content types is unclear.

Objective

To examine the allocation of and longitudinal changes in screen exposure across different content types and to explore their associations with mental health in children aged 3 to 6 years.

Design, Setting, and Participants

This cohort study used 3-wave, lagged generalized estimating equation models to analyze data from the Shanghai Children's Health, Education and Lifestyle Evaluation-Preschool (SCHEDULE-P) study in Shanghai, China. The cohort was a representative sample of kindergarten children. Data were collected between November 2016 and May 2019 when children were aged 3 to 4 years (wave 1), 4 to 5 years (wave 2), and 5 to 6 years (wave 3). Data analysis was performed between June 2022 and May 2023.

Exposure

Screen exposure (total daily time and time with each type of content, including educational programs, entertainment programs, non-child-directed programs, electronic games, and social media) was collected when children were aged 3, 5, and 6 years.

Main Outcomes and Measures

Mental health of children at age 3, 5, and 6 years was reported by parents using the Strengths and Difficulties Questionnaire.

Results

Of the 15 965 children included in the representative sample, 8270 were males (51.7%) and the mean (SD) age at wave 1 was 3.73 (0.30) years. As children developed from ages 3 to 6 years, the proportion of screen exposure to educational programs (≤1 hour per day: 45.0% [95% CI, 43.5%-46.5%] to 26.8% [95% CI, 25.3%-28.3%]) and entertainment programs (≤1 hour per day: 44.4% [95% CI, 42.8%-45.9%] to 32.1% [95% CI, 30.4%-33.9%]) decreased, whereas exposure to social media increased (≤1 hour per day: 1.5% [95% CI, 1.2%-1.9%] to 27.1% [95% CI, 25.5%-28.7%]). The associations between on-screen content and mental health varied. For a given total screen time, a higher proportion of screen exposure to educational programs was associated with a lower risk for mental health problems (adjusted odds ratio [AOR], 0.73; 95% CI, 0.60-0.90), whereas non-child-directed programs were associated with a higher risk for such problems (AOR, 2.82; 95% CI, 1.91-4.18). Regardless of the content, total screen time was consistently associated with mental health problems.

Conclusions and relevance

Results of this study indicated that both total screen time and different types of content were associated with mental health problems in children aged 3 to 6 years. Limiting children's screen time, prioritizing educational programs, and avoiding non-child-directed programs are recommended.

Is internet gaming disorder associated with suicidal behaviors among the younger generation? Multiple logistic regressions on a large-scale purposive sampling survey

The ubiquity of Internet gaming as part of the younger generation's (11-35 year-olds) lifestyle to-day warrants a deeper understanding of its impact on their mental health. In particular, there has been scant research investigating the link between Internet Gaming Disorder (IGD) and suicidal behaviors in this demographic group, even though several mental health symptoms of the former are known risk factors for the latter. This paper aims to establish the presence or absence of association between IGD and each of suicidal ideation, self-harm, and suicide attempt among the younger generation. A large-scale online survey on Internet gamers in Hong Kong was conducted in February 2019. 3430 respondents were recruited through purposive sampling. Study samples were stratified into distinct age groups and multiple logistic regression was conducted for each measured suicidal behavior in each age group. After controlling for sociodemographics, Internet usage, self-reported bullying perpetration and bullying victimization, social withdrawal, and self-reported psychiatric diagnoses such as depression and psychosis, analyses revealed that adolescent (11-17 year-old) gamers with IGD were more likely than their peers who had no IGD to have had suicidal ideation, self-harm, and suicide attempt in their lifetime. These associations did not hold for 18-35 year-old gamers. Findings suggest that it may be prudent to recognize IGD as a growing public mental health priority for the young populace, particularly adolescents. Existing suicide prevention efforts can be complemented through screening adolescents for IGD, and could be expanded to online gaming platforms to reach more hidden at-risk individuals.

The influence of sedentary behaviour on mental health among children and adolescents: A systematic review and meta-analysis of longitudinal studies

BACKGROUND

Systematic reviews that have examined associations between sedentary behaviour (SB) and mental health among children and adolescents are mainly based on cross-sectional investigations. There is a lack of evidence for a prospective relationship between SB and mental health in children and adolescents. This systematic review synthesized longitudinal studies that examined prospective associations between SB and mental health among children and adolescents.

METHODS

We conducted computer searches for English language literature from electronic databases of PubMed, Embase, PsycInfo and Google scholar, and manually screened the references of existing relevant studies to select studies for the synthesis. We included observational longitudinal studies that assessed the association between SB and mental health among children and adolescents. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

RESULTS

In total, 58 longitudinal studies met the inclusion criteria and were synthesized in the review. We found that higher SB among children and adolescents was associated with increased depression, anxiety and other mental health problems later in life. A dose-response association between SB and mental health was observed, suggesting that children and adolescents who spend more time on SB may have a higher risk of developing poorer mental health later.

CONCLUSIONS

The findings in the present study suggest that intervention programs targeting reducing SB may benefit to the prevention of poor mental health among children and adolescents. Future intervention studies especially randomized controlled trials are needed to elucidate a causal relationship between SB and mental health among children and adolescents.

Software professionals during the COVID-19 pandemic in Turkey: Factors affecting their mental well-being and work engagement in the home-based work setting

With the COVID-19 pandemic, strict measures have been taken to slow down the spread of the virus, and consequently, software professionals have been forced to work from home. However, home-based working entails many challenges, as the home environment is shared by the whole family simultaneously under pandemic conditions. The aim of this study is to explore software professionals' mental well-being and work engagement and the relationships of these variables with job strain and resource-related factors in the forced home-based work setting during the COVID-19 pandemic. An online cross-sectional survey based on primarily well-known, validated scales was conducted with software professionals in Turkey. The analysis of the results was performed through hierarchical multivariate regression. The results suggest that despite the negative effect of job strain, the resource-related protective factors, namely, sleep quality, decision latitude, work-life balance, exercise predict mental well-being. Additionally, work engagement is predicted by job strain, sleep quality, and decision latitude. The results of the study will provide valuable insights to management of the software companies and professionals about the precautions that can be taken to have a better home-based working experience such as allowing greater autonomy and enhancing the quality of sleep and hence mitigating the negative effects of pandemic emergency situations on software professionals' mental well-being and work engagement.

AOASM Position Statement on Esports, Active Video Gaming, and the Role of the Sports Medicine Physician

ABSTRACT

Electronic sports, or esports, has a global audience of over 300 million fans and is increasing in popularity, resulting in projected revenue of over $1 billion by the end of this past year. The global pandemic of 2020 had little to no effect on these increasing numbers because athletes have been able to continue to engage in sports because of its electronic nature and fans have been able to follow them virtually. Esports has been recognized as an organized sport by the International Olympic Committee, the US National Collegiate Athletic Association, and several secondary school athletic associations within the United States. In addition, professional teams have been established in several major cities within the United States, Canada, Europe, and Australia. With the growth of esports, the necessity of incorporating esports medicine into the practice of sports medicine physicians has become paramount. Esports can be played on a monitor or screen and played using physical activity in what has become known as active video gaming. Within both of these platforms, there have emerged certain conditions unique to esports. There are also certain conditions seen in other sports applicable to esports athletes. This document will review the evaluation of the esports athlete, introduce conditions unique to these athletes and review common conditions seen in esports, discuss diagnostics used in the evaluation of esports athletes, introduce treatment options for conditions unique to esports and review those for commonly seen injuries in esports, discuss prevention of injuries in esports, and introduce a framework for the future development of esports medicine that can be introduced into the daily practice of the sports medicine physician.

Unspoken: Child-Perpetrator Dynamic in the Context of Intrafamilial Child Sexual Abuse

The literature on child sexual abuse (CSA) has contributed greatly to the understanding of child-perpetrator dynamic while mainly addressing the concepts of grooming and manipulation. Considerably less attention has been dedicated, however, to child-perpetrator dynamic in intrafamilial child sexual abuse (IFCSA). The current study examined how children perceive and experience the dynamic with their perpetrator parents in the context of IFCSA, as conveyed by victims. Analysis of 29 forensic interviews with children aged 8 to 14 years suggested above all, across all identified themes, the unspoken nature of IFCSA. Specifically, the children shared their surprise at the abusive incidents despite having described a long and unspoken grooming process. The children shared their understanding of the secretive nature of IFCSA although that too was unspoken, while illustrating the fear and terror in the family dynamic. Finally, the children discussed the elusiveness of the dynamic in terms of the natural and unnatural aspects of the relationship. The discussion addresses the unique nature of IFCSA and the family dynamic. The main implication for practice is the urgent need to modify existing instruction and training programs for practitioners to better adjust them to IFCSA survivors. More specifically, the elusive nature of IFCSA must be conveyed to both clinical and forensic practitioners who need to evaluate and intervene in with child survivors of IFCSA. In addition, the fear and terror that characterize the family dynamic and the unspoken, unbridled rule of the perpetrator fathers are of central importance in adapting interventions to children and their families in the context of IFCSA.

Why iPlay: The Relationships of Autistic and Schizotypal Traits With Patterns of Video Game Use

Video games are popular and ubiquitous aspects of human culture, but their relationships to psychological and neurophysiological traits have yet to be analyzed in social-evolutionary frameworks. We examined the relationships of video game usage, motivations, and preferences with autistic and schizotypal traits and two aspects of neurophysiology, reaction time and targeting time. Participants completed the Autism Quotient, Schizotypal Personality Questionnaire, a Video Game Usage Questionnaire, and two neurophysiological tasks. We tested in particular the hypotheses, motivated by theory and previous work, that: (1) participants with higher autism scores would play video games more, and participants with higher schizotypy scores would play video games less; and (2) autism and positive schizotypy would be associated with opposite patterns of video game use, preferences and motivations. Females, but not males, with higher autism scores played more video games, and exhibited evidence of relatively male-typical video game genre preferences and motivations. By contrast, positive schizotypy was associated with reduced video game use in both genders, for several measures of game use frequency. In line with previous findings, males played video game more than females did overall, preferred action video games, and exhibited faster reaction and targeting times. Females preferred Puzzle and Social Simulation games. Faster reaction and targeting times were associated with gaming motives related to skill development and building behavior. These findings show that gaming use and patterns reflect aspects of psychology, and gender, related to social cognition and imagination, as well as aspects of neurophysiology. More generally, the results suggest that video game use is notably affected by levels of autistic and schizotypal traits, and that video games may provide an evolutionarily novel medium for imaginative play in which immersive play experiences can be decoupled from social interaction.

Covid-19 pandemic and its impact on increasing the risks of children's addiction to electronic games from a social work perspective

Children are among the social groups most affected by the COVID-19 pandemic because they have found themselves forced to stay at home, far from their schoolmates, their friends, and far from all the activities they used to do before the pandemic. so, it was their only refuge for recreation during their stay in Home is staying in front of the screens of tablets, smartphones, and computers to play electronic games for long hours, and there is no doubt that the sudden shift in the lifestyle of children during the Covid-19 pandemic had serious consequences and risks threatening their stability at all levels. In light of that, the current study aimed to determine the impact of the Covid-19 pandemic on increasing the social, psychological, behavioral, and health risks of children's addiction to electronic games from a social work perspective. This study falls under the type of descriptive-analytical studies that are based on describing the reality of the problem under study. The study sample included 289 children in the age group 6-17 years in the first grade to the twelfth grade at school. The researcher designed a questionnaire that reflects the four risks facing children to assess these risks. The results showed is that the value of all impacts of the Covid-19 pandemic on the increasing risks of children's addiction to electronic games came to a total weight of (27907), weighted relative weight of (80.47%). This indication is High, indicating that the level of impact is High for the Covid-19 pandemic on the increase in all types of risks of children's addiction to electronic games. It ranked first " Behavioral Risks " at 91.15%, It is followed by the ranked second "Social risks " at 85.5%, Then came third place " Psychological Risks" at 80.91%, and in finally in fourth place " Health Risks" at 64.28%, which necessitates the need to take a set of serious measures by educating parents to monitor the content of electronic games that their children play, especially violent games, in addition to, reduce the number of hours the child spends practicing these games, and to encourage parents to form a bridge of communication and constructive dialogue between them and their children, and that parents put controls and restrictions on their children's practice of electronic games to confront abnormal behavioral, psychological and social patterns such as aggression, violence, deception, lying, imitation, vigilance, physical stress, poor eyesight, distance from practicing religious rituals, academic delay, introversion, depression, intolerance, selfishness, sadness, isolation from society, social withdrawal and lack of forming social relationships and lack of communication with others. The researcher took care that the results of the current study are very accurate and representative of the reality of the research problem, in light of the researcher's emphasis on the commitment to observe ethical rules to ensure the confidentiality of data. finally, the current study will greatly benefit researchers interested in the field of childhood and its problems and they will rely on its results and recommendations in how to protect children from the dangers of electronic game addiction in light of the Covid-19 crisis in particular.

ADHD symptoms and callous-unemotional traits as predictors of violent media use in adolescence

We investigated ADHD symptoms and CU traits as predictors of violent media use in adolescence, controlling for delinquency and ODD symptoms. The effects on of disinhibition and arousal to negative stimuli, core characteristics of ADHD symptoms and CU traits, and of gender were investigated. At age 15, 88 adolescents, 50 % boys reported on CU traits, ADHD symptoms and delinquency. Parents rated the adolescents' CU traits, ADHD- and ODD symptoms. At age 16, adolescents reported on their media habits and performed tests of disinhibition and arousal to negative stimuli. Boys had higher levels of CU traits and violent media use and girls had higher levels of arousal to negative pictures. CU traits and inattention symptoms predicted violent media use, the latter association applying only to boys, with CU traits being the strongest predictor. Low arousal to threat pictures explained variance in violent media use, above CU traits. Attraction to violent media seems affected by problem behaviors, with CU traits coming forth as especially important.

Violence in video game produces a lower activation of limbic and temporal areas in response to social inclusion images

Exposure to violence in video games has been associated with a desensitization toward violent content, a decrease of empathy, and prosocial behavior. Moreover, violent video games seem to be related to a reduction of neural activation in the circuits linked to social emotional processing. The purpose of the present study was to compare the neural response to social inclusion images after violent and nonviolent video game playing. Electroencephalographic data of the 32 participants were recorded during a visual task with three presentations (T0, T1, T2) of 60 stimuli (30 social inclusion vs. 30 neutral images). After the T0 presentation, the participants played with a video game (orientation or violent). After the T1 presentation, the participants played with the other video game (orientation or violent). The two types of video games were randomly displayed. Event-related potential (ERP) components and low-resolution electromagnetic tomography (sLORETA) were analyzed. The main findings showed a longer latency of the P2 component on occipito-temporal montage and a lower activation of the limbic and temporal areas in response to the social inclusion images post violent video game compared with the post orientation video game. The findings suggest a reduction of emotional engagement in social processing after playing violent video game.

Social and Behavioral Health Factors Associated with Violent and Mature Gaming in Early Adolescence

We examined how risk level of video games, measured by maturity and violence level, was associated with behavioral health, social impacts, and online social interactions. School-based surveys in two different cohorts assessed self-reported gaming behaviors, health, and social media use. For Study 1, our 700 participants were 52% female and 48% White (mean age 12.7). Middle school students who played the high-risk games reported higher depressive symptoms and problematic internet behaviors, less sleep, more time spent playing games, and higher frequency of checking social media than non-gaming students. Those who played high-risk games were less likely to play alone and to play with strangers than those who played minimal-risk games. For Study 2, our 772 participants were 50% female and 57% White (mean age 12.6). Similar to Study 1, we found that those who played the high-risk games spent significantly more time playing games, were more interactive with other players, and had poorer sleep outcomes than non-high-risk gamers. Additionally, playing high-risk games had significantly different social impacts of gaming compared to less-risky gaming, including spending more money on games, spending less time on homework and with family or skipping meals due to gaming. Mature and violent content of video games and amount of online social interaction associated with gaming play a strong role in behavioral health and social impacts within families. These results can inform guidelines to intervene when problematic behaviors emerge.

Parental influence on youth violent video game use

Violent video games have been the subject of much news and analysis. One area of the debate, particularly in legal arenas, has been whether parents have or should have control over what games their children play. Despite such debates, only limited empirical research has examined whether parents actually do have influence over what games their children play or how much they play them. Using cross-sectional data from large-samples of American high-school and middle-school students, this study examines parental influences on violent video game play and the role of perceived parental opinion of violent video games. Results suggest that parental attachment and perceived parental opinion of video games play a significant role in the degree to which youth play violent games, even through later adolescence in high school.

Aggressive Video Games are Not a Risk Factor for Future Aggression in Youth: A Longitudinal Study

The issue of whether video games with aggressive or violent content (henceforth aggressive video games) contribute to aggressive behavior in youth remains an issue of significant debate. One issue that has been raised is that some studies may inadvertently inflate effect sizes by use of questionable researcher practices and unstandardized assessments of predictors and outcomes, or lack of proper theory-driven controls. In the current article, a large sample of 3034 youth (72.8% male Mage = 11.2) in Singapore were assessed for links between aggressive game play and seven aggression or prosocial outcomes 2 years later. Theoretically relevant controls for prior aggression, poor impulse control, gender and family involvement were used. Effect sizes were compared to six nonsense outcomes specifically chosen to be theoretically unrelated to aggressive game play. The use of nonsense outcomes allows for a comparison of effect sizes between theoretically relevant and irrelevant outcomes, to help assess whether any statistically significant outcomes may be spurious in large datasets. Preregistration was employed to reduce questionable researcher practices. Results indicate that aggressive video games were unrelated to any of the outcomes using the study criteria for significance. It would take 27 h/day of M-rated game play to produce clinically noticeable changes in aggression. Effect sizes for aggression/prosocial outcomes were little different than for nonsense outcomes. Evidence from this study does not support the conclusion that aggressive video games are a predictor of later aggression or reduced prosocial behavior in youth.

Female Gaming, Gaming Addiction, and the Role of Women Within Gaming Culture: A Narrative Literature Review

Research investigating female gaming has begun to emerge despite gaming being traditionally more popular with males. Research in the 21st century has drawn attention to the role of women in culture, society, and technology, and female gaming is one of the growing phenomena not to have been researched in depth. The aim of the present paper was to review female gaming (i.e., the role of females within video game culture) and identify any associated psychopathological symptomatology. The review adapted the Sample, Phenomenon of Interest, Design, Evaluation, Research (SPIDER) model in conducting a narrative literature review. A search of three scientific electronic databases yielded 49 papers for further evaluation. From a methodological perspective, studies had to fulfill the following criteria to be included: i) published between the years 2000 and 2018; ii) assessed female gaming or the female position within gaming culture, iii) contained quantitative, qualitative, or mixed methods approaches to produce empirical data or discuss theoretical implications through reviews, iv) be retrievable as a full-text peer-reviewed journal paper, and v) published in English, German, Polish, Spanish, Italian, Portuguese, or French. Four categories emerged from the papers: i) the benefits of female gaming, ii) why women might play video games less than men, iii) perceptions and realities of female characters within video games, and iv) women's position in gaming culture. The main findings showed playing video games has benefits for women in terms of enhancing cognitive, social, and physical abilities. However, they are less encouraged to play video games due to negative expectations based on gender and/or experiences during game play. Video games are associated with stereotypical male characteristics, such as being overly aggressive, and frequently contain sexualized content. Female gamers appear to require coping strategies to handle online harassment. Females look for different things in video games, which are not often included in game designs thereby limiting their abilities. For instance, female avatar representation-which is exaggerated and hypersexualized-can prompt social comparisons and lead to feelings of decreased self-esteem, depression, and other impacts on well-being. Overall, there are still obstacles for women playing video games even though they comprise half of the gaming population.

Developmental Links Between Gaming and Depressive Symptoms

The current longitudinal study tested the reciprocal relationships between video game play and depressive symptoms among 9,421 adolescents from the Add Health (M_age  = 16.15 years, SD = 1.64, 55% female), over 11 years (Waves 2, 3, and 4), ages 16 to 27. Based on structural equation modeling as well as latent growth models, findings indicated that (1) excessive gaming was largely transient over time, from adolescence to early adulthood; (2) excessive gaming predicted increases in depressive symptoms; and (3) in turn, depressive symptoms predicted decreases in gaming over time. Multigroup model tests by sex provided additional evidence that longitudinal relationships from excessive gaming to depressive symptoms were supported for male, but not for female youth.

"To Be Quite Honest, If It Wasn't for Videogames I Wouldn't Have a Social Life at All": Motivations of Young Adults With Autism Spectrum Disorder for Playing Videogames as Leisure

PURPOSE

Leisure activities are underutilized as a context for intervention in the field of speech-language pathology despite the fact that leisure can be an important context for skill development. The current study investigated the perceptions of individuals with autism spectrum disorder (ASD) who play videogames as their primary leisure activity regarding the role of videogames in their lives and their motivations for playing videogames.

METHOD

Qualitative interview methodology was used to investigate the experiences of 10 18-24-year-olds with ASD. Information was collected about the role of videogames in the lives of adolescents and young adults with ASD and the perceived benefits of playing videogames.

RESULTS

Results indicated the participants perceived playing videogames to have a positive impact on their lives and their development. The motivations for playing videogames described are similar to those reported by typically developing populations.

CONCLUSIONS

Videogaming is a popular leisure pursuit for adolescents and young adults with and without ASD. Speech-language pathologists should consider how videogame play may be a useful context for teaching new communication, social, and language.

The lone gamer: Social exclusion predicts violent video game preferences and fuels aggressive inclinations in adolescent players

Violent video game playing has been linked to a wide range of negative outcomes, especially in adolescents. In the present research, we focused on a potential determinant of adolescents' willingness to play violent video games: social exclusion. We also tested whether exclusion can predict increased aggressiveness following violent video game playing. In two experiments, we predicted that exclusion could increase adolescents' preferences for violent video games and interact with violent game playing fostering adolescents' aggressive inclinations. In Study 1, 121 adolescents (aged 10-18 years) were randomly assigned to a manipulation of social exclusion. Then, they evaluated the violent content of nine different video games (violent, nonviolent, or prosocial) and reported their willingness to play each presented video game. The results showed that excluded participants expressed a greater willingness to play violent games than nonviolent or prosocial games. No such effect was found for included participants. In Study 2, both inclusionary status and video game contents were manipulated. After a manipulation of inclusionary status, 113 adolescents (aged 11-16 years) were randomly assigned to play either a violent or a nonviolent video game. Then, they were given an opportunity to express their aggressive inclinations toward the excluders. Results showed that excluded participants who played a violent game displayed the highest level of aggressive inclinations than participants who were assigned to the other experimental conditions. Overall, these findings suggest that exclusion increases preferences for violent games and that the combination of exclusion and violent game playing fuels aggressive inclinations.

Influence of physical activity, sedentary behavior, and diet quality in childhood on the incidence of internalizing and externalizing disorders during adolescence: a population-based cohort study

PURPOSE

Studies among youth suggest that physical inactivity, sedentary behaviors, and poor diet quality are associated with poor mental health. Few population-based studies have investigated these relationships longitudinally. We examined the association between physical activity, sedentary behaviors, and diet quality in childhood and the incidence of internalizing and externalizing disorders throughout adolescence.

METHODS

We linked health behavior survey data from 2003 among 10- to 11-year-old children across Nova Scotia, Canada, with administrative health care data from 2003 to 2011. Students' diet quality was assessed using the Harvard Food Frequency Questionnaire. Physical activity and sedentary behaviors were self-reported, and internalizing and externalizing disorders were diagnosed by a physician. We applied Cox regression to examine the associations of the health behaviors with the incidence of internalizing and externalizing disorders between 2003 and 2011.

RESULTS

Of the 4861 participating students, 23.7% and 9.4% had a diagnosis of internalizing and externalizing disorders, respectively. The incidences of internalizing and externalizing disorders were higher among students who were less physically active and spent more time using computers and video games.

CONCLUSIONS

These findings suggest that promoting an active lifestyle in childhood may contribute to the prevention of both internalizing and externalizing disorders during adolescence.

The Association Between Electronic Media and Emotional and Behavioral Problems in Late Childhood

OBJECTIVE

There is growing concern that rising rates of electronic media use might be harmful. However, the extent to which different types of electronic media use might be associated with emotional and behavioral problems is unclear. In this study we examined associations between emotional and behavioral problems and electronic media use during late childhood, in a large community sample.

METHODS

Participants were 876 8- to 9-year-old children taking part in the Childhood to Adolescence Transition Study in Australia. Parents reported on their child's emotional and behavioral problems using the Strengths and Difficulties Questionnaire and on their child's duration of electronic media use (in hours: television, video games, general computer use).

RESULTS

Logistic regression analyses were conducted with adjustments for age, socioeconomic status, and body mass index z score, separately for male and female participants. Boys who played more video games had significantly greater odds of scoring borderline/abnormal on conduct (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.02-1.12) and emotional problems (OR, 1.07; 95% CI, 1.04-1.11) for each additional hour of weekly use. This equates to 2.58-fold greater odds for a boy who plays on average 2 hours per day per week. Television viewing was associated with greater odds of hyperactivity/inattention in boys (OR, 1.04; 95% CI, 1.00-1.07). There were no significant relationships for girls.

CONCLUSIONS

Because of the increasing rates of electronic media use in children, these results might have important implications for child mental health. Future interventions might be more effective if they are targeted at specific types of electronic media use.

Sedentary behavior among Spanish children and adolescents: findings from the ANIBES study

Background

An increase of sedentary behaviors far from the Mediterranean lifestyle is happening in spite of the impact on health. The aims of this study were to describe sedentary behaviors in children and adolescents.

Methods

A representative sample of 424 Spanish children and adolescents (38% females) involved in the ANIBES study was analyzed regarding their sedentary behaviors, together with the availability of televisions, computers, and consoles by means of the HELENA sedentary behavior questionnaire.

Results

For the total sample of children, 49.3% during weekdays and 84% during weekends did not meet the recommendation of less than 2 hours of screen viewing per day. The use of TV was higher during weekdays (p < 0.05) and there were significant differences between adolescents and children (16.9 vs. 25.1%, p < 0.05). The use of computer, console games and of internet for non-study reasons was higher during weekends (p < 0.001). Adolescents played more computer games and used more internet for non-study reasons than children during both weekdays and weekends (p < 0.05 and p < 0.001, respectively). The use of internet for academic reasons was lower in children (p < 0.001) than adolescents during weekends; however, no significant differences were found between sexes. In addition, more than 30% of the children and adolescents had at least one electronic device in their bedrooms.

Conclusions

Spanish children and adolescents are not meeting the recommendations regarding the maximum of screen viewing (<2 h/day), especially during the weekend, for all of sedentary behaviors. Urgent strategies and intervention studies are needed to reduce sedentary behavior in young people.

Do Angry Birds Make for Angry Children? A Meta-Analysis of Video Game Influences on Children’s and Adolescents’ Aggression, Mental Health, Prosocial Behavior, and Academic Performance

The issue of whether video games—violent or nonviolent—“harm” children and adolescents continues to be hotly contested in the scientific community, among politicians, and in the general public. To date, researchers have focused on college student samples in most studies on video games, often with poorly standardized outcome measures. To answer questions about harm to minors, these studies are arguably not very illuminating. In the current analysis, I sought to address this gap by focusing on studies of video game influences on child and adolescent samples. The effects of overall video game use and exposure to violent video games specifically were considered, although this was not an analysis of pathological game use. Overall, results from 101 studies suggest that video game influences on increased aggression ( r = .06), reduced prosocial behavior ( r = .04), reduced academic performance ( r = −.01), depressive symptoms ( r = .04), and attention deficit symptoms ( r = .03) are minimal. Issues related to researchers’ degrees of freedom and citation bias also continue to be common problems for the field. Publication bias remains a problem for studies of aggression. Recommendations are given on how research may be improved and how the psychological community should address video games from a public health perspective.

Violent video games and delinquent behavior in adolescents: A risk factor perspective

Over the years, criminological research has identified a number of risk factors that contribute to the development of aggressive and delinquent behavior. Although studies have identified media violence in general and violent video gaming in particular as significant predictors of aggressive behavior, exposure to violent video games has been largely omitted from the risk factor literature on delinquent behavior. This cross-sectional study therefore investigates the relationship between violent video game play and adolescents' delinquent behavior using a risk factor approach. An online survey was completed by 3,372 Flemish adolescents, aged 12-18 years old. Data were analyzed by means of negative binomial regression modelling. Results indicated a significant contribution of violent video games in delinquent behavior over and beyond multiple known risk variables (peer delinquency, sensation seeking, prior victimization, and alienation). Moreover, the final model that incorporated the gaming genres proved to be significantly better than the model without the gaming genres. Results provided support for a cumulative and multiplicative risk model for delinquent behavior. Aggr. Behav. 41:267-279, 2015. © 2015 Wiley Periodicals, Inc.

Children with developmental coordination disorder play active virtual reality games differently than children with typical development

BACKGROUND

Active virtual reality gaming (AVG) may be useful for children with developmental coordination disorder (DCD) to practice motor skills if their movement patterns are of good quality while engaged in AVG.

OBJECTIVE

This study aimed to examine: (1) the quality of motor patterns of children with DCD participating in AVG by comparing them with children with typical development (TD) and (2) whether differences existed in the motor patterns utilized with 2 AVG types: Sony PlayStation 3 Move and Microsoft Xbox 360 Kinect.

DESIGN

This was a quasi-experimental, biomechanical laboratory-based study.

METHODS

Twenty-one children with DCD, aged 10 to 12 years, and 19 age- and sex-matched children with TD played a match of table tennis on each AVG type. Hand path, wrist angle, and elbow angle were recorded using a motion analysis system. Linear mixed-model analyses were used to determine differences between DCD and TD groups and Move and Kinect AVG type for forehands and backhands.

RESULTS

Children with DCD utilized a slower hand path speed (backhand mean difference [MD]=1.20 m/s; 95% confidence interval [95% CI]=0.41, 1.98); greater wrist extension (forehand MD=34.3°; 95% CI=22.6, 47.0); and greater elbow flexion (forehand MD=22.3°; 95% CI=7.4, 37.1) compared with children with TD when engaged in AVG. There also were differences in movement patterns utilized between AVG types.

LIMITATIONS

Only simple kinematic measures were compared, and no data regarding movement outcome were assessed.

CONCLUSIONS

If a therapeutic treatment goal is to promote movement quality in children with DCD, clinical judgment is required to select the most appropriate AVG type and determine whether movement quality is adequate for unsupervised practice.

Aggressor Games: Of Violent Video Games and Aggression among Higher-income Group Schoolchildren in Malaysia

Violent video games have been linked to being one of the causes for increased aggressive behaviour and juvenile crimes in many developed and developing societies. This exploratory study investigates the effects of high income and gender on playing violent video games in Malaysia, and how it results in poor academic performance amongst secondary school children. This is a case study for other middle income nations in Southeast Asia, which also have strong Eastern cultural and religious beliefs. Contrary to earlier findings, the results indicated that boys from higher income backgrounds had a higher propensity for playing violent video games than adolescents from lower income backgrounds. The same effect though, is not manifested on adolescent girls. Nevertheless, playing violent video games was positively related to trait aggressive and negatively to academic performance in both the sexes. Our findings shed new light on socio-economic and demographic factors influencing violent video gaming, offering insights to both policy-makers and theoreticians in researching gaming effects.

Game-based digital interventions for depression therapy: a systematic review and meta-analysis

The aim of this study was to review the existing literature on game-based digital interventions for depression systematically and examine their effectiveness through a meta-analysis of randomized controlled trials (RCTs). Database searching was conducted using specific search terms and inclusion criteria. A standard meta-analysis was also conducted of available RCT studies with a random effects model. The standard mean difference (Cohen's d) was used to calculate the effect size of each study. Nineteen studies were included in the review, and 10 RCTs (eight studies) were included in the meta-analysis. Four types of game interventions-psycho-education and training, virtual reality exposure therapy, exercising, and entertainment-were identified, with various types of support delivered and populations targeted. The meta-analysis revealed a moderate effect size of the game interventions for depression therapy at posttreatment (d=-0.47 [95% CI -0.69 to -0.24]). A subgroup analysis showed that interventions based on psycho-education and training had a smaller effect than those based on the other forms, and that self-help interventions yielded better outcomes than supported interventions. A higher effect was achieved when a waiting list was used as the control. The review and meta-analysis support the effectiveness of game-based digital interventions for depression. More large-scale, high-quality RCT studies with sufficient long-term data for treatment evaluation are needed.

Video game access, parental rules, and problem behavior: A study of boys with autism spectrum disorder

Environmental correlates of problem behavior among individuals with autism spectrum disorder remain relatively understudied. The current study examined the contribution of in-room (i.e. bedroom) access to a video game console as one potential correlate of problem behavior among a sample of 169 boys with autism spectrum disorder (ranging from 8 to 18 years of age). Parents of these children reported on (1) whether they had specific rules regulating their child’s video game use, (2) whether their child had in-room access to a variety of screen-based media devices (television, computer, and video game console), and (3) their child’s oppositional behaviors. Multivariate regression models showed that in-room access to a video game console predicted oppositional behavior while controlling for in-room access to other media devices (computer and television) and relevant variables (e.g. average number of video game hours played per day). Additionally, the association between in-room access to a video game console and oppositional behavior was particularly large when parents reported no rules on their child’s video game use. The current findings indicate that both access and parental rules regarding video games warrant future experimental and longitudinal research as they relate to problem behavior in boys with autism spectrum disorder.

Video game violence use among "vulnerable" populations: the impact of violent games on delinquency and bullying among children with clinically elevated depression or attention deficit symptoms

The issue of children's exposure to violent video games has been a source of considerable debate for several decades. Questions persist whether children with pre-existing mental health problems may be influenced adversely by exposure to violent games, even if other children are not. We explored this issue with 377 children (62 % female, mixed ethnicity, mean age = 12.93) displaying clinically elevated attention deficit or depressive symptoms on the Pediatric Symptom Checklist. Results from our study found no evidence for increased bullying or delinquent behaviors among youth with clinically elevated mental health symptoms who also played violent video games. Our results did not support the hypothesis that children with elevated mental health symptoms constitute a "vulnerable" population for video game violence effects. Implications and suggestions for further research are provided.

The effect of violent and nonviolent video games on heart rate variability, sleep, and emotions in adolescents with different violent gaming habits

OBJECTIVE

To study cardiac, sleep-related, and emotional reactions to playing violent (VG) versus nonviolent video games (NVG) in adolescents with different gaming habits.

METHODS

Thirty boys (aged 13-16 years, standard deviation = 0.9), half of them low-exposed (≤1 h/d) and half high-exposed (≥3 h/d) to violent games, played a VG/NVG for 2 hours during two different evenings in their homes. Heart rate (HR) and HR variability were registered from before start until next morning. A questionnaire about emotional reactions was administered after gaming sessions and a sleep diary on the following mornings.

RESULTS

During sleep, there were significant interaction effects between group and gaming condition for HR (means [standard errors] for low-exposed: NVG 63.8 [2.2] and VG 67.7 [2.4]; for high-exposed: NVG 65.5 [1.9] and VG 62.7 [1.9]; F(1,28) = 9.22, p = .005). There was also a significant interaction for sleep quality (low-exposed: NVG 4.3 [0.2] and VG 3.7 [0.3]); high-exposed: NVG 4.4 [0.2] and VG 4.4 [0.2]; F(1,28) = 3.51, p = .036, one sided), and sadness after playing (low-exposed: NVG 1.0 [0.0] and VG 1.4 [0.2]; high-exposed: NVG 1.2 [0.1] and VG 1.1 [0.1]; (F(1,27) = 6.29, p = .009, one sided).

CONCLUSIONS

Different combinations of the extent of (low versus high) previous VG and experimental exposure to a VG or an NVG are associated with different reaction patterns-physiologically, emotionally, and sleep related. Desensitizing effects or selection bias stand out as possible explanations.

Electronic screen use and mental well-being of 10-12-year-old children

BACKGROUND

Today's children spend a great deal of time viewing electronic screen material, but the consequences of such behaviors, if any, are unknown. This study sought to identify (i) the magnitude of total daily electronic screen time and (ii) the relations between electronic screen use and mental well-being indicators, in a sample of 10-12-year-old children.

METHODS

We analysed cross-sectional, population-based data of 10-12-year-old children from the 2007 Youth in Iceland school survey (n = 10,829, response rate: 81.7%, boys: 50.5%). Logistic regression models with odds ratios and 95% confidence intervals were conducted to assess the odds of each selected mental well-being indicator, depending on the number of daily hours spent on each electronic screen-based activity. All analyses were conducted separately for boys and girls and adjusted for family structure.

RESULTS

The prevalence of self-reported screen use of 4 hours per day or more ranges from 2.8% to 6.6% among boys and from 1.0% to 3.8% among girls. All five screen-based activities were significantly associated with all seven well-being indicators (P < 0.001) with symptoms being more common with increased time spent on screen use.

CONCLUSIONS

This study is the first of its kind to demonstrate a dose-response relationship between electronic screen use and mental well-being in 10-12-year-old children. Further research is needed to assess the validity and potential implications of these findings.

The Relationship of Computer Games and Reported Anger in Young People

Playing computer games is a routine activity for most young people today. The aim of this study was to examine the relationship of time spent playing computer games, the violence of the game, and self-reported anger of students in North Cyprus. Four hundred participants between the ages of 15–18 completed the State-Trait Anger and the Anger Expression questionnaire, together with a section on gaming. The results showed that most (43%) students played computer games 3–4 days a week, with many (31.5%) playing every day. It was found that students who played computer games for 2–3 hours a day scored higher on expressed anger than those who played for less than half an hour a day. Those young people who preferred to play action, adventure, fight and strategy games were found to have reported higher levels of anger than those who played other types of computer games. The implications for guidance counsellors, parents and teachers are discussed.

Adolescents' Views on Active and Non-Active Videogames: A Focus Group Study

OBJECTIVE

Active games require whole-body movement and may be an innovative tool to substitute sedentary pastime with more active time and may therefore contribute to adolescents' health. To inform strategies aimed at reducing sedentary behavior by replacing non-active with active gaming, perceptions and context of active and non-active gaming are explored.

SUBJECTS AND METHODS

Six focus groups were conducted with adolescents 12-16 years old representing a range of education levels. A semistructured question route was used containing questions about perceptions and the context of gaming.

RESULTS

The adolescents had positive attitudes toward active gaming, especially the social interactive aspect, which was greatly appreciated. A substantial number of adolescents enjoyed non-active games more than active ones, mainly because of better game controls and more diversity in non-active games. Active games were primarily played when there was a social gathering. Few game-related rules and restrictions at home were reported.

CONCLUSIONS

Given the positive attitudes of adolescents and the limited restrictions for gaming at home, active videogames may potentially be used in a home setting as a tool to reduce sedentary behavior. However, to make active games as appealing as non-active games, attention should be paid to the quality, diversity, and sustainability of active games, as these aspects are currently inferior to those of traditional non-active games.

["Treasure Hunt"--a cognitive-behavioural computer game]

The development of video games promoting health related behaviour is increasing. This holds not only for chronic diseases like asthma and diabetes, but also for the field of child psychotherapy. At the Department of Child and Adolescent Psychiatry of Zürich University, the video game Treasure Hunt was developed to support psychotherapeutic treatment of children between eight and thirteen years of age. Treasure Hunt does not replace the therapist but supports treatment by offering attractive electronic work assignments. The scope of this article is an overview on health games for children and a description of Treasure Hunt. After the explanation of its therapeutic potentials, an evaluation based on questionnaires for therapists and children will be presented. 124 therapists answered a questionnaire on their impression of the game three months after download. 41 therapists were willing to participate in the further evaluation and sent questionnaires of 200 children with whom Treasure Hunt had been used. A limitation of these data is that a positive bias can not be excluded, as therapists with a positive attitude towards psychotherapeutic computer games were more likely to answer the questionnaire. 118 therapists (95.2%) considered Treasure Hunt a useful tool in child psychotherapy. 197 children (98.5%) report being satisfied with the use of the game during treatment. Treasure Hunt was predominantly used for the age group it is designed for and both, by very experienced and by young therapists. Eleven diagnostic categories reflect a broader range of indications than expected.

Virtual navigation performance: the relationship to field of view and prior video gaming experience

Two experiments examined whether learning a virtual environment was influenced by field of view and how it related to prior video gaming experience. In the first experiment, participants (42 men, 39 women; M age = 19.5 yr., SD = 1.8) performed worse on a spatial orientation task displayed with a narrow field of view in comparison to medium and wide field-of-view displays. Counter to initial hypotheses, wide field-of-view displays did not improve performance over medium displays, and this was replicated in a second experiment (30 men, 30 women; M age = 20.4 yr., SD = 1.9) presenting a more complex learning environment. Self-reported video gaming experience correlated with several spatial tasks: virtual environment pointing and tests of Judgment of Line Angle and Position, mental rotation, and Useful Field of View (with correlations between .31 and .45). When prior video gaming experience was included as a covariate, sex differences in spatial tasks disappeared.

Sadness, suicide, and their association with video game and internet overuse among teens: results from the youth risk behavior survey 2007 and 2009

We investigated the association between excessive video game/Internet use and teen suicidality. Data were obtained from the 2007 and 2009 Youth Risk Behavior Survey (YRBS), a high school-based, nationally representative survey (N = 14,041 and N = 16,410, respectively). Teens who reported 5 hours or more of video games/Internet daily use, in the 2009 YRBS, had a significantly higher risk for sadness (adjusted and weighted odds ratio, 95% confidence interval = 2.1, 1.7-2.5), suicidal ideation (1.7, 1.3-2.1), and suicide planning (1.5, 1.1-1.9). The same pattern was found in the 2007 survey. These findings support an association between excessive video game and Internet use and risk for teen depression and suicidality.

Cyber war--when virtual fear of death turns into a real threat of life

Many electronic games have violent contents. A growing population of adolescent boys and girls report to regularly play violent electronic games (VEGs). Extensive video game use has been linked with obesity, physical discomfort and seizures. We report on a young, healthy man who participated in an online VEG and developed a life threatening stress-induced cardiomyopathy (SICMP) with ventricular tachyarrhythmia and apical thrombus.

Video games and youth violence: a prospective analysis in adolescents

The potential influence of violent video games on youth violence remains an issue of concern for psychologists, policymakers and the general public. Although several prospective studies of video game violence effects have been conducted, none have employed well validated measures of youth violence, nor considered video game violence effects in context with other influences on youth violence such as family environment, peer delinquency, and depressive symptoms. The current study builds upon previous research in a sample of 302 (52.3% female) mostly Hispanic youth. Results indicated that current levels of depressive symptoms were a strong predictor of serious aggression and violence across most outcome measures. Depressive symptoms also interacted with antisocial traits so that antisocial individuals with depressive symptoms were most inclined toward youth violence. Neither video game violence exposure, nor television violence exposure, were prospective predictors of serious acts of youth aggression or violence. These results are put into the context of criminological data on serious acts of violence among youth.

Children's Motivations for Video Game Play in the Context of Normal Development

Electronic games are now an everyday part of childhood and adolescence. The debate has moved from whether children should play video games to how to maximize potential benefits and to identify and minimize potential harms. To do this, we must understand what motivates children to play electronic games and what needs the games meet. Drawing on a survey of 1,254 middle school children, focus groups with boys and their parents, and findings from other quantitative and qualitative research, the author describes a variety of motivations for video game play (including games with violent content) and how these may vary based on factors such as mood, environment, personality, and developmental stage. The findings are put into the context of normal development, and suggestions are given for parents, educators, and researchers.

Video Games in Psychotherapy

Video games have found their way into the clinical care of youth in most medical fields, and academic interest in their use is increasing steadily. The popularity of video games among youth may qualify them as a useful tool in psychotherapy for children and adolescents. Limited literature on use of video games in mental health care suggests that they can help young patients become more cooperative and enthusiastic about psychotherapy. Recent experience suggests that video games may facilitate therapeutic relationships, complement the psychological assessment of youth by evaluating cognitive skills, and elaborate and clarify conflicts during the therapy process. Concerns about video game content, perceived effects on youth, and lack of familiarity with this medium may form a barrier in their use in therapy offices. Further research on the benefits of video game use in psychotherapy, including patient characteristics that may moderate outcomes, is needed. Finally, future collaborations between clinicians and video game developers may produce specific games to be used in psychotherapy.