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Content and
Ratings of
Teen-Rated
Video
Games
Kevin Haninger;
Kimberly M. Thompson, ScD
JAMA. 2004;291:856-865.
Context Children's exposure to violence, blood, sexual themes, profanity, substances, and gambling in the media remains a source of public health concern. However,
content in
video
games played by older children and adolescents has not been quantified or compared with the rating information provided to consumers by the Entertainment Software Rating Board (ESRB).
Objectives To quantify and characterize the
content in
video
games rated T (for "Teen") and to measure the agreement between the
content observed in game play and the ESRB-assigned
content descriptors displayed on the game box.
Design and Setting We created a database of all 396 T-rated
video game titles released on the major
video game consoles in the United States by April 1, 2001, to identify the distribution of
games by genre and to characterize the distribution of ESRB-assigned
content descriptors. We randomly sampled 80
video game titles (which included 81
games because 1 title included 2 separate
games), played each game for at least 1 hour, quantitatively assessed the
content, and compared the
content we observed with the
content descriptors assigned by the ESRB.
Main Outcome Measures Depictions of violence, blood, sexual themes, gambling, and alcohol, tobacco, or other drugs; whether injuring or killing characters is rewarded or is required to advance in the game; characterization of gender associated with sexual themes; and use of profanity in dialogue, lyrics, or gestures.
Results Analysis of all
content descriptors assigned to the 396 T-rated
video game titles showed 373 (94%) received
content descriptors for violence, 102 (26%) for blood, 60 (15%) for sexual themes, 57 (14%) for profanity, 26 (7%) for comic mischief, 6 (2%) for substances, and none for gambling. In the random sample of 81
games we played, we found that 79 (98%) involved intentional violence for an average of 36% of game play, 73 (90%) rewarded or required the player to injure characters, 56 (69%) rewarded or required the player to kill, 34 (42%) depicted blood, 22 (27%) depicted sexual themes, 22 (27%) contained profanity, 12 (15%) depicted substances, and 1 (1%) involved gambling. Our observations of 81
games match the ESRB
content descriptors for violence in 77
games (95%), for blood in 22 (27%), for sexual themes in 16 (20%), for profanity in 14 (17%), and for substances in 1 (1%).
Games were significantly more likely to depict females partially nude or engaged in sexual behaviors than males. Overall, we identified 51 observations of
content that could warrant a
content descriptor in 39
games (48%) in which the ESRB had not assigned a
content descriptor. We found that the ESRB assigned 7
content descriptors for 7
games (9%) in which we did not observe the
content indicated within 1 hour of game play.
Conclusions
Content analysis suggests a significant amount of
content in T-rated
video
games that might surprise adolescent players and their parents given the presence of this
content in
games without ESRB
content descriptors. Physicians and parents should be aware that popular T-rated
video
games may be a source of exposure to a wide range of unexpected
content.
Author Affiliations: Center on Media and Child Health,
Children's Hospital, Boston, Mass, and Kids Risk Project, Harvard
School of Public Health, Harvard University, Boston, Mass.
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