Dr. Rich responds to comments on his Call of Duty post

by Boston Children's Hospital staff on January 13, 2010

Michael RichThank you for your energetic responses both in the comments section here on the Thrive blog and on Children’s Hospital Boston’s Facebook page to my recent post about Call of Duty and other violent video games; this is exactly the type of public dialogue that I was hoping for when I started my Ask the Mediatrician Web site last year. We all use media in different ways and have very personal opinions about the value it brings into our lives, but their use also impacts society as a whole, and my hope is for all of us to continue to question if we’re using them in a beneficial way.

Related to the some of the responses to the post that said I misrepresented some of the things that happen in the game, I acknowledge that, even though I play video games, I have neither the skills nor the practice time to be a great gamer, so Call of Duty: Modern Warfare 2 was demonstrated to me—I have not played it. I used the air terminal scene as an example of the game’s content, about which those of you with greater gaming experience have far more precise information and experience.

Rich_ATM_responseI apologize for any inaccuracies in my description of where certain events occur or how points are scored. These mistakes were not intentional and distracted from the goal of the post, which was to offer parents information about the effects that research has shown violent video games to have, and to encourage them to make their own decisions about how to parent their children using that information.

Setting aside the specifics of this particular game, it’s important to address what the research shows about violent video games in general. As individuals, we draw conclusions based on our experience, but health research is necessarily held to a higher standard—it must be based on observations of large groups of people. Therefore, physicians advise against smoking not because every individual who smokes gets cancer, but because smoking cigarettes increases your risk of getting cancer. Similarly, many research studies have shown (here, here and here) that the majority of violent video game players do not go out and start shooting people—but they do show that those who view violent movies or play violent video games experience a consistent, measurable shift in their attitudes and behaviors toward greater fear and anxiety (especially in children), desensitization to suffering, and, in some, increases in aggression.

The positive and negative effects of media on children deserve special attention because children’s brains are different than adults’ brains. For example, while children can say that an experience is “only make believe,” developmental psychology has demonstrated that until they are about 7 or 8, children’s brains have not developed to the point where they can reliably distinguish fantasy from reality. Even with older kids, the major concern is not that they will unthinkingly copy what they experience in violent media but that these media (like all media) will affect their expectations for normal human behavior. That means that experiences with violent media are more likely to contribute to everyday bullying than to the rare school shooting.

Video games, which present environments and conditions to which the player must respond in certain ways to do well, function as “behavioral scripts” which the player practices over and over. Interactive electronic media that immerse participants in a “virtual reality” are among the most effective teaching technologies we have. What children do, they will learn. Content matters. Therefore, as a pediatrician, I would steer parents and kids toward video games that are sports-, logic-, or strategy-based, instead of those that center on violence. And, as Steve said, in the end, it is parents themselves who know their kids best. They know what’s best for their family and we are offering them information with which they can make their own decisions.

It’s been great to hear from all of you. Let’s keep the conversation going!

22 comments

  • PC

    You’re bad, Doc. You’re just reposting the same thing over again, but telling us you posted some “inaccuracies” in your article. Hop off.

  • PC

    You're bad, Doc. You're just reposting the same thing over again, but telling us you posted some “inaccuracies” in your article. Hop off.

  • Anonymous

    I appreciate that you read and responded to our posts. I agree that a lot of people that responded back were very distracted by the fact that some of your details about the game were incorrect and that the focus should be on the effect the game has on its users.

    However, the original post was in response to a mother asking if her teenager should be allowed to play this game. While I still believe as a parent it is entirely her responsibility to make that decision based on the maturity level of her son, I feel that you changed the focus of your article in this re-post to children… I think most people would agree that children (which I can only assume means 12 and under) should not really be playing this game. It is violent. However a teenager, the mom did not say how old but even assuming he is 13, in general is completely capable of understanding the difference between reality and fantasy, as you stated in this article children gain that ability by the age of about 8.

    Setting aside the very small percent of teenagers that do commit violent acts and crimes, lets focus on the rest of the majority. Seeing as how the Call of Duty franchise is one of the greatest selling video game franchises of all time I would think that it is safe to say that more male teens than not have played or own this game (generalizing, but I don’t think the majority of female teens have played this game, though I am sure there are some). So if that is even close to accurate, you would lead us to believe that the majority of male teens these days have violent tendencies or detached views of society?

    Maybe instead of looking at groups of people and lumping them into two categories of “play violent games” and “don’t play violent games”, instead look at the less obvious aspects. And in this scenario I would focus on the parents. It is my opinion, that the majority of teens (13-17) and children (<13) that play Modern Warfare have parents that bought it for them just because the kid asked and didn’t look into what the game is about or care that their kid might be exposed to violence or questionable material. Now if I am right (I have done no research to check obviously) but would it not also make sense that these parents who don’t care what their kids are playing or watching, also are much less likely to be very involved in their kids lives? And that maybe, that is why the majority of “kids who play violent games” exhibit the tendencies that you mention in your article and it is not due to the games themselves?

    I bet you would get the same results if the categories for the study were “kids who’s parents are NOT actively involved in their lives” and “kids who’s parents are actively involved in their lives”. The ones who’s parents are not, would likely be less social and more aggressive, wouldn’t you agree?

    Lets stop blaming video games and movies and start putting the blame back where it belongs, on the parents for not raising their kids properly.

  • jaambageek

    I appreciate that you read and responded to our posts. I agree that a lot of people that responded back were very distracted by the fact that some of your details about the game were incorrect and that the focus should be on the effect the game has on its users.

    However, the original post was in response to a mother asking if her teenager should be allowed to play this game. While I still believe as a parent it is entirely her responsibility to make that decision based on the maturity level of her son, I feel that you changed the focus of your article in this re-post to children… I think most people would agree that children (which I can only assume means 12 and under) should not really be playing this game. It is violent. However a teenager, the mom did not say how old but even assuming he is 13, in general is completely capable of understanding the difference between reality and fantasy, as you stated in this article children gain that ability by the age of about 8.

    Setting aside the very small percent of teenagers that do commit violent acts and crimes, lets focus on the rest of the majority. Seeing as how the Call of Duty franchise is one of the greatest selling video game franchises of all time I would think that it is safe to say that more male teens than not have played or own this game (generalizing, but I don't think the majority of female teens have played this game, though I am sure there are some). So if that is even close to accurate, you would lead us to believe that the majority of male teens these days have violent tendencies or detached views of society?

    Maybe instead of looking at groups of people and lumping them into two categories of “play violent games” and “don't play violent games”, instead look at the less obvious aspects. And in this scenario I would focus on the parents. It is my opinion, that the majority of teens (13-17) and children (<13) that play Modern Warfare have parents that bought it for them just because the kid asked and didn't look into what the game is about or care that their kid might be exposed to violence or questionable material. Now if I am right (I have done no research to check obviously) but would it not also make sense that these parents who don't care what their kids are playing or watching, also are much less likely to be very involved in their kids lives? And that maybe, that is why the majority of “kids who play violent games” exhibit the tendencies that you mention in your article and it is not due to the games themselves?

    I bet you would get the same results if the categories for the study were “kids who's parents are NOT actively involved in their lives” and “kids who's parents are actively involved in their lives”. The ones who's parents are not, would likely be less social and more aggressive, wouldn't you agree?

    Lets stop blaming video games and movies and start putting the blame back where it belongs, on the parents for not raising their kids properly.

  • Anonymous

    Comments like this do not help the discussion, if you aren’t going to contribute then just close your browser and go on with your day.

  • jaambageek

    Comments like this do not help the discussion, if you aren't going to contribute then just close your browser and go on with your day.

  • Anonymous

    Thank you for taking the time to respond to the posts. I appreciate your willingness to admit you didn’t get a chance to experience the game first hand to accurately report on it’s content.
    But as you mentioned the much bigger question at hand is the violence in videogames and how it affects today’s youth.
    This isn’t an argument on whether videogames should be allowed to have mature content, but rather a discussion on how the violence affects us as people. Children should not be viewing any type of media that portrays mature situations, for the reasons you mentioned, and for the fact that certain forms of entertainment should be earned through age.
    I think the bigger question is how as this overflow of media that teenagers are subjected has affected our youth. The desensitization you speak of, if noticeable from videogames must be tenfold from such forms of entertainment as the internet, cell phones, and on demand TV.
    Entertainment Technology has blossomed in the past 30 years from a handful of television stations and old Apple IIe’s to it’s current form of practically anything the mind can conjure up.
    At a point when the brain is still developing it would seem to me that a glut of information would certainly result in very different paradigm’s than the past 30 years youth, and we may not be at a point were we can fully understand the implications of this.

  • niwiro

    Thank you for taking the time to respond to the posts. I appreciate your willingness to admit you didn't get a chance to experience the game first hand to accurately report on it's content.
    But as you mentioned the much bigger question at hand is the violence in videogames and how it affects today's youth.
    This isn't an argument on whether videogames should be allowed to have mature content, but rather a discussion on how the violence affects us as people. Children should not be viewing any type of media that portrays mature situations, for the reasons you mentioned, and for the fact that certain forms of entertainment should be earned through age.
    I think the bigger question is how as this overflow of media that teenagers are subjected has affected our youth. The desensitization you speak of, if noticeable from videogames must be tenfold from such forms of entertainment as the internet, cell phones, and on demand TV.
    Entertainment Technology has blossomed in the past 30 years from a handful of television stations and old Apple IIe's to it's current form of practically anything the mind can conjure up.
    At a point when the brain is still developing it would seem to me that a glut of information would certainly result in very different paradigm's than the past 30 years youth, and we may not be at a point were we can fully understand the implications of this.

  • Vinzent

    If you intend to comment as an ‘expert’ or ‘professional’, you are obligated to know what you are talking about. And while you might be a good pediatrician, it is painfully obvious that you don’t know a thing about video games.

    So how can you offer quality advice to parents on a subject you are unqualified to speak about?

  • Vinzent

    If you intend to comment as an 'expert' or 'professional', you are obligated to know what you are talking about. And while you might be a good pediatrician, it is painfully obvious that you don't know a thing about video games.

    So how can you offer quality advice to parents on a subject you are unqualified to speak about?

  • Watchdog

    Let me get this straight. You are a pediatrist giving psychological advice about a videogame you clearly never played or understood that is rated for adults and shouldn’t be played by children anyway? And you offer as evidence the same flawed studies used by other media scare-mongers?

    Are you seriously that ignorant or are you just trying to feed an angry frenzy to boost your site hits?

  • Watchdog

    Let me get this straight. You are a pediatrist giving psychological advice about a videogame you clearly never played or understood that is rated for adults and shouldn't be played by children anyway? And you offer as evidence the same flawed studies used by other media scare-mongers?

    Are you seriously that ignorant or are you just trying to feed an angry frenzy to boost your site hits?

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  • Tobruk

    Dear Dr. Rich:

    Thank you for taking the time to answer questions and I respect a lot of the work that you do. However, I’m afriad you are only telling the readers here half the story. Indeed while some research has found links between video game violence use and aggression, others, arguably those using better methods and controls find no effect. For instance a recent article in the Journal of Pediatrics (a leading journal in your field) by Ferguson, San Miguel and Hartley found no influence for video games on serious youth violence or aggression, yet you make no mention of this study (or others) to worried parents. Many other studies by Cheryl Olson, Lawrence Kutner, Devin Durkin, Dmitri Williams, etc., have found no effects, yet you mention none of these. Similarly the recent Ybarra et al article in Pediatrics (2008), once controlled for other variables, found no effect for video game playing or most other media violence variables on youth violence (see her Figure 1…I am aware she ignores her own findings to make scarier conclusions, but that merely shows some of the endemic problems with this research field).

    Again, I mean no disrespect, and I understand you mean well, but just as you have made errors in describing the Call of Duty Game, so too you present the research from a biased point of view. Unfortunately you turn in your credentials as an objective scientists when you do such a thing, and I am disappointed. I am sorry to say you are repeating, by and large, a moral panic, without stopping to consider the research in this area with caution and, indeed, healthy scientific skepticism.

  • Tobruk

    Dear Dr. Rich:

    Thank you for taking the time to answer questions and I respect a lot of the work that you do. However, I'm afriad you are only telling the readers here half the story. Indeed while some research has found links between video game violence use and aggression, others, arguably those using better methods and controls find no effect. For instance a recent article in the Journal of Pediatrics (a leading journal in your field) by Ferguson, San Miguel and Hartley found no influence for video games on serious youth violence or aggression, yet you make no mention of this study (or others) to worried parents. Many other studies by Cheryl Olson, Lawrence Kutner, Devin Durkin, Dmitri Williams, etc., have found no effects, yet you mention none of these. Similarly the recent Ybarra et al article in Pediatrics (2008), once controlled for other variables, found no effect for video game playing or most other media violence variables on youth violence (see her Figure 1…I am aware she ignores her own findings to make scarier conclusions, but that merely shows some of the endemic problems with this research field).

    Again, I mean no disrespect, and I understand you mean well, but just as you have made errors in describing the Call of Duty Game, so too you present the research from a biased point of view. Unfortunately you turn in your credentials as an objective scientists when you do such a thing, and I am disappointed. I am sorry to say you are repeating, by and large, a moral panic, without stopping to consider the research in this area with caution and, indeed, healthy scientific skepticism.

  • Anonymous

    If you play a game like this and suddenly feel that the events in said game are acceptable or anything less than “bad,” you had issues prior to the game.

    I can gun down civilians in the scenario you mentioned without losing a wink of sleep, and tomorrow I will look at pictures of the Haiti earthquake and be moved to tears. This is because I am a healthy adult with the ability to differentiate scenarios. I’ve been able to do this since early childhood. Some children can’t. Don’t give them games specifically geared towards adults. How hard is that?

    This particular game had moments like the No Russian level simply to try to elicit an emotional response. Unfortunately, instead of the countless Spocks out there unmoved, all you hear from is the doctors who don’t play it or the media figures who use it to raise their soapbox above that of their competitors.

    Please don’t see my comments as an affront to you personally, Doctor, it’s simply a problem with Doctors and society as a whole. But maybe, just maybe, we as a people can overcome unfounded prejudices and realize that scenarios differ for a reason.

  • phillipfry

    If you play a game like this and suddenly feel that the events in said game are acceptable or anything less than “bad,” you had issues prior to the game.

    I can gun down civilians in the scenario you mentioned without losing a wink of sleep, and tomorrow I will look at pictures of the Haiti earthquake and be moved to tears. This is because I am a healthy adult with the ability to differentiate scenarios. I've been able to do this since early childhood. Some children can't. Don't give them games specifically geared towards adults. How hard is that?

    This particular game had moments like the No Russian level simply to try to elicit an emotional response. Unfortunately, instead of the countless Spocks out there unmoved, all you hear from is the doctors who don't play it or the media figures who use it to raise their soapbox above that of their competitors.

    Please don't see my comments as an affront to you personally, Doctor, it's simply a problem with Doctors and society as a whole. But maybe, just maybe, we as a people can overcome unfounded prejudices and realize that scenarios differ for a reason.

  • Anonymous

    Dr. Rich,
    Thank you for helping us focus on the important thing: healthy child development. I’m not at all concerned about the details of a specific violent video game, but I am concerned about an entire generation of children who are growing up on violent video games. Unfortunately, the “M” rating doesn’t seem to be working in my community; people seem to think M is for Middle-school instead of Mature.
    Your objective, intelligent expertise is very much appreciated and will help parents make more informed decisions for their children.

  • susanpermom

    Dr. Rich,
    Thank you for helping us focus on the important thing: healthy child development. I'm not at all concerned about the details of a specific violent video game, but I am concerned about an entire generation of children who are growing up on violent video games. Unfortunately, the “M” rating doesn't seem to be working in my community; people seem to think M is for Middle-school instead of Mature.
    Your objective, intelligent expertise is very much appreciated and will help parents make more informed decisions for their children.

  • Insulted gamer

    This is an example of a professional post; showing the effect of fact used to emphasize on their opinion while still not showing a strong or obvious bias for their own opinion or against that of the opposition. But the main focus i would like to point out is the fourth sentence of the fourth paragraph stating “Now if I am right (I have done no research to check obviously) but would it not also make sense that these parents…” now the sentence itself is not the point (although the point it makes is a good one), but more of “(I have done no research to check obviously)”. Although this is another case of not doing research, at least this writer has the integrity to admit it and follow up with a believable response versus not admitting lack of evidence (or experience, at that) then making claims that are completely blown out of proportion.

    Just as well, in the game “Modern warfare 2″, the small portion referred to (and to my own dismay, very short) single player campaign, there is no way of “how points are scored.” but instead its “point” is to tell a story. unfortunately for uniformed parents or psychologists, the level brought up (counting the tutorial, is the fourth, by the way) is a pivotal point of the (granted, far fetched) plot which seems even more unbelievable with such an important set-piece missing (think avatar with out the first 45 minutes).

    I just think it is sad that people still can’t take videogames seriously, thinking that just because it is titled video “game” it must be a plaything for a child. I would have thought that the “controversy” with the game “Mass Effect” and the re-iteration of the idea of videogames for more mature audiences with the game “heavy rain” may have shown that there are games made for any age to enjoy as well as games created to appeal to specific older viewers/players.

    And once again, sadly, this “apology” doesn’t help me believe that you (dr. rich, not jaambageek) respect videogames.

  • Insulted Gamer

    Unfortunately this post brings up another insulting aspect of thought towards gaming; Parents that only look at the letter rating as apposed to the game itself. I see “supermoms” or “protective parents” do this on a near daily basis, and it infuriates me.

    Parents apparently don’t have the time to figure out what game their children are attempting to play, and taking the much lazier approach to said parenting.

    think about the extent of the “M” rating; it ranges from the honestly quite tame “halo” to the aptly named “Manslaughter” which i personally have tried and honestly have no hopes of picking it up any time in the future. It is practically undeniable that the “M” rating is an inexplicably and unhelpfully general rating merely MADE to inform on what may show up in the game, no matter how few times it appears. this falls back on the idea of if a parent remains ignorant to that which the child wants to do or play, that is the fault of the parent, not the action or game.

  • Joe

    Wow well I’m 28 and my little bro was playing a lot of Modern Warfare 2 and was stoked on it. He’d come home, burn through his homework which was the rule my parents put in place and then hit his game.

    Visiting my parents place a few times he was always talking about it. I had played video games but never online before. I thought I’d give is a shot to see what all the fuss was about. Well I’m hooked and it’s given my little bro and I something to connect on. Something that I think is extremely important as a parent.

    So my recommendation is to pick up the game, spend the time to try it out and see if you like it. You can go watch him play basketball, baseball, or soccer but wouldn’t it be so much more powerful if you could be in the games with him?

    I think it being a video game is irrelevant. If your kid is into something that badly why don’t you spend the time to see what it’s about instead of trying to tell him what he can and can’t do. It might actually help develop a relationship between you that will be invaluable to your future parenting. Never in a million years would I think I’d play a game for 7 hours straight. I just finished playing online with friends. It’s 3am in the morning and yes I have work in 6 hours. Was it worth it, absolutely.

    It boils down to boys being boys. In this day and age, where can a boy go out and shoot things. Start fires, learn and do the things he is wired to do? To protect and provide. Everything is too unsafe to do now for some reason. If there is an overwhelming desire to play these games isn’t that a symptom? Why is there such a desire to play these games is the bigger more important question. IMO it’s because our society is severely lacking things needed in a boys development.

    I’m tired, good night.

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