Violence in Teen-Rated Video Games
by Kevin Haninger, M. Seamus Ryan, and Kimberly M. Thompson, Medscape General Medicine 6(1) (March 12, 2004) Available at: http://www.medscape.com/viewarticle/468087 PDF

Press Release - March 11, 2004
Press coverage - This study motivated an ESPN Sports Center interview, which ABC World News Tonight used a piece of in its June 30, 2004 broadcast of "Foul Ball? Two Big League-licensed Video Games are Violent or Inappropriate for Kids." It also received coverage in The New York Times, and received the distinction of the "Most read article by specialty" for Public Health from www.Medscape.com for 2004. Also, see game designer Chris Crawford's note about this study.

Answers to frequently asked questions -

What are the study’s main findings?
What are the study’s main recommendations?
How did you select the video games? How many video games did you play and review?
How did you define violence?
How did you measure violence?
What other types of content did you observe?
Which T-rated video games contained the most violence as a percentage of game play time?
Which T-rated video games contained the most human deaths per hour of game play?
Why should parents be concerned about violence in video games?
Background on video game ratings

What are the study’s main findings?

  • This study demonstrates quantitatively that T-rated (for "Teen") video games contain significant amounts of violence, injury, and death. In the random sample of 81 T-rated video games we played, 79 games (98%) involved intentional violence, representing 36% of game play time, and 34 (42%) games contained blood.
  • We found 44 games (54%) that depicted injuries to nonhuman characters and 72 games (89%) that depicted injuries to human characters, including the player. Deaths from violence occurred in 77 percent of games, with 44 games (54%) depicting deaths to nonhuman characters and 51 games (63%) depicting deaths to human characters, including the player.
  • We observed a total of 11,499 character deaths in the 81 games, occurring at an average rate of 122 deaths per hour of game play time. This total included 5,689 human deaths, occurring at an average rate of 61 human deaths per hour of game play time.
  • We observed 37 games (46%) that rewarded or required the player to destroy objects, 73 games (90%) that rewarded or required the player to injure characters, and 56 games (69%) that rewarded or required the player to kill.
  • 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).
  • Fighting and action games contained the highest average percentages of violent game play time (60% and 41%, respectively). Shooting and action games depicted the highest average number of character deaths per hour (394 and 221, respectively) and the highest average number of human deaths per hour (270 and 75, respectively).
  • We also found that the R-rated films The Matrix and The Matrix: Reloaded depicted significantly less violence (10% and 16% of screen time, respectively) and fewer human deaths per hour (18 and 22, respectively) than the T-rated video game Enter the Matrix, which contained 45% violent game play and 117 human deaths per hour (mainly deaths of police officers, security guards, and postal workers). While the films contained blood and the video game did not, we noted that all portrayed graphic violence involving martial arts and guns. We also noted that the game manual contained a $3 rebate toward the purchase of The Matrix DVD, which indicates the continued marketing of R-rated violent entertainment to children.
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What are the study’s main recommendations?
  • The significant amounts 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 transparency in the ESRB rating process.
  • Our findings suggest that the Federal Trade Commission (FTC) should continue to examine the complex challenges regarding the cross-marketing of violent entertainment to children. In addition, our observations of both an adult film star in a T-rated video game and games containing music from albums that received Parental Advisory Labels also suggest that the FTC should consider cross-marketing issues related to non-violent content.
  • We see the convergence of media and cross-marketing issues as presenting major challenges to parents and rating boards. 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. We recognize that a single system would probably provide the simplest tool for parents, if one can be designed and effectively implemented.
  • We encourage physicians and parents 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 the majority of T-rated video games provide incentives to the players to commit simulated acts of violence. We emphasize that parents need to judge for themselves the appropriateness of game content, both by using the ESRB rating information and by experiencing the game with their child.
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How did you select the video games? How many video games did you play and review?

We developed 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. The database contained each game title's genre, console, release year, and ESRB-assigned content descriptors. The game titles can be viewed alphabetically or by genre. After verifying the database contents, we stratified the 396 video game titles by genre and randomly selected 20% to play. One selected game title contained two separate games, so overall we played 81 T-rated video games in the random sample. Given the release of two new video game consoles, Microsoft Xbox and Nintendo GameCube, and a significant number of T-rated video games released after we drew our random sample, we played and assessed nine additional games for these consoles. Overall, we played 90 T-rated video games. For consistency, an undergraduate student (Seamus Ryan) with considerable video gaming experience played all of the video games. The player first familiarized himself with each video game, then restarted the video game and recorded at least one hour of game play on videocassette for coding.
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How did you define violence?

We defined violence as intentional acts in which the aggressor causes or attempts to cause physical injury or death to another character. We did not include actions that led to unintentional physical harm, the effects of natural disasters, or the presence of dangerous obstacles not attributed to another character. We also did not include intentional acts of physical force that represent normal play in a sports game (e.g., tackling in football), but we counted all punches and kicks in boxing and wrestling games are violence because the intention in these sports is to cause injury.
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How did you measure violence?

One author (Kevin Haninger) reviewed and coded all of the recorded game play. We developed and collected several measures of violence. The Medscape General Medicine article contains tables that list each video game we played, as well as the genre, console, release year, ESRB-assigned content descriptors, and our measures of violence and blood.

  • Amount of Violence - To quantify the amount of violence in each game, we coded whether each second of recorded game play contained acts of violence. We further coded for both precursor acts of planning violence (i.e., selecting a weapon or aiming prior committing violence) and depictions of injury after violence (e.g., a character lying on the ground dead or wounded) in addition to coding whether each second of game play involved a character committing acts of violence. To summarize the amount of violence in the video game, we calculated the percentage of game play depicting acts of violence and the percentage of game play depicting either acts of violence, acts of planning violence, or depictions of injury after violence.
  • Portrayal of Violence - We used categories to rate how the video game depicted injuries to human and nonhuman characters. We designated the violence as relatively "mild" when the most severe depiction of violence in the game involved minor auditory or visual representations of injury and pain that primarily served to notify the player that a character was injured (e.g., characters grunted or turned red when injured, but did not scream or bleed). We designated the violence as relatively "moderate" when the most severe depiction involved more realistic representations of injury and pain (e.g., characters screamed, fell over, or bled when injured). We designated the violence as "strong" when the most severe depiction involved graphic representations of injury and pain that exaggerated or focused attention on suffering (e.g., characters screamed in agony or bled excessively when injured or when otherwise physically tortured). For each video game, we distinguished between human and nonhuman characters and coded the highest (and most severe) category we observed.
  • Other Measures of Violence - For each video game, we noted the types of weapons used for violence, whether the player could select these weapons, whether violence resulted in injury, whether injuring or killing human and nonhuman characters was rewarded or was required to advance in the game, the number of human and nonhuman deaths from violence, and the depiction of blood. We also noted whether destroying objects was rewarded or was required to advance in the game, although we did not code the destruction of objects as violence.
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What other types of content did you observe?

Using the same definitions as methods as in our article on content and ratings of T-rated video games, we quantified the content not related to violence and blood that could motivate the T-rating in the nine additional games we played on Microsoft Xbox and Nintendo GameCube. The Medscape General Medicine article contains tables that quantify and describe our observations of sexual themes, profanity, and substances in these additional games.
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Which T-rated video games contained the most violence as a percentage of game play time?

Game Title Genre Console Percentage
Twisted Metal Action Sony PlayStation 86.7
WWF Wrestlemania 2000 Fighting Nintendo 64 79.6
The Simpsons Wrestling Fighting Sony PlayStation 74.5
Tekken Tag Tournament Fighting Sony PlayStation 2 72.5
Tobal No. 1 Fighting Sony PlayStation 71.6
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Which T-rated video games contained the most human deaths per hour of game play?

Game Title Genre Console Human Deaths per Hour
Time Crisis: Project Titan Shooting Sony PlayStation 1291
Confidential Mission Shooting Sega Dreamcast   785
Fighting Force Action Sony PlayStation   308
Machine Hunter Shooting Sony PlayStation   272
Gekido Action Sony PlayStation   247
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Why should parents be concerned about violence in video games?

Parents should be concerned about violence in all contexts, not just in video games, but also in films, books, television, music, and the world around us. We are highlighting an important opportunity for parents to use video games to talk with their children about violence and other important content.
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Background on video game ratings

The Entertainment Software Rating Board (ESRB) is a self-regulatory body created in 1994 by the computer and video game industry. The ESRB is responsible for applying and enforcing the rating and advertising standards adopted by the industry. The ESRB rates video games with age-based rating symbols and content descriptors, which game manufacturers display on the game box. Age-based rating symbols include EC (for "Early Childhood"), E (for "Everyone"), T (for "Teen"), M (for "Mature), and AO (for "Adults Only"). Content descriptors are short phrases that indicate game content (e.g., "Violence" or "Mild Language"). To receive a rating, game manufacturers provide the ESRB with videotaped game footage and other information about game content. Three trained ESRB raters independently review the materials and assign the rating and content descriptors they believe are appropriate.
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