Video games are a pervasive pastime among children and adolescents. The growing popularity of video games has instigated a debate among parents, researchers, video game producers, and policymakers concerning potential harmful and helpful effects of video games on children. This article provides an overview of research findings on the positive and negative effects of video games, thus providing an empirical answer to the question, are video games good or bad? The article also provides some guidelines to help pediatricians, parents, and other caregivers protect children from negative effects and to maximize positive effects of video games.
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The growing popularity of video games has instigated a debate among parents, researchers, video game producers and policymakers concerning their harmful and helpful effects.
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Video games are very effective teachers that affect players in multiple domains.
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Some of these effects can be harmful (eg, effects of violent video games on aggression).
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Other video game effects can be beneficial (eg, effects of action games on visual-spatial skills).
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Video game effects are complex and would be better understood as multiple dimensions rather than a simplistic “good-bad” dichotomy.
The rising popularity of video games has instigated a debate among parents, researchers, video game producers, and policymakers concerning potential harmful and helpful effects of video games on children. Views expressed in this debate have often been extreme, either idealizing or vilifying video games. The critics and the proponents tend to ignore research evidence supporting the views of the opposing camps and label video games as clearly “good” or “bad.”
Are video games good or bad? Several relevant findings on the effects of video games are displayed in Table 1 . The explosion in research on video games in the past 10 years has helped increase our understanding of how video games affect players. It is clear that video games are powerful teachers that have significant effects in several domains, some of which could be considered beneficial and some of which could be considered harmful.
| Positive Effects | Negative Effects |
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The aim of this article is to give an overview of research findings on positive and negative effects of video games, thus providing an empirical answer to the question, “are video games good or bad?” Several negative effects of video games are reviewed first, including effects of violent video games on aggression-related variables as well as effects on attention deficits, school performance, and gaming addiction. Next, positive effects of video games are described, including effects of action games on visual-spatial skills, and effects of educational video games, exergames, and prosocial video games. Finally, some conclusions and guidelines are offered with the goal of helping pediatricians, parents, and other caregivers protect children from negative effects while maximizing the positive effects of| video games.
Five dimensions of the effects of video games
Gentile and colleagues have proposed that video games can affect players on at least 5 dimensions ( Box 1 ).
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Amount of game play
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Content of play
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Context of the game
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Structure of the game
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Mechanics of game play
Games are multidimensional and have complex effects on players. Each dimension is likely to be associated with different effects. The amount of game play has been linked to poorer academic performance and increased risk of obesity. Violent game content is a significant risk factor for aggression, whereas prosocial game content can increase empathy and helping, and educational games can improve specific skills. The context in which games are played may alter or create new effects. For example, playing in virtual teams can encourage collaboration. Research on effects of game structure shows that fast-paced action games can increase visual/spatial skills (sometimes misinterpreted as “improved attention”). Innovative game mechanics such as the interactive Wii controller have been successfully used to promote physical activity and have even been used for physical therapy.
A great strength of this approach is that it offers a different way of thinking about the effects of video games that surpasses a simplistic good-versus-bad dichotomy. Video games are complex and may influence players in different ways through different learning mechanisms. Even a single video game, such as Grand Theft Auto , might simultaneously have positive effects on players (improved visual processing) and negative effects (increased aggressive thoughts and feelings).
Negative effects of video games
Violent Video Game Effects
By far the largest and best understood research domain concerns the effects of violent video games on aggression. Findings of experimental, correlational, and longitudinal studies confirm that video game violence can significantly increase aggressive thoughts, emotions, and behavior over both the short term and the long term.
Although there are differing opinions about the strength of the data, a recent comprehensive meta-analytical review examined effects of violent video games on 6 relevant outcomes (aggressive behavior, aggressive cognition, aggressive affect, physiological arousal, empathy, and prosocial behavior). The meta-analysis included 136 research articles with 381 effect-size estimates involving more than 130,000 participants. This large sample included both published and unpublished studies from Eastern and Western cultures. The main findings of the meta-analysis are shown in Fig. 1 . Video game play had significant effects on all 6 outcomes. Exposure to violent video games can be seen as a causal risk factor for increased aggressive behavior, cognition, and affect, with reduced empathy and prosocial behavior.
Are the effect sizes large enough to be considered important? Even small effect sizes can have large practical consequences. Because such a high percentage of children and adolescents spend large amounts of time playing violent games, small effects can accumulate and significantly influence individuals and society. In fact, the obtained effect sizes of violent video games on aggression-related variables are comparable in size with the effect of second-hand smoke on lung cancer and the effect of calcium intake on bone mass (see Fig. 1 ).
Aggressive Cognition, Affect, and Behavior
Findings from experimental, correlational, and longitudinal studies generally show that violent video game play is a significant risk factor for aggression ( Box 2 ). This effect has been demonstrated in both short-term and long-term contexts, and in diverse populations.
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Experimental studies have been used to show causal effects of video game violence on immediate increases in aggression. For example, in a laboratory experiment, children and adolescents were more likely to blast a supposed opponent with loud noise through headphones after playing a violent video game compared with a nonviolent game.
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Correlational studies enabled researchers to explore associations between violent video game play and real-life instances of aggression. For example, adolescents who had consumed greater amounts of video game violence were more likely to be involved in a physical fight.
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Longitudinal studies have shown relationships between video game violence and increases of aggression over time. For example, children who played more violent games early in the school year were found to display more physical and verbal aggression 5 months later.
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Meta-analyses combine results of multiple studies and provide the strongest evidence that video game violence increases the risk of aggression. The most recent meta-analysis in this area showed a significant effect of video game violence on aggressive behaviors across different types of research designs.
Studies suggest that violent video games increase aggression by increasing aggressive thoughts and emotions, even when their physiologic arousal properties have been controlled. Playing violent video games can prime aggressive thoughts, increase positive attitudes toward violence, and help create a hostile attribution bias: a tendency to perceive other people’s behaviors as malevolent. In the short term, exposure to video game violence produces feelings of anger and hostility in players. Even the critics of violent game research support the findings on aggressive thoughts, arousal, and decreased prosocial behavior. Over longer periods of time, such changes can lead to the development of an aggressive personality.
Empathy, Desensitization, and Helping
Another line of research has found that video game violence produces desensitization to violence and decreases in empathy and helping. Desensitization can be defined as reduction in physiological and emotional reactivity to violence. Short-term exposure to violent media has been shown to produce physiological desensitization in only 20 minutes, whereas habitual video game playing has been linked to chronic desensitization.
A related line of research examined links between violent video games and empathy, the degree to which a person identifies and commiserates with a victim. Empathy has been shown to significantly mediate the link between violent video game play and aggressive behavior. It seems that this emotional numbing can also lead to a reduction in helping behavior. For example, students who had just played a violent video game were less likely to perceive a fight they witnessed as serious or to help the injured victim.
Attention Deficits and Cognitive Control
Findings of positive effects of gaming experience on visuospatial skills are sometimes misinterpreted to mean that video games benefit attention in general. However, a growing body of evidence suggests that video games may actually exacerbate attention problems and have harmful effects on some aspects of cognitive control.
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Several studies have found correlations between attention problems in childhood and video game play. High excitement and rapid changes of focus that occur in many video games may weaken children’s abilities to maintain focus on less exciting tasks (eg, schoolwork) and shorten their attention spans.
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In a longitudinal study on video game use and attention problems, video game play predicted children’s attention problems 13 months later, even while controlling for other relevant variables (earlier attention problems, television viewing, and gender). A 3-year longitudinal study of more than 3000 children found evidence of a bidirectional relation between attention problems and video game playing, and found a stronger relation between the amount of gaming and later attention problems than for the content of gaming.
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Several studies have also shown negative relations between video game play and cognitive control. It seems that video games have specific effects on different types of cognitive processing: they can increase visuospatial processing skills and can also harm proactive cognitive control.
Video Game Addiction
There are now scores of studies looking at what is being called pathological gaming or video game “addiction.” Many researchers define pathologic use of video games in the same way as pathological gambling, focusing on damage to family, social, school, occupational, and psychological functioning. Like gambling, playing video games starts as a form entertainment. It becomes pathological for some people when video games start producing negative life consequences. Overall, studies examining pathological video gaming show good reliability and validity. For example, a study conducted in the United States with a national sample of 1100 youth found that 8.5% of youth gamers could be classified as pathological, and similar percentages are being found in other countries. At present, video game addiction is not classified as a formal disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM). The American Psychiatric Association has proposed a new category for the DSM-V of addiction-like behavioral disorders. Gambling has been moved into this category, but more research is needed before video game and Internet addictions should be included.
Video Games and School Performance
Several studies have found a significant negative relation between the amount of screen time (television viewing and video game play) and school performance of children, adolescents, and college students. That is, high amounts of time on screen media are associated with poorer school performance. One explanation is the displacement hypothesis, which states that video games (and other screen media) may displace time that would otherwise be spent on activities such as reading, homework, or other enrichment activities. There has been some evidence to support the displacement hypothesis. In one study of a large nationally represented sample of youth aged 10 to 19 years, gamers spent 30% less time reading and 34% less time doing homework in comparison with nongamers.
Negative effects of video games
Violent Video Game Effects
By far the largest and best understood research domain concerns the effects of violent video games on aggression. Findings of experimental, correlational, and longitudinal studies confirm that video game violence can significantly increase aggressive thoughts, emotions, and behavior over both the short term and the long term.
Although there are differing opinions about the strength of the data, a recent comprehensive meta-analytical review examined effects of violent video games on 6 relevant outcomes (aggressive behavior, aggressive cognition, aggressive affect, physiological arousal, empathy, and prosocial behavior). The meta-analysis included 136 research articles with 381 effect-size estimates involving more than 130,000 participants. This large sample included both published and unpublished studies from Eastern and Western cultures. The main findings of the meta-analysis are shown in Fig. 1 . Video game play had significant effects on all 6 outcomes. Exposure to violent video games can be seen as a causal risk factor for increased aggressive behavior, cognition, and affect, with reduced empathy and prosocial behavior.
Are the effect sizes large enough to be considered important? Even small effect sizes can have large practical consequences. Because such a high percentage of children and adolescents spend large amounts of time playing violent games, small effects can accumulate and significantly influence individuals and society. In fact, the obtained effect sizes of violent video games on aggression-related variables are comparable in size with the effect of second-hand smoke on lung cancer and the effect of calcium intake on bone mass (see Fig. 1 ).
Aggressive Cognition, Affect, and Behavior
Findings from experimental, correlational, and longitudinal studies generally show that violent video game play is a significant risk factor for aggression ( Box 2 ). This effect has been demonstrated in both short-term and long-term contexts, and in diverse populations.
