Intern Cohen Children's Medical Center Great Neck, New York, United States
Background: Research has indicated that youths are playing video games for multiple hours daily. These games are free and easily downloaded from the app store. Video games have become a major health concern for children, as physical activity has lessened and in-person social interactions have decreased. These games may contain violence and introduce the concept of villains and weapons at an early age. Objective: The aim of this study is to examine the concepts of violence, villains, and weaponry in video games marketed in the Apple app store (AA) to ages 4+. Design/Methods: The top free 20 video games of each age-recommended category (4+, 9+, 12+, and 17+) were compiled from the AA. Each video game was evaluated by watching user gameplay video, showcasing the game’s attributes, utilized weaponry, interactions with other users, and violence. Violence was classified to 1) violence towards others 2) violence in movements 3) the presence of villains 4) villains 5) weapons. Results: A total of 73 app store games (54,346,477 reviews) met inclusion criteria. Games were categorized by the AA Content Rating System by age: 4+ (27%), 9+ (27%), 12+ (27%), and 17+ (18%). Across all age-groups, 26% had villains: Other players 45% (n = 9); Nonplayer characters 20% (n = 4); Animals 15% (n = 3); Monsters 10% (n = 2); Objects 5% (n = 1). Distribution of villains per age group were: 4+ 11% (n = 2), 9+ 58% (n = 11), 12+ 21% (n = 4), and 17+ 11% (n = 2). Of all games, 40% (n = 29) included violent movements, violence towards others, or both. Of these, 21%: 4+, 45% were 9+, 24% were 12+, and 10% were 17+. Fifty-three percent of games (n = 39) had weapons (Table 1). Distribution of weapons per age group were: 4+ (13%, n = 5), 9+ (54%, n = 21), 12+ (18%, n = 7), and 17+ (15%, n = 6).
Conclusion(s): Our study shows the majority of games involve weapons, most commonly guns. Games for ages 9+ involved the most violence, villains, and weapons compared to the other age groups. Interestingly, the presence of violence, villains, and weapons did not increase age. In fact, games recommended 4+ contained more violence than those recommended 17+. Of games that involved villains, a majority were identified as other players, promoting the idea that others in the real world are the “bad guys” and creating competition. Parents should be aware of potentially-violent content of the games their children download and evaluate the child’s maturity in relation to the content of the game. Physicians should discuss the use of parental controls on downloading free games from the app store and continuous monitoring of children’s gameplay.
