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Research Article

Reactions to Media Violence: It’s in the Brain of the Beholder

* E-mail: [email protected]

Affiliations Department of Psychiatry, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America, Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America

Affiliations Department of Psychiatry, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America, Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, United States of America

Affiliation Department of Psychiatry, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America

Affiliation Applied Mathematics and Statistics, SUNY, Stony Brook, New York, United States of America

Affiliation Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, United States of America

Affiliation Medical Department, Brookhaven National Laboratory, Upton, New York, United States of America

• Nelly Alia-Klein, 
• Gene-Jack Wang, 
• Rebecca N. Preston-Campbell, 
• Scott J. Moeller, 
• Muhammad A. Parvaz, 
• Wei Zhu, 
• Millard C. Jayne, 
• Chris Wong, 
• Dardo Tomasi, 

• Published: September 10, 2014
• https://doi.org/10.1371/journal.pone.0107260
• Reader Comments

Media portraying violence is part of daily exposures. The extent to which violent media exposure impacts brain and behavior has been debated. Yet there is not enough experimental data to inform this debate. We hypothesize that reaction to violent media is critically dependent on personality/trait differences between viewers, where those with the propensity for physical assault will respond to the media differently than controls. The source of the variability, we further hypothesize, is reflected in autonomic response and brain functioning that differentiate those with aggression tendencies from others. To test this hypothesis we pre-selected a group of aggressive individuals and non-aggressive controls from the normal healthy population; we documented brain, blood-pressure, and behavioral responses during resting baseline and while the groups were watching media violence and emotional media that did not portray violence. Positron Emission Tomography was used with [ 18 F]fluoro-deoxyglucose (FDG) to image brain metabolic activity, a marker of brain function, during rest and during film viewing while blood-pressure and mood ratings were intermittently collected. Results pointed to robust resting baseline differences between groups. Aggressive individuals had lower relative glucose metabolism in the medial orbitofrontal cortex correlating with poor self-control and greater glucose metabolism in other regions of the default-mode network (DMN) where precuneus correlated with negative emotionality. These brain results were similar while watching the violent media, during which aggressive viewers reported being more Inspired and Determined and less Upset and Nervous , and also showed a progressive decline in systolic blood-pressure compared to controls. Furthermore, the blood-pressure and brain activation in orbitofrontal cortex and precuneus were differentially coupled between the groups. These results demonstrate that individual differences in trait aggression strongly couple with brain, behavioral, and autonomic reactivity to media violence which should factor into debates about the impact of media violence on the public.

Citation: Alia-Klein N, Wang G-J, Preston-Campbell RN, Moeller SJ, Parvaz MA, Zhu W, et al. (2014) Reactions to Media Violence: It’s in the Brain of the Beholder. PLoS ONE 9(9): e107260. https://doi.org/10.1371/journal.pone.0107260

Editor: Jonathan A. Coles, Glasgow University, United Kingdom

Received: May 5, 2014; Accepted: August 7, 2014; Published: September 10, 2014

This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.

Data Availability: The authors confirm that, for approved reasons, some access restrictions apply to the data underlying the findings. All relevant brain and behavior data are provided in the supporting information files in excel format.

Funding: Funding was provided by (1) Brookhaven National Laboratory under contract DE-AC02-98CH10886, http://www.bnl.gov/world/ ; (2) National Institute of Mental Health: R01MH090134 (NAK), http://www.nimh.nih.gov/index.shtml ; and (3) National Institute of Mental Health NIDA and NIH K05DA020001 (JSF) and the National Institute of Alcohol Abuse and Alcoholism Intramural Program, http://www.drugabuse.gov/ and http://www.niaaa.nih.gov/ . The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exists.

Introduction

While visual media is replete with images of violence, only a small minority in the population engages in real-life violent behavior. Critically, whether a person will act violently depends on individual trait variations which play a prominent role in how visual media is experienced and processed [1] . Therefore, understanding the neurobiological underpinnings of those with aggressive personality traits above the documented norms, is an important prerequisite to the ongoing debate about media impact on behavior [2] . Enduring trait aggression reflects self-report of retaliatory motivation, with high face validity, where individuals endorse questions regarding the degree of their readiness to hurt others. It is emerging in the literature that aggressive individuals differ from non-aggressive individuals in their baseline, trait-like, neurobiological architecture [3] , suggesting involvement of the brain’s default mode network (DMN) [4] , [5] . The DMN forms a distributed circuit of connected brain systems that shows high and coherent metabolic activity or blood flow during awake yet passive resting states which may represent internal and self-referential processing [4] – [7] . The DMN includes regions typically spanning the posterior cingulate cortex (PCC) and precuneus, lateral inferior parietal gyrus (IPG), medial temporal gyrus (MTG), and ventromedial prefrontal cortex, including the orbitofrontal cortex (OFC) [8] . We hypothesize that at resting baseline, individuals with high trait aggression will exhibit different brain metabolism patterns in the DMN including its ventromedial prefrontal regions, revealing fundamentally different internal preoccupations than those with normative trait aggression.

Stimuli with violent themes can prime, or perhaps facilitate existing trait tendencies [1] , [9] . The General Aggression Model (GAM) [10] outlines the processes by which exposure to violence can cause aggressive behavior through the interplay of enduring traits that drive internal states, coupled with congruent visual stimuli from the environment (e.g., violent media). Therefore, according to GAM, chronic exposure to violent images in the media reinforces existing aggressive traits, thereby preparing the individual towards future violence [11] , [12] . The OFC is specifically involved in elements of aggressive behaviors [13] – [15] through its role in prioritizing emotional cues according to intrinsic salience [16] . Likewise, gray matter deficits in the OFC have been observed in individuals with aggressive and violent behavior [17] . As such, we predict involvement of the OFC since it appears to be specifically involved in response to repeated media violence [18] , [19] . Individual differences in brain and behavior during visual media viewing can be further understood in the context of self-reported affective states and autonomic responses (or lack thereof) [20] , [21] . For example, self-reported distress and systolic blood pressure changes were observed in response to viewing violent media [1] , [21] . Cortical representations of emotion-dependent autonomic response (e.g., blood pressure) have been shown in the OFC, anterior cingulate, and insula in response to viewing violent media in healthy controls [22] .

To test our hypotheses regarding baseline and media viewing differences as a function of trait aggression, we recruited a group of healthy aggressive individuals with a history of assault behavior and a group of non-aggressive healthy controls. Measurements of glucose metabolism with [ 18 F]fluoro-deoxyglucose using positron emission tomography (PET) were obtained at three conditions: at resting baseline, during exposure to violent media, and during exposure to emotional, non-violent media. Blood pressure (BP) and behavioral ratings of state affect were collected intermittently during the movie presentations. We expected that aggressive individuals would have a distinct intrinsic brain activity pattern at resting baseline and during passive viewing of the violent media compared to emotional media.

Ethics Statement

This research protocol was approved by the ethical review board of Stony Brook University and conducted accordingly. All participants provided written informed consent prior to participation. Approval number BNL-381.

Participants

A total of 54 males who responded to advertisement for healthy controls and healthy individuals with history of physical fights, were evaluated for their physical assault tendencies and other inclusion/exclusion criteria. Individuals were initially screened by phone and then seen at Brookhaven National Laboratory by a physician for general exclusion criteria which included current or past psychiatric disorders (e.g., drug abuse or dependence), neurological disease, significant medical illness, current treatment with medication (including over the counter drugs) and head trauma with loss of consciousness >30 minutes. Normal physical examination and laboratory tests were required for entry and pre-scan urine tests ensured the absence of any psychoactive drugs. Individuals were classified as aggressive (Ag) or non-aggressive (Na) depending on their responses on the Physical Aggression subscale of the Buss-Perry Aggression Questionnaire (the physical aggression subscale correlates strongly with peer ratings of aggression demonstrating its concurrent validity) [23] . Of these 54 participants, only individuals who reported physical fights in the last year and scored at or higher than 75 th percentile on the Physical Aggression scale (Ag, n = 12) or those who reported they did not engage in physical fights and scored at 50 th percentile or below on the Physical Aggression scale (Na, n = 13) were chosen for the study (mean age 25.15) [23] . As planned, the participants differed on Physical Aggression (Ag, mean ± standard error 33.5±1.2; Na, 14.5±1.0, p<.0001). They also differed significantly on the other subscales of the Buss-Perry: Verbal Aggression (Ag, 18.8±1.0; Na, 11.6±1.2, p<.0001), Anger (Ag, 23.7±1.5; Na, 9.6±0.6, p<.0001), Hostility (Ag, 23.1±2.0; Na, 11.8±0.9, p<.0001) and the total score (Ag, 99.5±3.8; Na, 47.5±2.7, p<.0001). The two groups did not differ on age, handedness [24] , socio-economic status [25] , estimates of verbal and non-verbal intelligence [26] , [27] , and depression symptoms [28] . Participants were asked about their media habits including the number of hours they watched TV per day on weekdays and on weekends ( Table 1 ). The participants were monetarily compensated for their participation. It is important to note that the staff performing the media exposure, imaging, nursing, and questionnaire completion, were blind to the subject’s assignment as aggressive or non-aggressive.

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https://doi.org/10.1371/journal.pone.0107260.t001

Personality and Behavioral Measures

In addition to the Buss-Perry Aggression Questionnaire, the Multidimensional Personality Questionnaire (MPQ) [29] , a three-factor structural model of personality was used. As listed in Table 1 , the MPQ models three higher order dimensions of personality: Negative Emotionality (NEM, or Neuroticism ) reflecting tendency toward emotional distress, alienation from others and aggressive behavior; Positive Emotionality (PEM, or extraversion) reflecting enduring positive affect through interpersonal engagement, and Constraint measuring tendencies toward self-control. Several lines of evidence have shown that high levels of NEM as Neuroticism are robustly associated with violence and aggression [30] . Similarly, individuals with elevated scores of NEM tend to experience/report more frequent negative emotions such as anger and anxiety, perceive their environment as hostile/unfair, and often exhibit poor coping mechanisms in a stressful situation [31] . The three NEM sub-scales include Stress Reaction which is linked to low frustration tolerance; Aggression which reflects the tendency to respond with retaliatory response style; and Alienation which is the most predictive primary scale of aggressive behavior. We also assessed attention and inhibitory control using a performance based measure, the Attention Network Task (ANT), that captures reaction-time performance on Alerting (response readiness), Orienting (scanning and selection), and Conflict (inhibitory control) in attention [32] .

Imaging Conditions and State Reactivity

There were three 40-minute imaging conditions: resting baseline, where participants were instructed to rest with eyes open, a video presentation of violent scenes, and a video presentation of emotional scenes not portraying violence. The two videos (violent and emotional) were edited from R-rated movies and documentary films. The violent media presentation contained 20 scenes of violent acts encompassing the depiction of intentional acts of violence from one individual to another (e.g. interpersonal, shootings, street fights). The emotional media presentation contained 19 emotionally intense and action filled but non-violent scenes (e.g. people interacting during a natural disaster, sudden failures during competitive sports). The length of each of the violent or emotional scenes was between 1–4 minutes; these scenes were separated by a black screen that appeared for 30 seconds which signaled the next scene. The level of valence and intensity of each of the violent and emotional scenes was evaluated internally in the laboratory (data not shown) for valence and intensity and sequenced to optimize with the dynamics of FDG uptake (most intense scenes during the first 10 minutes of FDG uptake period). During the movie presentations, state levels of emotional reactivity were assessed using the Positive and Negative Affective Schedule (PANAS) with adjectives of mood states (ranked from 1, slightly to 5, extremely) [33] . The PANAS was completed by the subjects 5 minutes before the media presentations, 10 minutes into the presentations, and at the end of the media presentations. Table 2 shows PANAS adjectives where differences were found between the groups at p<0.05 during the violent as compared to emotional media presentations. Systolic and diastolic BP was monitored with a compression cuff that operated automatically (Propaq Encore) on the participant’s non-dominant arm starting 5 minutes before the imaging and continued throughout the scanning sessions occurring at 5-minute intervals. For Figure 1 systolic BP data was first averaged within each group at each point in the time series during the violent and during the emotional media presentation. Then, the percentage changes in BP (delta) were calculated from the emotional to the violent media within each group [(violent-emotional)/emotional].

Ag (red) individuals show reduction in systolic blood pressure while watching the violent media versus Na (blue) individuals who show progressive increase in systolic blood pressure. Systolic blood pressure measures were averaged for each group at each time point and a percent change and a trend line were calculated (Y-axis). Error bars (joined and filled) reflect the standard deviation of the data that are presented.

https://doi.org/10.1371/journal.pone.0107260.g001

https://doi.org/10.1371/journal.pone.0107260.t002

PET Imaging

The 25 subjects were scanned 3 times with PET-FDG in counterbalanced order on separate days and under 3 conditions: resting baseline, violent scenes, non-violent emotional scenes. The scanning procedure is standardized and was described before [34] . The violent and neutral video presentations started 10 min prior to FDG injection and continued for a total of 40 min. PET imaging was conducted with a Siemens HR+ tomograph (resolution 4.5×4.5×4.5 mm 3 full-width half-maximum, 63 slices) in 3D dynamic acquisition mode. Static emission scan started 35 min after FDG injection and continued for the next 20 min. Arterialized blood was used to measure FDG in plasma. During the uptake period of FDG, subjects were resting with eyes open (no stimulation) or watching a movie (violent or emotional) in a quiet dimly lit room with a nurse by their side to ensure that they did not fall asleep. Metabolic rates were computed using an extension of Sokoloff’s model [35] . The emission data for all the scans were corrected for attenuation and reconstructed using filtered back projection.

Image and Data Analyses

Prior to the analysis, each participant’s PET image was mapped onto the Montreal Neurological Institute (MNI) template and smoothed via a Gaussian kernel with full width half maximum at 16 mm. Normalized metabolic images were analyzed using Statistical Parametric Mapping (SPM) [36] . The normalized images (relative images) were obtained by dividing the signal level of each voxel by the global mean, which was the average signal level of all voxels in the PET image. Analyses were performed in SPM8 with a flexible factor model design with one between-subject factor (Ag and Na groups) and one within-subject factor (baseline, violent, emotional conditions). Main effects of group were tested separately ( Figure 2 ) as well as group x condition interactions. The cluster threshold used was p<0.001, cluster extent >100; given the number of subjects, these parameters were chosen to ensure a minimum of t = 3.00 for each cluster reported. After the SPM results were obtained, cubic regions of interest (ROIs) with 125 voxels were centered at the peak coordinates of relevant activation clusters to compute average metabolic values within these ROIs. Pearson linear correlations were used to assess the association between average ROI measures and BP.

Left panel: Relative glucose metabolism (Y-axis) in Ag (red) and Na (blue) in response to the violent media. On the left of the dotted line are results from Ag>Na contrast and on the right of the dotted line are results from the Ag<Na contrast. Right panel: Glucose metabolism results in response to the emotional media Ag>Na. There were no significant results for Ag<Na. Standard error is presented in the corresponding error bars.

https://doi.org/10.1371/journal.pone.0107260.g002

The behavior and personality indices ( Table 1 ) were analyzed using independent-samples t-tests Bonferroni corrected for multiple comparisons [37] . The changes in BP (delta) were calculated from the emotional to the violent media within each group [(violent-emotional)/emotional] ( Figure 1 ). We tested whether the progressive change in systolic BP was significantly different between the groups with a general linear model (GLM), where time points and group were independent variables while the BP delta was the dependent variable. Two separate linear regression models were fitted within each group and used to test whether the delta in BP changed significantly over time and whether the slopes were significantly different between the groups. Analysis of PANAS responses to the violent and emotional media presentations was done by calculating differences in responses between violent and emotional presentations at 3 time points (pre, 10 min and end) using a GLM ( Table 2 ).

Traits, Inhibitory Control, and Resting Metabolism

As documented in Table 1 , the groups were not different on demographics and media exposure and no differences were found on MPQ personality traits of PEM which includes the subscales Well Being , Social Potency , Social Closeness and Achievement . Not surprisingly, the groups were substantially different on Negative Emotionality and inhibitory control. Individuals from the Ag group, reported more NEM, with high scores on the NEM subscales, Alienation , Aggression and Stress Reaction . The Ag group also demonstrated poor inhibitory control, reporting less self- Control on the MPQ and also showed increased latency to respond specifically in the Conflict condition of the ANT. This performance measure of inhibitory control correlated with self-reported aggression such that more latency as a result of conflict in attention was seen in those with more trait aggression as measured by two different self-report scales (Buss-Perry Physical Aggression scale r = .76, P<0.0001, and MPQ Aggression (r = .66, P<0.001).

The normalized brain metabolic measures were characterized by robust group effects at resting baseline, involving hyperactivity in the DMN and caudate, and dampened OFC metabolism in Ag as compared to Na ( Table 2 ). These resting metabolic measures in precuneus correlated positively across participants with NEM (R = .56, p<.01) and negatively with Control (R = −.46, 0<.05) whereas those in OFC showed the opposite pattern revealing a negative correlation with NEM (R = −.40, p<.05) and positive correlation with Control (R = .48, p<.05).

Glucose Metabolism and Mood Reactivity during Media Viewing

Listed in Table 2 are the main effects of group for each condition separately. These results show similar group differences at resting baseline than for the comparisons during violent media presentation, involving hyperactivity in the DMN and caudate, and dampened OFC metabolism in Ag than Na participants ( Figure 2, left panel ). While viewing the emotional media presentation, the only significant difference between groups was higher glucose metabolism in bilateral lingual gyrus in the Ag group ( Figure 2, right panel ). Group x condition interactions were not significant at our threshold or at a reduced threshold of p<0.005.

As documented in Table 3 , differences emerged between the groups in state reactivity 10 minutes into and at the end of the media presentations. During the violent media presentation as compared to the emotional media presentation, Ag participants when compared with the Na participants reported feeling less Upset ( Figure 3 ) and Nervous and more Inspired and Determined ( Table 3 ). In-line with the mood reactivity data, there were divergent responses between the groups in systolic BP across time. In the Na group, percent BP change progressively increased over time (t 16  = 3.26, p = 0.002) while in the Ag group, systolic BP progressively decreased (t 16  = −4.23, p = 0.0003) in response to the violent media as compared to emotional media ( Figure 1 ). A comparison of the trend lines between the groups shows that the trend lines were significantly opposite (F 1, 32  = 27.60, p<0.0001). Systolic and diastolic BP did not differ between the groups at resting baseline (p>0.05). Diastolic BP was not different between the groups in any of the conditions.

Self-report of being Upset immediately before, during, and at the end (EOV) of the violent media viewing. Standard error is presented in the corresponding error bars.

https://doi.org/10.1371/journal.pone.0107260.g003

https://doi.org/10.1371/journal.pone.0107260.t003

To examine the coupling of BP with glucose metabolism between the groups, we conducted ROI analyses to assess the correlation between regional metabolism during the violent media exposure and changes in systolic BP at time 37 (when most accentuated differences in BP were found between groups, as shown in Figure 1 ). In the Na, increases in BP were positively associated with increased metabolism in the right OFC (x = 22, y = 34, z = −26; r = 0.74; p<0.005) whereas the correlation was negative in (r = −0.56, p<0.005) ( Figure 4 ) in whom decreases in BP were also associated with metabolism in precuneus (R = −.81, p<.001). That is, in Na participants increases in BP were associated with higher metabolism in OFC whereas in Ag participants decreases in BP were associated with increased metabolism in the OFC and precuneus.

On the y-axis is response in the OFC response to violent media compared with emotional media; on the x-axis is systolic BP change between violent media compared with emotional media at time 37 into the media viewing.

https://doi.org/10.1371/journal.pone.0107260.g004

This study documented brain, behavior, and blood-pressure response as a function of trait aggression. Results showed that Ag had heightened traits of NEM and poor inhibitory control compared to Na. These constitutional differences between the groups were apparent in their brain function at resting baseline and during the violent media viewing, where Ag had higher relative metabolism in the retrosplenial DMN, and lower relative metabolism in OFC, gyrus rectus, and posterior cerebellum. While watching the violent compared to emotional media, the Ag viewers reported being more Inspired and Determined, less Upset and Nervous, and showed a progressive decline in systolic blood-pressure compared with controls in whom systolic BP increased. Furthermore, the BP findings were differentially coupled with glucose metabolism between the groups. While viewing violent media, increased blood-pressure in Na was associated with increased metabolism in OFC; in Ag, the observed reduced blood-pressure was associated with increased metabolism in this same region and also in the precuneus.

The Value of Pre-Selection Based on Abnormal Aggression Traits

In pre-selecting participants based on trait aggression this study revealed important baseline differences in brain and behavior compared with controls. Elevated trait aggression is found specifically in individuals with associated disorders, such as antisocial personality disorder and intermittent explosive disorder, as it has straightforward face validity [38] . In addition to elevated trait aggression, Ag also reported more Alienation and Stress Reaction and demonstrated poor inhibitory control, as measured by the ANT conflict [39] , which are part of externalizing behaviors in adults [40] . Studies show that inhibitory control (as documented here using the ANT) play an important role in violent media effects and aggression [41] . Similarly, high levels of NEM as Neuroticism have shown robust connections with violence and aggression [30] . These results on characterizing personality in trait aggression, lend support to the GAM theory, documenting the specificity of trait aggression in its effects on other personality traits [42] and their potential cognitive substrates. Those who endorse few or no aggression items, hence, the Na group, scored at the norms in NEM and PEM, demonstrating that it is normative to endorse very few aggression questions, providing an adequate control for Ag. Importantly, PEM and its subscales were comparable between the groups, perhaps validating a characterization of trait aggression specifically involving NEM while having normative PEM [42] . Supportive of the GAM theory on the role of traits in media viewing, these trait results are important in setting the context of brain metabolism comparisons between the groups.

Characterization of Trait Aggression through Resting Brain Metabolism

The most robust finding in this study is relative hyperactivity of the DMN during resting baseline with relative hypoactivity of the OFC and cerebellum in Ag compared to Na. The documented over-activity in components of the DMN may reflect a neural marker of enduring traits fostering inwardly directed attention to self-referential information stemming from years of social and cognitive learning [43] . Each of the DMN nodes and their network is associated with awareness and conscious information processing [44] , mental imagery, perspective taking, and autobiographical memory retrieval [45] – [47] needed to facilitate an enduring brain activity pattern of behavioral patterns (i.e., trait) [48] , [49] . Several studies mapped DMN regions with trait profiles; for example, Neuroticism (NEM in this study), was associated with lower volumetric measures and lower metabolism of the OFC [50] , [51] in line with our results of hypoactive OFC in Ag. Conducting direct correlations between resting metabolism and NEM as well as with trait Control , we found that the lower resting metabolism in the OFC the higher were NEM and lower Control scores. In contrast the higher resting metabolism in precuneus the higher was NEM and lower Control trait scores. Supporting this finding are recent findings of higher precuneus with reduced conscientiousness and openness [49] both associated with NEM and characteristic of those with high trait aggression.

Other over activated regions at baseline among Ag participants included the sensory motor area and caudate. One could speculate that this increased activity during rest would have a role in compromised responses during a cognitive task. A recent study proposed that striatal dopamine circuits, particularly the caudate, may provide a mechanism for the active suppression of the DMN under conditions that require increased processing of external stimuli (e.g., an attention demanding cognitive task) relative to internal, self-directed processing [52] . This might be related to a recent finding where heightened trait aggression is associated with reduced dopamine in striatum [53] and that striatal dopamine influences the DMN to affect shifting between internal states and cognitive demands [54] .

Brain Metabolism during Violent Media Viewing

The fusiform gyrus was uniquely activated during violent media viewing in Ag, perhaps suggesting increased attention to facial representation of socially relevant cues [55] . Aside from the fusiform activation, while viewing the violent media presentation, the Ag participants compared with the Na showed similar patterns of activation as they had during resting baseline. As such, it appears that DMN regions are active during passive viewing of visual stimuli (e.g., movie) [56] , [57] . We postulate that the violent media condition reflects congruence between the trait and the visual stimuli, such that the stimuli are syntonic (oscillating together) with internal processing, perhaps indicating personal experience with this material. Since resting baseline refers to mind wondering, it could be that participants in the Ag group have had aggressive thoughts that were instigating similar brain networks as during violent media viewing. A study in children during exposure to violent media documented engagement of the posterior cingulate and hippocampi, which was postulated to link memory and emotion to motor activation integrating existing aggression-related thoughts, thereby making them strongly accessible scripts over time [58] . The amygdala is a likely target for cortical arousal in violence viewing. Mathiak and Weber (2006) documented amygdala activation during active game-play in fMRI environment [59] . Their activation pattern showed signal decrease in the amygdala during players’ virtual violent behavior. Our study did not document amygdala responses possibly as a result of the passive nature of the viewing violent media or alternatively, amygdala was not documented because of the temporal resolution differences between PET and fMRI.

Hypoactivity of the Orbitofrontal Cortex

In our study, the Ag participants showed a pattern of reduced OFC activity relative to the Na in the both resting baseline and violent media conditions. The OFC plays a role in externalizing/impulsive behavior, and regulating emotional and social behavior [13] , [60] – [64] . Specific damage to the OFC is associated with impulsive and aggressive behavior [64] , and individuals with such damage show little control over their emotions as well as limited awareness of the moral implications of their actions, and poor decision making [65] . Impulsive aggressive personality disordered patients demonstrate impaired emotion regulation, and exhibit blunted prefrontal, including OFC, metabolism in response to a serotonergic challenge [66] . Deficits in the orbitofrontal lobes as represented by atrophy, lesion, or hypoactive metabolism have been observed across a number of psychiatric populations prone to aggression (e.g., antisocial personality disorder, psychopathy, borderline personality disorder, intermittent explosive disorder) [66] – [68] and suggest that OFC hypo-function may be a common mechanism underlying the pathophysiology of aggressive behavior in general (e.g., both impulsive and premeditated forms). Hypoactivity of the OFC in this study and its correlation with high NEM and low Control scores further support the reliable implication of OFC in the externalizing continuum.

This OFC hypoactivity is consistent with other studies where exposure to violent media is associated with decreased OFC activation. In a study that examined components of the fronto-parietal network in response to aggressive video cues, reduced levels of OFC activation were found [19] . It is possible that OFC hypoactivation reflects desensitization to violence and disrupts the process of moral evaluation of the violent visual stimuli [69] .

Familiarity with violent material could breed desensitization [69] – [71] . It could be that Ag have exhibited reduced inhibition and blunted evaluative categorization of violent stimuli as supported in other studies [71] such that they demonstrate a response (physiological/behavioral/cortical) that is suggestive of an overall desensitization to media violence [72] , [73] .

Under-reactive Emotional and Autonomic Response to Violent Media

There is further evidence in this study supporting the desensitization hypothesis. The Ag group reported being less Nervous and Upset and more Inspired and Determined during the media violence (compared with emotional media) while their systolic BP progressively decreased. In stark contrast, The Na mood and BP responses to the violent media may be associated with a threat evaluation producing sympathetic activation, resulting in BP increase in the Na group. In a study with healthy adolescents, participants viewing violent movie clips experienced increased BP compared to baseline; however, prior exposure to violence was associated with lowered BP [21] . Autonomic under-arousal to threat stimuli has been documented in individuals who exhibit low levels of fear [74] . Angered subjects permitted to commit aggression against the person who had annoyed them often display a drop in systolic blood pressure. They seem to have experienced a physiological relaxation, as if they had satisfied their aggressive urges [75] , [76] .

Indeed, the documented pattern of BP under-reactivity in Ag was associated with hypoactivations in the OFC ( Figure 3 ) and hyperactivation of the precuneus. Behaviorally-evoked changes in cardiovascular (e.g., blood pressure, heart rate) and cardiac-autonomic (e.g., heart rate variability) activity are correlated directly with neural activity within areas of the anterior cingulate cortex, OFC, medial prefrontal cortices, and the amygdala and often in interaction with activity in the insula, and relay regions of the thalamus and brainstem [22] , [77] , [78] . Based on neuroimaging and lesion evidence, a neurobiological model of cardiovascular reactivity shows that physiological and behavioral reactions are instantiated in the corticolimbic brains systems (e.g., medial/prefrontal corticies, insula, and amygdala) [79] . Afferent feedback, appraised by the OFC is integral in generation of somatic markers which trigger an emotional response, subsequently biasing overt behavior [80] . It is important to note here, that these results are relative to responses to emotional media viewing. It appears from our results that non-violent, yet emotionally salient action stimuli increase BP in the Ag individuals, whereas violent stimuli have the opposite effect of decreasing BP in these individuals. The specificity of hypo-response to violent content supports our assertion that the effects of violent media on individuals depend on theme-related traits, in this case aggression, and the brain of the beholder.

There are several limitations in this study that constrain our interpretation power and generalizability. First, there may have been too few participants in the study to ascertain group by condition interactions and to conduct correlations between trait and brain measures. Second, the inclusion of males only in this study was done to control for potentially differential emotional reaction patterns of activation as a function of sex. However, this approach prevents us from making any claims about female response to violent media. Future studies must include females. Third, the experimental design did not include an acute test of aggression following the media condition. Future studies could include such a test to document aggressive responses following violent media as a function of brain response during the violent media. Fourth, there are brain activity results during violent video games finding anterior cingulate involvement [59] , [81] . These results may not be comparable to this study since playing video games requires task-dependent active attention compared to passive attention maintained during movie viewing as we show in our results; therefore more studies are needed to distinguish responses to media sources requiring active attention such as video games from those requiring only passive attention as movie scenes [82] .

Acknowledgments

The authors gratefully acknowledge the contributions of all members of the Brookhaven PET team for advice and assistance in different aspects of this study.

Author Contributions

Conceived and designed the experiments: NAK NDV RZG JSF GJW. Performed the experiments: NAK MCJ CW DT. Analyzed the data: NAK MAP WZ CW. Contributed reagents/materials/analysis tools: WZ CW DT. Contributed to the writing of the manuscript: NAK SJM RPC RZG NDV MAP.

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• 27. Wechsler D (1999) Wechsler abbreviated scale of intelligence: San Antonio, TX: Psychological Corporation.
• 28. Beck AT, Steer RA, Brown GK. (1996) Beck Depression Inventory Manual. 2nd ed. San Antonio, TX: The Psychological Corporation.
• 29. Tellegen A, Waller NG (1997) Exploring personality through test construction: development of the multidimensional personality questionnaire. In: Briggs SR, Cheek JM, editors. Personality measures: development and evaluation. Greenwich: JAI Press.
• 30. Blonigen DM, Krueger RF. (2007) Personaity & Violence: The unifying role of structural models of personality. In: Flannery DJ VA, Waldman ID (Eds.), editor. The Cambridge handbook of violent behavior. New York, NY: Cambridge University Press.
• 37. Stevens J (1992) Applied multivariate statistics for the social sciences. 2nd ed. Lawrence Erlbaum Associates: NewJersey.
• 41. Swing EL, Anderson CA (2014) The role of attention problems and impulsiveness in media violence effects on aggression. Aggress Behav.
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Violent Media in Childhood and Seriously Violent Behavior in Adolescence and Young Adulthood

Michele l. ybarra.

Center for Innovative Public Health Research, San Clemente, California

Kimberly J. Mitchell

Crimes against Children Research Center, University of New Hampshire, Durham, New Hampshire

Jay Koby Oppenheim

Independent Consultant, New York, New York

Associated Data

To quantify the relative odds of self-reported seriously violent behavior in adolescence and young adulthood given one’s self-reported violent media diet in childhood.

Baseline data were collected nationally online from 1,586 youth 10–15 years of age in 2006. Follow-up data were collected in 2010–2011 and 2016. Children reported the amount of music, video games, television, websites with real people, and cartoons that depicted “physical fighting, hurting, shooting, or killing.” Seriously violent behavior was assessed 5 and 10 years later.

887 adolescents completed the survey at baseline and 5-year follow-up. The relative odds of reporting seriously violent behavior over time were 2.45-fold higher ( P <.001) with each incremental increase in one’s baseline violent media diet. After adjusting for other potentially influential characteristics, results persisted (aOR = 1.70, P =.01). The relative odds also were elevated for those frequently exposed to violence in music (aOR = 3.28, p=0.03), television (aOR = 3.51, p<0.001), and video games (aOR = 3.27, p=0.02). 760 young adults completed measures at baseline and 10-year follow-up. The relative odds of seriously violent behavior increased 2.18-fold ( P =.001) with each incremental increase in one’s baseline violent media diet. After adjusting for other factors, the association persisted (aOR = 1.72, P=.03). Frequent exposure to violence in video games (aOR = 3.28, p=0.03) and television (aOR = 3.14, p=0.02) also were implicated.

Discussion:

Exposure to violent media in childhood may be one modifiable influence on seriously violent behavior in adolescence and adulthood, even for those who have other risk factors.

Youth violence is a significant public health issue that negatively affects individuals, families, and communities. 1 , 2 Estimated costs associated with youth violence in the United States is more than $20 billion anually. 3 Although juvenile arrests in 2019 were down 58% since 2010, 4 youth nonetheless account for a sizable proportion of perpetrators: 9% of all violent crimes were committed by juveniles, and 21% by 18–24-year-olds. 5

No single risk factor causes violent behavior. Instead, an accumulation of exposures increases one’s risk at each level of the social ecology (e.g., exposure to spousal abuse). 2 , 6 – 9 Because it could easily be modified, exposure to violent media has been researched for decades as a potential contributor to aggressive behavior. Cross-sectional and laboratory research frequently document linkages. 10 – 12 Studies that measure violent behaviors report similar effect sizes to those that measure aggression. 10 Although fewer in number, longitudinal studies also report linkages: Huesmann and Eron found that adult criminal and violent behavior was associated with exposure to television violence 15 years prior. 13 Findings were replicated in a Finnish sample. 14 Further, Anderson and colleagues found that frequent violent video game play predicted physical aggression three to six months later for children and adolescents in three separate cohorts, two from Japan and one from the United States. 15 Some exceptions are noted. 16 Coyne and colleagues looked at longer term associations between externalizing behavior and violent video game play and did not find a linkage over the 5-year observation period. 17 This may be because the measure reflecting externalizing behavior included items that did meet the definition of aggression.

Youth media use is nearly ubiquitous 18 : Music is by far the most widely used medium in adolescence: 82% listen to music daily. 19 Most - 83% of adolescent girls and 97% of boys 13–17 years of age – also play video games; 95% own or have access to a smartphone, and 85% say they go online and exchange content. 20 Cross-sectional research by Ybarra and colleagues suggests that one’s general media violence diet may explain the increased odds of engaging in seriously violent behavior. 21 As such, it is important not just to examine the association that specific media may have but also the association that one’s violent media ‘diet’ across media may have with violent behavior over time.

The current study aims to fill noted research gaps. First, while extant research examines exposure to violence on television and in video games, exposures through other media, such as music, are less well studied yet constitute a large part of youth media diets. Second, much of the literature focuses on aggressive rather than violent behavior. Aggression is any behavior enacted by someone who intends to harm the other person when the other person does not want to be harmed. 22 , 23 Violence is a more severe type of aggression that carries with it the possibility of serious physical harm to the other individual. All violent behaviors are aggressive, whereas not all aggressive behaviors are violent. Third, few studies examine these linkages longitudinally, particularly between 5 and 10 years postexposure. Based on previous literature, we posit that violent media will predict violent behavior over time and that this will be particularly true for a general media diet as it reflects an accumulation of exposures.

Growing up with Media is a longitudinal study designed to study the association between violent media exposure in childhood and adolescence - particularly exposures to new media, including the Internet and seriously violent behavior. The survey protocol was reviewed and approved by the Centers for Disease Control and Prevention Institutional Review Board (IRB) for Waves 1–3 and by Chesapeake IRB for Waves 4–7 (subsequently acquired by Advarra IRB). Parents provided informed consent for their participation and permission for their child’s participation, and youth provided informed assent by reading the assent information and then clicking either “Yes, I want to take the survey” or “No, I do not want to take the survey.”

In 2006, 1,586 child-caregiver pairs were recruited through an email sent to randomly identified adult Harris Poll OnLine (HPOL) panel members who reported having a child living in their household. HPOL was the largest online panel at the time of recruitment, including four million members. Members were recruited through online advertising, advertising at conferences and events, and referrals.

Eligible adult caregivers reported having a child 10–15 years of age living in the household, speaking English, and being equally or more knowledgeable than other adults living in the household about their youth’s daily activities. Eligible youth participants were 10–15-year-olds who read English, lived in the household at least 50% of the time, and had used the Internet at least once in the last six months. Recruitment was balanced on youth age and sex; once a demographic ‘bin’ was filled (e.g., for 10–12-year-old girls), subsequent youth who met those criteria were marked ineligible.

Seriously violent behavior.

Seriously violent behavior, as defined by the US Department of Justice, 24 includes murder, aggravated assault, robbery, and sexual violence. Youth were coded as having engaged in past-year seriously violent behavior if they endorsed any of the following five behaviors: (1) behaviors that would likely result in murder (i.e., stabbing or shooting someone); (2) aggravated assault (i.e., threatening someone with a weapon; attacking someone resulting in the need for medical care); (3) robbery (i.e., using a knife or gun or some other kind of weapon like a bat to get something from someone else); and (4) sexual assault (kissing, touching, or doing anything sexual with another person when it was not wanted by that person). This last item was written to be developmentally appropriate for 10–15-year-olds. Because it may include behaviors that extend beyond rape, a sensitivity analysis was conducted to examine the results when this measure of sexual assault was excluded.

Exposure to violent media.

Youth reported the amount of violence they were exposed to across five different types of media: Television, computer and video games, music, websites of real people, and websites of cartoons. A similar question format was used for each medium: “When you [engage with media type], how many of them [show/talk about] physical fighting, hurting, shooting, or killing?” 25 Response options were captured on a four-point Likert scale [1 (almost none/none of them) – 4 (almost all / all of them)].

To reflect a general violent media diet, a factor score that included all five media, was estimated using maximum likelihood [Eigenvalue = 1.69, factor loadings ranged from .47 - .69, α = 0.70, Kaiser-Meyer-Olkin ranges from 0.71 – 0.78].

For specific mediums, a categorical measure was created based upon data distributions to reflect those who reported that: (1) none/almost none, (2) some, or (3) many or almost all/all of each of the medium they consumed depicted violence. Because of low cell stability, for all longitudinal analyses, baseline exposure to violence on television was dichotomized to compare none/almost none or some versus many or almost all/all; baseline exposures to real people engaging in violence online was dichotomized to none/almost none versus some, many, almost all/all. Wave 7 longitudinal analyses included a measure of baseline exposures to cartoons engaging in violence online dichotomized to none/almost none versus some, many, almost all/all.

Background variables.

Youth age and sex were reported by caregivers; race and ethnicity were reported by youth. At the individual level, because trait anger can be increased by media violence 26 , we include youths’ self-reported baseline propensity to respond with anger, measured by the 10-item State-Trait Anger Expression Inventory (STAXI-CA) T-Anger scale (α = 0.86). 27 At the peer level, baseline exposure to externalizing peers was measured by asking youth the number of close friends they had who “have been arrested or done things that could get them in trouble with the police.” 28 At the family level, youth were asked if: “Ever, in real life, have you seen one of your parents get hit, slapped, punched, or beat up by your other parent, or their boyfriend or girlfriend?” 29

Randomly identified adults were emailed a link to a brief online survey that assessed their eligibility. Ineligible adults were thanked for their participation; eligible adults were invited to complete a longer 5-minute survey after obtaining informed consent. They then forwarded their survey link to their child, who provided assent and completed the, on average, 21-minute survey. Youth were encouraged to return to the survey later if they were not in a space where their responses could be kept private from others, including their caregiver.

Data were collected online in 2006 (Wave 1), 2007–2008 (Wave 2), 2008 (Wave 3), 2010–2011 (Wave 4), 2011–2012 (Wave 5), 2012–2013 (Wave 6), and 2016 (Wave 7). In this paper, we examine data from baseline (Wave 1) and five years later (Wave 4, n=887); and baseline and 10 years later (Wave 7, n=779). Incentives were $10 in Wave 1 and increased to $40 in Wave 7. The Wave 1 survey response rate (31%) is consistent with well-conducted surveys using online panels at the time of baseline recruitment. The response rate at Wave 4 was 56% (i.e., 887/1586), and at Wave 7, 49% (i.e., 779/1586).

As the recruitment target, data were weighted statistically to reflect the population of adults with children ages 10 to 15 years old in the United States according to adult age, sex, race/ethnicity, region, education, household income, and child age and sex. Using data collected from random digit dial samples, propensity score weighting also was applied to adjust for adult respondents’ propensity to be online. The weight also adjusted for nonresponse across waves.

Plan of analysis

Rates of within-wave missingness were very low: Race (1.2%) had the highest rate of declination to answer. For all dichotomous variables, “decline to answer” was recoded as “symptom absent” (e.g., not having been in a physical fight). Those who declined to answer the question about race were coded as White, the majority race. For continuous variables, “decline to answer” was recoded to the cohort mean. As a sensitivity analysis, models also were estimated with missing data imputed. Youth who did not respond to Wave 4 or Wave 7, respectively, were excluded from that specific longitudinal analysis.

Analyses were conducted using Stata 15. 30 First, co-relations of violent exposure across media were explored using a correlation matrix and Cronbach’s alpha, which reflects the inter-relatedness of the items. We also examined the percent of youth who reported varying patterns of exposure across media types. Next, to understand the long-term association between media violence and later violent behavior, we first estimated direct, unadjusted logistic regression odds (Model 1). We then estimated logistic regression odds that adjusted for baseline levels of seriously violent behavior, one’s propensity to respond to stimuli with anger, exposure to externalizing peers, exposure to caregiver spousal abuse, sex, age, race, ethnicity, and self-reported dishonesty in answering survey questions (Model 2). For each time point, six unadjusted and adjusted models were estimated: One for violent media diet and five for each of the specific types of violent media of interest.

On average, youth were 12.6 years of age (SE: 0.05) at baseline, 16.7 years of age (SE: 0.07) at 5-year and 22.1 years of age (SE: 0.07) at 10-year follow-up. As shown in Table 1 , those who completed Waves 4 and 7, respectively, versus those who did not, respectively, generally had similar baseline demographic characteristics; exposure to externalizing peers was of exception.

Responses at Wave 1 (baseline) for completers and noncompleters of Wave 4 (5 years) and Wave 7 (10 years), respectively; weighted data

Co-relation of violence exposure across media

The five indicators of exposure to violence in specific media were interrelated: Cronbach’s alpha, Wave 1 = 0.70 (unweighted data given the computation ability of Stata). As shown in Supplemental Table 1 , all media were significantly interrelated. The strongest correlations were noted for violence exposure in television and video games (0.46), and television and music (0.44). Although still significantly interrelated, violence exposure in video games and websites with real people was the least correlated (0.22).

As shown in Figure 1 , more than half (56%) of youth said that none of the media they consumed was mostly violent (i.e., many, almost all, or all of it depicted physical violence).

The percent of youth who reported a specific amount of exposure to physical fighting, shooting, or killing across media types for 10–15-year-olds in the United States (n = 1,586). Different colored bars denote the number of media to which a youth were exposed to a certain level of violence. Five media were aggregated: television, video games, music, websites with real people, and websites with cartoon figures.

Relative odds of seriously violent behavior five years after exposure to youth’s general violent media diet

A factor score was estimated to reflect one’s “violent media diet,” that is, the intensity within and across youth exposures to violent content in five mediums. As shown in Table 2 and Supplemental Figure 1 , the relative odds of reporting seriously violent behavior five years later were 2.45-fold higher ( p <0.001) with each incremental increase in one’s baseline violent media diet. After adjusting for other potentially influential characteristics, the relative odds of seriously violent behavior five years later rose 1.70-fold ( p =0.01) with each incremental increase in one’s violent media diet at baseline.

The relative odds of seriously violent behavior 5 years after exposure to violence by media type and overall media diet, weighted data (n=887)

OR: Odds ratio; aOR: Adjusted odds ratio. Models are adjusted for youth age, sex, race, ethnicity; and baseline seriously violent behavior and exposure to caregiver spousal abuse, propensity to respond to stimuli with anger, externalizing peers, and self-reported honesty in answering survey questions. Bolded text denotes p<0.05; italicized text denotes p<0.20.

Specific types of media also were implicated: Frequent childhood exposure to violence in television (OR = 4.44, p<0.001), music (OR = 5.91, p<0.001), video games (OR=6.73, p<0.001), websites with real people (OR = 2.39, p=0.03) and websites with cartoons (OR = 3.35, p=0.03) each was associated with significantly elevated odds of seriously violent behavior in adolescence. Findings persisted for music (aOR = 3.28, p=0.03), television (aOR = 3.51, p<0.001) and video games (aOR = 3.27, p=0.02) even after adjusting for other childhood influences on violent behavior. Importantly, too, “some” exposure in childhood was associated with seriously violent behavior in adolescence for both music (aOR = 2.34, p=0.05) and video games (aOR = 2.72, p=0.02).

Longitudinal associations a decade later

As shown in Table 3 and Supplemental Figure 1 , the relative odds of seriously violent behavior 10 years after one’s exposure in childhood increased 2.18-fold ( p =0.001) with each incremental increase in one’s violent media diet. After adjusting for other factors, the association persisted (aOR = 1.72, p=0.03). As with adolescence, frequent childhood exposure to violence in music (OR = 4.48, p=0.008), television (OR = 4.26, p=0.001) and video games (OR = 5.38, p=0.001) each were associated with seriously violent behavior in adulthood. This longitudinal association persisted for video games (aOR = 3.28, p=0.03) and television (OR = 3.14, p=0.02) even after taking into account other potentially influential factors; violence depicted in music also was implicated (aOR = 2.85, p=0.13).

The relative odds of seriously violent behavior 10 years after exposure to violence by media type, weighted data (n=760)

RG: Reference group; OR: Odds ratio; aOR: Adjusted odds ratio. Models are adjusted for youth age, sex, race, ethnicity, baseline seriously violent behavior, concurrent propensity to respond to stimuli with anger and self-reported honesty in answering survey questions. Bolded text denotes p<0.05; italicized text denotes p<0.20.

Contrary to other trends observed, exposure to violent websites that depicted cartoons at baseline was associated with lower odds of seriously violent behavior a decade later (aOR = 0.48, p=0.09). Given that this is in the opposite direction of other violent media exposures examined, it seems likely that this may be a statistical anomaly.

Findings were replicated when seriously violent behavior was defined without the measure of sexual assault ( Supplemental Table 2 ), and when missing data were imputed ( Supplemental Table 3 ).

In this national, longitudinal study of children initially 10–15 years of age, findings suggest that exposure to violence in specific mediums and a general diet of violent media across media in childhood are associated with seriously violent behavior in adolescence and adulthood. Measured both in intensity and diversity of exposure, as one’s violent media diet increases incrementally, so too do the odds of seriously violent behavior by 70%, over time. The increased odds are evident even after taking into account other factors that could explain violent behavior later in life, such as one’s violent behaviors in childhood, exposure to caregiver spousal abuse, one’s propensity to respond with anger, and association with peers who engage in activities that could get them in trouble with the police. Pediatricians should work with parents to identify a media consumption plan for their children that is realistic and associated with the least amount of violence as possible across the online, television, game, and music content they consume. Efforts to co-view content and talk with youth about what they are being exposed to in the media they are consuming also are likely useful. 31

Youth do not experience media in a vacuum: Exposure to violence in one medium correlates highly with exposure in another medium. This saturation of messaging may be reinforcing the idea that violence is an appropriate and common tool to address situational anger across environments and stimuli. Understanding how individual types of media are affecting youth behavior is important. Current findings suggest that it may be equally important to understand how influences across media together are affecting behavior. Findings further suggest that early, intense exposure to violence in specific media, namely music, video games, and television, may be related to seriously violent behavior in adolescence and adulthood. There appears to be a stepwise association such that those who report “some” exposure in childhood are differentially at risk than those with more intense (i.e., many, almost all/all) exposures. This suggests that if parents are unable to eliminate their children’s violent media exposure entirely, pediatricians could encourage them to reduce their exposure as much as possible, and that this may still have a positive impact.

Much of the research on exposure to violent media has focused on visual media, such as television, movies, and video games; 17 , 32 , 33 or aggregated exposure across types. 34 Less is known about aural influences, like violent music, although studies exist: In one longitudinal study of adolescents, listening to aggression in music was associated with increased aggression one year later. 35 The current study builds upon this nascent research by noting associations at 5- and 10-years post-exposure, and suggests that more research attention could be focused on the content of the music to which adolescents are listening. Given the ease of digital download of music combined with the widespread ownership of smart phones among today’s adolescents, this exposure may be more hidden and require additional effort by adults to co-experience and manage their children’s consumption.

Limitations

Self-report is a less rigorous measure than objective measures of exposure to violent media. Given the length of the survey and the multitude of questions and topics queried however, it seems unlikely that youth were able to determine the study hypotheses, thereby introducing demand characteristics. Additionally, youth report the intensity of exposure to, and not the amount of time spent with, violent media. For example, some youth who primarily play violent video games may do so for 2 hours a week, whereas others may do so for 40 hours a week. This may result in an underestimate of the association between exposure and behavior. 36

Although community-based research facilitates a wider view into youth behavior than other sources, such as juvenile justice data, self-report is vulnerable to misreporting, particularly of behaviors deemed undesirable. Efforts were made to increase the validity of self-report (e.g., surveying youth online vs in person or over the telephone, reminding them their answers were private, adjusting for self-reported dishonesty in answering survey questions). The inclusion of a social desirability scale might have facilitated a more direct examination of the prevalence and impact of misreporting in the data. That said, one in twenty youth (5%) reported at least one of the seriously violent behaviors queried at baseline. This is generally consistent with base rates observed in other large self-reported surveys, 37 suggesting that under-reporting may not have been an issue in the present study.

Additionally, the multivariate models may be over-adjusting for confounders and report artificially attenuated effect sizes. 38 For example, trait anger can be increased by media violence exposure, 26 and is therefore likely interrelated with media violence exposure. Including trait anger in the multi-variate model, therefore, partially controls for prior effects that this exposure has had on behavior. Also, controlling for prior violent behavior also essentially adjusts for prior predictors of violent behavior. Moreover, youth who consume high levels of media violence may be more likely to spend time with externalizing peers. If true, then the current models may underestimate the association between media violence and violent behavior given that youth who were associating with such peers at baseline were less likely to participate in subsequent waves.

Moreover, although the data are national, they may not be representative. Survey weights were applied to adjust for this possibility. The national reach nonetheless affords a broader view of youth experiences than might not have been observed in a local setting. Moreover, given the study’s focus on mechanism, internal validity is more important than external validity. Finally, rates of attrition are suboptimal, although differential attrition generally was not apparent.

Implications

Since 2006, when baseline data were collected, technology has changed dramatically. A growing body of literature suggests that newer, peer-to-peer, and immersive technologies may positively affect health behavior change. 39 , 40 It stands to reason that a similar learning effect could be observed if content encouraged unhealthy behaviors, including violence. The current study supports this hypothesis with older technology. Future research should both replicate the current study and examine whether newer technologies are associated with an enhanced learning effect.

During childhood, exposure to violence across a variety of media, operationalized as one’s violent media “diet,” appears to be related to engaging in seriously violent behavior in adolescence and adulthood, even beyond one’s propensity to respond to situations with anger, having peers who are engaging in behaviors that could get them in trouble with the police, being exposed to caregiver spousal abuse, and engaging in violent behaviors as a child. Specific exposures to video games and television also appear to be associated with violent behavior over time; similar linkages are suggested for music. While findings should be replicated in other community-based samples, it seems reasonable to suggest that pediatricians might work with parents to identify a media consumption plan that minimizes children’s exposure to violence across media types and is realistic within the family milieu.

Implications and Contribution

In this national, longitudinal study, exposure to violent media at 10–15 years-old was associated with increased odds of seriously violent behavior 5 and 10 years later, adjusting for aggression, externalizing peers, and caregiver spousal abuse. This was true for a general ‘violent media diet;’ and video games, television and music.

Supplementary Material

Acknowledgements:.

We would like to thank the entire Growing up with Media study team from the Center for Innovative Public Health Research, Princeton Survey Research Associates International, Harris Interactive, Johns Hopkins Bloomberg School of Public Health, and the Centers for Disease Control and Prevention, who contributed to different parts of the planning and implementation of the study. Finally, we thank the families and youth for their time and willingness to participate in this study.

Funding/support

Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R01HD083072, and by the Centers for Disease Control and Prevention under Award Numbers U49 CE000206; R01 CE001543. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the Centers for Disease Control and Prevention. Neither funder was involved in data analysis or manuscript preparation.

Conflict of interest disclosure:

The authors have no conflicts of interest to declare.

Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Contributor Information

Michele L. Ybarra, Center for Innovative Public Health Research, San Clemente, California.

Kimberly J. Mitchell, Crimes against Children Research Center, University of New Hampshire, Durham, New Hampshire.

Jay Koby Oppenheim, Independent Consultant, New York, New York.

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Council on Communications and Media; Media Violence. Pediatrics November 2009; 124 (5): 1495–1503. 10.1542/peds.2009-2146

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Exposure to violence in media, including television, movies, music, and video games, represents a significant risk to the health of children and adolescents. Extensive research evidence indicates that media violence can contribute to aggressive behavior, desensitization to violence, nightmares, and fear of being harmed. Pediatricians should assess their patients' level of media exposure and intervene on media-related health risks. Pediatricians and other child health care providers can advocate for a safer media environment for children by encouraging media literacy, more thoughtful and proactive use of media by children and their parents, more responsible portrayal of violence by media producers, and more useful and effective media ratings. Office counseling has been shown to be effective.

Although shootings in schools around the world periodically prompt politicians and the general public to focus their attention on the influence of media violence, the medical community has been concerned with this issue since the 1950s. 1 – 3   The evidence is now clear and convincing: media violence is 1 of the causal factors of real-life violence and aggression. Therefore, pediatricians and parents need to take action. 4  

In 1972, the US Surgeon General issued a special report on the public health effects of media violence that was based on a growing and nearly unanimous body of evidence. 5   Ten years later, the National Institute of Mental Health issued a comprehensive review of the research on media violence and its effects, which outlined concerns about children's psychological health. 6   At a Congressional public health summit in July 2000, the American Academy of Pediatrics (AAP) was joined by the American Medical Association, the American Academy of Child and Adolescent Psychiatry, and the American Psychological Association in issuing an unprecedented joint statement on the impact of entertainment violence on children. 7   Also in 2000, the Federal Bureau of Investigation released a report on shootings in schools that stated that media violence is a risk factor. 8   In 2003, a panel of media-violence experts convened by the National Institute of Mental Health, at the request of the US Surgeon General, published its comprehensive report on the effects of media violence on youth, which revealed media violence to be a significant causal factor in aggression and violence. 9   Most recently, in 2007, the Federal Communications Commission (FCC) released its report on violent television programming and its effects on children and agreed with the Surgeon General that there is “strong evidence” that exposure to media violence can increase aggressive behavior in children. 10   The weight of scientific evidence has been convincing to pediatricians, with more than 98% of pediatricians in 1 study expressing the personal belief that media violence affects children's aggression. 11   Yet, the entertainment industry, the American public, politicians, and parents all have been reluctant to accept these findings and to take action. 4   The debate should be over. 9 , 12  

American children between 8 and 18 years of age spend an average of 6 hours and 21 minutes each day using entertainment media (television, commercial or self-recorded video, movies, video games, print, radio, recorded music, computers, and the Internet). 13   Children between 0 and 6 years of age spend an average of almost 2 hours each day using screen media (television, movies, computers). 14 , 15   Televisions are also commonly present in bedrooms, with 19% of infants, 29% of 2- to 3-year-olds, 43% of 4- to 6-year-olds, and 68% of children 8 years and older having a television in their bedrooms. 13 , 15 , 16   The effects of having a television in a child's bedroom are only beginning to be studied, but the early indications are alarming. Children with a television in their bedroom increase their television-viewing time by approximately 1 hour per day. 13 , 17   Their risk of obesity increases 31%, 17   and their risk of smoking doubles. 18   In addition, if children have a television in their bedroom, parents are less able to monitor what is seen; parents are less able to have consistent rules for children's media use; children participate in fewer alternative activities such as reading, hobbies, and games; and children perform more poorly in school. 19 , 20  

A large proportion of children's media exposure includes acts of violence that are witnessed or “virtually perpetrated” (in the form of video games) by young people. By 18 years of age, the average young person will have viewed an estimated 200000 acts of violence on television alone. 21   The National Television Violence study evaluated almost 10000 hours of broadcast programming from 1995 through 1997 and revealed that 61% of the programming portrayed interpersonal violence, much of it in an entertaining or glamorized manner. 22   The highest proportion of violence was found in children's shows. Of all animated feature films produced in the United States between 1937 and 1999, 100% portrayed violence, and the amount of violence with intent to injure has increased through the years. 23   In a study of the top-rated PG-13 films of 1999–2000, 90% contained violence, half of it of lethal magnitude. 24   An estimated 12% of 22 million 10- to 14-year-olds saw 40 of the most violent movies in 2003. 25   More than 80% of the violence portrayed in contemporary music videos is perpetrated by attractive protagonists against a disproportionate number of women and blacks. 26   Similarly, teenagers' music has become more violent, especially rap music. 3 , 27 , 28   And, as teenagers increasingly use the Internet, they are exposed to violence there as well; a survey of more than 1500 10- to 15-year-olds revealed that 38% had been exposed to violent scenes on the Internet. 29   Video games also are filled with violence. A recent analysis of the Entertainment Software Ratings Board (ESRB) ratings of video games revealed that more than half of all games are rated as containing violence, including more than 90% of games rated as appropriate for children 10 years or older (E10+ and T ratings). 30  

Prolonged exposure to such media portrayals results in increased acceptance of violence as an appropriate means of solving problems and achieving one's goals. 2 , 3 , 9   American media, in particular, tend to portray heroes using violence as a justified means of resolving conflict and prevailing over others. 24 , 31   Television, movies, and music videos normalize carrying and using weapons and glamorize them as a source of personal power. 22 , 32   Children in grades 4 through 8 preferentially choose video games that award points for violence against others, and 7 of 10 children in grades 4 through 12 report playing M-rated (mature) games, with 78% of boys reporting owning M-rated games. 33 , 34   Of 33 popular games, 21% feature violence against women. 35   Because children have high levels of exposure, media have greater access and time to shape young people's attitudes and actions than do parents or teachers, replacing them as educators, role models, and the primary sources of information about the world and how one behaves in it. 36  

After the tragic shootings at Columbine High School in 1999, the Federal Trade Commission (FTC) investigated whether the motion picture, music, and video-game industries specifically advertised and marketed violent material to children and adolescents. Working with industry-provided documents, the FTC determined that, despite the fact that their own rating systems found the material appropriate only for adults, these industries practiced “pervasive and aggressive marketing of violent movies, music, and electronic games to children,” such as promoting R-rated movies to Campfire girls. 37  

Studies have revealed that children and adolescents can and do easily access violent media that are deemed inappropriate for them by the various rating systems and parents. 13 , 38 , 39   In a study of PG-, PG-13-, and R-rated films, the rating did not even predict the frequency of violence in the various films. 39   Many parents find the entertainment industry's media-rating systems difficult to use. 40   The movie ratings are used by approximately three quarters of parents, but only about half of parents say they have ever used the video-game ratings, the television ratings, or the music advisories to guide their choices. 41   Many parents find the ratings unreliably low, with an objective parental evaluation revealing as many as 50% of television shows rated TV-14 to be inappropriate for their teenagers. 42   At the same time, most parents do not even know that their television is equipped with a V-chip (“V” for “viewer” control), and only 20% of parents actually use it. 40   Video games with higher ratings may actually attract more young children (the “forbidden-fruit” hypothesis). 43   The various media ratings are determined by industry-sponsored ratings boards or the artists and producers themselves. They are age based, which assumes that all parents agree with the raters about what is appropriate content for children of specific ages. Furthermore, different rating systems for each medium (television, movies, music, and video games) make the ratings confusing, because they have little similarity or relationship to one another. The AAP offers an informational brochure that pediatricians can offer to parents and children to help them use the various rating systems to guide better media choices. 44  

Research has associated exposure to media violence with a variety of physical and mental health problems for children and adolescents, including aggressive and violent behavior, bullying, desensitization to violence, fear, depression, nightmares, and sleep disturbances. Consistent and significant associations between media exposure and increases in aggression and violence have been found in American and cross-cultural studies; in field experiments, laboratory experiments, cross-sectional studies, and longitudinal studies; and with children, adolescents, and young adults. 9 , 45 – 47   The new Center on Media and Child Health at Harvard lists more than 2000 research reports. 48   The strength of the association between media violence and aggressive behavior found in meta-analyses 9 , 49   is greater than the association between calcium intake and bone mass, lead ingestion and lower IQ, and condom nonuse and sexually acquired HIV infection, and is nearly as strong as the association between cigarette smoking and lung cancer 50   —associations that clinicians accept and on which preventive medicine is based without question.

Children are influenced by media—they learn by observing, imitating, and adopting behaviors. 51   Several different psychological and physiologic processes underlie media-violence effects on aggressive attitudes, beliefs, behaviors, and emotions, and these processes are well understood. 2 , 3 , 9   Furthermore, because children younger than 8 years cannot discriminate between fantasy and reality, they may be especially vulnerable to some of these learning processes and may, thereby, be more influenced by media violence. 52 , 53   However, even older adolescents and young adults are adversely affected by consumption of media violence, demonstrating that the ability to discriminate between fantasy and reality does not inoculate one from the effects of media violence. 54 , 55  

Some research has indicated that the context in which media violence is portrayed and consumed can make the difference between learning about violence and learning to be violent. 3   Plays such as Macbeth and films such as Saving Private Ryan treat violence as what it is—a human behavior that causes suffering, loss, and sadness to victims and perpetrators. In this context, with helpful adult guidance on the real costs and consequences of violence, appropriately mature adolescent viewers can learn the danger and harm of violence by vicariously experiencing its outcomes. Unfortunately, most entertainment violence is used for immediate visceral thrills without portraying any human cost and is consumed by adolescents or children without adult guidance or discussion. Furthermore, even if realistic portrayals of harmful consequences of violence reduce the typical immediate short-term aggression-enhancement effect, there still exists the potential long-term harm of emotional desensitization to violent images. 9 , 47 , 54   Other studies have shown that the more realistically violence is portrayed, the greater the likelihood that it will be tolerated and learned. 3 , 56   Titillating violence in sexual contexts and comic violence are particularly dangerous, because they associate positive feelings with hurting others. 57 , 58   One study of nearly 32000 teenagers in 8 different countries, for example, revealed that heavy television-viewing was associated with bullying. 59  

In addition to modeling violent behavior, entertainment media inflate the prevalence of violence in the world, cultivating in viewers the “mean-world” syndrome, a perception of the world as a dangerous place. 60 – 62   Fear of being the victim of violence is a strong motivation for some young people to carry a weapon, to be more aggressive, and to “get them before they get me.” 61   For some children, exposure to media violence can lead to anxiety, depression, posttraumatic stress disorder, 56 , 63   sleep disturbances and nightmares, 56 , 64   and/or social isolation. 65   Some have defended media violence as an outlet for vicariously releasing hostility in the safety of virtual reality. However, research that has tested this “catharsis hypothesis” revealed that after experiencing media violence, children and young adults behave more aggressively, not less. 66 – 68   Numerous studies have shown that an insidious and potent effect of media violence is to desensitize all of us to real-life violence. 69 – 72  

Interactive media, such as video games and the Internet, are relatively new media forms with even greater potential for positive and negative effects on children's physical and mental health. Exposure online to violent scenes has been associated with increased aggressive behavior. 29   Studies of these rapidly growing and ever-more-sophisticated types of media have indicated that the effects of child-initiated virtual violence may be even more profound than those of passive media such as television. In many games, the child or teenager is “embedded” in the game and uses a “joystick” (handheld controller) that enhances both the experience and the aggressive feelings. Three recent studies directly compared the effects of interactive (video games) and passive (television and movies) media violence on aggression and violence; in all 3 cases, the new interactive-media-violence effect was larger. 54   Correlational and experimental studies have revealed that violent video games lead to increases in aggressive behavior and aggressive thinking and decreases in prosocial behavior. 62 , 73 – 76   Recent longitudinal studies designed to isolate long-term violent video-game effects on American and Japanese school-aged children and adolescents have revealed that in as little as 3 months, high exposure to violent video games increased physical aggression. 54 , 77   Other recent longitudinal studies in Germany and Finland have revealed similar effects across 2 years. 78 , 79   On the other hand, there is also good evidence that prosocial video games can increase prosocial attitudes and behavior. 80  

Children learn best by observing a behavior and then trying it. The consequences of their behavioral attempts influence whether they repeat the behavior. All violent media can teach specific violent behaviors, the circumstances when such behaviors seem appropriate and useful, and attitudes and beliefs about such behavior. In this way, behavioral scripts are learned and stored in memory. 47   Video games provide an ideal environment in which to learn violence and use many of the strategies that are most effective for learning. 81   They place the player in the role of the aggressor and reward him or her for successful violent behavior. Rather than merely observing only part of a violent interaction (such as occurs in television violence), video games allow the player to rehearse an entire behavioral script, from provocation, to choosing to respond violently, to resolution of the conflict. 54 , 62 , 82   Children and adolescents want to play them repeatedly and for long periods of time to improve their scores and advance to higher levels. Repetition increases their effect. In addition, some youth demonstrate pathologic patterns of video-game play, similar to addictions, in which game play disrupts healthy functioning. 81 , 83   Advances in the measurement of brain function have been applied to the study of media violence. Several studies have linked media-violence exposure to decreases in prefrontal cortex activity associated with executive control over impulsive behavior. 84  

Interpersonal violence, for victims and perpetrators, is now a more prevalent health risk than infectious disease, cancer, or congenital disorders for children, adolescents, and young adults. Homicide, suicide, and trauma are leading causes of mortality in the pediatric population. In 2004, unintentional injuries claimed 17741 lives, homicides claimed 5195 lives, and suicide claimed 4506 lives among 5- to 24-year-olds. 85   Of all deaths by homicide or suicide, fully half were gun related, making gun violence a leading killer of children and adolescents. 86   For young black males, homicide is the leading cause of death, accounting for nearly 45% of all deaths. The homicide rate for black males is 2.7 to 15.8 times higher than for other racial/ethnic groups at the same age. 87   Although violent crime rates have decreased by more than 50% between 1994 and 2004 for young people 12 to 24 years of age, they remain higher at this age than at any other age. 87   Furthermore, the proportion of youth admitting to having committed various violent acts within the previous 12 months has remained steady or even increased somewhat in recent years. 88   In the 2007 National Youth Risk Behavior Survey, 18% of students in the 9th through 12th grades reported carrying a weapon to school in the month preceding the survey, and more than one third had been in a physical fight in the year before the survey. 85   An estimated 30% of 6th- through 10th-graders report either bullying other students or being targets of bullies. 89   A recent large study of New York City students found that nearly 10% of girls and more than 5% of boys reported a lifetime history of being sexually assaulted, and 10% of both boys and girls reported experiencing dating violence in the previous year. 90   Although exposure to media violence is not the sole factor contributing to aggression, antisocial attitudes, and violence among children and adolescents, it is an important health risk factor on which we, as pediatricians and members of a compassionate society, can intervene. Some research has suggested that interventions of the types discussed below can reduce media-violence consumption and its effects on children and adolescents. 2 , 3 , 54 , 91 , 92  

Pediatricians must become cognizant of the pervasive influence that the wide and expanding variety of entertainment media have on the physical and mental health of children and adolescents. 4 , 93   Residency training conferences, grand rounds, and continuing medical education courses are all important venues that should be used for teaching pediatricians about the effects of media on children and adolescents.

Pediatricians should ask at least 2 media-related questions at each well-child visit: (1) How much entertainment media per day is the child or teenager watching? (2) Is there a television set or Internet connection in the child's or teenager's bedroom? 4 , 93   For all children, healthy alternatives such as sports, interactive play, and reading should be suggested. 94   When heavy media use by a child is identified, pediatricians should evaluate the child for aggressive behaviors, fears, or sleep disturbances and intervene appropriately. 95 , 96  

Pediatricians should encourage parents to adhere to the AAP media recommendations 11 , 95   :

Remove televisions, Internet connections, and video games from children's bedrooms.

Make thoughtful media choices and coview them with children. Coviewing should include discussing the inappropriateness of the violent solutions offered in the specific television show, movie, or video game and helping the child to generate nonviolent alternatives. Parents tend to limit sexual content more than violent content, 38   yet research has indicated that the latter is potentially more unhealthy. 2 , 3  

Limit screen time (including television, videos, computer and video games) to 1 to 2 hours per day, using the V-chip, and avoiding violent video games (defined as games that include intentional harm to other game characters, including cartoonish or unrealistic violence as well as realistic or gory violence). Counseling about limiting screen time has been shown to be effective in office settings. 97   For example, just a minute or two of office counseling about media violence and guns could lead to less violence exposure for more than 800000 children per year. 97   Parents also need to be reminded that they are important role models in terms of their own media use.

Avoid screen media for infants or toddlers younger than 2 years. 98   There have been no studies to indicate that screen time contributes positively to infant development, 99 , 100   and there are now 7 studies that have documented possible language delays among children younger than 2 years who are exposed to television or videos. 100 – 108  

Pediatricians and other child health professionals should ensure that only nonviolent media choices be provided to patients in outpatient waiting rooms and inpatient settings.

On a local level, pediatricians should encourage parents, schools, and communities to educate children to be media literate as a means of protecting them against deleterious health effects of media exposure. 93 , 109 , 110   Research has demonstrated that media education and thoughtful media use can reduce violent behavior in children. 9 , 92 , 111  

On state and national levels, pediatricians should work with the AAP and their AAP chapters and districts to collaborate with other health care organizations, educators, government, and research-funding sources to keep media violence on the public health agenda. Media violence is often characterized in the public domain as a values issue rather than what it truly is: a public health issue and an environmental issue. A recent revealed found that two thirds of parents actually favor increased governmental oversight of the media when children and teenagers are concerned. 40  

Pediatricians should advocate for more child-positive media. Pediatricians should support and collaborate with media producers, applying our expertise in child health and development toward creating child-friendly and truthful media. The AAP makes the following recommendations to the entertainment industry:

Avoid the glamorization of weapon-carrying and the normalization of violence as an acceptable means of resolving conflict.

Eliminate the use of violence in a comic or sexual context or in any other situation in which the violence is amusing, titillating, or trivialized.

Eliminate gratuitous portrayals of interpersonal violence and hateful, racist, misogynistic, or homophobic language or situations unless explicitly portraying how destructive such words and actions can be. Even so, violence does not belong in media developed for very young children.

If violence is used, it should be used thoughtfully as serious drama, always showing the pain and loss suffered by victims and perpetrators.

Music lyrics should be made easily available to parents so they can be read before deciding whether to purchase the recording.

Video games should not use human or other living targets or award points for killing, because this teaches children to associate pleasure and success with their ability to cause pain and suffering to others.

Play of violent video games should be restricted to age-limited areas of gaming arcades; the distribution of videos and video games and the exhibition of movies should be limited to appropriate age groups.

Pediatricians should advocate for a simplified, universal, content-based media-rating system to help parents guide their children to make healthy media choices. Content should be rated on the basis of research about what types of media depictions are likely to be harmful to children, rather than simply on what adults find offensive. Just as it is important that parents know the ingredients in food they may feed to their children, they should be fully informed about the content of the media their children may use. 4 , 30 , 112 , 113  

Gilbert L. Fuld, MD, Chairperson

Deborah Ann Mulligan, MD, Chair-elect

Tanya Remer Altmann, MD

Ari Brown, MD

Dimitri A. Christakis, MD

Kathleen Clarke-Pearson, MD

Benard P. Dreyer, MD

Holly Lee Falik, MD

Kathleen G. Nelson, MD

Gwenn S. O'Keeffe, MD

Lead author

Regina M. Milteer, MD

Donald L. Shifrin, MD

Michael Brody, MD

American Academy of Child and Adolescent Psychiatry

Brian Wilcox, PhD

American Psychological Association

Craig A. Anderson

Douglas A. Gentile

Gina Ley Steiner

Veronica Laude Noland

This document is copyrighted and is property of the American Academy of Pediatrics and its Board of Directors. All authors have filed conflict of interest statements with the American Academy of Pediatrics. Any conflicts have been resolved through a process approved by the Board of Directors. The American Academy of Pediatrics has neither solicited nor accepted any commercial involvement in the development of the content of this publication.

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The Facts on Media Violence

By Vanessa Schipani

Posted on March 8, 2018

In the wake of the Florida school shooting, politicians have raised concern over the influence of violent video games and films on young people, with the president claiming they’re “shaping young people’s thoughts.” Scientists still debate the issue, but the majority of studies show that extensive exposure to media violence is a risk factor for aggressive thoughts, feelings and behaviors.

The link between media violence and mass shootings is yet more tenuous. Compared with acts of aggression and violence, mass shootings are relatively rare events, which makes conducting conclusive research on them difficult.

President Donald Trump first raised the issue during a meeting on school safety with local and state officials, which took place a week after the shooting  at Marjory Stoneman Douglas High School in Parkland, Florida. The shooter, 19-year-old Nikolas Cruz, reportedly obsessively played violent video games.

Trump, Feb. 22: We have to look at the Internet because a lot of bad things are happening to young kids and young minds, and their minds are being formed. And we have to do something about maybe what they’re seeing and how they’re seeing it. And also video games. I’m hearing more and more people say the level of violence on video games is really shaping young people’s thoughts. And then you go the further step, and that’s the movies. You see these movies, they’re so violent.

Trump  discussed the issue again with members of Congress on Feb. 28 during another meeting on school safety. During that discussion, Tennessee Rep. Marsha Blackburn claimed mothers have told her they’re “very concerned” that “exposure” to entertainment media has “desensitized” children to violence.

Iowa Sen. Chuck Grassley also said during the meeting: “[Y]ou see all these films about everybody being blown up. Well, just think of the impact that makes on young people.”

The points Trump and members of Congress raise aren’t unfounded, but the research on the subject is complex. Scientists who study the effect of media violence have taken issue with how the popular press has portrayed their work, arguing that the nuance of their research is often left out.

In a 2015 review of the scientific literature on video game violence, the American Psychological Association elaborates on this point.

APA, 2015: News commentators often turn to violent video game use as a potential causal contributor to acts of mass homicide. The media point to perpetrators’ gaming habits as either a reason they have chosen to commit their crimes or as a method of training. This practice extends at least as far back as the Columbine massacre (1999). … As with most areas of science, the picture presented by this research is more complex than is usually depicted in news coverage and other information prepared for the general public.

Here, we break down the facts — nuance included — on the effect of media violence on young people.

Is Media Violence a Risk Factor for Aggression?

The 2015 report by the APA on video games is a good place to start. After systematically going through the scientific literature, the report’s authors “concluded that violent video game use has an effect on aggression.”

In particular, the authors explain that this effect manifests as an increase  in aggressive behaviors, thoughts and feelings and a decrease  in helping others, empathy and sensitivity to aggression. Though limited, evidence also suggests that “higher amounts of exposure” to video games is linked to “higher levels of aggression,” the report said.

The report emphasized that “aggression is a complex behavior” caused by multiple factors, each of which increases the likelihood that an individual will be aggressive. “Children who experience multiple risk factors are more likely to engage in aggression,” the report said.

The authors came to their conclusions because researchers have consistently found the effect across three different kinds of studies: cross-sectional studies, longitudinal studies and laboratory experiments. “One method’s limits are offset by another method’s strengths,” the APA report explains, so only together can they be used to infer a causal relationship.

Cross-sectional studies find correlations between different phenomena at one point in time. They’re relatively easy to conduct, but they can’t provide causal evidence because correlations can be spurious . For example, an increase in video game sales might correlate with a decrease in violent crime, but that doesn’t necessarily mean video games prevent violent crime. Other unknown factors might also be at play.

Longitudinal panel studies collect data on the same group over time, sometimes for decades. They’re used to investigate long-term effects, such as whether playing video games as a child might correlate with aggression as an adult. These studies also measure other risk factors for aggression, such as harsh discipline from parents, with the aim of singling out the effect of media violence. For this reason, these studies provide better evidence for causality than cross-sectional studies, but they are more difficult to conduct.

Laboratory experiments manipulate one phenomenon — in this case, exposure to media violence — and keep all others constant. Because of their controlled environment, experiments provide strong evidence for a causal effect. But for the same reason, laboratory studies may not accurately reflect how people act in the real world.

This brings us to why debate still exists among scientists studying media violence. Some researchers have found that the experimental evidence backing the causal relationship between playing video games and aggression might not be as solid as it seems.

Last July, Joseph Hilgard , an assistant professor of psychology at Illinois State University, and others published a study  in the journal Psychological Bulletin that found that laboratory experiments on the topic may be subject to publication bias. This means that studies that show the effect may be more likely to be published than those that don’t, skewing the body of evidence.

After Hilgard corrected for this bias, the effect of violent video games on aggressive behavior and emotions did still exist, but it was reduced, perhaps even to near zero. However, the effect on aggressive thoughts remained relatively unaffected by this publication bias. The researchers also found that cross-sectional studies weren’t subject to publication bias. They didn’t examine longitudinal studies, which have shown that youth who play more violent video games are more likely to report aggressive behavior over time.

Hilgard looked at a 2010 literature  review  by Craig A. Anderson , the director of the Center for the Study of Violence at Iowa State University, and others. Published in Psychological Bulletin,  this review influenced the APA’s report.

In response, Anderson took a second look at his review and found that the effect of violent video games on aggression was smaller than he originally thought, but not as small as Hilgard found. For this reason, he argued the effect was still a “societal concern.”

To be clear, Hilgard is arguing that there’s more uncertainty in the field than originally thought, not that video games have no effect on aggression. He’s also  not the first  to find that research on video games may be suffering from publication bias.

But what about movies and television? Reviews of the literature on these forms of media tend to be less recent, Kenneth A. Dodge , a professor of psychology and neuroscience at Duke University, told us by email.

Dodge, also one of the authors of the 2015 APA study, pointed us to one 1994 review of the literature on television published in the journal Communication Research that concluded that television violence also “increases aggressiveness and antisocial behavior.” Dodge told us he’s “confident” the effect this analysis and others found “would hold again today.”

Dodge also pointed us to a 2006 study that reviewed the literature on violent video games, films, television and other media together. “Most contemporary studies start with the premise that children are exposed [to violence] through so many diverse media that they start to group them together,” said Dodge.

Published in  JAMA Pediatrics , the review found that exposure to violent media increases the likelihood of  aggressive behavior, thoughts and feelings. The review also found media decreases the likelihood of helping behavior. All of these effects were “modest,” the researchers concluded. 

Overall, most of the research suggests media violence is a risk factor for aggression, but some experts in the field still question whether there’s enough evidence to conclusively say there’s a link.

Is Violent Media a Risk Factor for Violence?

There’s even less evidence to suggest media violence is a risk factor for criminal violence.

“In psychological research, aggression is usually conceptualized as behavior that is intended to harm another,” while, “[v]iolence can be defined as an extreme form of physical aggression,” the 2015 APA report explains . “Thus, all violence is aggression, but not all aggression is violence.”

The APA report said studies have been conducted on media violence’s relationship with “criminal violence,” but the authors “did not find enough evidence of sufficient utility to evaluate whether” there’s a solid link to violent video game use.

This lack of evidence is due, in part, to the fact that there are ethical limitations to conducting experiments on violence in the laboratory, especially when it comes to children and teens, the report explains. That leaves only evidence from cross-sectional studies and longitudinal studies. So what do those studies say?

One longitudinal study , published in the journal Developmental Psychology in 2003, found that, out of 153 males, those who watched the most violent television as children were more likely 15 years later “to have pushed, grabbed, or shoved their spouses, to have responded to an insult by shoving a person” or to have been “to have been convicted of a crime” during the previous year. Girls who watched the most violent television were also more likely to commit similar acts as young women. These effects persisted after controlling for other risk factors for aggression, such as parental aggression and intellectual ability.

A 2012 cross-sectional  study that Anderson, at Iowa State, and others published in the journal  Youth Violence and Juvenile Justice  did find that the amount of violent video games juvenile delinquents played correlated with how many violent acts they had committed over the past year. The violent acts included gang fighting, hitting a teacher, hitting a parent, hitting other students and attacking another person.

However, a 2008 review of the literature published in the journal Criminal Justice and Behavior concluded that “ the effects of exposure to media violence on criminally violent behavior have not been established.” But the authors clarify: “Saying that the effect has not been established is not the same as saying that the effect does not exist.”

In contrast to the APA report, Anderson and a colleague argue in a 2015 article published in American Behavioral Scientist  that “research shows that media violence is a causal risk factor not only for mild forms of aggression but also for more serious forms of aggression, including violent criminal behavior.”

Why did Anderson and his colleagues come to different conclusions than the APA? He told us that the APA “did not include the research literature on TV violence,” and excluded “several important studies on video game effects on violent behavior published since 2013.”

In their 2015 article, Anderson and his colleague clarify that, even if there is a link, it “does not mean that violent media exposure by itself will turn a normal child or adolescent who has few or no other risk factors into a violent criminal or a school shooter.” They add, “Such extreme violence is rare, and tends to occur only when multiple risk factors converge in time, space, and within an individual.”

Multiple experts we spoke with did point to one factor unique to the United States that they argue increases the risk of mass shootings and lethality of violence in general — access to guns.

For example, Anderson told us by email: “There is a pretty strong consensus among violence researchers in psychology and criminology that the main reason that U.S. homicide rates are so much higher than in most Western democracies is our easy access to guns.”

Dodge, at Duke, echoed Anderson’s point.”The single most obvious and probably largest difference between a country like the US that has many mass shootings and other developed countries is the easy access to guns,” he said.

So while scientists disagree about how much evidence is enough to sufficiently support a causal link between media violence and real world violence, Trump and other politicians’ concerns aren’t unfounded.

Editor’s note: FactCheck.org is also based at the University of Pennsylvania’s Annenberg Public Policy Center. Hilgard, now at Illinois State, was a post doctoral fellow at the APPC.

Essay on Media and Violence

Introduction

Research studies indicate that media causes violence and plays a role in desensitization, aggressive behavior, fear of harm, and nightmares. Examples of media platforms include movies, video games, television, and music. Violence in media has also been associated with health concerns. The youth have been the most common victims of media exposure and thus stand higher chances of exposure to violence (Anderson, 2016). In the contemporary world, violence in media platforms has been growing, reaching heightened levels, which is dangerous for society. When you turn on the television, there is violence, social media platforms; there is violence when you go to the movies; there is violence. Studies indicate that an average person in the United States watches videos for nearly five hours in a day. In addition, three-quarters of television content contain some form of violence, and the games being played today have elements of violence. This paper intends to evaluate the concept of media messages and their influence on violent and deviant behaviors. Television networks and video games will be considered.

The Netflix effect involves the behavior of staying home all day, ordering food, and relaxing the couch to watch Netflix programs (McDonald & Smith-Rowsey, 2016). Netflix and binge-watching have become popular among the younger generation and thus are exposed to different kinds of content being aired. Studies indicate that continuous exposure to violent materials has a negative effect on the aggressive behavior of individuals. Netflix is a global platform in the entertainment industry (Lobato, 2019). Although, the company does not have the rights to air in major countries such as China, India, and Japan, it has wide audience. One of the reasons for sanctions is the issues of content being aired by the platform, which may influence the behaviors of the young generation. The primary goal of Netflix is entertainment; it’s only the viewers who have developed specific effects that affect their violent behaviors through imitation of the content.

Television Networks

Television networks focus on feeding viewers with the latest updates on different happenings across the globe. In other instances, they focus on bringing up advertisements and entertainment programs. There is little room for violent messages and content in the networks unless they are airing movie programs, which also are intended for entertainment. However, there has been evidence in the violence effect witnessed in television networks. Studies called the “Marilyn Monroe effect” established that following the airing of many suicidal cases, there has been a growth in suicides among the population (Anderson, Bushman, Donnerstein, Hummer, & Warburton, 2015). Actual suicide cases increased by 2.5%, which is linked to news coverage regarding suicide. Additionally, some coverages are filled with violence descriptions, and their aftermath with may necessitate violent behaviors in the society. For instance, if televisions are covering mass demonstrations where several people have been killed, the news may trigger other protests in other parts of the country.

Communications scholars, however, dispute these effects and link the violent behaviors to the individuals’ perception. They argue that the proportion of witnessing violent content in television networks is minimal. Some acts of violence are associated with what the individual perceives and other psychological factors that are classified into social and non-social instigators (Anderson et al., 2015). Social instigators consist of social rejection, provocation, and unjust treatment. Nonsocial instigators are physical objects present, which include weapons or guns. Also, there are environmental factors that include loud noises, overcrowding, and heat. Therefore, there is more explanation of the causes of aggressive behaviors that are not initiated by television networks but rather a combination of biological and environmental factors.

Video games

Researchers have paid more attention to television networks and less on video games. Children spend more time playing video games. According to research, more than 52% of children play video games and spend about 49 minutes per day playing. Some of the games contain violent behaviors. Playing violent games among youth can cause aggressive behaviors. The acts of kicking, hitting, and pinching in the games have influenced physical aggression. However, communication scholars argue that there is no association between aggression and video games (Krahé & Busching, 2015). Researchers have used tools such as “Competition Reaction Time Test,” and “Hot Sauce Paradigm” to assess the aggression level. The “Hot Sauce Paradigm” participants were required to make hot sauce tor tasting. They were required to taste tester must finish the cup of the hot sauce in which the tester detests spicy products. It was concluded that the more the hot sauce testers added in the cup, the more aggressive they were deemed to be.

The “Competition Reaction Time Test” required individuals to compete with another in the next room. It was required to press a button fast as soon as the flashlight appeared. Whoever won was to discipline the opponent with loud noises. They could turn up the volume as high as they wanted. However, in reality, there was no person in the room; the game was to let individuals win half of the test. Researchers intended to test how far individuals would hold the dial. In theory, individuals who punish their opponents in cruel ways are perceived to be more aggressive. Another way to test violent behaviors for gamer was done by letting participants finish some words. For instance, “M_ _ _ ER,” if an individual completes the word as “Murder” rather than “Mother,” the character was considered to possess violent behavior (Allen & Anderson, 2017). In this regard, video games have been termed as entertainment ideologies, and the determination of the players is to win, no matter how brutal the game might be.

In this paper, fixed assumptions were used to correlate violent behaviors and media objects. But that was not the case with regards to the findings. A fixed model may not be appropriate in the examination of time-sensitive causes of dependent variables. Although the model is applicable for assessing specific entities in a given industry, the results may not be precise.

Conclusion .

Based on the findings of the paper, there is no relationship between violent behaviors and media. Netflix effect does not influence the behavior of individuals. The perceptions of the viewers and players is what matters, and how they understand the message being conveyed. Individuals usually play video games and watch televisions for entertainment purposes. The same case applies to the use of social media platforms and sports competitions. Even though there is violent content, individuals focus on the primary objective of their needs.

Analysis of sources

The sources have been thoroughly researched, and they provide essential information regarding the relationship between violent behaviors and media messages. Studies conducted by various authors like Krahé & Busching did not establish any relationship between the two variables. Allen & Anderson (2017) argue that the models for testing the two variables are unreliable and invalid. The fixed assumptions effect model was utilized, and its limitations have been discussed above. Therefore, the authors of these references have not been able to conclude whether there is a connection between violence and media messages.

Allen, J. J., & Anderson, C. A. (2017). General aggression model.  The International Encyclopedia of Media Effects , 1-15.

Anderson, C. A. (2016). Media violence effects on children, adolescents and young adults.  Health Progress ,  97 (4), 59-62.

Anderson, C. A., Bushman, B. J., Donnerstein, E., Hummer, T. A., & Warburton, W. (2015). SPSSI research summary on media violence.  Analyses of Social Issues and Public Policy ,  15 (1), 4-19.

Krahé, B., & Busching, R. (2015). Breaking the vicious cycle of media violence use and aggression: A test of intervention effects over 30 months.  Psychology of Violence ,  5 (2), 217.

Lobato, R. (2019).  Netflix nations: the geography of digital distribution . NYU Press.

McDonald, K., & Smith-Rowsey, D. (Eds.). (2016).  The Netflix effect: Technology and entertainment in the 21st century . Bloomsbury Publishing USA.

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Computer Science > Computation and Language

Title: realm: reference resolution as language modeling.

Abstract: Reference resolution is an important problem, one that is essential to understand and successfully handle context of different kinds. This context includes both previous turns and context that pertains to non-conversational entities, such as entities on the user's screen or those running in the background. While LLMs have been shown to be extremely powerful for a variety of tasks, their use in reference resolution, particularly for non-conversational entities, remains underutilized. This paper demonstrates how LLMs can be used to create an extremely effective system to resolve references of various types, by showing how reference resolution can be converted into a language modeling problem, despite involving forms of entities like those on screen that are not traditionally conducive to being reduced to a text-only modality. We demonstrate large improvements over an existing system with similar functionality across different types of references, with our smallest model obtaining absolute gains of over 5% for on-screen references. We also benchmark against GPT-3.5 and GPT-4, with our smallest model achieving performance comparable to that of GPT-4, and our larger models substantially outperforming it.

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Trump Shares Video Featuring Image of a Hog-Tied Biden

The social media post reflects the increasingly violent and personal attacks that Donald J. Trump has employed during the presidential campaign.

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By Chris Cameron

Former President Donald J. Trump posted a video on Friday to his social media website that features an image of President Biden with his hands and feet tied together.

Mr. Trump posted the video to Truth Social early Friday afternoon with a line that said it was filmed on Long Island on Thursday, when Mr. Trump attended the wake of a slain New York City police officer in Massapequa Park, N.Y. The video shows two moving trucks decorated with flags and decals supporting Mr. Trump. The tailgate of the second vehicle features the image of Mr. Biden.

Macabre imagery targeting Mr. Trump’s perceived enemies frequently circulates online among right-wing provocateurs and pro-Trump groups, and in some cases has been featured at conservative conferences . Photos of trucks featuring similar images of Mr. Biden tied up have been shared across social media, and online vendors sell vehicle stickers with the image.

Mr. Trump’s promotion of the video featuring the image reflects the increasingly caustic and personal attacks that he has directed against Mr. Biden — for example, in a speech this month he said that “everything Joe Biden touches turns to” filth, though he used an expletive — and it extends a record in which the former president features violent imagery on his social media accounts.

“Trump is regularly inciting political violence, and it’s time people take him seriously — just ask the Capitol Police officers who were attacked protecting our democracy on Jan. 6,” said Michael Tyler, a spokesman for the Biden campaign, referring to a pro-Trump mob that stormed the U.S. Capitol on Jan. 6, 2021.

Steven Cheung, a spokesman for the Trump campaign, said “that picture was on the back of a pickup truck that was traveling down the highway,” adding that “Democrats and crazed lunatics have not only called for despicable violence against President Trump and his family, they are actually weaponizing the justice system against him.”

The video was still on Mr. Trump’s Truth Social page as of late Friday evening.

The Trump campaign has repeatedly cited Democratic statements from years past to defend Mr. Trump’s rhetoric. Mr. Cheung on Friday pointed to a statement by Mr. Biden in 2018 in which he said, referring to Mr. Trump, “If we were in high school, I’d take him behind the gym and beat the hell out of him.” Mr. Biden was responding to comments that Mr. Trump had made about women on a tape linked to the show “Access Hollywood.”

Mr. Trump has previously posted doctored photos and videos depicting him physically attacking political opponents, focusing particularly on Mr. Biden in the last year. The former president has, for example, repeatedly shared videos depicting him hitting Mr. Biden with golf balls . Mr. Trump also posted a photo last year of him holding a baseball bat next to Alvin L. Bragg , the Manhattan district attorney, who is prosecuting Mr. Trump in connection to a hush money payment made to a porn star during the 2016 campaign.

Mr. Trump has also used increasingly authoritarian language on the campaign trail, repeatedly saying that migrants are “poisoning the blood of our country” and describing his political opponents in a Veterans Day speech last year as “vermin” who needed to be “rooted out.”

This month, Mr. Trump said that some migrants were “not people” and, amid a discussion of the auto industry, that the country would face a “blood bath” if he lost the election. A few days later, he attacked Jewish Democrats in a radio interview, saying that Jews who vote for Democrats hate their religion and Israel .

On Saturday, Mr. Trump posted to Truth Social a new attack on the daughter of Justice Juan M. Merchan, who is overseeing his hush money trial in Manhattan.

The attack linked to a news article that displays two pictures of the daughter, both of which appeared in Mr. Trump’s post.

The attack came soon after an official working for Mr. Bragg, the Manhattan district attorney, argued in a letter to the court that Justice Merchan’s daughter was covered by a limited gag order that the judge issued earlier in the week. The letter urged the judge to make clear that the gag order protects family members of the judge from attacks by Mr. Trump. The judge is expected to state in the coming days whether he agrees.

Mr. Trump also posted a handful of attacks on the judge’s daughter earlier this week. His lawyers have said that because she has done work for Democrats, Mr. Trump should be able to attack her, insisting that his freedom of political speech is being curtailed.

In one post earlier this week, Mr. Trump claimed that an account on X with a photo of him behind bars belonged to the judge’s daughter. Court officials said the account was not hers.

Maggie Haberman contributed reporting.

Chris Cameron covers politics for The Times, focusing on breaking news and the 2024 campaign. More about Chris Cameron

Our Coverage of the 2024 Presidential Election

News and Analysis

Robert F. Kennedy Jr. has emerged as a wild card in the 2024 election , attracting a motley mix of ideologically diverse supporters, raising piles of cash and drawing legal attacks from Democrats and verbal barrages from former President Donald Trump.

Melania Trump, who has been mostly absent from public view while her husband campaigns for president, will appear at a fund-raiser at Mar-a-Lago , marking a return of sorts to the political arena.

The centrist group No Labels has abandoned its plans to run a presidential ticket in the 2024 election, having failed to recruit a candidate. The group had suffered a string of rejections recently  as prominent Republicans and Democrats declined to run on its ticket.

Florida court rulings on abortion have all but guaranteed that voters will have the issue on their minds in November, bringing potential risks for two anti-abortion Republicans  in the state whose districts aren’t solidly red.

Trump’s falsehoods about mail voting have created a strategic disadvantage for Republicans, who must rely on Election Day turnout . The group Turning Point Action has a $100 million plan to change voters’ habits to encourage early voting.

The focus of Trump’s hotel business is shifting from big cities to his golf resorts,  after a deal to host tournaments for LIV Golf , the upstart league sponsored by Saudi Arabia’s sovereign wealth fund, another example of the ties between the Saudis and the Trump family.

Biden and Trump are the oldest people ever to seek the presidency , challenging norms about what the public should know about candidates’ health.

Simon Rosenberg, a Democratic strategist and consultant, has spent the past two years telling Democrats they need to calm down. His Biden-will-win prediction is his next big test .

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Reasonable Grounds to Believe Conflict-Related Sexual Violence Occurred in Israel During 7 October Attacks, Senior UN Official Tells Security Council

There are reasonable grounds to believe that conflict-related sexual violence — including rape and gang-rape — occurred across multiple locations of Israel and the Gaza periphery during the attacks on 7 October 2023, a senior United Nations official reported to the Security Council today, as she presented findings from her visit to Israel and the occupied West Bank.

Following allegations of brutal sexual violence committed during and in the aftermath of the Hamas-led terror attacks, Pramila Patten, the Special Representative of the Secretary-General on Sexual Violence in Conflict, led an official visit to Israel from 29 January to 14 February to gather, analyse and verify reports of sexual violence related to the 7 October attack.  Due to ongoing hostilities, the Special Representative did not request to visit Gaza, where other UN entities that monitor sexual violence are operational.

“What I witnessed in Israel were scenes of unspeakable violence perpetrated with shocking brutality,” Ms. Patten recalled. Detailing her methodology, she said that her team met with families of hostages and members of communities displaced from several kibbutzim.  It conducted confidential interviews with 34 individuals, including survivors and witnesses of the 7 October attacks, released hostages, first responders and health and service providers.  It visited four attack sites — as well as the morgue to which the bodies of victims were transferred — and reviewed over 5,000 photographic images and some 50 hours of footage of the attacks.

“It was a catalogue of the most extreme and inhumane forms of killing, torture and other horrors,” including sexual violence, she stated.  The team also found convincing information that sexual violence was committed against hostages, and has reasonable grounds to believe that such violence may still be ongoing against those in captivity.  While there are reasonable grounds to believe that conflict-related sexual violence occurred in the Nova music festival site, Route 232, and kibbutz Re’im, reported incidents of rape could not be verified in other locations. Concurrently, the team determined that at least two allegations of sexual violence in kibbutz Be’eri — widely reported in the media — were unfounded.

Turning to the West Bank, she painted a grim picture of “intense fear and insecurity, with women and men terrified and deeply disturbed over the ongoing tragedy in Gaza”.  On her visit to Ramallah, she spotlighted instances of sexual violence in the context of detention, such as invasive body searches; beatings, including in the genital areas; and threats of rape against women and female family members.  Sexual harassment and threats of rape during house raids and at checkpoints were also reported.  She expressed disappointment that the immediate reaction to her report by some Israeli political actors was not to open inquiries into those alleged incidents but, rather, to reject them outright via social media.

However, she underscored that her findings do not legitimize further hostilities.  Instead, they create a moral imperative for a humanitarian ceasefire to end the unspeakable suffering imposed on Palestinian civilians in Gaza and bring about the immediate and unconditional release of all hostages.  “I am horrified by the injustice of women and children killed in Gaza,” she said, stressing that the end goal of her mandate is not “a war without rape” but a “world without war”.

In the following discussion, numerous Council Members — among them, the representatives of China, Switzerland, Japan, Slovenia, Malta, Mozambique and Ecuador — expressed shock over the incidents of sexual violence related to the 7 October attacks detailed in the Special Representative’s report.  Many urged Hamas to immediately release all hostages, who — according to the report — can still be subjected to such acts.  Some, including the representatives of the United States and France, criticized the Council’s failure to condemn Hamas.

There can be no doubt about what happened on 7 October, said the representative of the United States, pointing to the report’s findings that several bodies, naked from the waist down, were recovered — mostly “women with hands tied and shot multiple times, often in the head”.  The report also indicated that the detention of Palestinians has been compounded by sexual violence.  Nevertheless, she rejected “the false equivalency between these actions and hostage-taking by a foreign terrorist organization”.

Incidents of sexual violence in Israel and the West Bank contained in the report “add another horrific dimension to the tragedy unfolding in the Middle East”, observed Guyana’s delegate.  Noting that at least two widely reported allegations of sexual violence were unfounded, she urged all parties “to act responsibly and avoid sensationalizing headlines”. 

Tariq Ahmad, Minister of State in the Foreign, Commonwealth and Development Office of the United Kingdom, said that London is ready to provide support, including its team of experts on preventing sexual violence in conflict and its toolkit that provides practical measures to address the stigma faced by survivors.  “All reports of sexual violence must be fully investigated to ensure justice for survivors and victims,” he said, adding that “justice delayed is justice denied”. 

Many echoed that call for accountability, including Sierra Leone’s delegate, who urged Israel to grant access to the Office of the United Nations High Commissioner for Human Rights (OHCHR) — as well as the Independent International Commission of Inquiry in the Occupied Palestinian Territory, including East Jerusalem, and Israel — to fully investigate all alleged violations.  

Likewise, his counterpart from Switzerland underscored that competent bodies must establish the facts to help identify violations and ensure accountability.  Adding to that, the representative of the Republic of Korea stressed that a comprehensive investigative process, involving national authorities and OHCHR, will “bring light to the complete extent of alleged violations”.

The Russian Federation’s delegate, meanwhile, questioned the UN’s selective approach to visits in the region — including the Special Representative’s recent trip, which did not cover the Gaza Strip.  “We are dealing with some sort of half-truth that in no way gives a full picture,” she stressed.  Noting that the Special Representative’s report was based on data received from the Israeli Government rather than accounts of the 7 October victims, she underscored that “putting an end to violence, including sexual violence, will only be possible when we have objective and verified information”. 

Calling for such impartiality was Algeria’s delegate, who said that the Special Representative should have been granted authorization to visit the numerous detention centres where more than 3,484 Palestinian administrative detainees are held without trial.  “Her presence in the Gaza Strip would have allowed her to witness, first-hand, the extent of sexual abuse inflicted upon Palestinians by occupying forces and convey it to the international community,” he stressed.  

The plight of Palestinians is not a recent phenomenon, he continued, noting that only three criminal investigations have been initiated in response to 1,400 complaints about acts of torture since 2001.  None have led to indictments.  “What the Palestinians — particularly women — endure is a litmus test for the credibility of international law and the global framework outlined in Security Council resolutions,” he underscored, urging an immediate end to ongoing atrocities.

For his part, the Permanent Observer of the State of Palestine said that the Council has shown “unprecedented reactivity” by convening a briefing on a report just released.  For decades, similar reports regarding sexual assault against Palestinians have not led to the convening of a single Council meeting.  He then recalled that the Special Representative’s mission did not seek to gather information or verify allegations in the Occupied Palestinian Territory, so as not to duplicate the ongoing work of other UN entities there.    

Yet, none of these entities were invited today to present their findings, he pointed out, extending an invitation for the Special Representative to visit Gaza.  He also pledged Palestine’s readiness to cooperate with OHCHR and the Independent International Commission of Inquiry.  The Council should demand that Israel do the same since that country keeps saying that it has nothing to hide, he stated, adding:  “Let the facts speak, let the law decide.”

Israel Katz, Minister for Foreign Affairs of Israel, criticized the United Nations for remaining silent about Hamas’ horrible acts for too long.  According to the Special Representative’s report, the killings of innocent young men and women on 7 October were crimes against humanity.  Against this backdrop, he called on the United Nations to declare Hamas a terrorist organization, citing the recognition of this status by numerous countries.  Emphasizing that “Hamas does not speak on behalf of the Muslim world,” he urged Muslim leaders to denounce the crimes committed by Hamas, particularly those involving sexual violence.  

Turning to the situation of hostages, he urged the Council to take urgent action to ensure the release of 134 kidnapped individuals and “stop this living hell”.  “By doing so, you will show the world that the Security Council can be a shining light of justice for all,” he added.

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