Children, Adolescents, and the Media: Issues and Solutions

I believe television is going to be the test of the modern world, and that in this new opportunity to see beyond the range of our vision we shall discover either a new and unbearable disturbance of the general peace or a saving radiance in the sky. We shall stand or fall by television. —Author E. B. White1Television and other media represent one of the most important and underrecognized influences on children and adolescents' health and behavior in the 1990s. Their impact should be eliciting serious concern, not just from parents and educators but from physicians, public health advocates, and politicians as well (Fig 1). Although objections to various programming and advertising practices can exist on common sense, philosophical, aesthetic, humanistic, or public health grounds without strict scientific data, 2 increasing numbers of studies document that a serious problem exists. By time criteria alone, television represents the predominant medium. Young people average 16 to 17 hours of viewing weekly, beginning as early as age 2. 3 When video game and videocassette usage are added, some teenagers may spend as many as 35 to 55 hours in front of the television set. 4 More families own a television set than a telephone. 5However, other media are important as well. Adolescents can spend nearly equal amounts of time listening to the radio, although music is used frequently as an accompaniment to other activities. 4, 6 More than half of all 15- to 16-year-olds had seen the majority of the most popular, recent R-rated movies in one study. 7 In a separate study, 92% of males and 84% of females had seen or read Playboy or Playgirl by age 15. 8Finally, playing video games has become a favorite pastime of children and adolescents and now represents a 7 billion per year industry. 9 One survey of nearly 400 seventh- and eighth-grade students found that teens average 2 to 4 hours per week playing such games. 10 Although not much data are available about young people's use of new technology such as the Internet, there is every reason to believe that “surfing the Net” will prove popular as well. Indeed, in one recent national survey 89% of teenagers reported using a computer, 61% “surfed the Net, ” and 14% reported seeing something that they did not want their parents to know about. 11 By 1996, nearly five million youths had used the Internet or an on-line service from school or home. 12Media exert a significant displacement effect—2 to 3 hours per day spent watching television or playing video games means less physical activity, reading, and interaction with friends—but such data do not speak to cause-and-effect concerns. Likewise, content analyses can only demonstrate what the average child or adolescent will view. Even so, such analyses are disturbing when they reveal what the average American child or teenager is exposed to annually. Young people view an estimated 10 000 acts of violence each year. 13 Most recently, the National Television Violence Study examined nearly 10 000 hours of television programming throughout 3 years and found that 61% contains violence, with children's programming being the most violent (Fig 2). 14–16 In addition, 26% of violent interactions involved the use of guns. 16 During the 3 years of the study, none of the key indicators of violence in the media changed, despite widespread public concern. 14–16 A recent comprehensive analysis of rock music videos of all genres demonstrated that 22. 4% of all Music Television videos portrayed overt violence, 20% of all rap videos contained violence, and weapon carrying was depicted in 25% of all Music Television videos. 17 Attractive role models are the aggressors in more than 80% of violent music videos. 18Each year, teenagers view nearly 15 000 sexual references, innuendoes, and jokes, of which <170 will deal with abstinence, birth control, sexually transmitted diseases, or pregnancy. 19The so-called family hour of prime time television (8 to 9pm) contains more than 8 sexual incidents per hour, more than four times as much as in 1976. 20 Nearly one-third of family hour shows contain sexual references, and the incidence of vulgar language is increasing dramatically as well. 21 The Internet offers unparalleled access to hard-core pornography with just a few keystrokes. 22A recent content analysis found that alcohol, tobacco, or illicit drugs are present in 70% of prime time network dramatic programs, 38 out of 40 top-grossing movies, and half of all music videos. 23 In another recent study, one-fourth of all Music Television videos contained alcohol or tobacco use. 24Several studies document that smoking is making a comeback in Hollywood movies: a 1994 study of the 62 top-grossing films from 1960 to 1990 found that levels of smoking remained constant despite decreases in real-life and that lead characters were far more likely to smoke on screen (65%) than their real-life counterparts with similar demographic characteristics. 25, 26 Similarly, an American Lung Association study of 133 movies released in 1994 to 1995 found that 77% depicted tobacco use. 27In addition to programming, young people view ∼20 000 commercials each year, of which nearly 2000 are for beer and wine. 28For every “just say no” or “know when to say when” public service announcement, teens will view 25 to 50 beer and wine advertisements. 29 Alcohol and tobacco advertisers are becoming an increasing commercial presence on the Internet as well, with more than 35 alcoholic beverages represented, homepages devoted to smoking, a Budweiser on-line radio network, interactive games, free giveaways, brand spokescharacters, and specially designed chat rooms. 12 Altogether, tobacco manufacturers spend 6 billion per year, and alcohol manufacturers 2 billion per year in all media, trying to entice young people into “just saying yes. ”30, 31Data like these are alarming, but are the media actually responsible for episodes of child aggression, teen homicides, and increased rates of teenage drug use and sexual activity? 32Or, as the entertainment industry maintains, do the media merely mirror an increasingly violent, drug-oriented, and sexualized society? A close examination of the available data are essential. The research is voluminous and very clear on the relationship between media violence and real-life aggression: a cause-and-effect relationship exists. 33–38 Such research involves detailed cross-sectional studies, 39–43 naturalistic studies, 44, 45 longitudinal studies, 46–50 and several meta-analyses. 51–54 Two government reports, the 1972 Surgeon General's Report55 and the 1982 National Institute of Mental Health56 report affirmed this conclusion after examining all available data. The latter stated unequivocally: 56After 10 more years of research, the consensus among most of the research community is that violence on television does lead to aggressive behavior by children and teenagers who watch the programs. This conclusion is based on laboratory experiments and on field studies. Not all children become aggressive, of course, but the correlations between violence and aggression are positive. In magnitude, television violence is as strongly correlated with aggressive behavior as any other behavioral variable that has been measured (authors' italics). The research question has moved from asking whether or not there is an effect to seeking explanations for the effect. Taken together, the research data are persuasive that high levels of television viewing are causally related to aggressive behavior and the acceptance of aggressive attitudes. 57 The correlations found are stable throughout time, place, and demographics. 13, 34 Added to this is the now-sizable body of research demonstrating that the more adolescents are exposed to violence or are victims of violence in their homes or communities, the more likely they are to use violence or carry weapons themselves. 58–61 Clearly, the witnessing of violence is an important determinant of violent behavior; and media violence represents the witnessing of violence vicariously, on the television or movie screen. As long ago as the 1960s, laboratory experiments by Bandura et al62 established that young children are liable to imitate what they see on the television screen, particularly if the behavior is performed by an attractive role model and is either rewarded or goes unpunished (Bandura's social learning theory). Several longitudinal correlational studies have tracked children or adults for a period of up to 30 years and found that viewing media violence at young ages (8 years and younger) is a significant risk factor for adolescent or adult aggressive behavior or even criminal violence. 43, 4548–50, 63 Researchers have concluded that children learn their attitudes about violence at a very young age and, once learned, the attitudes tend to be life-long. 64American media are also rife with portrayals of justified violence (eg, the “good guy” beating up the “bad guy”), which research shows is the single strongest positive reinforcer for young people. 30, 65 Not only can media violence facilitate aggressive or antisocial behavior, it may also desensitize viewers to future violence and can also increase viewers' perception that they are living in a mean and dangerous world. 36, 66 The problem is that the entertainment industry does not want to admit the connection any more than the tobacco industry will acknowledge the cause-and-effect relationship between cigarette smoking and lung cancer. 63Media violence is not the sole cause of violence in society. Poverty, racism, inadequate parenting, the dissolution of the American family, individual psychologic differences all may have far more impact. Studies have found that child abuse, sexual abuse, witnessing domestic violence, or witnessing community violence may all play a key role in determining who will become violent. 58–6167–70But the use of violence to achieve goals or to settle conflicts is, in fact, learned behavior. Such learning occurs in social groups such as the family, peer groups, and gangs. Television and other media may function as a super peer in this respect. 32How much do media contribute to real-life violence? When 22 separate estimates of effect size were collated from various surveys, the size of the effect for media violence was estimated to be 5% to 15%. 30, 35 Given all the factors contributing to violence, to be able to isolate media violence as one factor is significant. Homicide and suicide are the second and third leading causes of death among adolescents, and guns contribute significantly to both. 71 What links adolescent homicides to American media is the glamorization of guns, which represent 26% of all violent interactions on television (Table 1). 16, 36 Although there are no specific data linking viewing gunplay in the media with actual gun-related offenses in real life, the connection seems logical, at least to one television critic: 72On average, a violent crime is committed (in the US) every 17 seconds. The entertainment industry alone cannot be blamed for this, any more than guns alone, and not the people who pull their triggers, can be blamed for gun-related deaths; however the connections are inescapable. 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