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With game consoles and computers now part of everyday life, millions of parents are deciding whether to give in to children’s pleas to buy particular games, and are worried about how to set limits.

The facts and reassurance found in Grand Theft ChildhoodThe Surprising Truth About Violent Video Games and What Parents Can Do (Simon & Schuster) may be just what parents are looking for.

The book’s common-sense advice is based on a two-year, $1.5 million research program funded by the U.S. Department of Justice, as well as a review of relevant studies from around the world. Authors Cheryl K. Olson, Sc.D. and Lawrence Kutner, Ph.D. are a husband-and-wife research team affiliated with Massachusetts General Hospital and Harvard Medical School. They are also the parents of a teenage boy who plays video games.

Through surveys and focus groups with 7th and 8th grade children and their parents, Olson and Kutner studied how and why kids play video games, and looked for patterns of play linked to greater risk of school or behavior problems.

A survey of 1254 children showed that—although most of children’s top-ten games were rated Teen (for ages 13+) or below—Grand Theft Auto was by far the most popular game series among boys. In fact, 44% of them reported playing at least one game in the series “a lot in the past six months.” (Similarly, a 2005 survey by the Kaiser Family Foundation found that over 3/4 of boys in grades 7 to 12 had ever played a GTA game.) Surprisingly, Grand Theft Auto was the second most popular series among girls, after The Sims.

“Parents told us they were concerned about violent games, but frustrated by their limited control and by their lack of information about what’s actually in the games,” says Kutner.

As one parent lamented in a focus group, “I know that my son does not play Grand Theft Auto in my house. But he seems to know all the characters and what they say, so he must be playing it someplace.” Another noted, “He may bring a Mario game to his buddy’s house and bring back a Grand Theft Auto when I’m not aware of it.”

Parents have every right to refuse to buy or rent games that offend their values or seem inappropriate for their children. However, if you are the parent of a young teen, there’s a good chance that your child will play a game with violent content such as Grand Theft Auto IV—if not at home, then at a friend’s house. Kutner and Olson suggest that parents prepare for this by arming themselves with information.

What attracts children to Grand Theft Auto games?

Grand Theft Auto IV is rated Mature (for ages 17 and older), with six content descriptors including “intense violence,” “blood,” and “strong language.”

“Boys’ comments suggest that the open environment, rather than the violence, may be the key to the series’ appeal,” says Olson. “Boys told us they liked the freedom either to carry out missions and win the game, or to explore the wide variety of places, vehicles, weapons and characters.”

One boy in their study explained, “If you happen to get a police car, or a tank, or a fire truck, or ambulance or whatever…you press a button, and all of a sudden, you’re working for them. You can catch criminals, or drive people places, or put out fires. It’s more creative than just walking around, than shooting people, and doing a mission when you feel like it.”

Another boy added, “And you can be a good guy and a bad guy at the same time!”

Parents may worry that if their child enjoys playing a thug in Grand Theft Auto, it might inspire similar behavior in the real world. “In focus groups, boys told us repeatedly that they liked the ‘unreality’ of games such as GTA,” says Kutner. “As one said, ‘You get to see something that, hopefully, will never happen to you. So you want to experience it a little bit without actually being there.’”

What problems may be linked to M-rated game play?

This does not mean that Grand Theft Auto is appropriate or risk-free for all teens. One issue is whether a child is mature enough understand the game’s satirical content. A mother in a focus group expressed her concerns this way: ”It’s actually a very clever game. But it really should be limited to adults. You start seeing the prostitutes, and it’s a riot, if you are looking at it as an adult. But I step back and go, ‘Hey, my 13-year-old has never seen that!’ He doesn’t have the background information.”  Another concern is exposure to sexist or racist behavior and language.

Kutner and Olson’s research team found that children who routinely played any Mature-rated (age 17+) title such as GTA were at higher risk for aggressive behaviors (such as beating up someone, or damaging property for fun) and school problems (such as getting poor grades, or getting in trouble with a teacher or principal). The more M-rated titles on a child’s list of five games he or she “played a lot in the past six months,” the more likely the child was to be involved in these problem behaviors at least once during the past year. Heavy game play (every day, or more than 15  hours per week) was also linked to increased risk. Even so, most kids who played M-rated games or who played more than 15 hours per week did not have significant problems or get into trouble. The authors emphasize that a one-time survey cannot prove cause-and-effect.

“We can’t say whether games like Grand Theft Auto encourage aggression, whether aggressive kids like GTA, or if other factors affect both of these,” notes Olson. “But parents should definitely keep a closer eye on children who play mostly violent games, or play for many hours per week.” She also recommends limiting violent game use by children with aggressive temperaments, developmental delays or emotional problems, since they may react differently.

What can parents do to monitor game play and minimize problems?

•Become familiar with the content of the games. Parents can find plot details, screenshots, videos and reviews at CommonSenseMedia.org, the Entertainment Software Rating Board, or at web sites aimed at game players such as Gamespot.com. Talk with your teen about aspects of the game you like (such as humor), and aspects that offend you or go against your values. If you can find something positive to say, your child is more likely to listen to your concerns.

•Keep video game consoles in common areas at home, such as the living room. (Game consoles in bedrooms are associated with more M-rated game play.) This also allows parents to monitor game content over time; objectionable behavior or language may not appear until higher levels of a game are reached.

•Ask older teens and adult relatives to be mindful of where they play or store their games. M-rated game play is more common among children who often play with older siblings.

•Because GTA games are so flexible, watching how children choose to play may give insights into their thoughts and feelings. “Our research found that many children play games like Grand Theft Auto to deal with stress or get out anger; others enjoy competing with friends,” says Olson. If your child seems more angry or stressed after playing a violent game, consider locking the game away until he or she is older.

For more information for parents, see Dr. Olson’s videos.