The study by Chang and Bushman1 reports findings from a randomized clinical trial designed to determine whether children who played a video game with gun violence would hold a handgun for a longer period and pull the handgun’s trigger more times during subsequent play compared with children who played the same video game with sword violence or no violence. The children, aged 8 to 12 years, had access to a variety of toys during the play period, including 2 real, disabled 9-mm handguns. Among the study’s sample of 242 children, 220 (90.9%) found the handguns. Among the children who found a handgun, 38.6% touched a handgun and did not tell an adult and 17.7% pulled the trigger at least 1 time. Relative to the other 2 conditions, playing the video game with gun violence was associated with more firearm touching, firearm trigger pulls, and shooting at oneself and one’s playmate. Other variables, including trait aggressiveness, attitude toward guns, parental estimate of the child’s interest in guns, and previous exposure to violent media, were also predictors of children’s greater handgun use.
We cannot extrapolate from these study results to suggest that playing shooter video games for a short time has a long-term effect on violent behavior or firearm-related pediatric injuries; however, the children’s greater tendency to handle firearms, even in the short term, is cause for concern. Firearm-related injuries are the second leading cause of death among children in the United States, and suicides and homicides account for 35% and 59% of these deaths, respectively.2
A prominent theory of suicide risk, the interpersonal-psychological theory of suicidal behavior,3 points to capability for self-harm as a contributing factor distinguishing those who experience suicidal thoughts from those who also act on these thoughts. The theory proposes that suicidal behavior and suicides occur when an individual has both the desire for death because of thwarted belongingness and perceived burdensomeness and an acquired capability to enact lethal self-injury. Acquired capability is conceptualized as a fearlessness about self-harm and physical pain, which may be obtained through engaging in risky behaviors, painful experiences, or fear-provoking experiences. The possibility that experience with handling a firearm is associated with a greater acquired capability for using a firearm in a suicide attempt is consistent with the results of a 2018 study4 of adults that suggested that the experience of shooting a firearm was related to higher self-reported capability for suicide. Experience or comfort with using a firearm combined with access to a firearm during a period of acute suicide risk5 are likely to substantially increase the risk of death because of the high lethality associated with firearm suicide attempts.
The short-term precipitating effects identified by Chang and Bushman1 also have implications for our understanding of intentional violence toward others. A child or adolescent who actively engages with a video game with firearm violence may have a lower threshold for using a firearm against another person when experiencing strong negative emotions and a precipitating event. This may occur through 1 or more of the mechanisms that have been proposed to account for the relationship of exposure to violence with aggressive behavior (eg, desensitization, activation of a schema or script for aggression).6 One framework for understanding the likelihood of subsequent aggression, the general aggression model,7 emphasizes the importance of personal variables (eg, personality traits) and situational or external variables (eg, presence of weapons, exposure to media violence, availability of alcohol, provocation of others). Based on this framework, the risk profiles of children and adolescents are highly heterogeneous, ever changing, and not entirely controllable. Nevertheless, we can target modifiable risk factors in our prevention efforts. These include children’s access to firearms and their developing understanding of and moral codes regarding firearm use.
Unintentional firearm injuries also warrant consideration, as these characterize many of the firearm-related injuries and deaths in younger children. In 2016, 126 children were killed unintentionally with firearms in the United States.2 Most unintentional firearm-related deaths involve children shooting themselves or another child and occur when children find guns that are not safely stored and handle them. More than half of the children in the study by Chang and Bushman1 who found an unsecured weapon touched it, nearly 17.8% pulled the trigger, and 35.8% of total trigger pulls were aimed at themselves or their playmates. These data strongly support the importance of safe firearm storage in the home.
Among gun-owning households with children, approximately 21% of gun owners have a loaded and unlocked firearm in their home, and many more have at least 1 firearm that is either locked and loaded or unlocked and unloaded.8 In fact, 7% of all US children live in a household where at least 1 gun is stored loaded and unlocked, and this percentage has been increasing.8 We recommend focused and collaborative efforts with firearm owners to improve the safe storage of firearms in family homes. Although the study by Chang and Bushman1 was laboratory based and limited to short-term effects, its randomized design and careful measurement of important study constructs make its primary findings clear: playing a video game with firearms increased the likelihood that a child would subsequently handle and pull the trigger of a firearm. Perhaps an equally important finding was that many of the children handled and pulled the trigger of a firearm they found in a playroom. This—on its own—is a strong argument for the safe storage of firearms.
Published: May 31, 2019. doi:10.1001/jamanetworkopen.2019.4327
Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2019 King CA et al. JAMA Network Open.
Corresponding Author: Cheryl A. King, PhD, Department of Psychiatry, Michigan Medicine, University of Michigan, 4250 Plymouth Rd, Rachel Upjohn Bldg, Ann Arbor, MI 48109 (email@example.com).
Conflict of Interest Disclosures: The Firearm Safety Among Children and Teens Consortium, an initiative based at the University of Michigan, is funded by the National Institutes of Health. No other disclosures were reported.
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King CA, Ewell Foster C. Gun Violence in Video Games and Subsequent Firearm Play: An Argument for the Safe Storage of Firearms. JAMA Netw Open. 2019;2(5):e194327. doi:10.1001/jamanetworkopen.2019.4327
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