Content and ratings of mature-rated video games.
OBJECTIVE
To quantify the depiction of violence, blood, sexual themes, profanity, substances, and gambling in video games rated M (for "mature") and to measure agreement between the content observed and the rating information provided to consumers on the game box by the Entertainment Software Rating Board.


METHODS
We created a database of M-rated video game titles, selected a random sample, recorded at least 1 hour of game play, quantitatively assessed the content, performed statistical analyses to describe the content, and compared our observations with the Entertainment Software Rating Board content descriptors and results of our prior studies.


METHODS
Harvard University, Boston, Mass.


METHODS
Authors and 1 hired game player.


METHODS
M-rated video games.


METHODS
Percentages of game play depicting violence, blood, sexual themes, gambling, alcohol, tobacco, or other drugs; use of profanity in dialogue, song lyrics, or gestures.


RESULTS
Although the Entertainment Software Rating Board content descriptors for violence and blood provide a good indication of such content in the game, we identified 45 observations of content that could warrant a content descriptor in 29 games (81%) that lacked these content descriptors. M-rated video games are significantly more likely to contain blood, profanity, and substances; depict more severe injuries to human and nonhuman characters; and have a higher rate of human deaths than video games rated T (for "teen").


CONCLUSIONS
Parents and physicians should recognize that popular M-rated video games contain a wide range of unlabeled content and may expose children and adolescents to messages that may negatively influence their perceptions, attitudes, and behaviors.
Kids Risk Project, Harvard School of Public Health, Harvard University, 677 Huntington Avenue, Boston, MA 02115, USA. kimt@hsph.harvard.edu
Kimberly M
KM
Thompson
Karen
K
Tepichin
Kevin
K
Haninger
D006801:Humans; D009040:Motion Pictures / Q000145:classification / Q000706:statistics & numerical data; D018910:Video Games / Q000145:classification / Q000706:statistics & numerical data; D014754:Violence