title: Can clans protect adolescent players of massively multiplayer online games from violent behaviors?
abstract: OBJECTIVE
  To examine whether clan membership mediates observed associations between violent game content and externalizing behaviors among youth who play massively multiplayer online games (MMOGs).
  
  
  METHODS
  Responses from 486 11- to 18-year-olds who: live in the United States, read English, have been online at least once in the past 6 months, and have played MMOGs in the past year were examined. Generalized estimating equations were used to estimate the population-averaged incident rate ratio of aggressive, delinquent, and seriously violent behaviors among MMOG players given one's self-reported exposure to in-game content depicting violence.
  
  
  RESULTS
  Twenty-nine percent of all youth respondents played MMOGs in the past year. Rates of aggressive, IRR: 1.59, 95% CI [1.11, 2.26], and delinquent, IRR: 1.44, 95% CI [0.99, 2.08], behaviors were significantly higher for MMOG players who were in clans versus not in clans. For females, clan membership attenuated but did not eliminate the observed relation between exposure to in-game violent content and both aggressive and seriously violent behavior (16% and 10% reductions in IRR, respectively); whereas for males, clan membership was largely uninfluential (i.e., less than 2% change).
  
  
  CONCLUSIONS
  Clan membership is neither associated with lower rates of externalizing behaviors for youth, nor does it affect the likelihood of reporting externalizing behaviors among male players. There is some suggestion that clan membership may attenuate the concurrent association between in-game violent content and some externalizing behaviors for females.
authors.affiliation: Center for Innovative Public Health Research, 555 El Camino Real A347, San Clemente, CA, 92672, USA, michele@innovativepublichealth.org.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Ybarra
authors.forename: Danah
authors.initials: D
authors.lastname: Boyd
mesh_terms: D000293:Adolescent; D000374:Aggression / Q000523:psychology*; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008402:Mass Media / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D012309:Risk-Taking; D060756:Social Networking; D013997:Time Factors; D014481:United States; D018910:Video Games / Q000523:psychology* / Q000706:statistics & numerical data*; D014754:Violence / Q000517:prevention & control / Q000523:psychology* / Q000706:statistics & numerical data