A Case Study of Videogame-Related Violence Among Adolescents

Black man playing video game
The American Psychological Association has strongly endorsed a link between video games and aggression. However, other scientists have been critical of current studies on this issue. This study shows how children presented at an ER with aggression after playing video games.

The following article is a part of conference coverage from the American Psychiatric Association Annual Meeting 2021, held virtually from May 1 to 3, 2021. The team at Psychiatry Advisor will be reporting on the latest news and research conducted by leading experts in psychiatry. Check back for more from the APA 2021.


Videogames may negatively affect children and adolescents by promoting aggressive behaviors. These findings were presented during the American Psychiatric Association annual meeting held virtually from May 1 to 3, 2021.

Medical charts from 3 children who presented at the emergency department at the Buffalo General Medical Center due to aggressive behavior involving a videogame were reviewed.

A boy aged 11 years who was White and had previously been diagnosed with attention deficit hyperactive disorder and oppositional defiant disorder was brought to the hospital after a confrontation with his brother. The 2 boys had an episode of physical aggression over a videogame in which the boy chased his brother with a knife. The patient had a history of physical abuse from his stepfather and was being bullied at school.

Another 11-year-old White boy with attention deficit hyperactive disorder and oppositional defiant disorder was escorted to the hospital by the police for an emergency mental health evaluation. Unprovoked, the boy had become physically aggressive with his mother in reaction to losing in Super Smash Bros. The mother indicated he had a history of violent outburst after minimal provocation in the context of videogame use.

A boy who was 14 years of age and Black, who had not been diagnosed with any psychiatric condition was mandated by police to have a mental health evaluation after he displayed physical aggression in reaction to his mother confiscating his videogame console. The boy’s mother had caught him stealing her credit card in order to purchase online videogames. He had a history of violence at school and poor sleep hygiene due to nightly videogaming. The boy had been physically abused by his father.

The children listed above had at least one of the risk factors associated with aggression: inadequate parenting, childhood abuse, poor school performance, ADHD, substance abuse. It presents a real-life model in which children and adolescents with pre-existing risk factors could be affected by videogame use.

This case study was limited by the few cases and the retrospective review of medical records.

These data suggested some children may be negatively affected by playing videogames. Studies are needed to assess how playing certain videogames may promote aggressive behavior among children such that appropriate videogame use guidelines can be formulated. A clinical study with a larger sample size will help in understanding the risk factors, gender differences, ethnicity, and age groups that may be associated with video-game related aggression

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Nijhara K, Antonius D, Brooks V. A clinical perspective on video game-related violence: A case series of adolescents who presented to the psychiatric ER after playing videogames. Presented at: APA annual meeting May 1-3, 2021. Abstract/Poster 4216.