What are the adverse effects of video game play on health, behavioral and educational outcomes in longitudinal studies involving young people?
PubMed, PsycINFO & the Cochrane Database of Systematic Reviews will be searched for original research on the effects of exposure to video, computer or arcade game play on any of the following outcome keywords: Addiction/addictive behavior, social isolation, aggression, depressive disorder/depression, anxiety, sleep, inactivity, obesity, academic, grade(s) (based on preliminary investigation of a variety of search strategies). Terms will be adapted to include appropriate subject headings, and limited to studies conducted over the last ten years (since 2002) in children, adolescents or youth. Articles with the keywords/subject headings of anesthesia, user-computer interface, computer-assisted instruction or computer-assisted therapy will be excluded as 100% of titles and abstracts reviewed in preliminary searches that included these terms dealt with beneficial effects of video games.
Of the articles retrieved through this strategy, titles and abstracts will be reviewed to ensure that only articles which cover longitudinal outcomes of video game play are included. We will exclude titles and abstracts that discuss video games only as a composite variable (e.g., as part of media exposure in general or "screen time"). We will exclude articles that measure change in attitudes but will include self-reported behavior, mental health and academic performance. Reviews, commentary and guidelines will also be excluded.
Types of study to be included
Longitudinal studies (panel surveys and clinical trials) will be included. Cross-sectional/prevalence studies will be excluded, as will experimental designs where outcome is measured within one month of exposure. Review articles, commentary and guidelines will not be included.
Condition or domain being studied
Mental health and behavioral outcomes: addiction/addictive behavior, social isolation, aggression, depression and anxiety. Other outcomes: sleep, inactivity, obesity, school performance. All outcomes may be assessed by self-report. Short-term outcomes such as those arising from brief experiments will be excluded. We will also exclude case reports and case series.
Children, adolescents and youth will be included both as keywords and subject headings (where available).
Studies will be included that examine video, computer or arcade games of all genres as the primary exposure with the outcomes noted above, where exposure and outcome are measured at least one month apart. We will include studies of video games of all genres. We will exclude studies that examine video games only in conjunction with other media exposure (e.g., do not report video game exposure separately) or that report results of brief experiments (less than one month between exposure and outcome). We will also exclude studies that examine the benefits of video game exposure (such as studies where video game exposure improves performance of physicians on laparoscopy), unless such studies also report adverse effects.
Inclusions: Games played on the Internet, consoles or computers by young people in naturalistic settings over a period of at least one month. Exclusions: Video games used in a therapeutic or rehabilitative setting, short-term experimental studies.
Mental health and behavioral outcomes, sleep, inactivity/obesity and school performance assessed by self-report, parent-report, clinician report or teacher report.
Video game exposure must be separated from outcome assessment by at least one month.
Data extraction, (selection and coding)
Citations meeting search criteria will be downloaded into Zotero where duplicates will be removed and a bibliography with abstracts created. This bibliography will be screened by two reviewers for meeting inclusion criteria; articles lacking an abstract but otherwise meeting criteria will be included in this stage. Full text of remaining articles will be retrieved and examined to further decide on inclusion and exclusion; unclear cases will be included. Data will be extracted to evidence tables, which will be used to develop consensus on inclusion by two independent raters.
Data to be extracted will include the citation, sources of funding and competing interests, setting, methods, results, and a critical appraisal of the study quality including study authors' conclusions as well as quality assessment variables discussed below as appropriate.
Risk of bias (quality) assessment
Quality assessment will be based on Cochrane Handbook methods and GRADE recommendations and will evaluate such factors as conflict of interest and competing interests, outcome measurement, loss to follow-up, confounding, group contamination, selective reporting of outcomes, effect size, and dose-response gradient.
Strategy for data synthesis
We will provide a narrative synthesis of included studies grouped by outcome type as well as evidence tables as described above. While a meta-analysis may be forthcoming, we do not have a protocol for this at this time.
Analysis of subgroups or subsets
Results of this review will be included in guidelines developed for the Young and Well Cooperative Research Center on video games and wellbeing in young people. In addition, results will be discussed at appropriate conferences.
Contact details for further information
Michelle Colder Carras
624 N. Broadway, Hampton House
Baltimore, MD 21205
Organisational affiliation of the review
Johns Hopkins Bloomberg School of Public Health/Department of Mental Health
Ms Michelle Colder Carras, Johns Hopkins Bloomberg School of Public Health/Department of Mental Health Dr Daniel Johnson, Queensland University of Technology Dr Christian Jones, University of the Sunshine Coast
Details of any existing review of the same topic by the same authors
Anticipated or actual start date
22 August 2012
Anticipated completion date
21 January 2013
Ms. Carras is supported by the National Institute of Mental Health Child Mental Health Services and Service System Research Training Fellowship T32MH019545-21, Philip J. Leaf, Ph.D., Principal Investigator.
Conflicts of interest
Ms. Carras and Drs. Johnson and Jones are members of the Young and Well Cooperative Research Centre's (YAW) Gaming Research Group. The Gaming Research Group is part of the YAW's Safe and Supportive project area, which explores technologies as settings to promote cybersafety and strengthen the resilience, mental health and wellbeing of all young people.
Australia, United States of America
Subject index terms status
Subject indexing assigned by CRD
Subject index terms
Adolescent; Behavior; Child; Education; Health; Humans; Obesity; Video Games
Any other information
This review will address gaps in prior literature by including non-violent video games, by examining long-term outcomes of direct interest to parents and policymakers, and by including reviews of study quality.
Date of registration in PROSPERO
26 September 2012
Date of publication of this revision
26 September 2012
Stage of review at time of this submission
Piloting of the study selection process
Formal screening of search results against eligibility criteria
Risk of bias (quality) assessment
PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites.