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Don’t blame the game: Parents, videogame content, and age ratings

Back in March 2015, BBC News reported that parents of children in 16 Cheshire county schools had been sent a letter saying that head teachers would report them to the authorities if they allowed their children to play videogames that are rated for adults (i.e., games that have an ‘18’ rating). The teachers claimed that popular games like Grand Theft Auto and Call of Duty are too violent to be played by those under the age of 18 years. They also stated that such games increased sexualised behaviour and left children vulnerable to sexual grooming. The schools also threatened to report parents who let their children play such games because it was a form of parental neglect. The author of the letter, Mary Hennessy Jones, was quoted as saying that:

“We are trying to help parents to keep their children as safe as possible in this digital era. It is so easy for children to end up in the wrong place and parents find it helpful to have some very clear guidelines”.

I’m sure the letter to parents was written with the best of intentions but as a parent of three ‘screenagers’ and someone that has spent almost three decades researching the effects of video games on human behaviour, this appears to be a very heavy-handed way to deal with the issue. Although it is illegal for any retailer to sell ‘18’ rated games to minors, it is not illegal for children to play such games, or illegal for parents to allow their children to play such games. Many parents need to be educated about the positives and negatives of playing video games but reporting them to the “authorities” is not the right way forward.


Back in the early 1990s I was probably the only academic in the UK carrying out scientific research on children’s video game playing. In fact, I was proud of my role in getting age ratings onto all video games in the first place, and for writing the text for educational information leaflets for parents (outlining the effects of excessive playing of such games) sponsored by the National Council for Educational Technology. There are many positive benefits of playing video games (something that I wrote about in a previous article for The Conversation).

I know from first-hand experience that children often play games that are age-inappropriate. Two years ago, my (then) 13-year old son said he was the only boy in his class that did not play or own the Call of Duty video game. This is also borne out by research evidence. One study that I was involved in found that almost two-thirds of children aged 11- to 13-years of age (63%) had played an 18+ video game. Unsurprisingly, boys (76%) were more likely than girls (49%) to have played an 18+ video game. Children were also asked about how often they played 18+ video games. Of the two-thirds who had played them, 8% reported playing them “all the time”, 22% reported playing them “most of the time”, 50% reported playing them “sometimes”, 18% reported playing them “hardly ever”. Again, boys were more likely than girls to play 18+ video games more frequently. Children were asked how they got access to 18+ plus video games. The majority had the games bought for them by family or friends (58%), played them at a friend’s house (35%), swapped them with friends (27%), or bought games themselves (5%). This research certainly appears to suggest that parents and siblings are complicit in the playing of age-inappropriate games.

There is a growing amount of scientific literature that has examined the content of video games designed for adults. For instance, a study led by Dr. Kimberley Thompson and published in the Archives of Pediatric and Adolescent Medicine attempted to quantify the depiction of violence, blood, sexual themes, profanity, substances, and gambling in adult (18+) video games and to assess whether the actual game content matched the content descriptor on the packaging. Although content descriptors for violence and blood provided a good indication of content in the 36 games examined, the authors concluded that 81% of the games studied (n=29) lacked content descriptors of other adult content. Other studies carried out by the same research team have found that adult content can be found in lots of games aimed at young children and teenagers.

Another study led by Dr. David Walsh published in Minerva Pediatrica tested the validity of media rating systems (including video games). Results showed that when the entertainment industry rated a product as inappropriate for children, parents also agreed that it was inappropriate. However, parents disagreed with many industry ratings that were designated as containing material as suitable for children. The products rated as appropriate for adolescents by the industry were of the greatest concern to parents.

The issue of children and adolescents playing 18+ games is no different from the debates about children and adolescents watching 18+ films. However, based on anecdotal evidence appears that parents are more likely to adhere to age ratings on films than they are on video games. This is one area that both media researchers and media educators need to inform parents to be more socially responsible in how they monitor their children’s leisure activity. A school sending out a threatening letter to parents is unlikely to change parental behaviour. Education and informed debate is likely to have a much greater effect in protecting our children from the potential harms of video game playing.

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

 Further reading

Anderson, C.A., Gentile, D.A., & Dill, K.E. (2012). Prosocial, antisocial and other effects of recreational video games. In D.G. Singer, & J.L. Singer (Eds), Handbook of Children and the Media, Second Edition, (pp. 249-272). Thousand Oaks, CA: Sage.

Anderson, C. A., Shibuya, A., Ihori, N., Swing, E. L., Bushman, B.J., Sakamoto, A., Rothstein, H.R., & Saleem, M. (2010). Violent video game effects on aggression, empathy, and prosocial behavior in eastern and western countries: a meta-analytic review. Psychological Bulletin, 136, 151-173.

Bartlett, C. P., Anderson, C.A. & Swing, E.L. (2009). Video game effects confirmed, suspected and speculative: A review of the evidence. Simulation and Gaming, 40, 377-403.

Ferguson, C. J. (2007). Evidence for publication bias in video game violence effects literature: A meta analytic review. Aggression and Violent Behavior, 12, 470-482.

Ferguson, C. J. (2013). Violent video games and the supreme court: Lessons for the scientific community in the wake of Brown v. Entertainment Merchants Association. American Psychologists, 68, 57-74.

Ferguson, C. J., San Miguel, S. & Hartley, T. (2009).  Multivariate analysis of youth violence and aggression: The influence of family, peers, depression and media violence. Journal of Paediatrics, 155, 904-908.

Gentile, D. A. & Stone, W. (2005). Violent video game effects in children and adolescents: A review of the literature. Minerva Pediatrics, 57, 337-358.

Griffiths, M.D. (1998). Video games and aggression: A review of the literature. Aggression and Violent Behavior, 4, 203-212.

Griffiths, M.D. (2000). Video game violence and aggression: Comments on ‘Video game playing and its relations with aggressive and prosocial behaviour’ by O. Weigman and E.G.M. van Schie. British Journal of Social Psychology, 39, 147-149.

Griffiths, M.D. (2010). Age ratings on video games: Are the effective? Education and Health, 28, 65-67.

Griffiths, M.D. & McLean, L. (in press). Content effects: Online and offline games. In P. Roessler (Ed.), International Encyclopedia of Media Effects. Chichester: Wiley.

Grüsser, S.M., Thalemann, R. & Griffiths, M.D. (2007). Excessive computer game playing: Evidence for addiction and aggression?  CyberPsychology and Behavior, 10, 290-292.

Ivory, J.D., Colwell, J., Elson, M., Ferguson, C.J., Griffiths, M.D., Markey, P.M., Savage, J. & Williams, K.D. (2015). Manufacturing consensus in a divided field and blurring the line between the aggression concept and violent crime. Psychology of Popular Media Culture, 4, 222–229.

McLean, L. & Griffiths, M.D. (2013). The psychological effects of videogames on young people. Aloma: Revista de Psicologia, Ciències de l’Educació i de l’Esport, 31(1), 119-133.

McLean, L. & Griffiths, M.D. (2013). Violent video games and attitudes towards victims of crime: An empirical study among youth. International Journal of Cyber Behavior, Psychology and Learning, 2(3), 1-16.

Mehroof, M. & Griffiths, M.D. (2010). Online gaming addiction: The role of sensation seeking, self-control, neuroticism, aggression, state anxiety and trait anxiety. Cyberpsychology, Behavior, and Social Networking, 13, 313-316.

The song and binding mode: Musical hallucinations in video game playing

According to a 2015 review in the journal Frontiers in Psychology by Jan Coebergh and colleagues, musical hallucinations (MHs) “are auditory hallucinations characterized by songs, tunes, melodies, harmonics, rhythms, and/or timbres…and that the mechanisms responsible for the mediation of MH are probably diverse”. While Danilo Vitorovic and Jose Biller reported in a 2013 issue of Frontiers in Neurology that the prevalence rate of MHs among the general population is at present unknown and/or rare, ‘involuntary musical imagery’ (INMI) is thought to be more commonplace. For instance, in a 2012 Finnish study in the journal Psychology of Music, Lassi Liikkanen reported that 89% of the total sample (n=12,519) reported experiencing INMI at least once a week. Music hallucination prevalence rates among various groups have been reported including obsessive-compulsive disorder patients (41%; Journal of Clinical Psychiatry, 2004), elderly people with auditory problems (2.5%; International Journal of Geriatric Psychiatry, 2002), and general hospital setting patients (0.16%; Psychosomatics, 1998).

Although Coebergh and colleagues described MHs, they were not explicitly defined. In a review in a 2014 issue of the Journal of Medical Case Reports, Woo and colleagues defined MHs as complex auditory perceptions in the absence of an external acoustic stimulus and are often consistent with previous listening experience” whereas the 2013 review by Vitorovic and Biller (see above) noted that MHs represent a specific form of auditory hallucinations whereby patients experience formed songs, instrumental music, or tunes, without an external musical stimulus”. In a 2015 paper in the journal Psychomusicology: Music, Mind, and Brain, Tim Williams provided a classification of INMI and noted they cover a number of different types of involuntary musical experience (including MHs). Despite the lack of detailed definition, it is known that MHs occur within the context of an individual’s culture and are often viewed by those experiencing them as intrusive and sometimes unpleasant.


In 2015, Dr. Angelica Ortiz de Gortari and I wrote a commentary paper on musical hallucinations in videogame playing in response to the review by Coebergh and colleagues. As far as we were aware, we noted that no review paper examining musical hallucinations had ever included papers referring to musical hallucinations arising from playing video games. The earliest report in the psychological literature is by Sean Spence (published in 1993 in the Irish Journal of Psychological Medicine) who reported the case of a 20-year-old female patient with a family history of psychosis. She presented with persecutory delusions, suicidal ideation, violent behaviour and third-person auditory hallucinations comprising 48 hours of constant MHs from the Mario Brothers videogame that developed into delusional thoughts. No drugs were found in her urinary system and her EEG was normal when MHs occurred. The MHs from the videogame decreased within 48 hours of treatment (using antidepressants and neuroleptics).

More recently, a series of papers by Dr. Ortiz de Gortari and I examined Game Transfer Phenomena (GTP). GTP research has demonstrated how the videogame can keep on playing even after the game has been turned off. GTP are non-volitional phenomena (e.g., altered perceptions, automatic mental processes, and involuntary behaviors). In an analysis of over 1600 gamers’ self-reports, our research has shown that videogame playing can lead to (i) perceptual distortions of physical objects, environments, and/or sounds, (ii) misperceptions of objects and sounds that are similar to those in the videogame, (iii) interpretation of events in real life contexts that utilize the logic of the videogame, (iv) ghost perceptions and sensations of images, sounds, and tactile experiences, and (v) involuntary actions and behaviors based on experiences from the videogame.

One study that we published in a 2014 issue of the International Journal of Cyber Behavior, Psychology and Learning specifically examined auditory GTP experiences. Gamers’ experiences identified as GTP in one or more modalities (e.g., visual, auditory) were collected from 60 online videogame forums over seven months. Of these, there were 192 auditory experiences from 155 gamers collected. The largest numbers of experiences (90%) were identified as involuntary auditory imagery. This manifested as hearing music (n = 73), sound (n = 83), or voices from within the game (n = 12). Some experiences were triggered by external cues associated with the game, while others were not. Experiences with music included hearing high pitch music in addition to calm and classical music.

Music from the videogames was usually experienced persistently, while sound effects or voices appeared to have occurred more episodically. Hearing the music persistently provoked sleep deprivation, annoyance, and uncertainty. When the music was re-experienced very vividly, the gamers attributed them to external sources associated with the videogame. More specifically, when auditory cues were associated with adverse videogame content, they resulted in irrational thoughts, reactions and changes in behaviour. In many cases, the gamers said that they had been playing intensively (i.e., either playing long sessions or playing frequently). Previous studies have linked hearing music in absence of auditory stimuli with the recent or repeated exposure to music (see ‘Further reading’ below including: Gardner, 1985; Gerra et al., 1998; Hyman et al., 2012).

In our study, one gamer said that he heard the sound of music coming out from the speakers so he stood up to check them while another heard music from Pokémon when vacuuming. It also appears that musical hallucinations can cross sensory modalities. For instance, some gamers have reported hearing music while seeing images from the video game. An online survey about GTP with a convenience sample of 2,362 gamers found that hearing music from videogames when not playing were the more prevalent (74%) than hearing sounds (65.0%) or voices (46%) when not playing (Ortiz de Gortari & Griffiths, 2015b).

Based on what is known empirically, our paper concluded that (i) MHs from videogame playing – although not well documented – appear to be relatively commonplace among gamers and prevalence appears to be higher than found in other populations, (ii) individual interpretation of MHs from videogames are influenced by the meanings and uses of auditory cues in the videogames, (iii) MHs can manifest beyond one sensory modality and has been reported across-sensory channels (e.g., hearing music while seeing ghost images from the game), (iv) there is little evidence that MHs among videogame players are linked to other underlying pathology (e.g., epilepsy, psychiatric disorder, etc.), (v) those researching in the field of MHs and INMI appear to have overlooked the literature on these phenomena related to videogame playing, and (vi) better definitions are needed for MHs and a distinction between MHs and INMI is required.

(Please note: This blog is based on material used in the following paper: Griffiths, M.D. & Ortiz de Gortari, A.B. (2015). Musical hallucinations: Review of treatment effects. Frontiers in Psychology, 6, 1885. doi: 10.3389/fpsyg.2015.01885).

Dr. Mark Griffiths, Professor of Behavioural Addiction, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK

Further reading

Coebergh, J. A. F., Lauw, R. F., Bots, R., Sommer, I. E. C., & Blom, J. D. (2015) Musical hallucinations: review of treatment effects. Frontiers in Psychology, 6, 814.

Cole M.G., Dowson, L., Dendukuri, N., & Belzile, E. (2002). The prevalence and phenomenology of auditory hallucinations among elderly subjects attending an audiology clinic. International Journal of Geriatric Psychiatry (2002) 17, 444–52.

Fukunishi, I., Horikawa, N., & Onai, H. Prevalence rate of musical hallucinations in a general hospital setting. Psychosomatics (1998) 39, 175.

Hermesh H. (2004). Musical hallucinations: prevalence in psychotic and nonpsychotic outpatients. Journal of Clinical Psychiatry, 65, 191–7. doi:10.4088/JCP.v65n0208

Gardner, M. P. (1985). Mood states and consumer behavior: A critical review. Journal of Consumer Research, 12, 281-300.

Gerra, G., Zaimovic, A., Franchini, D., Palladino, M., Giucastro, G., Reali, N., . . . Brambilla, F. (1998). Neuroendocrine responses of healthy volunteers to `techno-music’: relationships with personality traits and emotional state. International Journal of Psychophysiology, 28(1), 99-111.

Griffiths, M.D. & Ortiz de Gortari, A.B. (2015). Musical hallucinations: Review of treatment effects. Frontiers in Psychology, 6, 1885. doi: 10.3389/fpsyg.2015.01885

Hyman, I. E., Burland, N. K., Duskin, H. M., Cook, M. C., Roy, C. M., McGrath, J. C., & Roundhill, R. F. (2012). Going gaga: Investigating, creating, and manipulating the song stuck in my head. Applied Cognitive Psychology, 27, 204-215.

Liikkanen, L. A. (2012). Musical activities predispose to involuntary musical imagery. Psychology of Music, 40(2), 236-256.

Ortiz de Gortari, A. B, Aronsson, K. & Griffiths, M. D. (2011). Game Transfer Phenomena in video game playing: A qualitative interview study. International Journal of Cyber Behavior, Psychology and Learning, 1(3), 15-33.

Ortiz de Gortari, A. B. & Griffiths, M. D. (2014). Auditory experiences in Game Transfer Phenomena: An empirical self-report study. International Journal of Cyber Behavior, Psychology and Learning, 4(1), 59-75.

Ortiz de Gortari, A. B. & Griffiths, M. D. (2014). Altered visual perception in Game Transfer Phenomena: An empirical self-report study. International Journal of Human-Computer Interaction, 30, 95-105.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2014). Automatic mental processes, automatic actions and behaviours in Game Transfer Phenomena: An empirical self-report study using online forum data. International Journal of Mental Health and Addiction, 12, 432-452.

Ortiz de Gortari, A.B. & Griffiths, M.D. (2015). Game Transfer Phenomena and its associated factors: An exploratory empirical online survey study. Computers in Human Behavior, 51, 195-202.

Ortiz de Gortari, A. B., Pontes, H. M. & Griffiths, M. D. (2015). The Game Transfer Phenomena Scale: An instrument for investigating the non-volitional effects of video game playing. Cyberpsychology, Behavior and Social Networking, in press.

Ortiz de Gortari, A.B. & Griffiths, M.D (2015b). Prevalence and characteristics of Game Transfer Phenomena: A descriptive survey study. Manuscript under review.

Spence, S. A. (1993). Nintendo hallucinations: A new phenomenological entity. Irish Journal of Psychological Medicine, 10, 98–99.

Vitorovic, D. & Biller, D. (2013). Musical hallucinations and forgotten tunes – case report and brief literature review. Frontiers in Neurology, 4, 109. doi: 10.3389/fneur.2013.00109

Williams, T. I. (2015). The classification of involuntary musical imagery: The case for earworms. Psychomusicology: Music, Mind, and Brain, 25(1), 5-13.

Woo, P. Y. M. Leung, L. N. Y., Cheng, S. T. M. & Chan, K-Y. (2014). Monoaural musical hallucinations caused by a thalamocortical auditory radiation infarct: a case report. Journal of Medical Case Reports, 8, 400.