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Video Games Effect and Prosocial and Aggressive Behaviors The positive impact of video games also concerns the social and relational dimension, as occurs in the VG training of prosocial or educational skills. Several studies have reported that playing prosocial VGs, even for a short time, increases prosocial cognition [81], positive affect [82] and helping behaviors [13,81,82,83,84,85], whereas it decreases antisocial thoughts and the hostile expectation bias, such as the tendency to perceive any provocative actions of other people as hostile even when they are accidental [13,86]. Such findings have been found in correlational, longitudinal and experimental investigations [82,85,87]. In four different experiments [13], playing VGs with prosocial content was positively related to increased prosocial behavior, even though participants played the VGs for a relatively short time, suggesting that VGs with prosocial content could be used to improve social interactions, increase prosocial behavior, reduce aggression and encourage tolerance. Following experimental, correlational, longitudinal and meta-analytic studies provided further evidence that playing a prosocial VG results in greater interpersonal empathy, cooperation and sharing and subsequently in prosocial behavior [87,88,89,90]. Such literature’s data are consistent with the General Learning Model [91,92], according to which the positive or negative content of the game impacts on the player’s cognition, emotions and physiological arousal, which, in turn, leads to positive or negative learning and behavioral responses [12,93,94,95]. Therefore, repeated prosocial behavioral scripts can be translated into long-term effects in cognitive, emotional and affective constructs related to prosocial actions, cognition, feelings, and physiological arousal, such as perceptual and expectation schemata, beliefs, scripts, attitudes and stereotypes, empathy and personality structure [83,91]. In the same conceptual framework, educational video games have been found to positively affect behaviors in a wide range of domains [12], school subjects [96] and health conditions [97,98]. In randomized clinical trials, for example, diabetic or asthmatic children and adolescents improved their self-care and reduced their emergency clinical utilization after playing health education and disease management VGs. After six months of playing, diabetic patients decreased their emergency visits by 77 percent [99]. Therefore, well-designed games can provide powerful interactive experiences that can foster young children’s learning, skill building, self-care and healthy development [100]. Violence in VGs is a matter of intense debate, both in public opinion and in the scientific context [101,102]. A vast majority of common opinions, parents and educators consider the violence of VGs as the most negatively impacting feature to emotional and relational development of youth and children. Actually, studies agree on the negative impact of violent video games on aggressive behavior. Several meta-analyses have examined violent VGs [6,7,8,103] and, although they vary greatly in terms of how many studies they include, they seem to agree with each other. The most comprehensive [8] showed that violent VGs, gradually and unconsciously, as a result of repeated exposure to justified and fun violence, would increase aggressive thoughts, affect and behavior, physiological persistent alertnes, and would desensitize players to violence and to the pain and suffering of others, supporting a perceptual and cognitive bias to attribute hostile intentions to others. Similarly, experimental, correlational and longitudinal studies supported the causal relationship between violent VGs and aggression, in the short- and long-term, both in a laboratory and in a real-life context. A greater amount of violent VGs, or even a brief exposure, were significantly associated with more positive attitudes toward violence [104], higher trait hostility [105] and with increased aggressive behaviors [106], physical fights [107] and aggressive thoughts [108] and affect [109]. In a two-year longitudinal study, children and adolescents who played a lot of violent VGs showed over time more aggressive behaviors, including fights and delinquency [110]. Saleem, Anderson and Gentile [82] examined the effects of short-term exposure to prosocial, neutral and violent VGs in a sample of 191 children of 9–14 years old. Results indicated that while playing prosocial games increased helpful and decreased hurtful behaviour, the violent games had the opposite effect. In summation, the overall literature data support the opinion that violent video games, over time, affect the brain and activate a greater availability to aggressive behavior patterns, although some researchers have pointed out that the negative effects of violent VGs are small and may be a publication bias [14,111].